Vamorolone trial in Duchenne muscular dystrophy shows dose-related improvement of muscle function.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
24 09 2019
24 09 2019
Historique:
received:
26
10
2018
accepted:
29
05
2019
pubmed:
28
8
2019
medline:
19
2
2020
entrez:
28
8
2019
Statut:
ppublish
Résumé
To study vamorolone, a first-in-class steroidal anti-inflammatory drug, in Duchenne muscular dystrophy (DMD). An open-label, multiple-ascending-dose study of vamorolone was conducted in 48 boys with DMD (age 4-<7 years, steroid-naive). Dose levels were 0.25, 0.75, 2.0, and 6.0 mg/kg/d in an oral suspension formulation (12 boys per dose level; one-third to 10 times the glucocorticoid dose in DMD). The primary goal was to define optimal doses of vamorolone. The primary outcome for clinical efficacy was time to stand from supine velocity. Oral administration of vamorolone at all doses tested was safe and well tolerated over the 24-week treatment period. The 2.0-mg/kg/d dose group met the primary efficacy outcome of improved muscle function (time to stand; 24 weeks of vamorolone treatment vs natural history controls), without evidence of most adverse effects of glucocorticoids. A biomarker of bone formation, osteocalcin, increased in vamorolone-treated boys, suggesting possible loss of bone morbidities seen with glucocorticoids. Biomarker outcomes for adrenal suppression and insulin resistance were also lower in vamorolone-treated patients with DMD relative to published studies of glucocorticoid therapy. Daily vamorolone treatment suggested efficacy at doses of 2.0 and 6.0 mg/kg/d in an exploratory 24-week open-label study. This study provides Class IV evidence that for boys with DMD, vamorolone demonstrated possible efficacy compared to a natural history cohort of glucocorticoid-naive patients and appeared to be tolerated.
Identifiants
pubmed: 31451516
pii: WNL.0000000000008168
doi: 10.1212/WNL.0000000000008168
pmc: PMC7011869
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Biomarkers
0
Glucocorticoids
0
Prednisone
VB0R961HZT
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1312-e1323Subventions
Organisme : NIAMS NIH HHS
ID : R01 AR061875
Pays : United States
Organisme : NINDS NIH HHS
ID : R44 NS095423
Pays : United States
Organisme : NICHD NIH HHS
ID : U54 HD090254
Pays : United States
Informations de copyright
Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
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