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A Study to Assess Vamorolone in Boys Ages 2 to <4 Years and 7 to <18 Years With Duchenne Muscular Dystrophy (DMD)

Primary Purpose

Duchenne Muscular Dystrophy

Status
Recruiting
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
Vamorolone
Sponsored by
ReveraGen BioPharma, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Duchenne Muscular Dystrophy focused on measuring Duchenne Muscular Dystrophy, Becker Muscular Dystrophy, Duchenne and Becker Muscular Dystrophy, Muscular Dystrophy

Eligibility Criteria

2 Years - 17 Years (Child)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject's parent(s) or legal guardian(s) has (have) provided written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization, where applicable, prior to any study-related procedures; participants will be asked to give written or verbal assent according to local requirements;
  2. Subject has a centrally confirmed (by TRiNDS central genetic counselor[s]) diagnosis of DMD, defined as:

    1. Dystrophin immunofluorescence and/or immunoblot showing complete dystrophin deficiency, and clinical picture consistent with typical DMD, OR
    2. Identifiable mutation within the DMD gene (deletion/duplication of one or more exons), where reading frame can be predicted as 'out-of-frame,' and clinical picture consistent with typical DMD, OR
    3. Complete dystrophin gene sequencing showing an alteration (point mutation, duplication, other) that is expected to preclude production of the dystrophin protein (i.e., nonsense mutation, deletion/duplication leading to a downstream stop codon), with a clinical picture consistent with typical DMD;
  3. Subject is male, 2 to <4 years or 7 to <18 years of age at time of enrollment in the study;
  4. If 7 to <18 years of age and currently taking standard of care glucocorticoids for treatment of DMD, subject has been taking standard of care glucocorticoids at stable dose for at least 3 months prior to enrollment in the study, and will continue the same stable dose regimen through the date of the Baseline Day -1 Visit. [Note: Inhaled and/or topical glucocorticoids are permitted if last use is at least 4 weeks prior to enrollment or if administered at stable dose beginning at least 4 weeks prior to enrollment and anticipated to be used at the stable dose regimen for the duration of the study];
  5. If 7 to <18 years of age, and not currently glucocorticoid-treated, subject has not received oral glucocorticoids or other oral immunosuppressive agents for at least 3 months prior to enrollment. [Note: Inhaled and/or topical glucocorticoids are permitted if last use is at least 4 weeks prior to enrollment or if administered at stable dose beginning at least 4 weeks prior to enrollment and anticipated to be used at the stable dose regimen for the duration of the study];
  6. Clinical laboratory test results are within the normal range at the Screening Visit, or if abnormal, are not clinically significant, in the opinion of the Investigator. [Notes: Serum gamma glutamyl transferase (GGT), creatinine, and total bilirubin all must be ≤ upper limit of the normal range at the Screening Visit. An abnormal vitamin D level that is considered clinically significant will not exclude a subject from participating];
  7. Subject has evidence of chicken pox immunity as determined by:

    • Presence of IgG antibodies to varicella, as documented by a positive test result from the local laboratory from blood collected during the Screening Period; OR
    • Documentation, provided at the Screening Visit, that the subject has had 2 doses of varicella vaccine, with or without serologic evidence of immunity; the second of the 2 immunizations must have been given at least 14 days prior to assignment to a dose group;
  8. Subject and parent(s)/guardian(s) are willing and able to comply with scheduled visits, study drug administration plan, and study procedures.

