Duchenne Muscular Dystrophy (DMD) is inherited neuromuscular disorders due to mutation in the gene that encodes critical muscle protein called dystrophin. Currently, there is no effective treatment option for the disease. A pharmacological approach by promoting mRNA translation regardless of the presence of premature stop codons by nonsense mutation, called the readthrough strategy, has been developing recently for DMD with nonsense mutation. NPC-14 is a candidate compound for the readthrough strategy, since effective readthrough activities were demonstrated in nonclinical studies. This study is a phase II study designed to assess safety, tolerability, and efficacy of NPC-14 in ambulant DMD patients with nonsense mutation that were confirmed by whole genome analysis. These goals will be accomplished by monitoring adverse events by physical examination, cardiac, pulmonary, auditory, balance, and laboratory tests as safety endpoints, and dystrophin expression in muscle biopsy as primary efficacy endpoint, muscle function (NSAA, timed test, muscle strength (QMT, MMT) , dairy activities by lifecorder), and biomarkers as secondary efficacy endpoints. The study is a randomized, double blind, placebo-controlled study in 21 DMD patients. After screening, eligible patients are allocated dynamically to weekly NPC-14 or a placebo (saline) in a 2:1 ratio and will receive study drugs for 36 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
21
NPC-14 will be administrated as following steps. The dose of NPC-14 will be calculated and adjusted by a non-blinded medical doctor and/or a non-blinded pharmacist. * An initial dose of NPC-14 will be half of that calculated by distribution volume:Vd based on patient age for safety reason. * After the initial administration, the dose of NPC-14 will be adjusted and maintained by actual Vd, therapeutic drug monitoring of peak serum levels of NPC-14
Dose will be adjusted by volume of distribution (Vd) of patients in accordance with the NPC-14 dose regimen
Kobe university hospital, department of pediatrics
Kobe, Hyōgo, Japan
Hyogo College of Medicine
Nishinomiya, Hyōgo, Japan
National center of neurology and psychiatry
Kodaira, Tokyo, Japan
Tokyo Women's Medical University
Shinjuku-ku, Tokyo, Japan
Safety and tolerability (Adverse events)
Time frame: Up to 38 weeks (36 weeks treatment period and 2 weeks follow up period)
Change of dystrophin expression rate in muscle tissues from the baseline assessment
Time frame: At 37 weeks (1 week after from 36 weeks treatment period)
North Star Ambulatory Assessment
Time frame: At 36 weeks
Timed test (6MWT, time to walk/run 10 meters, time to climb/descent four steps, time to rise from the floor)
Time frame: At 36 weeks
Muscle strength (MMT, QMT)
Time frame: At 36 weeks
Dairy activities
Time frame: At 36 weeks
Biomarkers (CK, ALD)
Time frame: At 36 weeks
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