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| ID | Type | Description | Link |
|---|---|---|---|
| 15-NR-0072 |
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Background:
- Ryanodine receptor type 1-related myopathies (RYR1-RM) are the most common non-dystrophic muscle diseases that people are born with in the U.S. They affect development, muscles, and walking. Researchers want to test a new drug to help people with these diseases.
Objectives:
- To see if the drug N-acetylcysteine decreases muscle damage in people with RYR1-RM. To see if it improves their exercise tolerance.
Eligibility:
- People age 7 and older with a confirmed genetic diagnosis of RYR1 or a clinical diagnosis of RYR1 and a family member with a confirmed genetic diagnosis.
Design:
Although genetic disorders of muscle that present at birth are rare, RYR1-related myopathies comprise the most common non-dystrophic congenital myopathy in the United States, with a prevalence of approximately 1/90,000 people (Amburgey et al, 2011). Causative mutations in the ryanodine receptor gene of skeletal muscle, RYR1, have been found in several myopathy subtypes, including central core disease and centronuclear myopathy. These mutations result in defective excitation-contraction coupling and increased mitochondrial oxidative stress. Most patients present in childhood with delayed motor milestones, extremity muscle weakness, impaired ambulation, joint contractures, progressive scoliosis, and in some cases eye movement paralysis, respiratory failure, or susceptibility to malignant hyperthermia, an allelic condition. Despite these important morbidities and the risk of early mortality, no treatments exist to date.
RYR1 encodes a homotetrameric transmembrane ion channel, RyR1, which resides on the terminal sarcoplasmic reticulum in close proximity to the T-tubule. By releasing calcium from the sarcoplasmic reticulum into the cytosol in response to muscle fiber stimulation by the motor neuron at the neuromuscular junction, it mediates excitation-contraction coupling and functions as a regulator of cellular calcium concentrations and redox homeostasis. Dowling et al. (2012) recently elucidated the latter mechanism in zebrafish and patient myotubes, showing that RYR1 mutations result in increased oxidative stress and that this is rescued in both models by treatment with N-acetylcysteine (NAC), a known anti-oxidant. NAC functions as a precursor of glutathione, an endogenous antioxidant that becomes deficient during oxidative stress. This was substantiated by a cystic fibrosis clinical trial in which low glutathione levels in neutrophils undergoing oxidative stress significantly increased with NAC administration.
Dowling et al. (2012) found significant changes post NAC treatment including increased travel distance (endurance) in zebrafish and complete protection from cell death induced by experimentally increasing oxidative stress in myotubes. Thus NAC was a successful treatment in both ex vivo and in vivo model systems. Based on these results, we plan to perform a randomized, double-blinded, placebo controlled clinical trial of NAC in a subgroup of RYR1-related myopathy patients as the first pathophysiologically based treatment for this devastating disorder.
The objectives of the study are to determine if NAC reduces oxidative stress, fatigability, and fatigue in a study population of patients with RYR1-RM. The study population includes both males and females 7 years of age and older. The study design has two phases. The first 6-month phase will be used to validate the selected outcome measures in RYR1 congenital myopathy. The second 6-month phase is a randomized, double-blinded, placebo controlled drug intervention trial. The primary outcome measures are blood glutathione for oxidative stress and six minute walk test for fatigability. Healthy volunteers will be evaluated to determine normal values of biomarkers, muscle ultrasound, and near infrared spectroscopy in this rare disease, in order to develop a comparison between healthy and RYR1-RM individuals.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| RYR1-RM Patients Administered N-acetylcysteine | Active Comparator | N-acetylcysteine |
|
| RYR1-RM Patients Administered Placebo | Placebo Comparator | Placebo |
|
| Healthy Volunteers | No Intervention | Healthy volunteers who had physical exam, study biomarker, Near Infrared Spectroscopy (NIRS) testing and muscle ultrasound only, in one visit. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| N-acetylcysteine | Drug |
| ||
| Placebo |
| Measure | Description | Time Frame |
|---|---|---|
| Urine 15-F2t Isoprostane Concentration | Urine will be assayed for 15-isoprostane-F2, which is formed when arachidonic acid reacts with reactive oxygen species(ROS). A validated gas chromatography(GC)-mass spectrometer (MS) method will be used to quantify 15-isoprostane-F2 | 12 months |
| Six Minute Walk Test (6MWT) | Meters walked in 6 minutes will be recorded; distances in meters will be recorded at each minute interval; speed will be calculated. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| DCF-fluorescence Intensity (AU) | Dichlorodihydrofluorescein (DCFH) will be used on participate muscle biopsies to analyze intracellular oxidant activity [H2DCFDA (H2-DCF, DCF)]. | 12 months |
| Time to Ascend Steps (Seconds) |
| Measure | Description | Time Frame |
|---|---|---|
| Urine 15-F2t Isoprostane Concentration Pre-Intervention | Urine will be assayed for 15-isoprostane-F2, which is formed when arachidonic acid reacts with reactive oxygen species(ROS). A validated gas chromatography(GC)-mass spectrometer (MS) method will be used to quantify 15-isoprostane-F2 | 6 months |
| Six Minute Walk Test (6MWT) Pre-Intervention |
at each study visit as a precautionary measure). Liver disease is defined as moderate to severe hepatic impairment based on the following:
Alanine Aminotransferase (ALT) greater than or equal to 8x upper limit of normal (ULN) with total bilirubin 2x ULN (plus >35% direct bilirubin) and/or International normalized ratio (INR) >1.5 or
Gamma-glutamyl transferase (GGT) > 2-3x ULN with bilirubin 2x ULN (plus >35% direct bilirubin) and/or INR
Research, Vandreuil-Dorion, QC, Canada), Nacystelyn (Galephar, Brussels)] in the 4 weeks before recruitment.
