Muscular Dystrophy, Duchenne Clinical Trial
Official title:
An Open-Label Pilot Study of Pentoxifylline in Steroid-naive Duchenne Muscular Dystrophy
In this study, the primary aim will be to estimate the magnitude and variability of strength change over time that may be expected for subjects on the study treatment. This estimate of effect will allow us to develop a rigorous statistical plan in the future randomized study. The specific estimation technique to be applied will use a linear random effects model to estimate average strength change during the 3-month lead-in period and then during the twelve-month treatment period, taking into account the quantitative muscle testing (QMT) measures for each subject. Accounting for the correlation between repeated measures from each subject by using a random effects model will yield an unbiased estimate of variability for the population average change in strength. We will use an analysis of pre- and post-treatment data to inform a best estimate of treatment effect. For example, the difference in QMT trends pre- and post-treatment would provide a straightforward measure of efficacy.
Duchenne muscular dystrophy (DMD) is a progressive disease of skeletal muscle caused by the
absence of dystrophin due to a genetic mutation in the x-linked dystrophin gene. The absence
of dystrophin results in a fragile muscle membrane that permits an abnormal permeability to
electrolytes, especially Ca ++. The increase in intracellular calcium triggers a
pathological cascade of events that ultimately results in muscle necrosis and fibrosis,
which impedes normal muscle regeneration. The increased knowledge of the pathophysiology of
DMD opens the opportunity for pharmacological treatment, with the purpose of altering the
disease process and or reverting the muscle degeneration.
This research study requires having Duchenne muscular dystrophy (DMD) and the subject to be
between 4 and 7 years old. We expect 5 children to take part in this study at Children's
Hospital and 10 other children to participate at other hospitals worldwide.
There will be two (2) screening visits to help decide whether you will be able to
participate in the study. At the second screening visit, there will be a blood test (about
13 tablespoons of blood), and an EKG. Once the study doctors decide eligibility to be in the
study, the subject will then come back once a month for three months to have his strength
tested. After three months, the subject will begin to take the pentoxifylline and have an
MRI (you will have a test called an MRI to look inside the muscles of your legs). This will
continue for 12 months.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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