CoQ10 and Prednisone in Non-Ambulatory DMD

Condition(s) targeted: Duchenne Muscular Dystrophy

Intervention: Prednisone (Drug); Coenzyme Q10 (Dietary Supplement)

Phase: Phase 3

Status: Suspended

Sponsored by: Cooperative International Neuromuscular Research Group

Official(s) and/or principal investigator(s):
Paula R Clemens, M.D., Study Chair, Affiliation: University of Pittsburgh

This study will help determine if CoQ10 and prednisone, alone and as a combination decrease the decline in cardiopulmonary and skeletal muscle function that occurs in the wheelchair confined phase of DMD. Participants who are enrolled in this study should not have taken any corticosteroids within the last six months. This is a 13-month, prospective, randomized study comparing a daily prednisone arm (0. 75mg/kg/day), a CoQ10 arm (serum of greater than 2. 5 ug/mL) and a combination arm (prednisone and CoQ10) with an enhanced standard of care arm in wheelchair confined males age 10 to 18 years with an established DMD diagnosis.

Official title: PITT0503: Clinical Trial of Coenzyme Q10 and Prednisone in Duchenne Muscular Dystrophy

Study design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study

Primary outcome:

Pulmonary function and quantitative muscle strength will be measured using the CINRG Quantitative Measurement System (CQMS).

The CQMS is a modification of the Tufts Quantitative Neuromuscular Testing Equipment designed for adult neuromuscular studies.

Cardiac function will be measured by echocardiogram.

Secondary outcome: Compare side effect profiles of the three study groups.

Detailed description: Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy affecting 1: 3500 male births worldwide. Despite an increase in our understanding of the disorder since the discovery and characterization of the causative gene and its product dystrophin in 1987, current therapeutic management remains largely supportive. Improvement in the treatment of DMD will depend upon the development of better therapies. Affected boys become symptomatic at 3 to 5 years of age with proximal leg weakness that impairs mobility, ability to get up from a squat, and precludes a normal ability to run. By 8 years of age, some affected boys begin to lose the ability to walk and resort to a wheelchair for mobility. This shift from the ambulant to non-ambulant phase occurs in all boys with a diagnosis of DMD by age 12 years. In this study, participants will be randomized into groups after being screened to determine eligibility. Participants will then be followed for a 12-month investigation period.

Minimum age: 10 Years. Maximum age: 18 Years. Gender(s): Male.

Criteria:

Inclusion Criteria:

- Age 10-18 years

- Non-ambulatory (primary mode of transportation is via wheelchair for 3 years or less)

- Confirmed DMD diagnosis

- Steroid-naive for the 6 months prior to screening

- Stable dose of b-blocker or ACE inhibitor medication for the 6 months prior to

screening, if taking either of these medications

- Ability to provide reproducible repeat QMT grip score within 15% of first assessment

score

- Has not participated in other therapeutic research protocol within the last 6 months

prior to screening

- Ability to swallow tablets

Exclusion Criteria:

- Failure to achieve one or more of the diagnostic inclusion criteria cited above

- Symptomatic DMD carrier

- Use of carnitine, other amino acids, creatine, glutamine, CoQ10 or any herbal

medicines (this would not include herbal teas unless they are consumed daily with intended medicinal effect) within the last 3 months

- History of significant concomitant illness or significant impairment of renal or

hepatic function, or other contraindication to steroid therapy

- Positive PPD

- No prior exposure to chickenpox and no immunization against chicken pox

- Baseline serum CoQ10 level of 5. 0mg/ml or greater

University of Puerto Rico, Medical Sciences Campus, San Juan 00936, Puerto Rico

Children's National Medical Center, Washington, District of Columbia 20010, United States

University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States

Royal Children's Hospital, Melbourne, Victoria 3052, Australia

Starting date: March 2006
Ending date: December 2010
Last updated: June 9, 2008