-Daily use of acetaminophen (including Percocet, Vicodin, Oxycodone, Excedrin, and other
acetaminophen-containing drugs), nitroglycerine, or carbamazepine during the past 7 days.
EXCLUSION CRITERIA - HEALTHY VOLUNTEERS:
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| Name | Affiliation | Role |
|---|---|---|
| Suzanne J Wingate, C.R.N.P. | National Institute of Nursing Research (NINR) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda | Maryland | 20892 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40993798 | Derived | Chin LMK, Todd JJ, Chrismer IC, Witherspoon JW, Jain M, Waite M, Meilleur KG, Drinkard B, Lawal TA. Exercise capacity in RYR1-related myopathies. Orphanet J Rare Dis. 2025 Sep 24;20(1):485. doi: 10.1186/s13023-025-04013-7. | |
| 35698232 | Derived | Greer LK, Meilleur KG, Harvey BK, Wires ES. Identification of ER/SR resident proteins as biomarkers for ER/SR calcium depletion in skeletal muscle cells. Orphanet J Rare Dis. 2022 Jun 13;17(1):225. doi: 10.1186/s13023-022-02368-9. |
| Label | URL |
|---|---|
| NIH Clinical Center Detailed Web Page | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | RYR1-RM Volunteers | Subjects with RYR1-RM entered into the Natural History Phase of the study. |
| FG001 | Healthy Volunteers | Healthy volunteers entered into the study for a one-visit assessment; no treatment given. |
| FG002 | RYR1-RM Volunteers: N-acetylcysteine (NAC) | RYR1-RM subjects who were eventually randomized to NAC 900 mg tablets |
| FG003 | RYR1-RM Volunteers: Placebo | RYR1-RM subjects who were eventually randomized to Placebo 900 mg tablets without active NAC |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Phase 1 (up to 6 Months) |
|
| ||||||||||||||||||
| Phase 2 (up to 6 Months, Randomized) |
|
The baseline analysis population contains the healthy volunteer participants, who only had one visit to determine normal values of biomarkers, muscle ultrasound, and near infrared spectroscopy in this rare disease, in order to develop a comparison between healthy and RYR1-RM individuals.
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| ID | Title | Description |
|---|---|---|
| BG000 | RYR1-RM Volunteers | All participants with RYR1-RM enrolled into the natural history period of the trial. |
| BG001 | Healthy Volunteers | Healthy volunteers were evaluated to determine normal values of biomarkers, muscle ultrasound, and near infrared spectroscopy in this rare disease, in order to develop a comparison between healthy and RYR1-RM individuals. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Baseline measures are provided for the 53 RYR1-RM participants and the 10 healthy volunteers in the natural history phase, and for the 33 subjects who continued on into the randomized phase. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Urine 15-F2t Isoprostane Concentration | Urine will be assayed for 15-isoprostane-F2, which is formed when arachidonic acid reacts with reactive oxygen species(ROS). A validated gas chromatography(GC)-mass spectrometer (MS) method will be used to quantify 15-isoprostane-F2 | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers post-baseline (months 6 and 12), thus they are not included in the analysis. | Posted | Least Squares Mean | 95% Confidence Interval | ng/mg Cr | 12 months |
|
Adverse events (AE) were collected from start of study drug through the end of the study at 12 months. AEs were analyzed for the natural history period and the treatment period separately.
