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Safety and Efficacy Study of Recombinant Human Insulin-Like Growth Factor-I/Recombinant Human Insulin-Like Growth Factor Binding Protein-3 (rhIGF-I/rhIGFBP-3) In Myotonic Dystrophy Type 1

Primary Purpose

Myotonic Dystrophy Type 1

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
rhIGF-I/rhIGFBP-3
placebo
Sponsored by
Insmed Incorporated
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Myotonic Dystrophy Type 1

Eligibility Criteria

21 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria (list is not inclusive):

  • A diagnosis of DM1, confirmed by DM1 genetic mutation
  • Ability to walk 30 feet - assistance with cane and/or leg bracing permitted
  • Able to self-administer study medication by subcutaneous injection or caregiver is available to administer study medication

Exclusion Criteria (list is not inclusive):

  • Congenital DM1
  • Weight greater than 100 kg or body mass index greater than 30 kg/m2
  • Prior treatment with glucocorticoids, anabolic steroids, testosterone, growth hormone, investigational agent within 60 days of screening
  • Current diagnosis or history of malignancy expect for surgically cured skin cancer or pilomatricoma
  • Changes in lipid lowering medications during the 3 months prior to screening
  • Diaphragmatic weakness such that patients are unable to tolerate the supine position, or swallowing impairment such that patients are unable to maintain nutrition without use of gastrostomy.
  • Major psychiatric illness (major depression, bipolar disorder or schizophrenia) within twelve months of screening
  • History of non-compliance with other therapies

Sites / Locations

  • University of California Irvine Medical Center; MDA, ALS and Neuromuscular Center
  • University of California, Davis
  • University of Kansas Medical Center
  • Johns Hopkins Hospital
  • University of Minnesota
  • Washington University Medical School
  • University of Rochester, Neuromuscular Disease Center
  • Ohio State University Medical Center
  • Oregan Health and Science University
  • Universit of Texas Medical Branch
  • University of Texas Health Science Center
  • University of Utah

