Prospective Natural History Study of POLG Disease

Global Prospective Natural History Study of POLG Disease

The PIONEER study is a prospective, natural history study dedicated to characterizing the clinical progression of POLG-related disorders. The research aims to bridge the gap between genetic diagnosis and drug development by mapping how these rare mitochondrial conditions evolve over time. By observing the disease's natural trajectory through a multi-center approach, The study identifies critical clinical milestones that serve as a foundation for evaluating therapeutic efficacy and future therapeutic interventions

This is a multi-centre, Multi-country Prospective Observational Natural History study designed to bridge the gap between genetic diagnosis and therapeutic development for POLG-related disorders. These mitochondrial conditions are rare. This study utilizes a prospective, longitudinal design which allows researchers to track the "phenotypic evolution" of the disease over several years, providing the high-quality baseline data that regulatory agencies like the FDA require to evaluate the success of future drug interventions.

clinical parameters such as the Newcastle Mitochondrial Disease Scale (NMDAS) for multi-system involvement, the SARA scale for ataxia, and functional tests like the Nine-Hole Peg Test for motor dexterity, alongside fluid biomarkers including GDF-15 and FGF-21 are conducted to validate clinical endpoints throughout the study duration. inclusion criteria require participants of any age to have a genetically confirmed POLG-related disorder with documented pathogenic variants, as well as the ability to comply with longitudinal follow-up assessments over 3 years. This rigorous framework allows researchers to correlate specific genetic mutations with objective clinical milestones, providing the necessary baseline data to evaluate the efficacy of future therapeutic interventions.

Inclusion Criteria:

• male & female from age 0 to 75.
• A genetically confirmed POLG -associated disorder based on both phenotype and genotype is required.
• Parental/guardian permission (informed consent) and if appropriate with child assent.

Exclusion Criteria:

• Diagnosis of mitochondrial disorder other than POLG
• Subject with POLG Variant of unknown significance or benign variant.
• Parents/guardians or subjects who, in the opinion of the investigator, may be non-compliant with the study schedules or procedures.
• Subjects unable or unwilling to provide informed consent.
• History of or current clinically important condition other than what is related to the PMD which, in the opinion of the Investigator will confound the results of the NHS.