A 24-year-old woman from York has become one of the first patients worldwide to participate in a groundbreaking gene therapy trial that could halt the progression of facioscapulohumeral muscular dystrophy (FSHD), a rare and incurable muscle-weakening disorder. The landmark FORTITUDE study, conducted at Sheffield Teaching Hospitals NHS Foundation Trust, represents the first attempt to target the underlying genetic cause of this devastating condition.
Lauren Clarke, who was diagnosed with FSHD at age 14, can no longer stand for prolonged periods and struggles with daily activities such as washing her hair. "I'm trying not to get excited but there's a possibility this gene therapy could improve my condition. I feel very fortunate to have this chance," Clarke said.
Revolutionary Gene Silencing Approach
The therapy, developed by Avidity Biosciences Ltd, USA, is the first to target the DUX4 gene, which is widely viewed as the trigger for muscle weakness and degeneration in FSHD patients. FSHD is caused by the activation of an abnormal gene that increases the toxic build-up of the DUX4 protein in muscle cells, resulting in loss of strength in the face, shoulders, arms, legs, and hands.
By silencing the DUX4 gene, researchers believe they can disrupt the disease's progression and improve outcomes for patients. There are currently no approved drug treatments for the condition, making this trial particularly significant for the FSHD community.
Promising Early Results
Preliminary data from the first phase of the study, which commenced last year, showed "unprecedented" and "consistent reduction" of the DUX4 regulated genes in a small number of patients at the four-month timepoint, along with indications of functional improvement. These early results have generated considerable optimism among researchers and patients alike.
The randomized, placebo-controlled trial will enroll up to 100 FSHD patients across the world, with participants randomly assigned to receive either the experimental drug or a placebo.
Global Research Initiative
Sheffield Teaching Hospitals NHS Foundation Trust is one of only two non-American centers in the world and the only UK site in the North of England recruiting eligible patients into the trial. The study is being supported by the Sheffield National Institute for Health and Care (NIHR) Clinical Research Facility.
Dr. Channa Hewamadduma, Principal investigator and Lead Neuromuscular Consultant Neurologist at Sheffield Teaching Hospitals NHS Foundation Trust, emphasized the significance of the research: "Our neuromuscular team are delighted to be bringing this hugely exciting research to the UK for the benefit of patients in the North of England and beyond. This is another milestone in our leading role in pioneering the promise of 'gene silencing' as a way to treat people living with inherited neuromuscular conditions previously thought to be incurable."
Disease Impact and Patient Experience
FSHD is the third most common inherited muscle disease and is estimated to affect between 2,000-2,500 people in the UK. For Clarke, the condition has progressively impacted her quality of life since her university years.
"I'm slow to walk now. I struggle to wash my hair and put my hair up. There are things I can still do, but it's hard to go upstairs and there's a lot of overcompensation and funkier movements. When I go out to late-night bars people think I'm intoxicated because I walk funny. It's an invisible illness and I'm at the point where it's quite 'bad,'" Clarke explained.
The FORTITUDE trial offers hope not only for current participants but also for the broader FSHD community, as it represents a potential breakthrough in treating a condition that has long been considered incurable. Clinical trials like this provide patients with rare genetic neuromuscular disorders access to cutting-edge gene modifying treatments before they reach standard healthcare systems.
