Clinical Intramuscular Gene Transfer of rAAV1.CMV.huFollistatin344 Trial to Patients With Duchenne Muscular Dystrophy

The primary objective of this study is safety and endpoints will include hematology, serum
chemistry, urinalysis, immunologic response to rAAV1 and follistatin, and reported history
and observations of symptoms. Efficacy measures will be used as secondary outcomes and
include the distance walked on the 6MWT, functional tests by PT, life quality questionnaire,
MRI, EIM, and muscle biopsy. Subject will have follow up visits on days 7, 14, 30, 45, 60,
90, 180 and 9,12, 18 and 24 months post-gene transfer.

Inclusion Criteria:

- Age 7 or older

- Confirmed DMD gene mutations

- Impaired muscle function based on clinical evidence including difficulty climbing
stairs, getting from the floor (Gowers' sign), and weakness of individual muscles of
extremities

- Males of any ethnic group will be eligible

- Ability to cooperate with study procedures including muscle testing.

- Willingness of sexually active subjects with reproductive capacity to practice
reliable method of contraception

- Subjects must be on stable dose of prednisone for three months at time of enrollment
or be started on oral dose of daily prednisone regimen for 30 days prior to gene
transfer. Study participants will continue prednisone post gene transfer unless there
is adverse event that warrants prednisone taper or withdrawal.

Exclusion Criteria:

- Active viral infection based on clinical observations.

- The presence of a DMD gene mutation without weakness or loss of function

- Symptoms or signs of cardiomyopathy, including:

- Dyspnea on exertion, pedal edema, shortness of breath upon lying flat, or rales at the
base of the lungs

- Echocardiogram with ejection fraction below 40%

- Serological evidence of HIV infection, or Hepatitis A, B or C infection

- Diagnosis of (or ongoing treatment for) an autoimmune disease

- Concomitant illness or requirement for chronic drug treatment that in the opinion of
the PI creates unnecessary risks for gene transfer

- Subjects with rAAV1 binding antibody titers > 1:50 as determined by ELISA immunoassay

- Abnormal laboratory values for liver, kidney, CBC, in the clinically significant
range, based upon normal values in the Nationwide Children's Hospital Laboratory