(Institutional Review Board) IRB determination was used for the classification of adverse events
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | RYR1-RM Volunteers | All participants with RYR1-RM enrolled into the natural history period of the trial |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Intestinal Malrotation | Congenital, familial and genetic disorders | MedDRA (18.0) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Blurred Vision | Eye disorders | MedDRA (18.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Katherine Meileur Chief, Neuromuscular Symptoms Unit | National Institute of Nursing | 301-435-1503 | meilleurk@mail.nih.gov |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 31, 2018 | Mar 22, 2019 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jul 2, 2018 | May 16, 2019 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D009468 | Neuromuscular Diseases |
| D009135 | Muscular Diseases |
| ID | Term |
|---|---|
| D009422 | Nervous System Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D000111 | Acetylcysteine |
| ID | Term |
|---|---|
| D003545 | Cysteine |
| D000603 | Amino Acids, Sulfur |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
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| Drug |
|
Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to ascend four steps, the subject was asked to ascend four steps whilst being timed.
| 12 months |
| Descend Steps | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to descend four steps, the subject was asked to descend four steps whilst being timed. | 12 months |
| Walk/Run 10 Meters | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For walk/run 10 meters, participants were timed as they walked/ran a marked 10-meter course as quickly as possible. | 12 months |
| Supine to Stand | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to transition from supine to standing, participants were asked to lay supine and then the time taken to move from supine to standing was recorded. | 12 months |
| Motor Function Measure-32 (MFM-32) Domain 1 (D1) | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D1 domains measure standard and transfers, and consist of 13 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. Total score is the sum of all the domains for D1 divided by the maximum score possible and multiplied by 100. Min=0, Max = 100. Lower numbers on the scale represent a worse outcome. | 12 months |
| Motor Function Measure-32 (MFM-32) Domain 2 (D2) | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D2 domains measure axial and proximal motor function and consists of 12 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D2, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | 12 months |
| Motor Function Measure-32 (MFM-32) Domain 3 (D3) | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D3 domains measure distal motor function and consist of 7 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D3, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | 12 months |
| Motor Function Measure-32 (MFM-32) Total Score | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains, divided by maximum score possible (96) and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | 12 months |
| Hand Grip Strength | Grip and pinch strength were determined using Myotools dynamometry. The myogrip hand held dynamometer was used to assess grip strength. Higher scores represent better outcomes. | 12 months |
| Hand Pinch Strength | Grip and pinch strength were determined using Myotools dynamometry. The myopinch pinch gauge was used to measure finger strength. Higher scores represent better outcomes. | 12 months |
| Peak Torque Flexion | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | 12 months |
| Peak Torque Extension | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | 12 months |
| Adult Patient-Reported Outcomes Measurement Information System (PROMIS) - Fatigue | Participants were asked to complete the PROMIS (patient-reported outcomes measurement information system) through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores are normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 12 months |
| Adult Quality of Life in Neurological Disorders (NeuroQoL) Fatigue | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. The NeuroQoL scores were normed to 100, meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 12 months |
| Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue | Participants were asked to complete the PROMIS questionnaire through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores were normed to 100 meaning that the raw scores were converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 12 months |
| Pediatric Quality of Life in Neurological Disorders (NeuroQoL) Fatigue | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. NeuroQoL scores were normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 12 months |
| Multidimensional Fatigue Inventory - 20 (MFI-20) General Fatigue Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 12 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Physical Fatigue Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 12 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Activity Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 12 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Motivation Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 12 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Mental Fatigue Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 12 months |
| Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score | Participants were asked to complete the FACIT-f questionnaire through the NIH online, self-administered Clinical Trials Survey System. Minimum value = 0, maximum value = 160. Higher scores represent a better outcome/ better QOL. | 12 months |
| Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Trial Outcome Index | Participants were asked to complete the FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System. The Trial Outcome Index (TOI) is the sum of the physical well-being, functional well-being and 'additional concerns' subscales. The minimum value = 0, and maximum value = 52. Scores under 30 is considered to be severe fatigue. Higher scores represent a better outcome/QOL. | 12 months |
| Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score | Pediatric participants (< 18 years) were asked to complete the Peds-FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System.Minimum value = 0, maximum value = 52. Higher scores represent a better outcome/ better QOL. | 12 months |
| Blood Glutathione Reduced (GSH):Oxidized (GSSG) Ratio | GSH:GSSG ratio analyzed only at baseline to offer comparison of RYR1-RM affected individuals to the general population. | Baseline |
Meters walked in 6 minutes will be recorded; distances in meters will be recorded at each minute interval; speed will be calculated. |
