"Observational study of clinical outcomes for testosterone treatment of pubertal delay in Duchenne Muscular Dystrophy" is a single centre observational study that aims to follow the progress of 20 adolescents with Duchenne Muscular Dystrophy (DMD) and delayed puberty who are treated by the Newcastle muscle team, as they are treated with testosterone to induce puberty. The participants will all be treated with the standard stepwise regimen of testosterone injections every 4 weeks and data will be collected to help determine the effectiveness and tolerability of the current treatment regimen. The investigators will use the data to explore the effect of testosterone on pubertal development, growth, muscle strength and function, bone mineral density and body composition and characterise any side effects. Semi-structured interviews will also be carried out to learn the boys' views on the tolerability of the regimen. The study will last up to a maximum of 27 months in total for each participant, but may be less if they are happy with pubertal development before this time. It is important to do this study because from the investigator's limited experience in this group, testosterone treatment seems to be well liked and tolerated but the best treatment regimen to use remains unknown and there is no current consensus. It is not currently part of the standard of care in DMD but it would be important to include it if this study can show that it is an effective treatment for pubertal delay.
Study Type
OBSERVATIONAL
Enrollment
15
Standard incremental regimen of Sustanon
Institute of Genetic Medicine
Newcastle upon Tyne, United Kingdom
Total score in the Treatment Satisfaction Questionnaire for Medication (TSQM)
Time frame: 2 years
Subject's reported effectiveness of testosterone therapy as assessed by semi-structured interviews pre and post treatment
Time frame: 2 years
Total score in Northstar Ambulatory Assessment or Performance of the Upper Limb if non-ambulant
Time frame: 2 years
Z-score from Bone mineral adjusted density of the lumbar spine and total body (minus head) using Dual Xray Absorptiometry (DXA)
Time frame: 2 years
Percentage of body mass assessed by DXA
Time frame: 2 years
Osteocalcin level, measured by blood test
Time frame: 2 years
P1NP level, measured by blood test
Time frame: 2 years
Percentage fat fraction as assessed by muscle Magnetic Resonance Imaging (MRI) of upper and lower limbs
Time frame: 2 years
Pubertal staging assessed using Tanner staging and testicular volume
Time frame: 2 years
Bone age as assessed by wrist and hand X-Ray
Time frame: 2 years
Hormonal assessment of pubertal staging using testosterone level
Time frame: 2 years
Forced vital capacity, measured by spirometry
Time frame: 2 years
Cardiac function, assessed by Electrocardiogram (ECG) and echo
Time frame: 2 years
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