Myocardial Fibrosis Progression in Duchenne and Becker Muscular Dystrophy - ACE Inhibitor Therapy Trial
Primary Purpose
Myocardial Fibrosis, Muscular Dystrophies
Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Enalapril
Sponsored by
About this trial
This is an interventional treatment trial for Myocardial Fibrosis focused on measuring cardiac magnetic resonance, myocardial fibrosis, muscular dystrophies
Eligibility Criteria
Inclusion Criteria:
- Patients with biopsy-proven Muscular Dystrophy of Duchenne or Becker
Exclusion Criteria:
- Contraindications to cardiovascular magnetic resonance imaging
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
ACE inhibitor
Control
Arm Description
ACE inhibitor (enalapril up to 20mg BID), in patients with preserved EF (LVEF grater than 50%) and with detectable delayed enhancement (myocardial fibrosis) in cardiac magnetic resonance, randomized to therapy or not.
Patients with preserved EF (LVEF grater than 50%) and with no detectable delayed enhancement (myocardial fibrosis) in cardiac magnetic resonance
Outcomes
Primary Outcome Measures
Quantitative Myocardial Fibrosis by CMR in patients with and without ACE inhibitor therapy
Progression of myocardial fibrosis
Secondary Outcome Measures
Specific genetic mutations as predictors of cardiac involvement
Relation of dystrophin gene site mutations in exons <45 relation and the extent of myocardial fibrosis measured by cardiac magnetic resonance
Full Information
NCT ID
NCT02432885
First Posted
March 24, 2015
Last Updated
May 1, 2015
Sponsor
InCor Heart Institute
Collaborators
Federal University of Minas Gerais, University of Sao Paulo
1. Study Identification
Unique Protocol Identification Number
NCT02432885
Brief Title
Myocardial Fibrosis Progression in Duchenne and Becker Muscular Dystrophy - ACE Inhibitor Therapy Trial
Official Title
Myocardial Fibrosis Progression in Duchenne and Becker Muscular Dystrophy - Angiotensin-Converting-Enzyme (ACE) Inhibitor Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
April 2015
Overall Recruitment Status
Completed
Study Start Date
June 2009 (undefined)
Primary Completion Date
June 2012 (Actual)
Study Completion Date
June 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
InCor Heart Institute
Collaborators
Federal University of Minas Gerais, University of Sao Paulo
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This trial intends to evaluate myocardial Fibrosis progression in Duchenne and Becker Muscular Dystrophy, as well the influence of ACE inhibitors in fibrosis progression. Additionally, this study aims to determine genetic predictors of cardiac involvement in these dystrophies.
Detailed Description
Duchenne and Becker muscular dystrophies (DMD/BMD) are diseases characterized by progressive skeletal muscle degeneration and replacement by fibrofatty tissue. Data on cardiac involvement (defined as myocardial fibrosis), effect of ACE-inhibitors and specific genetic mutations on myocardial involvement detected by cardiac magnetic resonance (CMR) is lacking.
The study will include 76 patients with DMD/BMD. All patients will be referred to two CMRs for assessment of ventricular function and myocardial fibrosis. Patients with myocardial fibrosis and normal left ventricle ejection fraction (LVEF) will be randomized into two groups, each group receiving ACE-inhibitor treatment or no treatment for cardiomyopathy. A genetic profile will be performed in every patient to identify possible mutations related to cardiac involvement.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Fibrosis, Muscular Dystrophies
Keywords
cardiac magnetic resonance, myocardial fibrosis, muscular dystrophies
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
76 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ACE inhibitor
Arm Type
Experimental
Arm Description
ACE inhibitor (enalapril up to 20mg BID), in patients with preserved EF (LVEF grater than 50%) and with detectable delayed enhancement (myocardial fibrosis) in cardiac magnetic resonance, randomized to therapy or not.
Arm Title
Control
Arm Type
No Intervention
Arm Description
Patients with preserved EF (LVEF grater than 50%) and with no detectable delayed enhancement (myocardial fibrosis) in cardiac magnetic resonance
Intervention Type
Drug
Intervention Name(s)
Enalapril
Intervention Description
up to 20mg bid
Primary Outcome Measure Information:
Title
Quantitative Myocardial Fibrosis by CMR in patients with and without ACE inhibitor therapy
Description
Progression of myocardial fibrosis
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Specific genetic mutations as predictors of cardiac involvement
Description
Relation of dystrophin gene site mutations in exons <45 relation and the extent of myocardial fibrosis measured by cardiac magnetic resonance
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with biopsy-proven Muscular Dystrophy of Duchenne or Becker
Exclusion Criteria:
Contraindications to cardiovascular magnetic resonance imaging
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carlos E Rochitte, MD, PhD
Organizational Affiliation
InCor, Heart Institute, University of Sao Paulo Medical School
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
27926769
Citation
Silva MC, Magalhaes TA, Meira ZM, Rassi CH, Andrade AC, Gutierrez PS, Azevedo CF, Gurgel-Giannetti J, Vainzof M, Zatz M, Kalil-Filho R, Rochitte CE. Myocardial Fibrosis Progression in Duchenne and Becker Muscular Dystrophy: A Randomized Clinical Trial. JAMA Cardiol. 2017 Feb 1;2(2):190-199. doi: 10.1001/jamacardio.2016.4801.
Results Reference
derived
Learn more about this trial
Myocardial Fibrosis Progression in Duchenne and Becker Muscular Dystrophy - ACE Inhibitor Therapy Trial
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