| 6 months |
| DCF-fluorescence Intensity (AU) Pre-Intervention | Dichlorodihydrofluorescein (DCFH) will be used on participate muscle biopsies to analyze intracellular oxidant activity [H2DCFDA (H2-DCF, DCF)]. | 6 months |
| Time to Ascend Steps (Seconds) Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to ascend four steps, the subject was asked to ascend four steps whilst being timed. | 6 months |
| Descend Steps Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to descend four steps, the subject was asked to descend four steps whilst being timed. | 6 months |
| Walk/Run 10 Meters Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For walk/run 10 meters, participants were timed as they walked/ran a marked 10-meter course as quickly as possible. | 6 months |
| Supine to Stand Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to transition from supine to standing, participants were asked to lay supine and then the time taken to move from supine to standing was recorded. | 6 months |
| Motor Function Measure-32 (MFM-32) Domain 1 (D1) Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D1 domains measure standard and transfers, and consist of 13 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. Total score is the sum of all the domains for D1 divided by the maximum score possible and multiplied by 100. Min=0, Max = 100. Lower numbers on the scale represent a worse outcome. | 6 months |
| Motor Function Measure-32 (MFM-32) Domain 2 (D2) Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D2 domains measure axial and proximal motor function and consists of 12 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D2, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | 6 months |
| Motor Function Measure-32 (MFM-32) Domain 3 (D3) Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D3 domains measure distal motor function and consist of 7 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D3, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | 6 months |
| Motor Function Measure-32 (MFM-32) Total Score Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains, divided by maximum score possible (96) and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | 6 months |
| Hand Grip Strength Pre-Intervention | Grip and pinch strength were determined using Myotools dynamometry. The myogrip hand held dynamometer was used to assess grip strength. Higher scores represent better outcomes. | 6 months |
| Hand Pinch Strength Pre-Intervention | Grip and pinch strength were determined using Myotools dynamometry. The myopinch pinch gauge was used to measure finger strength. Higher scores represent better outcomes. | 6 months |
| Peak Torque Flexion Pre-Intervention | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | 6 months |
| Peak Torque Extension Pre-Intervention | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | 6 months |
| Adult Patient-Reported Outcomes Measurement Information System (PROMIS) - Fatigue Pre-Intervention | Participants were asked to complete the PROMIS (patient-reported outcomes measurement information system) through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores are normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 6 months |
| Adult Quality of Life in Neurological Disorders (NeuroQoL) Fatigue Pre-Intervention | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. The NeuroQoL scores were normed to 100, meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 6 months |
| Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Pre-Intervention | Participants were asked to complete the PROMIS questionnaire through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores were normed to 100 meaning that the raw scores were converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 6 months |
| Pediatric Quality of Life in Neurological Disorders (NeuroQoL) Fatigue Pre-Intervention | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. NeuroQoL scores were normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | 6 months |
| Multidimensional Fatigue Inventory - 20 (MFI-20) General Fatigue Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 6 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Physical Fatigue Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 6 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Activity Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 6 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Motivation Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 6 months |
| Multidimensional Fatigue Inventory-20 (MFI-20) Mental Fatigue Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | 6 months |
| Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score Pre-Intervention | Participants were asked to complete the FACIT-f questionnaire through the NIH online, self-administered Clinical Trials Survey System. Minimum value = 0, maximum value = 160. Higher scores represent a better outcome/ better QOL. | 6 months |
| Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Trial Outcome Index Pre-Intervention | Participants were asked to complete the FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System. The Trial Outcome Index (TOI) is the sum of the physical well-being, functional well-being and 'additional concerns' subscales. The minimum value = 0, and maximum value = 52. Scores under 30 is considered to be severe fatigue. Higher scores represent a better outcome/QOL. | 6 months |
| Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score Pre-Intervention | Pediatric participants (< 18 years) were asked to complete the Peds-FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System.Minimum value = 0, maximum value = 52. Higher scores represent a better outcome/ better QOL. | 6 months |
| Urine 15-F2t Isoprostane Concentration at Baseline | Urine will be assayed for 15-isoprostane-F2, which is formed when arachidonic acid reacts with reactive oxygen species(ROS). A validated gas chromatography(GC)-mass spectrometer (MS) method will be used to quantify 15-isoprostane-F2 | Baseline |
| 31941795 | Derived | Todd JJ, Lawal TA, Witherspoon JW, Chrismer IC, Razaqyar MS, Punjabi M, Elliott JS, Tounkara F, Kuo A, Shelton MO, Allen C, Cosgrove MM, Linton M, Michael D, Jain MS, Waite M, Drinkard B, Wakim PG, Dowling JJ, Bonnemann CG, Emile-Backer M, Meilleur KG. Randomized controlled trial of N-acetylcysteine therapy for RYR1-related myopathies. Neurology. 2020 Mar 31;94(13):e1434-e1444. doi: 10.1212/WNL.0000000000008872. Epub 2020 Jan 15. |
| 29970108 | Derived | Witherspoon JW, Vasavada RP, Waite MR, Shelton M, Chrismer IC, Wakim PG, Jain MS, Bonnemann CG, Meilleur KG. 6-minute walk test as a measure of disease progression and fatigability in a cohort of individuals with RYR1-related myopathies. Orphanet J Rare Dis. 2018 Jul 3;13(1):105. doi: 10.1186/s13023-018-0848-9. |
| Medicinal contraindication |
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| Screening failure |
