The main objective of this study is to evaluate the efficacy of SRP-4045 (casimersen) and SRP-4053 (golodirsen) compared to placebo in participants with DMD with out-of-frame deletion mutations amenable to skipping exon 45 and exon 53, respectively.
This is a double-blind, placebo-controlled, multi-center study to evaluate the efficacy and safety of SRP-4045 and SRP-4053. Eligible participants with out-of-frame deletion mutations amenable to exon 45 or 53 skipping will be randomized to receive once weekly intravenous (IV) infusions of 30 milligrams/kilograms (mg/kg) SRP-4045 or 30 mg/kg SRP-4053 respectively (combined-active group) or placebo for up to 96 weeks (the placebo-controlled period of the trial). This will be followed by an open-label extension period in which all participants will receive open-label active treatment for 48 weeks (up to Week 144 of study). The study will enroll approximately 222 participants. Twice as many participants will be randomized to receive active treatment as will receive placebo (2:1 randomization). Clinical efficacy will be assessed at regularly scheduled study visits, including functional tests, such as the 6-minute walk test (6MWT). All participants will undergo a muscle biopsy at baseline and a second muscle biopsy either at Week 48 or Week 96. Safety will be assessed through the collection of adverse events (AEs), laboratory tests, electrocardiograms (ECGs), echocardiograms (ECHOs), vital signs, and physical examinations throughout the study. Blood samples will be taken periodically throughout the study to assess the pharmacokinetics of both drugs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
228
Change From Baseline in the 4-Step Ascend Velocity at Week 96
Time frame: Baseline, Week 96
Change from Baseline in the Total Distance Walked During 6MWT at Week 96
Time frame: Baseline, Week 96
Change from Baseline in Rise from Floor Velocity at Week 96
Time frame: Baseline, Week 96
Change From Baseline in the 4-Step Ascend Velocity at Week 144
Time frame: Baseline, Week 144
Change From Baseline in Total Distance Walked During the 10-meter walk/run (10-MWR) Velocity
Time frame: Baseline, Week 96
Change From Baseline in the North Star Ambulatory Assessment (NSAA) Total Score at Week 96
The NSAA is a clinician administered scale that rates the participant's performance on various functional activities. During this assessment, participants will be asked to perform 17 different functional activities, including a 10 meter walk/run, rising from a sit to standing, standing on 1 leg, climbing a box step, descending a box step, rising from lying to sitting, rising from the floor, lifting the head, standing on heels, and jumping. Participants will be graded as follows: 2 = achieves goal without any assistance; 1 = modified method but achieves goal independent of physical assistance from another person; and 0 = unable to achieve goal independently. NSAA Total Score ranges from 0 to 34, with a score of 34 implying normal function.
Time frame: Baseline, Week 96
Change from Baseline in Dystrophin Protein Levels Determined by Western Blot at Weeks 48 or 96
Time frame: Baseline, Week 48 or Week 96
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Neuromuscular Research Center
Phoenix, Arizona, United States
Children's Hospital Los Angeles
Los Angeles, California, United States
David Geffen School of Medicine, UCLA
Los Angeles, California, United States
Rady Children's Hospital San Diego/ UCSD
San Diego, California, United States
Stanford University School of Medicine/Medical Center
Stanford, California, United States
University of Florida
Gainesville, Florida, United States
NW Florida Clinical Research Group, LLC
Gulf Breeze, Florida, United States
Center for Integrative Rare Disease Research (CIRDR)
Atlanta, Georgia, United States
Ann and Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
University of Iowa Children's Hospital
Iowa City, Iowa, United States
...and 66 more locations
Change from Baseline in Dystrophin Intensity Levels Determined by Immunohistochemistry (IHC) at Weeks 48 or 96
Time frame: Baseline, Week 48 or Week 96