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

rhIGF-I/rhIGFBP-3

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Change From Baseline to Week 24 in Distance Walked as Assessed by the Six-minute Walk Test (6MWT) Distance
The 6MWT measured the distance in meters that participants were able to walk over a total of six minutes. After a 10 minute resting period, the participants completed the 6MWT on a hard, flat surface at baseline and at Week 24.
Change From Baseline in Daily Step Count
The number of steps taken per day was measured using a step activity monitor for 7 days at baseline and again at Week 24. Change from baseline scores were measured where a negative change from baseline indicates a decrease in the number of daily steps.
Peak Activity Index: Change From Baseline in Number of Steps Walked Per Minute During the 30 Minute Period of Fastest Walking
The peak activity index measures the number of steps walked in the 30 minutes of fastest walking that occurred in a 24 hour period. This was measured using a step activity monitor for 7 days at baseline and again at Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the number of steps walked during the 30 minute period of fastest walking.
Sustained Activity Index: Change From Baseline in the Highest Number of Steps Walked Per Minute Over 20 Minutes of Activity
The sustained activity index measures the highest number of steps sustained over a continuous 20 minute period. This was measured using a step activity monitor for 7 days at baseline and again at Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the number of steps walked over 20 minutes of activity.
Change From Baseline in the Percentage of Time That Participants Spent Inactive
Change from baseline scores were measured where a negative change from baseline indicates less time spent inactive.
Change From Baseline in Time Taken for Participants to Ascend and Descend 4 Stairs
Participants were timed on their ability to climb up 4 stairs and timed separately to climb down 4 stairs at baseline and at week 24. The stairs were free-standing or the same flight of stairs was used at each assessment. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the time taken for paticipants to ascend or descend 4 stairs.
Change From Baseline in Time Taken to Traverse 30 Feet
Participants were timed on their ability to travel 30 feet on the same surface at each assessment at baseline and at Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the time taken to travel 30 feet.
Change From Baseline in Purdue Pegboard Test Scores
The Purdue Pegboard Test consists of a board with two sets of 25 holes, 4 concave cups, and a number of small metal pins. Participants were required to pick up the pins from a holder and place them in the holes as quickly as possible over 30 seconds with their dominant hand. The score was calculated as the number of pins placed into holes in 30 seconds and was measured at baseline and Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the number of pins placed in the board.
Change From Baseline in Forced Vital Capacity (FVC) Volume While Sitting or Lying Down
FVC is the volume of air that can be forcibly exhaled from the lungs after taking the deepest breath possible, as measured by spirometry.
Change From Baseline in Forced Vital Capacity (FVC) Percent Predicted While Sitting or Lying Down
FVC is the volume of air that can be forcibly exhaled from the lungs after taking the deepest breath possible, as measured by spirometry.
Change From Baseline in Manual Muscle Test (MMT) Scores
The MMT was used to assess muscle strength in the distal muscles and the proximal muscles. Distal muscles assessments included wrist extension, wrist flexion, ankle dorsiflexion and plantarflexion. Proximal muscle assessments included shoulder abduction, elbow extension, elbow flexion, hip extension, hip abduction, hip flexion, knee extension and knee flexion. In MMT, each muscle assessment was given a score of 0 to 5, where 0 indicated 'no contraction palpable' and 5 indicated 'normal strength'. The scores from each muscle were summed and the maximum overall score of all measured muscles was 140, the maximum distal score was 40 and the maximum proximal score was 80. Higher scores indicated higher muscle strength. Change from baseline scores were measured where a positive change from baseline indicates an improvement in muscle strength.
Change From Baseline in Selective Reminding Test T-Scores (Total Word and Delayed Words)
The Selective Reminding Test measures verbal learning and memory and involves remembering a verbal list of 12 words. Participants were required to recall the 12 words presented. Words that were missed on recall were presented again, and the process was repeated until all 12 words were correctly recalled. The total word list recall and delayed recall were calculated as T-scores. Raw scores were converted to T-score using available normative data. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Change From Baseline in Selective Reminding Test Raw Scores (Cued Recall and Recognition)
The Selective Reminding Test measures verbal learning and memory and involves remembering a verbal list of 12 words. Participants were required to recall the 12 words presented. Words that were missed on recall were presented again, and the process is repeated until all 12 words were correctly recalled. The cued recall scores ranged from 0-11 and multiple choice recognition scores ranged from 0-12. Change from baseline scores were measured where a positive change from baseline indicates an improvement in verbal recall and memory.
Change From Baseline in Rey Complex Figure (RCF) Test Scores
The Rey Complex Figure Test (RCFT) assesses visuospatial construction ability and visual memory through four different tests: copy (copying a complex geometric figure), immediate recall of the figure (drawing figure from memory at 3 minutes), delayed recall (drawing figure at 30 minutes after initial copy), and recognition score (selecting individual parts of the figure from sketches provided). Copy performances are divided into 18 components with a maximum score of 2 each. The maximum score for each figure is 36.
Change From Baseline in Letter-Number Sequencing (LNS) Test Scores
The LNS test from the Welchsler Adult Intelligence Scale-III was used to assess working memory. The test required that participants recall, in order, numbers and letters presented in an unordered sequence. The number of items is 21. With each item being marked 0 if reported incorrectly or 1 if reported correctly, the maximum score is 21. Raw scores were converted into T-scores using available normative data. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Change From Baseline in Trail Making Test (TMT) Scores
