Title

Safety and Efficacy Study of IGF-1 in Duchenne Muscular Dystrophy
IGF-1 Therapy and Muscle Function in Duchenne Muscular Dystrophy
  • Phase

    Phase 1/Phase 2
  • Study Type

    Interventional
  • Study Participants

    44
The purpose of this study is to determine whether IGF-1 therapy improves or preserves muscle function in Duchenne Muscular Dystrophy (DMD).
Detailed Description:

DMD is a progressive degenerative muscle disorder for which there is no current cure. Glucocorticoids (GC) are often used to improve motor function and survival but have significant side effects such as growth failure, weight gain, insulin resistance and osteoporosis. IGF-1 stimulates both the proliferation and differentiation of skeletal muscle cells and is thus important for muscle repair and regeneration. IGF-1 offers potential as a therapeutic agent for DMD as it may improve or preserve motor function and reduce GC side effects such as growth failure and insulin resistance.
Study Started
Nov 30
2010
Primary Completion
Oct 31
2012
Study Completion
Jun 30
2013
Results Posted
Jan 20
2021
Last Update
Jan 20
2021

Drug IGF-1

IGF-1 will be administered once daily by subcutaneous injection every morning with breakfast. Duration 6 months.

  • Other names: Increlex (mecasermin [rDNA origin] injection)

IGF-1 Experimental

IGF-1 plus standard steroid treatment

Standard steroid treatment alone No Intervention

Standard daily steroid treatment for DMD

Criteria

Inclusion Criteria:

DMD diagnosed with mutational testing and/or complete absence of dystrophin on muscle biopsy
Proximal pelvic girdle weakness (Gower's maneuver, difficulty with arising from floor and going up steps)
Male
Age > 5 years of age
Bone maturation (assess by bone age x-ray): </= 11 years of age
Daily GC (prednisone or deflazacort) therapy for > 12 months
Ambulatory
Informed consent
Willingness and ability to comply with all protocol requirements and procedures

Exclusion Criteria:

Current or prior treatment with growth hormone or IGF-1 therapy
Non-ambulatory
Pubertal (based on clinical Tanner staging examination)
Congestive cardiac failure
History of intracranial hypertension
Daytime ventilatory dependence (non-invasive or tracheostomy)
Concomitant therapy - any other medications/supplements that would be considered, in the opinion of the investigators, to affect muscle function, need to have been started 3 months prior to enrollment
Patients enrolled in other clinical drug trials
Any physical or mental conditions which may, in the investigators'opinions, render the subject unable to complete the tasks of the study appropriately
There will be no selection by ethnicity

Summary

IGF-1

Standard Steroid Treatment Alone

All Events

Event Type Organ System Event Term IGF-1 Standard Steroid Treatment Alone

Difference in 6-Minute Walk Distance Between Groups (Control Minus IGF-1) for Change at 6 Months Versus Baseline

Outcome Measure Data Table shows change of 6-Minute Walk Distance at 6 months versus baseline in each arm. The Statistical Analysis section shows the 6-month difference between the 2 arms (control minus IGF-1).

IGF-1

3.4
meters (Mean)
Standard Deviation: 32.4

Standard Steroid Treatment Alone

-5.1
meters (Mean)
Standard Deviation: 50.2

Difference in Height Velocity Between Groups (Control Minus IGF-1) for Change at 6 Months Versus Baseline

Outcome Measure Data Table shows change of height velocity at 6 months versus baseline in each arm. The Statistical Analysis section shows the 6-month difference between the 2 arms (control minus IGF-1).

IGF-1

2.6
cm/year (Mean)
Standard Deviation: 1.64

Standard Steroid Treatment Alone

-0.06
cm/year (Mean)
Standard Deviation: 1.69

Difference in North Star Ambulatory Assessment (NSAA) Score Between Groups (Control Minus IGF-1) for Change at 6 Months Versus Baseline

Outcome Measure Data Table shows change of North Star Ambulatory Assessment (NSAA) score at 6 months versus baseline in each arm. The Statistical Analysis section shows the 6-month difference between the 2 arms (control minus IGF-1). The NSAA is a 17-item scale that grades performance of various functional skills on a scale from 0 (unable), 1 (complete independently but with modifications), and 2 (complete without compensation). The range of NSAA score is from 0 to 34. The higher score indicates better motor function.

IGF-1

-0.94
score on a scale (Mean)
Standard Deviation: 2.41

Standard Steroid Treatment Alone

-0.4
score on a scale (Mean)
Standard Deviation: 3.0

Total

38
Participants

Age, Continuous

8.64
Years (Mean)
Standard Deviation: 1.67

Sex: Female, Male

Overall Study

IGF-1

Standard Steroid Treatment Alone