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



Status:Completed
Conditions:Neurology
Therapuetic Areas:Neurology
Healthy:No
Age Range:5 - Any
Updated:10/18/2017
Start Date:October 26, 2011
End Date:November 4, 2013

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An Exploratory Study to Assess Two Doses of GSK2402968 in the Treatment of Ambulant Boys With Duchenne Muscular Dystrophy

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.

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.

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
We found this trial at
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Portland, Oregon 97227
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Baltimore, Maryland 21201
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Cincinnati, Ohio 45229
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Columbus, Ohio 43219
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Dallas, Texas 75230
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Durham, North Carolina 27705
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Gulf Breeze, Florida 32561
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Iowa City, Iowa 52242
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Iowa City, IA
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Kansas City, Kansas 66160
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Minneapolis, Minnesota 55404
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New York, New York 10032
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Sacramento, California 95815
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Saint Louis, Missouri 63110
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Saint Louis, MO
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Stanford, California 94305
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Stanford, CA
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