Dysferlinopathy Clinical Trial
Official title:
Deflazacort in Dysferlinopathies (LGMD2B/MM) - a Double Blind, Placebo-controlled Clinical Study
The present study is designed to assess the natural history in a one year pre-phase of the trial and evaluate therapeutic efficacy and side effects of deflazacort in LGMD2B/MM patients in a placebo-controlled trial. Furthermore, long-term development of the disease under naturalistic conditions will be documented in a 2-year follow-up after the end of the double-blind treatment phase.
Limb girdle muscular dystrophies (LGMDs) are a genetically heterogeneous group of disorders
encompassing various genetically defined subtypes (LGMD 2A-2H). Therapeutic trials should
address each disease entity separately to assess effectiveness of medical treatments. A
placebo-controlled trial in patients with dysferlinopathy may reveal insights in the natural
course of the disease and show therapeutic options in a homogeneous group of patients. So
far, steroids are the only drugs showing efficacy in muscular dystrophies, mainly in
Duchenne muscular dystrophy (DMD). Both dystrophin and dysferlin are attached to the
sarcolemma and deficiency of both proteins cause sarcolemmal defects; therefore, any
membrane-stabilizing steroid effect may be beneficial in both DMD and LGMD2B/ Myoshi
myopathy (MM). Furthermore, there is marked inflammation in muscle biopsies of many LGMD2B
patients. Therefore, the anti-inflammatory effect of steroids may improve muscle function in
LGMD2B/MM. In our trial, effects of deflazacort in patients with dysferlinopathy (LGMD2B/MM)
on strength and daily-life activities are addressed. The present study is designed to assess
the natural history and evaluate therapeutic efficacy and side effects of deflazacort /
placebo in LGMD2B/MM patients.
Although no major therapeutic breakthrough has been achieved and curative treatment
modalities are not yet applicable, life expectancy and quality of life of dysferlinopathy
patients could be remarkably improved by establishing a drug therapy, capable of delaying
the dystrophic process and improving muscle strength and function. Therefore, the results of
this study are warranted and may influence further guidelines for steroid treatment in
dysferlinopathies. Furthermore, the assessment of the natural history of the disease will
provide new insights in the clinical understanding of dysferlinopathies.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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