Clinical trial NCT04322357: Twice Weekly Steroids and Exercise as Therapy for DMD
Official title: Impact and Interplay of Corticosteroid Regimen and Exercise Training on DMD Muscle Function
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: PHASE2
Conditions: Duchenne Muscular Dystrophy (DMD)
Keywords: steroid side effects, low dose steroid regimen, exercise training therapy
Lead sponsor: University of Florida
Sponsor class: OTHER
Collaborators: name: U.S. Army Medical Research and Development Command
First posted: 2020-03-26
Enrollment: 89
Sex: MALE
Minimum age (years): 5
Maximum age (years): 9
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

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.


Eligibility criteria: 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

Primary outcomes:
measure: Change in BMI
timeFrame: Baseline up to 12 months
Secondary outcomes:
Other outcomes:
Locations:
city: Gainesville
country: United States
facility: University of Florida
state: Florida
Study officials:
affiliation: University of Florida
name: Tanja Taivassalo, MD
role: PRINCIPAL_INVESTIGATOR
References: