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Metabolic MyopathiesNCT07268287

Assessment of Energy Metabolism in Metabolic Myopathies

A study testing 12-week Physiotherapy Intervention, 13C-Glucose Breath Test and Doubly labelled water & urine test in people with Metabolic Myopathies, run by University of British Columbia at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Patients with metabolic myopathies suffer from exercise intolerance due to impaired ability to produce energy and secondary de-conditioning. There is a lack of methods enabling a non-invasive assessment of muscle energy production and studies regarding the benefits of therapeutic interventions are lacking as well. Read more about this study

Who is it for?
Ages 10 to 18 years
Conditions the study is for
Metabolic Myopathies
What is being tested?
12-week Physiotherapy Intervention, 13C-Glucose Breath Test and Doubly labelled water & urine test
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
3 participants
Where
1 siteCanada
Study dates
26 Jun 2022to 8 Oct 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Confirmed diagnosis of the following: Mitochondrial Metabolic Myopathy (mMM), Fatty Acid Oxidation Disorder (FAOD), Pompe disease, or muscle Glycogen Storage Disease (GSD) (McArdle) via demonstration of deficient enzyme activity and / or demonstration of molecular testing confirming respective pathogenic variants and or compatible with disease phenotype.
  • Age ≥10 years up to 18 years.
  • Any gender.
  • No past history of rhabdomyolysis requiring hospitalization.
  • No signs or symptoms of infectious disease at least 14 days prior to the commencement of study visit (to mitigate the risk of rhabdomyolysis and coronavirus transmission).
  • Participant must speak/understand English.
  • Participant must have a smart phone or a tablet with a provider plan or that can be linked to Wi-Fi.
  • Participant must have the time to commit to 11 visits at BC Children's Hospital over 21 weeks.

Who cannot join

  • Any concurrent disorders / conditions that would interfere with /impact the study procedure (breath test and/or low intensity exercise).
  • Diabetes Mellitus type I or II.
  • Abnormal Cardiac assessment: cardiomyopathy or arrhythmia not allowing physical exercise.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • BC Children's Hospital Research Institute

    Vancouver, British Columbia, V5Z 4H4

Other trials in Canada

About this study

Official title: Establishment of a Platform for the in Vivo Assessment of Therapies to Treat Metabolic Myopathies, Using Biomarkers and Stable Isotope Tracers to Evaluate Energy Metabolism: A First Step Towards Monitoring the Effectiveness of Innovative Therapies.

Patients with metabolic myopathies suffer from exercise intolerance due to impaired ability to produce energy and secondary de-conditioning. There is a lack of methods enabling a non-invasive assessment of muscle energy production and studies regarding the benefits of therapeutic interventions are lacking as well. In this pilot study, the main aim is to assess the benefit of an intervention: a regular at home physiotherapy program for metabolic myopathies by measuring different outcomes pre and post therapeutic intervention using minimally invasive tests. The secondary aim of this study: investigators plan to describe the results of established non-invasive stable isotope tracer tests, namely, "glucose breath test" and "doubly labelled water \& urine test" in patients pre and post 12 weeks at-home physiotherapy exercise program. The results of this study will be used for a larger scale study to assess energy metabolism in patients in patients with metabolic myopathies using non-invasive tests like breath and urine tests.

Read the detailed description

Metabolic myopathies are a group of genetic conditions which affect the production of energy in the muscle and are caused by muscle adenosine triphosphate (ATP) depletion. This group includes disorders of mitochondrial oxidative phosphorylation (mitochondrial myopathies, MM), fatty acid oxidation (FAOD), Pompe disease and generation of glycolytic substrates (muscle glycogenosis, GSDs) from muscle glycogen. At large, these disorders are amenable to treatment including exercise and dietary treatment and/or vitamins cofactors supplementation.

There is a lack of non-invasive biomarkers which could be used to monitor treatment effectiveness. Traditionally, maximal oxygen consumption (VO2 max), quality of life questionnaire, dual-energy x-ray absorptiometry (DXA/DEXA), muscle biopsies, blood lactate and creatine kinase are used as a surrogate biomarker but have a limited validity to assess response to therapeutic interventions in patients with myopathies. The ultimate goal is to established a platform for clinical trials using minimally invasive tests to evaluate energy metabolism in patients with metabolic myopathies in response to therapeutic interventions, such as physiotherapy exercise program. These minimally invasive tests could be used to develop a platform for clinical trials for patients with muscle disease.