Exclusion Criteria:

  1. Subject has current or history of major renal or hepatic impairment, diabetes mellitus or immunosuppression;
  2. Subject has current or history of chronic systemic fungal or viral infections;
  3. Subject has used mineralocorticoid receptor agents, such as spironolactone, eplerenone, canrenone (canrenoate potassium), prorenone (prorenoate potassium), or mexrenone (mexrenoate potassium) within 4 weeks prior to enrollment;
  4. Subject has a history of primary hyperaldosteronism;
  5. Subject has evidence of symptomatic cardiomyopathy [Note: Asymptomatic cardiac abnormality on investigation would not be exclusionary];
  6. If 2 to <4 years of age, subject is currently being treated or has received previous treatment with oral glucocorticoids or other immunosuppressive agents [Notes: Past transient use of oral glucocorticoids or other oral immunosuppressive agents for no longer than 1 month cumulative, with last use at least 3 months prior to enrollment, will be considered for eligibility on a case-by-case basis, unless discontinued for intolerance. Inhaled and/or topical glucocorticoids are permitted if last use is at least 4 weeks prior to enrollment or if administered at stable dose beginning at least 4 weeks prior to enrollment and anticipated to be used at the stable dose regimen for the duration of the study];
  7. Subject has an allergy or hypersensitivity to the study medication or to any of its constituents;
  8. Subject has used idebenone within 4 weeks prior to enrollment;
  9. Subject has severe behavioral or cognitive problems that preclude participation in the study, in the opinion of the Investigator;
  10. Subject has previous or ongoing medical condition, medical history, physical findings or laboratory abnormalities that could affect safety, make it unlikely that treatment and follow-up will be correctly completed or impair the assessment of study results, in the opinion of the Investigator;
  11. Subject is taking (or has taken within 4 weeks prior to enrollment) herbal remedies and supplements which can impact muscle strength and function (e.g., Co-enzyme Q10, creatine, etc);
  12. Subject is taking (or has taken within 3 months prior to enrollment) any medication indicated for DMD, including Exondys51, Exondys53, Exondys45, Viltepso and Translarna;
  13. Subject has been administered a live attenuated vaccine within 14 days prior to the first dose of study medication;
  14. Subject is currently taking any other investigational drug or has taken any other investigational drug within 3 months prior to enrollment;
  15. Subject has previously been enrolled in the VBP15-006 study or any other vamorolone study.

Sites / Locations

  • Alberta's Children HospitalRecruiting
  • British Columbia Children's HospitalRecruiting
  • Children's Hospital of Eastern OntarioRecruiting
  • The Hospital for Sick ChildrenRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Treatment Group 1

Treatment Group 2

Treatment Group 3

Treatment Group 4

Treatment Group 5

Treatment Group 6

Arm Description

Patients in Treatment Group 1 must be ages 2-<4 years and will receive Vamorolone at 2.0 mg/kg/day for the duration of the study. Treatment Group 1 will be enrolled prior to Treatment Group 2.

Patients in Treatment Group 2 must be ages 2-<4 years and will receive Vamorolone at 6.0 mg/kg/day for the duration of the study. Treatment Group 2 will be enrolled after Treatment Group 1.

Patients in Treatment Group 3 must be ages 7-<18 years and must be steroid untreated at entry. Treatment Group 3 will receive Vamorolone at 2.0 mg/kg/day for the duration of the study.

Patients in Treatment Group 4 must be ages 7-<18 years and must be on a stable dose of steroid for 3 months prior to entry. Treatment Group 4 will receive Vamorolone at 2.0 mg/kg/day for the duration of the study.

Patients in Treatment Group 5 must be ages 7-<18 years and must be steroid untreated at entry. Treatment Group 3 will receive Vamorolone at 6.0 mg/kg/day for the duration of the study.

Patients in Treatment Group 6 must be ages 7-<18 years and must be on a stable dose of steroid for 3 months prior to entry. Treatment Group 4 will receive Vamorolone at 6.0 mg/kg/day for the duration of the study.