The TMT assesses executive function, sequencing, mental flexibility, visual spanning speed and motor function. In TMT Part A, the participant had to draw lines in the correct order between 25 numbers randomly arranged on the page. In TMT Part B, the participant had to draw lines between 25 numbers and letters in alternating order (e.g., 1-A-2-B...etc). Times for Part A and Part B were used to derive T-scores which can range from a minimum of 0 and a maximum of 100. Raw scores were converted into T-scores using available normative data. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Change From Baseline in the Stroop Color Word Test Scores
The Stroop Color Word Test measures selective attention and cognitive flexibility. The test has three parts, the Word test (reading words), the Color test (naming the ink color in which words are displayed) and the Color-Word test (saying the ink color not reading the word). An interference score was calculated from the Color, Word and Color-Word scores and is an indication of how well a person can complete a task while disregarding interfering information. Raw scores were converted into T-scores using available normative data. Scores range from 0 to 100. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Change From Baseline to Week 24 Scores on the Beck Depression Inventory II (BDI-II) Questionnaire
BDI-II is a validated self-reported instrument of 21 questions which are each scored 0-3. Total scores range from 0-63, with higher score totals indicating more severe depression symptoms. {0-9: indicates minimal depression; 0-18: indicates mild depression; 19-29: indicates moderate depression; 30-63: indicates severe depression. Lower scores indicate no or minimal depression, with a maximum total score of 63.
Change From Baseline in Average Fasting Glucose Concentration in the Blood
Participants were administered 75 grams (g) glucose solution prior to administration of the first dose of IPlex™ and after administration of the last dose. A 2-hour oral glucose tolerance test (OGTT) was performed under fasted conditions.
Change From Baseline in Average Fasting Insulin Concentration in the Blood
Participants were administered 75 g glucose solution prior to administration of the first dose of IPLEX™ and after administration of the last dose. A 2-hour OGTT was performed under fasted conditions.
Change From Baseline in Qualitative Insulin Sensitivity Check Index (QUICKI)
The QUICKI is based on fasting glucose and insulin measurements and are calculated using the following equation: QUICKI = 1/[ log(fasting glucose in mg/dL) + log (fasting insulin in uU/mL) ]
Change From Baseline in Insulin Sensitivity Index-Matsuda (ISI-Matsuda)
The ISI-Matsuda is based on the average glucose and insulin values obtained during the entire oral glucose tolerance test and are calculated using the following equation: ISI = 10,000 / √ [ fasting glucose (mg/dL) x fasting insulin(uU/mL) x mean glucose x mean insulin ]
Change From Baseline in Total Blood Cholesterol Level
A negative change from baseline indicates a decrease in total blood cholesterol level.
Change From Baseline in Total Blood Low-density Lipoproteins (LDL) Level
A positive change from baseline indicates an increase in total blood LDL level.
Change From Baseline in Total Blood High-density Lipoproteins (HDL) Level
A negative change from baseline indicates a decrease in total blood HDL level.
Change From Baseline in Total Blood Triglycerides Level
A negative change from baseline indicates a decrease in total blood triglycerides level.
Change From Baseline in Gastro-esophageal Reflux Disease (GERD) Symptom Frequency Questionnaire (GSFQ) Scores
The GSFQ contains 6 questions that assess the frequency of certain GERD symptoms and their impact on daily life. Scores were converted and reported out of 100 with higher scores indicative of more frequent and intense GERD symptoms. Change from baseline scores were measured where a negative change from baseline indicates less frequent and intense GERD symptoms.
Change From Baseline in Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) Questionnaire Scores
The GSRS-IBS has 13 questions aimed at identifying the frequency and intensity of IBS symptoms during the past week. Answers are given a score from 1 (no discomfort at all) to 7 (very severe discomfort). A total score was calculated and ranged from 0 to 78. A lower score indicates less discomfort from IBS symptoms. Change from baseline scores were measured where a positive change from baseline indicates increased discomfort from IBS symptoms.
Change From Baseline in Swallowing Disturbance Questionnaire (SDQ) Scores
The SDQ had 15 questions relating to the oral phase and pharyngeal phase of swallowing. Answers for 14 questions were assigned a number (0-3) based on a 4-point verbal scale (never, seldom, frequently, very frequently) and the last question was a yes or no question about respiratory infections. A higher score is indicative of greater swallowing issues with 44.5 as the highest possible score. A total score of ≥ 11 suggests impairment. Change from baseline scores were measured where a positive change from baseline indicates increased swallowing impairment.
Change From Baseline in Short Form (36) (SF-36) Questionnaire Scores
The SF-36 is a 36-item questionnaire that evaluates quality of life through physical and mental health across eight scales, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability. Change from baseline scores were measured where a positive change from baseline indicates an improvement in quality of life.
Change From Baseline in Brief Pain Inventory (BPI) Questionnaire - Severity Scores
The BPI contains 15 questions that assess the severity of pain and its impact or interference on functions of daily life. Pain severity was measured as the mean of 7 items of the questionnaire on an 11-point scale where 0 indicates no pain and 10 indicates the worst pain. A higher score indicates greater pain. Categories assessed include worst pain in 24 hours and average pain. Change from baseline scores were measured where a positive change from baseline indicates a worsening in pain.
Change From Baseline in Brief Pain Inventory (BPI) Questionnaire - Interference Scores
The BPI contains 15 questions that assess the severity of pain and its impact or interference on functions of daily life. Pain interference is measured as the mean of 7 items on an 11-point scale where 0 indicates no interference and 10 indicates complete interference. A higher score indicates greater impairment due to pain. Change from baseline scores were measured where a positive change from baseline indicates a worsening of interference due to pain.

