McArdle Disease Clinical Trial
Official title:
Modified Ketogenic Diet in Patients With McArdle Disease Part A - a Pilot Study
McArdle disease, glycogen storage disease type V, is a rare metabolic disease. Affected
individuals are unable to utilize sugar stored as glycogen in muscle.
We hypothesize that a modified ketogenic diet could be a potential treatment option, by
providing ketones as alternative fuel substrates for working muscle.
In this open interventional pilot study we wish to investigate 3 different modified ketogenic
diet regimes, to find an optimal composition of a modified ketogenic diet that ensures
adequate degree of ketosis and at the same time is well tolerated for patients with McArdle
disease.
Open interventional study to investigate 3 different modified ketogenic diet regimes, to find
an optimal composition of a modified ketogenic diet for patients with McArdle disease
McArdle disease, glycogen storage disease type V, is a rare metabolic disease caused by
mutations in the PYGM gene resulting in absence of the enzyme muscle phosphorylase. Affected
individuals are unable to utilize sugar stored as glycogen in muscle, leading to exercise
intolerance, exercise-induced muscle pain, contractures and rhabdomyolysis, which may cause
renal failure. Currently, there are no satisfactory treatment options for McArdle disease.
Ketones are feasible fuel alternatives to muscle glycogen when muscle glycogenolysis is
blocked as in McArdle disease.
A key element of alleviating symptoms in McArdle disease is to provide alternative fuels for
energy metabolism. Ketosis can potentially provide alternative fuel substrates by provision
of endogenous ketone bodies (KBs) which are desirable fuels for skeletal muscle and brain.
Ketosis can be reached by fasting and can be induced by adhering to a modified ketogenic
diet, which entails a high-fat, low-carbohydrate diet, which simulates the metabolic effects
of fasting.
The optimal modified ketogenic diet composition, that ensures adequate degree of ketosis and
at the same time is well tolerated, has not been investigated in patients with McArdle
disease. Therefore this pilot study seeks to investigate which of 3 different diets is the
most optimal ad effective for patients with McArdle disease. The 3 different diets will have
carbohydrate percentages ranging from 5-25%, and fat percentage from 60-80%.
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