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Study is no longer necessary given the safety and efficacy of emflaza in this age range has already been established after review of already available data.
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The primary objective of this study is to evaluate the safety of a 0.9 milligrams per kilogram (mg/kg) and 0.45 mg/kg daily dose of deflazacort with a comparable natural history control group after 52 weeks of treatment in males with DMD aged greater than or equal to (>=) 2 to lesser than (<) 5 years.
The study will comprise of 2 periods (Period 1: 52-week safety and pharmacokinetics [PK], and Period 2: 52-week extension). Participants will be randomized in a 1:1 ratio to one of 2 treatment arms: 0.9 mg/kg deflazacort, and 0.45 mg/kg of deflazacort. A historic control group (which should match the study population as closely as possible) will be used as a comparator to characterize the safety and tolerability of deflazacort.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm A: Deflazacort 0.9 mg/kg | Experimental | Participants will receive approximately 0.9 mg/kg deflazacort once daily orally for 52 weeks in Period 1 and for 52 weeks in Period 2. The target dose could be varied +/- 20 percent (%) depending upon the available tablet strengths and change in participant's weight. |
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| Arm B: Deflazacort 0.45 mg/kg | Experimental | Participants will receive approximately 0.45 mg/kg deflazacort once daily orally for 52 weeks in Period 1. Participants will either continue to receive 0.45 mg/kg deflazacort or escalated dose of deflazacort (0.9 mg/kg) once daily orally in Period 2 at the investigator's discretion and in consultation with the caregiver. The target dose could be varied +/- 20% depending upon the available tablet strengths and change in participant's weight. |
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| Natural History Control Group | No Intervention | Control participants matching to the study population as closely as possible, will be used as a comparator to characterize the safety and tolerability of deflazacort. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Deflazacort | Drug | Deflazacort tablets will be administered as per schedule and dose specified in respective arms. |
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| Measure | Description | Time Frame |
|---|---|---|
| Period 1 and 2: Number of Participants With Treatment Emergent Adverse Events (TEAEs) | 52 weeks | |
| Period 1 and 2: Change From Baseline in Vital Signs and Electrocardiogram (ECG) at Week 52 | Baseline, Week 52 | |
| Period 1 and 2: Change From Baseline in the Child Behavior Checklist Score at Week 52 | Baseline, Week 52 | |
| Period 1 and 2: Change From Baseline in the Normalized Measure of Bone Density Change (Z-score) for the Dual Energy X-ray Absorptiometry (DEXA) at Week 52 | Baseline, Week 52 | |
| Period 1 and 2: Mean Change From Baseline in Height at Week 52 | Baseline, Week 52 | |
| Period 1 and 2: Mean Change From Baseline in Body Weight at Week 52 | Baseline, Week 52 | |
| Period 1 and 2: Mean Change From Baseline in Height Percentile for Age at Week 52 | Baseline, Week 52 | |
| Period 1 and 2: Number of Participants With Clinically Significant Laboratory Tests | 52 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Period 1: Peak Plasma Concentration (Cmax) of Deflazacort | Pre-dose, 0.25, 2, 4, and 6 hours post-dose at Baseline (Week 1) and Week 13 | |
| Period 1: Area Under the Curve (AUC) of Deflazacort | Pre-dose, 0.25, 2, 4, and 6 hours post-dose at Baseline (Week 1) and Week 13 |
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Inclusion Criteria:
Exclusion Criteria:
The participant has received 4 weeks or more of continuous corticosteroid therapy within 3 months of study screening visit.
The participant has, in the judgment of the Investigator, clinically significant abnormal clinical laboratory parameters at screening or baseline that may affect safety.
The participant has, in the judgment of the Investigator, a history or current medical condition that could affect safety including, but not limited to:
The participant has a history of hypersensitivity or allergic reaction to steroids or their formulations including, but not limited to lactose, sucrose, etc.
The participant has received any drug, including prescription and non-prescription medications, and herbal remedies known to be significant inhibitors and/or inducers of cytochrome P3A4 (CYP3A4) enzymes and/or P glycoprotein (P-gp) 14 days prior to the first dose of study drug.
The participant has an indication that requires long-term use of strong CYP3A4 inhibitors and/or inducers that would interfere with the pharmacokinetics of deflazacort.
The participant has received any investigational compound and/or has participated in another clinical study within 30 days prior to study treatment with the exception of observational cohort studies or non-interventional studies.
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| Name | Affiliation | Role |
|---|---|---|
| Francesco Bibbiani, MD | PTC Therapeutics | Study Director |
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| ID | Term |
|---|---|
| D020388 | Muscular Dystrophy, Duchenne |
| ID | Term |
|---|---|
| D009136 | Muscular Dystrophies |
| D020966 | Muscular Disorders, Atrophic |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| C021988 | deflazacort |
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| Period 1: Volume of Distribution (Vd) of Deflazacort | Pre-dose, 0.25, 2, 4, and 6 hours post-dose at Baseline (Week 1) and Week 13 |
| Period 1: Clearance (CL) of Deflazacort | Pre-dose, 0.25, 2, 4, and 6 hours post-dose at Baseline (Week 1) and Week 13 |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D040181 | Genetic Diseases, X-Linked |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |