A Clinical Study to Assess Two Doses of GSK2402968 in Subjects With Duchenne Muscular Dystrophy (DMD) (DMD114876)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
GlaxoSmithKline
ClinicalTrials.gov Identifier:
NCT01462292
First received: October 3, 2011
Last updated: April 17, 2014
Last verified: April 2014
  Purpose

The purpose of this study is to determine if GSK2402968 is effective in the treatment of ambulant boys with Duchenne muscular dystrophy resulting from a mutation thought to be corrected by exon 51 skipping. Two doses of GSK2402968 and placebo will be used in this study.


Condition Intervention Phase
Muscular Dystrophies
Drug: GSK2402968 3mg/kg/week
Drug: GSK2402968 6 mg/kg/week
Drug: Placebo to match GSK2402968 3 mg/kg/week
Drug: Placebo to match GSK2402968 6 mg/kg/week
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: An Exploratory Study to Assess Two Doses of GSK2402968 in the Treatment of Ambulant Boys With Duchenne Muscular Dystrophy (DMD)

Resource links provided by NLM:


Further study details as provided by GlaxoSmithKline:

Primary Outcome Measures:
  • Mean change from baseline to week 24 in the 6 Minute Walk Distance Test [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Timed Function tests (times and grading) [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Muscle Strength [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • North Star Ambulatory Assessment Scores [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Clinician Global Impression of Improvement [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  • Measurement of dystrophin expression via muscle biopsy analysis [ Time Frame: 36 weeks ] [ Designated as safety issue: No ]
  • Frequency of accidental falls during 6 Minute Walk Distance test [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  • Creatine kinase Serum concentrations [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]
  • Pulmonary Function [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Functional Outcomes Survey [ Time Frame: 48 weeks ] [ Designated as safety issue: No ]

Enrollment: 51
Study Start Date: October 2011
Study Completion Date: November 2013
Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: GSK2402968 3 mg/kg/week
3 mg/kg/week of investigational product
Drug: GSK2402968 3mg/kg/week
Comparison of 2 doses of GSK2402968
Experimental: GSK2402968 6 mg/kg/week
6 mg/kg/week of investigational Product
Drug: GSK2402968 6 mg/kg/week
Comparison of 2 doses of GSK2402968
Experimental: Placebo to match GSK2402968 3 mg/kg/week
Placebo
Drug: Placebo to match GSK2402968 3 mg/kg/week
Matched placebo
Experimental: Placebo to match GSK2402968 6 mg/kg/week
Placebo
Drug: Placebo to match GSK2402968 6 mg/kg/week
Matched Placebo

Detailed Description:

Boys with Duchenne Muscular Dystrophy (DMD) suffer from a relentless, progressive and fatal disease due to lack of dystrophin, a critical muscle protein. There is currently no known cure for the disease. GSK2402968 is thought to correct several genetic mutations through skipping of exon 51 and therefore targets only those boys with these mutations.

A reasonable hypothesis is that increasing dystrophin will result in clinical improvement, and that the amount of dystrophin expressed will correlate with clinical improvement above a threshold level (e.g. around 30% of control). The initial limited efficacy data from completed and ongoing unblinded studies with GSK2402968 are encouraging as they have demonstrated de novo production of dystrophin and improved walking ability (primary efficacy endpoint) after 48 weeks of treatment which has been generally well tolerated.

This study is designed to explore the efficacy, safety and pharmacokinetics of two doses of GSK2402968 given over 24 weeks. The two doses to be assessed are 6mg/kg/week and 3mg/kg/week. Based on pharmacokinetic and pharmacodynamic modeling, it is predicted at steady-state that the 6 mg/kg/week dose will induce dystrophin expression greater than 30% of control. The 3 mg/kg/week dose was chosen as modeling predicts 3 mg/kg/week of GSK2402968 will produce dystrophin expression in the range of 18-22%. Potential variability between subjects could theoretically produce higher expression and lead to a dystrophin level correlated with clinical improvement.

Following the treatment period, the study has a 24 week post-treatment phase. The purpose of the post-treatment phase is to model the half-life of dystrophin, assess maintenance of response, and provide information about resolution of adverse event and laboratory abnormalities following cessation of treatment.