Secondary Outcome Measures

Full Information

First Posted
December 18, 2007
Last Updated
December 8, 2021
Sponsor
Insmed Incorporated
Collaborators
Muscular Dystrophy Association
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1. Study Identification

Unique Protocol Identification Number
NCT00577577
Brief Title
Safety and Efficacy Study of Recombinant Human Insulin-Like Growth Factor-I/Recombinant Human Insulin-Like Growth Factor Binding Protein-3 (rhIGF-I/rhIGFBP-3) In Myotonic Dystrophy Type 1
Official Title
A Placebo Controlled, Randomized, Double-Blind Phase II Clinical Trial to Evaluate Tolerability, Safety and Efficacy Endpoints After Administration of Recombinant Human Insulin-Like Growth Factor-I/Recombinant Human Insulin-Like Growth Factor Binding Protein-3 (rhIGF-I/rhIGFBP-3) for 24 Weeks in Adults With Myotonic Dystrophy Type 1
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
December 2007 (Actual)
Primary Completion Date
December 29, 2008 (Actual)
Study Completion Date
December 29, 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Insmed Incorporated
Collaborators
Muscular Dystrophy Association

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To investigate the effects of rhIGF-I/rhIGFBP-3 treatment for 24 weeks on endurance, ambulation, cognitive functioning, insulin resistance, lipid levels, muscle function and strength, pain, gastrointestinal functioning, and quality of life endpoints in DM1 patients
Detailed Description
Efficacy Measures: Endurance, Ambulation, Cognitive function, Insulin resistance, Cholesterol and triglycerides, Muscle function and strength, Pain, Gastrointestinal function, Quality of life MINIMUM INCLUSION CRITERIA A diagnosis of DM1, confirmed by DM1 genetic mutation Age 21 to 65 years (inclusive) Ability to walk 30 feet - assistance with cane and/or leg bracing permitted Able to self-administer study medication by subcutaneous injection or caregiver is available to administer study medication

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myotonic Dystrophy Type 1

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
69 (Actual)