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| Confirmatory genetic testing negative |
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| Study closure |
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| COMPLETED |
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| NOT COMPLETED |
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| BG002 | RYR1-RM Volunteers: N-acetylcysteine (NAC) | N-acetylcysteine (NAC) 900 mg tablets; week 1 up to 1800 mg/day; Week 2- through end of study based on participant weight: < 50 kg subjects up to 2700 mg/day, >50 kg subjects 2700 mg/day |
| BG003 | RYR1-RM Volunteers :Placebo | Placebo 900 mg tablets identical but did not contain NAC |
| BG004 | Total | Total of all reporting groups |
| Mean |
| Standard Deviation |
| years |
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| Sex: Female, Male | Baseline measures are provided for the 53 RYR1-RM participants and the 10 healthy volunteers in the natural history phase, and for the 33 subjects who continued on into the randomized phase. | Count of Participants | Participants | No |
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| Race (NIH/OMB) | Baseline measures are provided for the 53 RYR1-RM participants and the 10 healthy volunteers in the natural history phase, and for the 33 subjects who continued on into the randomized phase. | Count of Participants | Participants |
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| Region of Enrollment | This measure of Region of Enrollment is presented for subjects enrolled in the Natural History phase of the study as well as the Healthy Volunteers. | Count of Participants | Participants |
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| Region of Enrollment | This measure of Region of Enrollment is presented for the subjects in the randomized period of the study, ie, randomized population. | Number | participants |
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| Body Mass Index BMI(kg/m^2) | Baseline measures are provided for the 53 RYR1-RM participants and the 10 healthy volunteers in the natural history phase, and for the 33 subjects who continued on into the randomized phase. | Mean | Standard Deviation | kg/m^2 |
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| Mode of Inheritance, dominant/de novo | Mode of Inheritance is not applicable to healthy volunteer participants and therefore was not collected. | Mode of Inheritance is not applicable to healthy volunteer participants and therefore was not collected. Baseline measures are provided for each of the other two parts of the study: natural history and randomized. Of the 53 participants in the natural history period, 33 continued on into the randomized phase. | Count of Participants | Participants | No |
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| OG001 | Placebo | Placebo 900 mg tablets identical but did not contain NAC |
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| Primary | Six Minute Walk Test (6MWT) | Meters walked in 6 minutes will be recorded; distances in meters will be recorded at each minute interval; speed will be calculated. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | meters | 12 months |
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| Secondary | DCF-fluorescence Intensity (AU) | Dichlorodihydrofluorescein (DCFH) will be used on participate muscle biopsies to analyze intracellular oxidant activity [H2DCFDA (H2-DCF, DCF)]. | This analysis was performed only on participants in the randomized population who volunteered to have the muscle biopsy performed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | 95% Confidence Interval | AU | 12 months |
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| Secondary | Time to Ascend Steps (Seconds) | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to ascend four steps, the subject was asked to ascend four steps whilst being timed. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | seconds | 12 months |
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| Secondary | Descend Steps | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to descend four steps, the subject was asked to descend four steps whilst being timed. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | seconds | 12 months |
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| Secondary | Walk/Run 10 Meters | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For walk/run 10 meters, participants were timed as they walked/ran a marked 10-meter course as quickly as possible. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | seconds | 12 months |
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| Secondary | Supine to Stand | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to transition from supine to standing, participants were asked to lay supine and then the time taken to move from supine to standing was recorded. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | seconds | 12 months |
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| Secondary | Motor Function Measure-32 (MFM-32) Domain 1 (D1) | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D1 domains measure standard and transfers, and consist of 13 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. Total score is the sum of all the domains for D1 divided by the maximum score possible and multiplied by 100. Min=0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | % of maximum score | 12 months |
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| Secondary | Motor Function Measure-32 (MFM-32) Domain 2 (D2) | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D2 domains measure axial and proximal motor function and consists of 12 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D2, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | % of maximum score | 12 months |
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| Secondary | Motor Function Measure-32 (MFM-32) Domain 3 (D3) | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D3 domains measure distal motor function and consist of 7 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D3, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | % of maximum score | 12 months |
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| Secondary | Motor Function Measure-32 (MFM-32) Total Score | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains, divided by maximum score possible (96) and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | % of maximum score | 12 months |
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| Secondary | Hand Grip Strength | Grip and pinch strength were determined using Myotools dynamometry. The myogrip hand held dynamometer was used to assess grip strength. Higher scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | kg | 12 months |