The main aim (objective) of this study is to assess the benefit of an intervention: a 12 weeks at-home physiotherapy exercises program for metabolic myopathies by measuring different outcomes pre and post therapeutic intervention using minimally-invasive tests. The investigators will administer a 12-week at-home physiotherapy exercises program to 3 metabolic myopathies pediatric patients between age 10 and 18 years.

The following outcomes will be measured pre and post intervention:

  1. Glucose breath test: glucose oxidation (in mg/kg/min) measured by 13C glucose oxidation.
  2. Doubly labelled water \& urine test: assess free-living total energy expenditure (in kcal).
  3. Exercise test: VO2 max (in ml/kg/min).
  4. Muscle content test: Muscle mass (in grams) measured by DXA.
  5. Quality of life questionnaire test: Quality of life measure by PedsQL.

The secondary aim (objective) of this study is to show that a glucose breath test measuring glucose oxidation (in mg/kg/min) and a doubly labelled water \& urine test measuring total energy expenditure (in kcal) are outcomes that can be used in clinical trials to evaluate therapeutic interventions, along VO2 max, DXA and quality of life questionnaires. In that regard, this is a proof-of-concept study with the aim to describe the two biomarkers results in response to a therapeutic intervention in comparison to VO2-max and DXA scan and quality of life and clinical questionnaire in 3 participants.

The study design is n of 1 and will compare results of the tests pre and post therapeutic interventions in the same patients.

The glucose breath test: for the glucose oxidation (in mg/kg/min) measured by 13C glucose oxidation, results will be plotted as repeated measurements (3 times pre and post-intervention) for each individual participant. Repeat measurements will reduce the intra-individual variability. A 12 weeks at-home physiotherapy exercise protocol has been developed by the investigator team physician and kinesiologists experienced with exercise, children and metabolic myopathies. The therapeutic intervention, a 12 weeks at-home physiotherapy exercises program performed at least 5 times per week, under virtual supervision 3 times per week by a kinesiologist, contains the same type of exercises that are normally prescribed to this population on a clinical basis. All patients will perform the same program to reduce inter-variability.

In parallel, clinical methods such as VO2max, PedsQL and DXA will be measured pre- (baseline) and post-intervention evaluation. The investigators consulted a BCCHRI statistician with regard to the data analysis. Statistical analysis will include the intra-individual data analysis (n=1 study design) and will compare - using a Paired T test -the pre- and post- intervention data obtained from the two stable isotope tracer methods, VO2 max, DXA and quality of life questionnaires. The results of these tests will also be descriptively analyzed and the pre and post-intervention results will be plotted graphically.

The results of this proof of concept study will inform a larger scale project that was initially planned.

Being tested
12-week Physiotherapy Intervention, 13C-Glucose Breath Test, Doubly labelled water & urine test, Clinical Assessments - Exercise Test, Clinical Assessment - Muscle Content

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 12-week Physiotherapy InterventionOther

    A 12 week at-home physiotherapy exercises program performed at least 5 times per week, under virtual supervision 3 times per week by a kinesiologist, contains the same type of exercises that are normally prescribed to this population on a clinical basis. All patients will perform the same program to reduce inter-variability.

  • 13C-Glucose Breath TestDietary supplement

    Experiment piece 1:

    Oral glucose isotope is administered to fasted participants on pre and post-intervention study days. Breath is collected over a 4-hour period following ingestion.

    Other Names:

    • D-glucose (Thermo Scientific™ NERL™ Trutol™)
  • Doubly labelled water & urine testDietary supplement

    Experiment piece 2:

    1 study day pre and post-intervention fasted participants ingest a single oral dose of doubly labelled water (2H218O) isotope. 4 urine samples are collected over a 4 hour period following isotope administration, and once a day over 14 days.

    DLW is a safe and minimally invasive technique, considered the gold standard for precise measurement energy expenditure in humans. It involves enriching the body water with heavy hydrogen and oxygen (2H218O). The method is based on the principle that the 2H2 derived from body water is eliminated only as water (2H2O), while 18O is eliminated as both water (H2 18O) and carbon dioxide (C18O2).

  • Clinical Assessments - Exercise TestDiagnostic test

    Experiment piece 3: Using a well-established clinical method VO2 max, once pre and post-intervention to assess for body composition (oxygen consumption during exercise).