8. Arms, Groups, and Interventions

Arm Title
rhIGF-I/rhIGFBP-3
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
rhIGF-I/rhIGFBP-3
Intervention Description
1.0 mg/kg rhIGF-I/rhIGFBP-3 or placebo daily, subcutaneous injections from baseline through the last day of the end of study visit.
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
1.0 mg/kg rhIGF-I/rhIGFBP-3 or placebo daily, subcutaneous injections from baseline through the last day of the end of study visit.
Primary Outcome Measure Information:
Title
Change From Baseline to Week 24 in Distance Walked as Assessed by the Six-minute Walk Test (6MWT) Distance
Description
The 6MWT measured the distance in meters that participants were able to walk over a total of six minutes. After a 10 minute resting period, the participants completed the 6MWT on a hard, flat surface at baseline and at Week 24.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Daily Step Count
Description
The number of steps taken per day was measured using a step activity monitor for 7 days at baseline and again at Week 24. Change from baseline scores were measured where a negative change from baseline indicates a decrease in the number of daily steps.
Time Frame
Baseline and Week 24
Title
Peak Activity Index: Change From Baseline in Number of Steps Walked Per Minute During the 30 Minute Period of Fastest Walking
Description
The peak activity index measures the number of steps walked in the 30 minutes of fastest walking that occurred in a 24 hour period. This was measured using a step activity monitor for 7 days at baseline and again at Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the number of steps walked during the 30 minute period of fastest walking.
Time Frame
Baseline and Week 24
Title
Sustained Activity Index: Change From Baseline in the Highest Number of Steps Walked Per Minute Over 20 Minutes of Activity
Description
The sustained activity index measures the highest number of steps sustained over a continuous 20 minute period. This was measured using a step activity monitor for 7 days at baseline and again at Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the number of steps walked over 20 minutes of activity.
Time Frame
Baseline and Week 24
Title
Change From Baseline in the Percentage of Time That Participants Spent Inactive
Description
Change from baseline scores were measured where a negative change from baseline indicates less time spent inactive.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Time Taken for Participants to Ascend and Descend 4 Stairs
Description
Participants were timed on their ability to climb up 4 stairs and timed separately to climb down 4 stairs at baseline and at week 24. The stairs were free-standing or the same flight of stairs was used at each assessment. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the time taken for paticipants to ascend or descend 4 stairs.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Time Taken to Traverse 30 Feet
Description
Participants were timed on their ability to travel 30 feet on the same surface at each assessment at baseline and at Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the time taken to travel 30 feet.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Purdue Pegboard Test Scores
Description
The Purdue Pegboard Test consists of a board with two sets of 25 holes, 4 concave cups, and a number of small metal pins. Participants were required to pick up the pins from a holder and place them in the holes as quickly as possible over 30 seconds with their dominant hand. The score was calculated as the number of pins placed into holes in 30 seconds and was measured at baseline and Week 24. Change from baseline scores were measured where a positive change from baseline indicates an improvement in the number of pins placed in the board.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Forced Vital Capacity (FVC) Volume While Sitting or Lying Down
Description
FVC is the volume of air that can be forcibly exhaled from the lungs after taking the deepest breath possible, as measured by spirometry.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Forced Vital Capacity (FVC) Percent Predicted While Sitting or Lying Down
Description
FVC is the volume of air that can be forcibly exhaled from the lungs after taking the deepest breath possible, as measured by spirometry.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Manual Muscle Test (MMT) Scores
Description
The MMT was used to assess muscle strength in the distal muscles and the proximal muscles. Distal muscles assessments included wrist extension, wrist flexion, ankle dorsiflexion and plantarflexion. Proximal muscle assessments included shoulder abduction, elbow extension, elbow flexion, hip extension, hip abduction, hip flexion, knee extension and knee flexion. In MMT, each muscle assessment was given a score of 0 to 5, where 0 indicated 'no contraction palpable' and 5 indicated 'normal strength'. The scores from each muscle were summed and the maximum overall score of all measured muscles was 140, the maximum distal score was 40 and the maximum proximal score was 80. Higher scores indicated higher muscle strength. Change from baseline scores were measured where a positive change from baseline indicates an improvement in muscle strength.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Selective Reminding Test T-Scores (Total Word and Delayed Words)
Description
The Selective Reminding Test measures verbal learning and memory and involves remembering a verbal list of 12 words. Participants were required to recall the 12 words presented. Words that were missed on recall were presented again, and the process was repeated until all 12 words were correctly recalled. The total word list recall and delayed recall were calculated as T-scores. Raw scores were converted to T-score using available normative data. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Selective Reminding Test Raw Scores (Cued Recall and Recognition)