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| Secondary | Hand Pinch Strength | Grip and pinch strength were determined using Myotools dynamometry. The myopinch pinch gauge was used to measure finger strength. Higher scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | kg | 12 months |
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| Secondary | Peak Torque Flexion | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | nM | 12 months |
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| Secondary | Peak Torque Extension | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | nM | 12 months |
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| Secondary | Adult Patient-Reported Outcomes Measurement Information System (PROMIS) - Fatigue | Participants were asked to complete the PROMIS (patient-reported outcomes measurement information system) through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores are normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | t score | 12 months |
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| Secondary | Adult Quality of Life in Neurological Disorders (NeuroQoL) Fatigue | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. The NeuroQoL scores were normed to 100, meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | t score | 12 months |
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| Secondary | Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue | Participants were asked to complete the PROMIS questionnaire through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores were normed to 100 meaning that the raw scores were converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | t score | 12 months |
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| Secondary | Pediatric Quality of Life in Neurological Disorders (NeuroQoL) Fatigue | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. NeuroQoL scores were normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | t score | 12 months |
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| Secondary | Multidimensional Fatigue Inventory - 20 (MFI-20) General Fatigue Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Multidimensional Fatigue Inventory-20 (MFI-20) Physical Fatigue Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Activity Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Motivation Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Multidimensional Fatigue Inventory-20 (MFI-20) Mental Fatigue Score | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score | Participants were asked to complete the FACIT-f questionnaire through the NIH online, self-administered Clinical Trials Survey System. Minimum value = 0, maximum value = 160. Higher scores represent a better outcome/ better QOL. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Trial Outcome Index | Participants were asked to complete the FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System. The Trial Outcome Index (TOI) is the sum of the physical well-being, functional well-being and 'additional concerns' subscales. The minimum value = 0, and maximum value = 52. Scores under 30 is considered to be severe fatigue. Higher scores represent a better outcome/QOL. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score | Pediatric participants (< 18 years) were asked to complete the Peds-FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System.Minimum value = 0, maximum value = 52. Higher scores represent a better outcome/ better QOL. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Least Squares Mean | 95% Confidence Interval | scores on a scale | 12 months |
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| Secondary | Blood Glutathione Reduced (GSH):Oxidized (GSSG) Ratio | GSH:GSSG ratio analyzed only at baseline to offer comparison of RYR1-RM affected individuals to the general population. | Posted | Mean | Standard Deviation | ratio | Baseline |
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| Other Pre-specified | Urine 15-F2t Isoprostane Concentration Pre-Intervention | Urine will be assayed for 15-isoprostane-F2, which is formed when arachidonic acid reacts with reactive oxygen species(ROS). A validated gas chromatography(GC)-mass spectrometer (MS) method will be used to quantify 15-isoprostane-F2 | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers post baseline, thus they are not included in this analysis.. | Posted | Mean | Standard Deviation | ng/mg Cr | 6 months |
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| Other Pre-specified | Six Minute Walk Test (6MWT) Pre-Intervention | Meters walked in 6 minutes will be recorded; distances in meters will be recorded at each minute interval; speed will be calculated. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | meters | 6 months |
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| Other Pre-specified | DCF-fluorescence Intensity (AU) Pre-Intervention | Dichlorodihydrofluorescein (DCFH) will be used on participate muscle biopsies to analyze intracellular oxidant activity [H2DCFDA (H2-DCF, DCF)]. | This analysis was performed only on participants in the randomized population who volunteered to have the muscle biopsy performed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | AU | 6 months |
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| Other Pre-specified | Time to Ascend Steps (Seconds) Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to ascend four steps, the subject was asked to ascend four steps whilst being timed. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | seconds | 6 months |
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| Other Pre-specified | Descend Steps Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to descend four steps, the subject was asked to descend four steps whilst being timed. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | seconds | 6 months |
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| Other Pre-specified | Walk/Run 10 Meters Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For walk/run 10 meters, participants were timed as they walked/ran a marked 10-meter course as quickly as possible. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | seconds | 6 months |
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| Other Pre-specified | Supine to Stand Pre-Intervention | Participants completed the following timed function tests: supine to stand, ascend four steps, descend four steps, and walk/run 10 meters. For time taken to transition from supine to standing, participants were asked to lay supine and then the time taken to move from supine to standing was recorded. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | seconds | 6 months |
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| Other Pre-specified | Motor Function Measure-32 (MFM-32) Domain 1 (D1) Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D1 domains measure standard and transfers, and consist of 13 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. Total score is the sum of all the domains for D1 divided by the maximum score possible and multiplied by 100. Min=0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | % of maximum score | 6 months |