  Eligibility

Ages Eligible for Study:   5 Years and older
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Ambulant subjects with Duchenne muscular dystrophy (DMD) resulting from a mutation/deletion within the DMD gene, confirmed by a state-of-the-art DNA diagnostic technique covering all DMD gene exons, including but not limited to MLPA (Multiplex Ligation-dependent Probe Amplification), CGH (Comparative Genomic Hybridisation), SCAIP (Single Condition Amplification/Internal Primer) or H-RMCA (High-Resolution Melting Curve Analysis), and correctable by GSK2402968-induced DMD exon 51 skipping
  • Males, aged at least 5 years,
  • Life expectancy of at least 1 year,
  • Able to rise from floor in < or =15 seconds (without aids/orthoses) at Screening Visit 1 and Screening Visit 2,
  • Able to complete 6 Minute Walk Distance (6MWD) test with minimal distance of at least 75 meters, with reproducible results (within 20% of each other) at Screening Visit 1, Screening Visit 2 and at the baseline visit prior to randomization,
  • Receiving oral glucocorticoids for a minimum of 6 months immediately prior to screening, with no significant change in total daily dosage or dosing regimen for a minimum of 3 months immediately prior to screening and a reasonable expectation that total daily dosage and dosing regimen will not change significantly for the 48 week duration of the study (Dose adjustments that are based on weight changes are permitted),
  • QTc <450msec (based on single or average QTc value of triplicate ECGs obtained over a brief recording period), or <480 msec for subjects with Bundle Branch Block. Note: QTc may be either QTcB or QTcF, and machine read or manual overread
  • Willing and able to comply with all protocol requirements and procedures,
  • Able to give informed assent and/or consent in writing signed by the subject and/or parent(s)/legal guardian (according to local regulations).

Exclusion Criteria:

  • Any additional missing exon for DMD that cannot be treated with GSK2402968,
  • Current or history of liver disease or impairment including :

    1. an INR vaue above 1.5 is in and of itself exclusionary
    2. a total bilirubin greater than 2 times the Upper Limit of Normal is in and of itself exclusionary
    3. a GGT greater than 2 times the Upper Limit of Normal is in and of itself exclusionary
  • Current or history of renal disease or impairment,
  • Baseline platelet count below the Lower Limit of Normal,
  • aPPT above the Upper Limit of Normal,
  • History of significant medical disorder which may confound the interpretation of either efficacy or safety data e.g. inflammatory disease
  • Acute illness within 4 weeks of the first anticipated administration of study medication which may interfere with study assessments,
  • Use of anticoagulants, antithrombotics or antiplatelet agents, previous treatment with investigational drugs, idebenone or other forms of Coenzyme Q10 within 1 month of the first administration of study medication,
  • Current or anticipated participation in any investigational clinical studies,
  • Positive hepatitis B surface antigen, hepatitis C antibody test (if verified via RIBA or PCA testing), or human immunodeficiency virus (HIV) test at screening,
  • Symptomatic cardiomyopathy. If subject has a left ventricular ejection fraction <45% at Screening, the investigator should discuss inclusion of subject in the study with the medical monitor,
  • Children in Care. The definition of a Child in Care is a child who has been placed under the control or protection of an agency, organisation, institution or entity by the courts, the government or a government body, acting in accordance with powers conferred on them by law or regulation. The definition of a child in care can include a child cared for by foster parents or living in a care home or institution, provided that the arrangement falls within the definition above. The definition of a child in care does not include a child who is adopted or has an appointed legal guardian
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01462292

Locations
United States, California
GSK Investigational Site
Sacramento, California, United States, 95817
GSK Investigational Site
Stanford, California, United States, 94305
United States, Florida
GSK Investigational Site
Gulf Breeze, Florida, United States, 32561
United States, Iowa
GSK Investigational Site
Iowa City, Iowa, United States, 52242
United States, Kansas
GSK Investigational Site
Kansas City, Kansas, United States, 66160
United States, Maryland
GSK Investigational Site
Baltimore, Maryland, United States, 21205
United States, Minnesota
GSK Investigational Site
Minneapolis, Minnesota, United States, 55455
United States, Missouri
GSK Investigational Site
St. Louis, Missouri, United States, 63110
United States, New York
GSK Investigational Site
New York, New York, United States, 10032
United States, North Carolina
GSK Investigational Site
Durham, North Carolina, United States, 27710
United States, Ohio
GSK Investigational Site
Cincinnati, Ohio, United States, 45229
GSK Investigational Site
Columbus, Ohio, United States, 43205
United States, Oregon
GSK Investigational Site
Portland, Oregon, United States, 97239
United States, Texas
GSK Investigational Site
Dallas, Texas, United States, 75207
Sponsors and Collaborators
GlaxoSmithKline
Investigators
Study Director: GSK Clinical Trials GlaxoSmithKline
  More Information

No publications provided

Responsible Party: GlaxoSmithKline
ClinicalTrials.gov Identifier: NCT01462292     History of Changes
Other Study ID Numbers: 114876
Study First Received: October 3, 2011
Last Updated: April 17, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by GlaxoSmithKline:
968
Duchenne Muscular Dystrophy
GSK2402968
DMD
Duchenne
GSK

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 August 28, 2014