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Phase 2 N=59 Randomized Double-blind Treatment

Effectiveness of Mexiletine for Treating People With Non-Dystrophic Myotonia

Myotonia · Non-Dystrophic Myotonia

Enrolled (actual)
59
Serious AEs
0.9%
Results posted
Mar 2013
Primary outcome: Primary: Patient-reported Stiffness on the IVR — 2.53; 4.21; 1.60; 5.27 units on a scale — p=<0.001

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Mexiletine (Drug); Placebo (Drug)
Age
Pediatric, Adult, Older Adult · 16+ yrs
Sex
All
Sponsor
Richard Barohn, MD
Primary completion
Mar 2011

Outcome Measures

OutcomeResultp-value
PRIMARY
Patient-reported Stiffness on the IVR
2.53; 4.21; 1.60; 5.27 <0.001 sig
SECONDARY
Patient Reported Pain on the IVR
1.54; 3.17 <0.001 sig
SECONDARY
Patient Reported Weakness on the IVR
1.96; 3.22 <0.001 sig
SECONDARY
Patient Reported Tiredness on the IVR
2.90; 3.82 <0.001 sig
SECONDARY
Quantitative Measure of Hand Grip Myotonia (Seconds)
0.321; 0.429 <0.001 sig
SECONDARY
Compound Motor Action Potentials After Short Exercise Test
83.1; 78.6 0.09
SECONDARY
Graded Myotonia by Needle Electromyography - Right Abductor Digiti Minimi
2.05; 2.62 <0.001 sig
SECONDARY
Clinical Hand Grip Myotonia Evaluation (Seconds)
0.164; 0.494 <0.001 sig
SECONDARY
Clinical Eye Closure Myotonia Evaluation (Seconds)
0.161; 0.474 <0.001 sig
SECONDARY
Graded Myotonia by Needle Electromyography - Right Tibialis Anterior
2.07; 2.54 <0.001 sig
SECONDARY
Compound Motor Action Potentials After Long Exercise Test
81.8; 80.1 0.50
SECONDARY
Individualized Neuromuscular Quality of Life Scale - Summary Score
14.0; 16.7 <0.001 sig
SECONDARY
Short Form 36 - Physical Composite Score
44.8; 39.2 <0.001 sig
SECONDARY
Short Form 36 - Mental Composite Score
47.4; 47.7; 53.1; 42.7 0.90

Summary

Nondystrophic myotonias (NDM) are neuromuscular disorders caused by genetic abnormalities in certain muscle cell membrane proteins. The proteins affect muscle contraction. Individuals with NDM experience limited muscle relaxation, which then can cause pain, weakness, incoordination, and impaired physical activity and function. Because NDM is very rare, information on the best way to treat people with the disorders is lacking, and there are no FDA-approved therapies. The purpose of this study is to determine the effectiveness of the medication mexiletine in treating people with NDM.

Eligibility Criteria

Inclusion Criteria

  • Clinical symptoms or signs suggestive of myotonic disorders
  • Presence of myotonic potentials on electromyography (EMG)
  • Participant in the Non-Dystrophic Natural History study (RDCRN 5303) or a new patient with confirmed non-dystrophic myotonia

Exclusion Criteria

  • Other neurological condition that might affect the assessment of the study measurements
  • Genetic confirmation of DM1 (more than 50 repeats of CTG) or DM2
  • Existing cardiac conduction defects, as evidenced on EKG, including but not limited to the following conditions: malignant arrhythmia or cardiac conduction disturbances (e.g., second degree AV block, third degree AV block, or prolonged QT interval)
  • Existing permanent pacemaker
  • Current use of any of the following antiarrhythmic medications for a cardiac disorder: flecainide acetate, encainide, disopyramide, procainamide, quinidine, propafenone, or mexiletine
  • Use of medications for myotonia, such as phenytoin and flecainide acetate, within 5 days of study entry; carbamazepine and mexiletine within 3 days of study entry; or propafenone, procainamide, disopyramide, quinidine, and encainide within 2 days of study entry
  • Use of medications that produce myotonia, which may include fibrate acid derivatives, hydroxymethylglutaryl CoA reductase inhibitors, chloroquine, and colchicines
  • Kidney or liver disease
  • Heart failure
  • Seizure disorder
  • Pregnant or breastfeeding
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00832000). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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