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| Other Pre-specified | Motor Function Measure-32 (MFM-32) Domain 2 (D2) Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D2 domains measure axial and proximal motor function and consists of 12 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D2, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis.. | Posted | Mean | Standard Deviation | % of maximum score | 6 months |
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| Other Pre-specified | Motor Function Measure-32 (MFM-32) Domain 3 (D3) Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. The D3 domains measure distal motor function and consist of 7 items. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains for D3, divided by maximum score possible and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | % of maximum score | 6 months |
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| Other Pre-specified | Motor Function Measure-32 (MFM-32) Total Score Pre-Intervention | Motor Function Measure, MFM-32 is a well-established scale of motor function in congenital muscle disease. Generic Values for each domain are: 0 = cannot perform the task, 1 = initiated the task, 2 - performs the movement incompletely, or completely but imperfectly, 3 = performs the task fully and 'normally'. The total score is the sum of all the MFM-32 domains, divided by maximum score possible (96) and multiplied by 100. Min = 0, Max = 100. Lower numbers on the scale represent a worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | % of maximum score | 6 months |
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| Other Pre-specified | Hand Grip Strength Pre-Intervention | Grip and pinch strength were determined using Myotools dynamometry. The myogrip hand held dynamometer was used to assess grip strength. Higher scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | kg | 6 months |
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| Other Pre-specified | Hand Pinch Strength Pre-Intervention | Grip and pinch strength were determined using Myotools dynamometry. The myopinch pinch gauge was used to measure finger strength. Higher scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | kg | 6 months |
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| Other Pre-specified | Peak Torque Flexion Pre-Intervention | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | nM | 6 months |
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| Other Pre-specified | Peak Torque Extension Pre-Intervention | Lower-body isometric strength testing was used to determine peak torque during flexion and extension. Participant's blood pressure was assessed, to rule-out hypertension (>140/90), prior to starting the test. Participants were then asked to push against a stationary arm and remained at the same joint angle for the duration of each test. Two short trials were completed to establish maximal force for each participant. This was followed by a long trial of flexion and extension to capture rate of fatigue to 50% after reaching their pre-determined maximal force. In the interest of safety, participants with hypertension and/or a history of knee injury did not perform the test. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | nM | 6 months |
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| Other Pre-specified | Adult Patient-Reported Outcomes Measurement Information System (PROMIS) - Fatigue Pre-Intervention | Participants were asked to complete the PROMIS (patient-reported outcomes measurement information system) through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores are normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | t score | 6 months |
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| Other Pre-specified | Adult Quality of Life in Neurological Disorders (NeuroQoL) Fatigue Pre-Intervention | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. The NeuroQoL scores were normed to 100, meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | t score | 6 months |
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| Other Pre-specified | Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Pre-Intervention | Participants were asked to complete the PROMIS questionnaire through the NIH online, self-administered Clinical Trials Survey System. PROMIS scores were normed to 100 meaning that the raw scores were converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | t score | 6 months |
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| Other Pre-specified | Pediatric Quality of Life in Neurological Disorders (NeuroQoL) Fatigue Pre-Intervention | Participants were asked to complete the NeuroQoL questionnaire through the NIH online, self-administered Clinical Trials Survey System. NeuroQoL scores were normed to 100 meaning that the raw score is converted to a scale where 50 is the mean and the standard deviation is 10. Scores less than 50 indicate less fatigue compared to the average and scores over 50 indicate more fatigue than the average. Lower scores represent better outcomes. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | t score | 6 months |
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| Other Pre-specified | Multidimensional Fatigue Inventory - 20 (MFI-20) General Fatigue Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Multidimensional Fatigue Inventory-20 (MFI-20) Physical Fatigue Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Activity Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Multidimensional Fatigue Inventory-20 (MFI-20) Reduced Motivation Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Multidimensional Fatigue Inventory-20 (MFI-20) Mental Fatigue Score Pre-Intervention | Participants were asked to complete the MFI-20 questionnaire through the NIH online, self-administered Clinical Trials Survey System. The MFI consists of 5 subscales: general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation. Values range from 4-20 for each scale. Higher scores represent increased fatigue/ worse outcome. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score Pre-Intervention | Participants were asked to complete the FACIT-f questionnaire through the NIH online, self-administered Clinical Trials Survey System. Minimum value = 0, maximum value = 160. Higher scores represent a better outcome/ better QOL. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Trial Outcome Index Pre-Intervention | Participants were asked to complete the FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System. The Trial Outcome Index (TOI) is the sum of the physical well-being, functional well-being and 'additional concerns' subscales. The minimum value = 0, and maximum value = 52. Scores under 30 is considered to be severe fatigue. Higher scores represent a better outcome/QOL. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) Total Score Pre-Intervention | Pediatric participants (< 18 years) were asked to complete the Peds-FACIT-F questionnaire through the NIH online, self-administered Clinical Trials Survey System.Minimum value = 0, maximum value = 52. Higher scores represent a better outcome/ better QOL. | Outcome measures are reported for participants who were randomized and continued into the randomized, double-blind period of the trial. Missing data was not imputed. This measure was not collected for Healthy Volunteers, thus they are not included in this analysis. | Posted | Mean | Standard Deviation | scores on a scale | 6 months |
