Literature DB >> 28450193

Developing standardized corticosteroid treatment for Duchenne muscular dystrophy.

Michela Guglieri1, Kate Bushby2, Michael P McDermott3, Kimberly A Hart3, Rabi Tawil3, William B Martens3, Barbara E Herr3, Elaine McColl4, Jennifer Wilkinson4, Janbernd Kirschner5, Wendy M King3, Michele Eagle2, Mary W Brown3, Tracey Willis6, Deborah Hirtz7, Perry B Shieh8, Volker Straub2, Anne-Marie Childs9, Emma Ciafaloni3, Russell J Butterfield10, Iain Horrocks11, Stefan Spinty12, Kevin M Flanigan13, Nancy L Kuntz14, Giovanni Baranello15, Helen Roper16, Leslie Morrison17, Jean K Mah18, Adnan Y Manzur19, Craig M McDonald20, Ulrike Schara21, Maja von der Hagen22, Richard J Barohn23, Craig Campbell24, Basil T Darras25, Richard S Finkel26, Giuseppe Vita27, Imelda Hughes28, Tiziana Mongini29, Elena Pegoraro30, Matthew Wicklund31, Ekkehard Wilichowski32, W Bryan Burnette33, James F Howard34, Hugh J McMillan35, Mathula Thangarajh36, Robert C Griggs3.   

Abstract

Despite corticosteroids being the only treatment documented to improve strength and function in boys with Duchenne muscular dystrophy (DMD) corticosteroid prescription is inconsistent and in some countries, corticosteroids are not prescribed. We are conducting a clinical trial that (1) compares the 3 most frequently prescribed corticosteroid regimes; (2) standardizes treatment of DMD complications; and (3) standardizes prevention of corticosteroid side effects. Investigators at 38 sites in 5 countries plan to recruit 300 boys aged 4-7 who are randomly assigned to one of three regimens: daily prednisone; daily deflazacort; or intermittent prednisone (10days on/10days off). Boys are followed for a minimum of 3years to assess the relative effectiveness and adverse event profiles of the different regimens. The primary outcome is a 3-dimensional variable consisting of log-transformed time to rise from the floor, forced vital capacity, and subject/parent satisfaction with treatment, each averaged over all post-baseline visits. The study protocol includes evidence- and consensus-based treatment of DMD complications and of corticosteroid side effects. This study seeks to establish a standard corticosteroid regimen for DMD. Since all new interventions for DMD are being developed as add-on therapies to corticosteroids, defining the optimum regimen is of importance for all new treatments.
Copyright © 2017. Published by Elsevier Inc.

Entities:  

Keywords:  Deflazacort; Duchenne muscular dystrophy; Prednisolone; Randomized; Standards of care

Mesh:

Substances:

Year:  2017        PMID: 28450193      PMCID: PMC6279424          DOI: 10.1016/j.cct.2017.04.008

Source DB:  PubMed          Journal:  Contemp Clin Trials        ISSN: 1551-7144            Impact factor:   2.226


  39 in total

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Journal:  Neuromuscul Disord       Date:  2004-09       Impact factor: 4.296

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Journal:  Lancet Neurol       Date:  2009-11-27       Impact factor: 44.182

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Authors:  V Dubowitz; M Kinali; M Main; E Mercuri; F Muntoni
Journal:  Eur J Paediatr Neurol       Date:  2002       Impact factor: 3.140

9.  Clinical investigation in Duchenne dystrophy: 2. Determination of the "power" of therapeutic trials based on the natural history.

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Authors:  A Y Manzur; T Kuntzer; M Pike; A Swan
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Review 5.  Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management.

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Journal:  Lancet Neurol       Date:  2018-02-03       Impact factor: 44.182

6.  The effect of steroid treatment on weight in nonambulatory males with Duchenne muscular dystrophy.

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7.  Relationships between DMD mutations and neurodevelopment in dystrophinopathy.

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Review 8.  Targeting IRES-dependent translation as a novel approach for treating Duchenne muscular dystrophy.

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9.  Patients' and caregivers' maximum acceptable risk of death for non-curative gene therapy to treat Duchenne muscular dystrophy.

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Review 10.  Aberrant NLRP3 Inflammasome Activation Ignites the Fire of Inflammation in Neuromuscular Diseases.

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