Description
The Selective Reminding Test measures verbal learning and memory and involves remembering a verbal list of 12 words. Participants were required to recall the 12 words presented. Words that were missed on recall were presented again, and the process is repeated until all 12 words were correctly recalled. The cued recall scores ranged from 0-11 and multiple choice recognition scores ranged from 0-12. Change from baseline scores were measured where a positive change from baseline indicates an improvement in verbal recall and memory.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Rey Complex Figure (RCF) Test Scores
Description
The Rey Complex Figure Test (RCFT) assesses visuospatial construction ability and visual memory through four different tests: copy (copying a complex geometric figure), immediate recall of the figure (drawing figure from memory at 3 minutes), delayed recall (drawing figure at 30 minutes after initial copy), and recognition score (selecting individual parts of the figure from sketches provided). Copy performances are divided into 18 components with a maximum score of 2 each. The maximum score for each figure is 36.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Letter-Number Sequencing (LNS) Test Scores
Description
The LNS test from the Welchsler Adult Intelligence Scale-III was used to assess working memory. The test required that participants recall, in order, numbers and letters presented in an unordered sequence. The number of items is 21. With each item being marked 0 if reported incorrectly or 1 if reported correctly, the maximum score is 21. Raw scores were converted into T-scores using available normative data. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Trail Making Test (TMT) Scores
Description
The TMT assesses executive function, sequencing, mental flexibility, visual spanning speed and motor function. In TMT Part A, the participant had to draw lines in the correct order between 25 numbers randomly arranged on the page. In TMT Part B, the participant had to draw lines between 25 numbers and letters in alternating order (e.g., 1-A-2-B...etc). Times for Part A and Part B were used to derive T-scores which can range from a minimum of 0 and a maximum of 100. Raw scores were converted into T-scores using available normative data. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Time Frame
Baseline and Week 24
Title
Change From Baseline in the Stroop Color Word Test Scores
Description
The Stroop Color Word Test measures selective attention and cognitive flexibility. The test has three parts, the Word test (reading words), the Color test (naming the ink color in which words are displayed) and the Color-Word test (saying the ink color not reading the word). An interference score was calculated from the Color, Word and Color-Word scores and is an indication of how well a person can complete a task while disregarding interfering information. Raw scores were converted into T-scores using available normative data. Scores range from 0 to 100. Change from baseline T-scores were measured where a positive change from baseline indicates improvement in performance.
Time Frame
Baseline and Week 24
Title
Change From Baseline to Week 24 Scores on the Beck Depression Inventory II (BDI-II) Questionnaire
Description
BDI-II is a validated self-reported instrument of 21 questions which are each scored 0-3. Total scores range from 0-63, with higher score totals indicating more severe depression symptoms. {0-9: indicates minimal depression; 0-18: indicates mild depression; 19-29: indicates moderate depression; 30-63: indicates severe depression. Lower scores indicate no or minimal depression, with a maximum total score of 63.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Average Fasting Glucose Concentration in the Blood
Description
Participants were administered 75 grams (g) glucose solution prior to administration of the first dose of IPlex™ and after administration of the last dose. A 2-hour oral glucose tolerance test (OGTT) was performed under fasted conditions.
Time Frame
Baseline - Pre-dose and 30, 60, 90 and 120 minutes post glucose solution; Week 24 - Pre-dose and 30, 60, 90 and 120 minutes post glucose solution
Title
Change From Baseline in Average Fasting Insulin Concentration in the Blood
Description
Participants were administered 75 g glucose solution prior to administration of the first dose of IPLEX™ and after administration of the last dose. A 2-hour OGTT was performed under fasted conditions.
Time Frame
Baseline - Pre-dose and 30, 60, 90 and 120 minutes post glucose solution; Week 24 - Pre-dose and 30, 60, 90 and 120 minutes post glucose solution
Title
Change From Baseline in Qualitative Insulin Sensitivity Check Index (QUICKI)
Description
The QUICKI is based on fasting glucose and insulin measurements and are calculated using the following equation: QUICKI = 1/[ log(fasting glucose in mg/dL) + log (fasting insulin in uU/mL) ]
Time Frame
Baseline and Week 24
Title
Change From Baseline in Insulin Sensitivity Index-Matsuda (ISI-Matsuda)
Description
The ISI-Matsuda is based on the average glucose and insulin values obtained during the entire oral glucose tolerance test and are calculated using the following equation: ISI = 10,000 / √ [ fasting glucose (mg/dL) x fasting insulin(uU/mL) x mean glucose x mean insulin ]
Time Frame
Baseline and Week 24
Title
Change From Baseline in Total Blood Cholesterol Level
Description
A negative change from baseline indicates a decrease in total blood cholesterol level.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Total Blood Low-density Lipoproteins (LDL) Level
Description
A positive change from baseline indicates an increase in total blood LDL level.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Total Blood High-density Lipoproteins (HDL) Level
Description