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| Other Pre-specified | Urine 15-F2t Isoprostane Concentration at Baseline | Urine will be assayed for 15-isoprostane-F2, which is formed when arachidonic acid reacts with reactive oxygen species(ROS). A validated gas chromatography(GC)-mass spectrometer (MS) method will be used to quantify 15-isoprostane-F2 | Healthy volunteers who participated in a one-visit assessment and RYR1-RM Volunteers measured at Baseline. | Posted | Mean | Standard Deviation | ng/mg Cr | Baseline |
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| 0 |
| 53 |
| 1 |
| 53 |
| 36 |
| 53 |
| EG001 | RYR1-RM Volunteers: N-acetylcysteine (NAC) | N-acetylcysteine (NAC) 900 mg tablets for 6 months; week 1 up to 1800 mg/day; Week 2- through end of study based on subject weight: < 50 kg subjects up to 2700 mg/day, >50 kg subjects 2700 mg/day | 0 | 16 | 4 | 16 | 16 | 16 |
| EG002 | RYR1-RM Volunteers :Placebo | Placebo 900 mg tablets for 6 months; identical but did not contain NAC | 0 | 17 | 5 | 17 | 17 | 17 |
| EG003 | Healthy Volunteers | Healthy volunteers were evaluated at a one-visit assessment at baseline to determine normal values of biomarkers, muscle ultrasound, and near infrared spectroscopy in order to develop a comparison between healthy and RYR1-RM individuals | 0 | 10 | 0 | 10 | 5 | 10 |
| Diarrhoea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Uterine Leiomyoma | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Ovarian Cyst | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Chest Discomfort | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Hypotension | Vascular disorders | MedDRA (18.0) | Systematic Assessment |
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| Barrett's Oesophagus | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Stomach Virus | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Faecal Incontinence | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Abdominal Distension | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Abdominal Pain Upper | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Dry Mouth | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Influenza-like Illness | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Upper Respiratory Tract Infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Fall | Injury, poisoning and procedural complications | MedDRA (18.0) | Systematic Assessment |
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| Joint Dislocation | Injury, poisoning and procedural complications | MedDRA (18.0) | Systematic Assessment |
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| Gamma-glutamyl Transferase Increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Alanine Aminotransferase Increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Prothombin Time Prolonged | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Red Cell Distribution Width Increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Activated Partial Thromboplastin Time Prolonged | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Blood Creatinine Phosphokinase Increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Blood Creatinine Decreased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA (18.0) | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Enchondroma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (18.0) | Systematic Assessment |
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| Malignant Melanoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (18.0) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Memory Impairment | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Menorrhagia | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Night Sweats | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Pruritis | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Urticaria | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Flushing | Vascular disorders | MedDRA (18.0) | Systematic Assessment |
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| Left inguinal lymph node | Blood and lymphatic system disorders | MedDRA (18.0) | Systematic Assessment |
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| Malrotation of bowel | Congenital, familial and genetic disorders | MedDRA (18.0) | Systematic Assessment |
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| Blood Pressure Increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Hematocrit increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Hemoglobin increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Mean corpuscular volume increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| mean corpuscular hemoglobin concentration decreased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| C-reactive protein increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Creatinine kinase increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| White blood cell count increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| White blood cell count decreased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Arthrosis | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Bone island benign tumor | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Bursitis | Musculoskeletal and connective tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Inguinal hernia | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Ovarian cyst | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Uterine fibroids | Reproductive system and breast disorders | MedDRA (18.0) | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Alkaline phosphatase increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Pain | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Mean Platelet Volume (MVP) low | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Bilirubin high | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Aspartate Aminotransferase Increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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Not provided
Not provided
Not provided
| D000596 |
| Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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