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Safety, Tolerability and Effects of L-Arginine in Boys With Dystrophinopathy on Corticosteroids

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Namita Goyal, Massachusetts General Hospital
ClinicalTrials.gov Identifier:
NCT01388764
First received: July 5, 2011
Last updated: June 30, 2012
Last verified: June 2012
History of Changes
  Purpose

The purpose of the study is to assess the safety, tolerability, and effects of L-Arginine on muscles in boys with dystrophinopathy on corticosteroids. Specifically, to see if L-arginine reduces muscle signal abnormalities on MRI done pre and post 30 days of L-arginine administration.


Condition Intervention Phase
Dystrophinopathy
Duchenne Muscular Dystrophy
Becker's Muscular Dystrophy
 Drug: L-arginine
 Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Official Title: Pilot Study: To Assess the Safety, Tolerability and Effects of L-Arginine on Muscles in Boys With Dystrophinopathy on Corticosteroids

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • MRI/MRS of calf muscle [ Time Frame: Day 0 and Day 30 ] [ Designated as safety issue: No ]
    MRI/MRS will be performed of the calf muscle in all subjects (N=8) to assess muscle signal abnormalities on MRI and creatine levels on MRS, done at the start of the study (Day 0) and at the end of the study (Day 30), after 30 days of L-arginine administration.


Secondary Outcome Measures:
  • Blood tests [ Time Frame: Day 0 and Day 30 ] [ Designated as safety issue: Yes ]
    We will obtain safety labs [complete blood count (CBC) and comprehensive metabolic panel (CMP)] from all subjects (N =8), at day 0 and day 30, after 30 days of oral L-argninine administration.

  • Assessment of muscle strength and function [ Time Frame: Day 0 and Day 30 ] [ Designated as safety issue: No ]
    Measurements of upper and lower extremity strength will be performed using a hand-held dynamometer. Functional tests will also be performed which include time to walk specified distances and time to climb stairs.

  • Pulmonary function tests [ Time Frame: Day 0 and Day 30 ] [ Designated as safety issue: No ]
    Subjects will have pulmonary function studies to assess forced vital capacity


Enrollment: 7
Study Start Date: January 2012
Study Completion Date: May 2012
Primary Completion Date: May 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: L-arginine Drug: L-arginine
Subjects will receive oral L-Arginine (0.3 grams/kg/day, divided 2 times per day, not to exceed 14 grams/day)

Detailed Description:

Dystrophinopathy is a muscular dystrophy (includes Duchenne or Becker's Muscular Dystrophy) that can be a lethal muscle disorder resulting from defects in the gene for dystrophin, a structural protein required to maintain muscle integrity. Absence of functional dystrophin leaves the muscle membrane vulnerable to damage during contraction. This damage can be exacerbated by an inflammatory response leading to myofiber necrosis.

L-arginine is a widely available dietary supplement amino acid postulated to affect dystrophinopathy in several favorable ways: upregulation of utrophin, vasodilation in muscle via nitric oxide, enhanced synthesis of creatine, increase levels of growth hormone.

We hypothesize that administration of L-arginine may increase levels of creatine and growth hormone and in turn reduce the extent of myofiber damage in our patients with dystrophinopathy

  Eligibility

Ages Eligible for Study:   7 Years to 11 Years
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Confirmation of diagnosis of dystrophinopathy, documented by clinical exam and dystrophin DNA mutation analysis
  • Ambulatory male subjects between the ages of 7-11 years
  • Stable dosage of corticosteroids for 3 months prior to entry (Screening/Baseline Day 0) and during treatment period
  • Able to follow instructions and give assent
  • Able to complete nonsedated MR

Exclusion Criteria:

  • Presence of metallic orthopedic hardware in the lower extremity that could affect MRI/MRS measurements
  • Routine MRI exclusion criteria such as the presence of a pacemaker, cochlear implant, or cerebral aneurysm clip
  • Subjects not capable of cooperating during MR examination
  • Known hypersensitivity to L-arginine
  • Exposure to another investigational agent, investigational supplements, growth hormone within 3 months prior to entry (Screening/Baseline Day 0) or during treatment period
  • Subjects must not be taking L-arginine for at least 4 weeks prior to entry (Day 0)
  • Subjects who are non-ambulatory or with daytime ventilatory dependence
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01388764

Locations
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Massachusetts General Hospital
Investigators
Principal Investigator: Namita Goyal, MD Massachusetts General Hospital
  More Information

No publications provided

Responsible Party: Namita Goyal, Physician Neurologist, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT01388764     History of Changes
Other Study ID Numbers: 2011D001591
Study First Received: July 5, 2011
Last Updated: June 30, 2012
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by Massachusetts General Hospital:
L-arginine supplement study

Additional relevant MeSH terms:
Muscular Dystrophy, Duchenne
Muscular Dystrophies
Muscular Disorders, Atrophic
Muscular Diseases
Musculoskeletal Diseases
 Neuromuscular Diseases
Nervous System Diseases
Genetic Diseases, X-Linked
Genetic Diseases, Inborn

ClinicalTrials.gov processed this record on May 21, 2013