MedPath

Twice Weekly Steroids and Exercise as Therapy for DMD

Phase 2
Active, not recruiting
Conditions
Duchenne Muscular Dystrophy (DMD)
Interventions
Behavioral: In-home Exercise Training
Registration Number
NCT04322357
Lead Sponsor
University of Florida
Brief Summary

The study team will determine the potential of low dose twice weekly prednisone and whether exercise training can synergize to delay disease progression and improve muscle strength/physical function in boys with Duchenne muscular dystrophy (DMD). Current standard of care (daily prednisone) is associated with adverse side effects. Evidence from DMD mouse models suggest that weekly dosing provides same efficacy without side effects. Appropriate exercise may also benefit but this area has not been adequately explored.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Male
Target Recruitment
89
Inclusion Criteria
  • Diagnosis of DMD confirmed by 1) clinical history with features before the age of five, 2) physical examination, 3) elevated serum creatine kinase level and 4) absence of dystrophin expression, as determined by immunostain or Western blot (<2%) and/or DNA confirmation of dystrophin mutation.
  • Age 5.0 to 9 years: a lower age limit of 5.0 years is selected as children younger than that are likely unable to cooperate and comply with all of the exercise measures as needed. An upper age limit of 9 years has been set as boys with DMD tend to reach a rapid progression into a late ambulatory phase soon after this age.
  • Ambulatory at the time of the first visit, defined as the ability to walk for at least 100 m without an external assistive device and able to climb four stairs.
  • Aim 1 only: GC-naïve at baseline (and prior 6 months)
  • Aim 2 only: on stable daily GC regimen for 6 months prior to baseline
Exclusion Criteria
  • Contraindication to an MR examination (e.g. aneurysm clip, severe claustrophobia, magnetic implants)
  • Presence of unstable medical problems, significant concomitant illness including cardiomyopathy or cardiac conduction abnormalities
  • Presence of a secondary condition that impacts muscle function or muscle metabolism (e.g. myasthenia gravis, endocrine disorder, mitochondrial disease)
  • Presence of a secondary condition leading to developmental delay or impaired motor control (e.g. cerebral palsy)
  • Presence of an unstable medical condition (e.g. uncontrolled seizure disorder)
  • Behavioral problems causing an inability to cooperate during testing or understand exercise instruction
  • Participation in other forms of drug or gene therapy during the period of the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Daily glucocorticoid with exerciseIn-home Exercise TrainingPatients on daily glucocorticoids will undergo 6 months of structured, supervised and home-based exercise training.
Daily glucocorticoid with exercisePrednisone plus exercisePatients on daily glucocorticoids will undergo 6 months of structured, supervised and home-based exercise training.
Twice weekly glucocorticoid with or without exercisePrednisonePatients will be randomized to one of 2 groups: * Twice weekly prednisone alone for 12 months * Twice weekly prednisone for 6 months followed by twice weekly prednisone plus 6 months of structured, supervised and home-based exercise training.
Daily glucocorticoid with exercisePrednisonePatients on daily glucocorticoids will undergo 6 months of structured, supervised and home-based exercise training.
Primary Outcome Measures
NameTimeMethod
Change in BMIBaseline up to 12 months

Participant body mass index change (weight and height will be combined to report BMI in kg/m\^2) over the course of one year

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University of Florida

🇺🇸

Gainesville, Florida, United States

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