  • Clinical Assessment - Muscle ContentDiagnostic test

    Experiment piece 3: Using a well-established clinical method, DXA, once pre and post-intervention to assess for body muscle content (lean muscle mass)

  • Clinical Assessment - Quality of LifeDiagnostic test

    Experiment piece 3: Using a well-established clinical survey, PedsQL, once pre and post-intervention to assess for participants perception of quality of life.

Study groups in NCT07268287
Study groupRoleWhat they receive
13C-Glucose Breath TestExperimentalExperiment piece 1: 3 study days (pre-physio intervention) - single oral dose of unlabeled glucose and U-13C-glucose isotope. 3 study days (post-physio intervention) - single oral dose of unlabeled glucose and U-13C-glucose isotope. Both in mg/kg/min.
Receives: Dietary Supplement: 13C-Glucose Breath Test
Doubly Labelled Water & Urine TestExperimentalExperiment piece 2: 1 study day (pre-physio intervention) - single oral dose of doubly labelled water (2H218O) isotope. 1 study days (post-physio intervention) - single oral dose of doubly labelled water (2H218O) isotope. Assess free-living total energy expenditure (in kcal).
Receives: Dietary Supplement: Doubly labelled water & urine test
12-week Physiotherapy InterventionExperimentalPerformed once by all participants, in between the pre- and post-intervention experiments described in the other arms.
Receives: Other: 12-week Physiotherapy Intervention
Clinical Assessments - Exercise TestExperimentalExperiment piece 3: 1 study day (pre-intervention) and 1 study day (post-intervention). Exercise test: Maximum oxygen consumption (VO2 max) (in ml/kg/min).
Receives: Diagnostic Test: Clinical Assessments - Exercise Test
Clinical Assessments - Muscle ContentExperimentalExperiment piece 3: 1 study day (pre-intervention) and 1 study day (post-intervention). Muscle content test: Muscle mass measured by Dual-Energy X-ray Absorptiometry (DXA/DEXA) (in grams).
Receives: Diagnostic Test: Clinical Assessment - Muscle Content
Clinical Assessments - Quality of Life QuestionnaireExperimentalExperiment piece 3: 1 study day (pre-intervention) and 1 study day (post-intervention). Quality of life questionnaire test: Quality of life measure by pediatric quality of life questionnaire (PedsQL).
Receives: Diagnostic Test: Clinical Assessment - Quality of Life

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Glucose Oxidation

    Breath samples will be collected during the 3 pre and post-intervention study days to measure the rate of oxidation of 13C glucose (mg/kg/min).

    Measured: 4 Hours

Secondary outcomes (4)
  1. Doubly Labeled Water Free-living Total Energy Expenditure

    Energy expenditure can be calculated by measuring the difference in elimination rates of the heavy hydrogen and heavy oxygen in urine. The elimination rate is assessed from urine collected at the beginning and end of the observation period (~ 2 weeks). The 18O and 2H concentrations in urine are measured using isotope ratio mass spectrometry (IRMS). Assessed once pre- and post-intervention for free-living total energy expenditure (in kcal).

    Measured: 14 Days

  2. Clinical Assessments - Exercise Test

    Exercise test: Maximal Oxygen Consumption (VO2 max) (ml/kg/min) during monitored exercise. Assessed once pre- and post-intervention.

    Measured: 1-2 Hours

  3. Clinical Assessments - Muscle Content

    Muscle content test: Lean muscle mass measured by Dual-Energy X-ray Absorptiometry (DXA/DEXA) (grams). Assessed once pre- and post-intervention.

    Measured: 1 Hour

  4. Clinical Assessments - Quality of Life

    Quality of life questionnaire test: Quality of life measure by the pediatric quality of life questionnaire (PedsQL) to assess for participants perceived mental, physical and emotional health. Assessed once pre- and post-intervention.

    Measured: 30 minutes

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2025
  2. Study start26 Jun 2022
  3. Primary completion24 May 2024
  4. Study completion8 Oct 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
3 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07268287
Sponsor's protocol ID
H20-01177
Status last verified
Dec 2025
First submitted
18 Nov 2025
Last updated
5 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing 12-week Physiotherapy Intervention, 13C-Glucose Breath Test and Doubly labelled water & urine test in people with Metabolic Myopathies, run by University of British Columbia at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Glucose Oxidation (time frame: 4 Hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Dec 2025.

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