A negative change from baseline indicates a decrease in total blood HDL level.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Total Blood Triglycerides Level
Description
A negative change from baseline indicates a decrease in total blood triglycerides level.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Gastro-esophageal Reflux Disease (GERD) Symptom Frequency Questionnaire (GSFQ) Scores
Description
The GSFQ contains 6 questions that assess the frequency of certain GERD symptoms and their impact on daily life. Scores were converted and reported out of 100 with higher scores indicative of more frequent and intense GERD symptoms. Change from baseline scores were measured where a negative change from baseline indicates less frequent and intense GERD symptoms.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) Questionnaire Scores
Description
The GSRS-IBS has 13 questions aimed at identifying the frequency and intensity of IBS symptoms during the past week. Answers are given a score from 1 (no discomfort at all) to 7 (very severe discomfort). A total score was calculated and ranged from 0 to 78. A lower score indicates less discomfort from IBS symptoms. Change from baseline scores were measured where a positive change from baseline indicates increased discomfort from IBS symptoms.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Swallowing Disturbance Questionnaire (SDQ) Scores
Description
The SDQ had 15 questions relating to the oral phase and pharyngeal phase of swallowing. Answers for 14 questions were assigned a number (0-3) based on a 4-point verbal scale (never, seldom, frequently, very frequently) and the last question was a yes or no question about respiratory infections. A higher score is indicative of greater swallowing issues with 44.5 as the highest possible score. A total score of ≥ 11 suggests impairment. Change from baseline scores were measured where a positive change from baseline indicates increased swallowing impairment.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Short Form (36) (SF-36) Questionnaire Scores
Description
The SF-36 is a 36-item questionnaire that evaluates quality of life through physical and mental health across eight scales, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability. Change from baseline scores were measured where a positive change from baseline indicates an improvement in quality of life.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Brief Pain Inventory (BPI) Questionnaire - Severity Scores
Description
The BPI contains 15 questions that assess the severity of pain and its impact or interference on functions of daily life. Pain severity was measured as the mean of 7 items of the questionnaire on an 11-point scale where 0 indicates no pain and 10 indicates the worst pain. A higher score indicates greater pain. Categories assessed include worst pain in 24 hours and average pain. Change from baseline scores were measured where a positive change from baseline indicates a worsening in pain.
Time Frame
Baseline and Week 24
Title
Change From Baseline in Brief Pain Inventory (BPI) Questionnaire - Interference Scores
Description
The BPI contains 15 questions that assess the severity of pain and its impact or interference on functions of daily life. Pain interference is measured as the mean of 7 items on an 11-point scale where 0 indicates no interference and 10 indicates complete interference. A higher score indicates greater impairment due to pain. Change from baseline scores were measured where a positive change from baseline indicates a worsening of interference due to pain.
Time Frame
Baseline and Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (list is not inclusive): A diagnosis of DM1, confirmed by DM1 genetic mutation Ability to walk 30 feet - assistance with cane and/or leg bracing permitted Able to self-administer study medication by subcutaneous injection or caregiver is available to administer study medication Exclusion Criteria (list is not inclusive): Congenital DM1 Weight greater than 100 kg or body mass index greater than 30 kg/m2 Prior treatment with glucocorticoids, anabolic steroids, testosterone, growth hormone, investigational agent within 60 days of screening Current diagnosis or history of malignancy expect for surgically cured skin cancer or pilomatricoma Changes in lipid lowering medications during the 3 months prior to screening Diaphragmatic weakness such that patients are unable to tolerate the supine position, or swallowing impairment such that patients are unable to maintain nutrition without use of gastrostomy. Major psychiatric illness (major depression, bipolar disorder or schizophrenia) within twelve months of screening History of non-compliance with other therapies
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Moxley, M.D.
Organizational Affiliation
University of Rochester Neuromuscular Disease Center
Official's Role
Study Chair
Facility Information:
Facility Name
University of California Irvine Medical Center; MDA, ALS and Neuromuscular Center
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
University of California, Davis
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Washington University Medical School
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
University of Rochester, Neuromuscular Disease Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Oregan Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Universit of Texas Medical Branch
City
Galveston
State/Province
Texas
ZIP/Postal Code
77555-0539
Country
United States
Facility Name
University of Texas Health Science Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84112
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy Study of Recombinant Human Insulin-Like Growth Factor-I/Recombinant Human Insulin-Like Growth Factor Binding Protein-3 (rhIGF-I/rhIGFBP-3) In Myotonic Dystrophy Type 1

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