Outcomes

Primary Outcome Measures

Change in Body Mass Index (BMI) from baseline to Week 12
Body Mass Index is a measure of weight adjusted for height.
Change in Body Mass Index (BMI) z-score from baseline to Week 12
Body Mass Index z-scores is a measure of relative weight adjusted for child age and sex.
Change in Weight from baseline to each of the scheduled on treatment and post-treatment assessment time points
Body weight will be assessed at each of the scheduled time points.
Change in Height from baseline to Week 12
Standing height will be assessed for subjects ages 2-<4 years; height calculated from ulnar length in subjects ages 7-<18.
Change in Height z score from baseline to Week 12
Standing height will be assessed for subjects ages 2-<4 years; height calculated from ulnar length in subjects ages 7-<18.
Change in sitting blood pressure from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Sitting blood pressure will be assessed at scheduled on-treatment and post-treatment time points.
Change in heart rate from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Heart rate will be assessed at scheduled on-treatment and post-treatment time points.
Change in respiratory rate from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Respiratory rate will be assessed at scheduled on-treatment and post-treatment time points.
Change in body temperature from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Body temperature will be assessed at scheduled on-treatment and post-treatment time points.
Number of participants with Cushingoid features
Cushingoid features measured by the presence of buffalo hump obesity, striations, adiposity, hypertension, diabetes, or osteoporosis. Change from baseline to each of the scheduled on-treatment and post-treatment assessment time points.
Number of participants with abnormal blood laboratory test results
Blood samples will be collected from subjects for the analysis of clinical chemistry parameters, including White Blood cells (WBCs), Red Blood Cells, (RBCs), hemoglobin, Platelets, Sodium, Potassium, Chloride, Calcium, Inorganic Phosphorus, Blood Urea Nitrogen (BUN), Creatinine, Total Protein, Albumin, Bicarbonate, Lactate Dehydrogenase (LDH), Cystatin C, Total Bilirubin, Uric Acid, Glucose, Alkaline Phosphatase (ALP), Gamma Glutamyl Transferase (GGT), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Creatine kinase (CK), Lipase, Amylase, Vitamin D, Triglycerides, Total cholesterol, Low Density Lipoprotein (LDL) and High density Lipoprotein (HDL). Change from baseline to each of the scheduled on treatment and post-treatment time points will be assessed.
Number of participants with abnormal urine laboratory test results
Urine biomarkers will include protein, glucose, ketones, leukocyte esterase, White Blood Cells (WBCs), Red Blood Cells, (RBCs) and bacteria and will be assessed by dipstick and microscopic analysis. Change from baseline to each of the scheduled on treatment and post-treatment time points will be assessed.
Number of participants with abnormal ECGs
12-lead 1electrocardiogram (ECG) as recorded after subject has rested quietly in a supine position for at least 5 minutes. ECG components are QRS duration, PR [PQ] interval, RR interval, QT interval and QTc. Change from baseline to Week 12
Number of participants with Glaucoma
Glaucoma as by measured by ocular pressure.Week 12 assessments compared to baseline.
Number of participants with Cataracts
Cataracts as measured by the presence of partial or complete opacity of the crystalline lens of one or both eyes. Week 12 assessments compared to baseline.
Number of Participants with Adverse Events as Assessed by Common Terminology Criteria for Adverse Events version 4.03 (CTCAE v4.03)
An Adverse Event is any untoward medical occurrence in a subject and does not necessarily have to have a causal relationship with the intervention. Pre-existing conditions that worsen during the study are to be reported as AEs.

Secondary Outcome Measures

Area under the Curve infinity (AUCinf) following oral administration
The pre-dose and post-dose plasma concentration measurements of vamorolone at Day 1 and Week 2 will be used for comparison of drug exposures by age group, dose level, and glucocorticoid treatment at entry (7 to <18 years only).
Change in morning cortisol concentration from baseline to Week 12
Adrenal suppression is directly associated with risk of adrenal crisis, delay of puberty and stunting of growth. Measurement of morning cortisol concentrations will reflect the degree of adrenal suppression. Cortisol measures falling below 3.6 µg/dL (or 100 nM) will be considered to be indicative of the development of adrenal suppression.
Change in fasting serum concentration of glucose from baseline to Week 12
Glucocorticoids cause both acute and chronic insulin resistance, with serum elevations of both insulin and glucose. Measures of hyperinsulinemia and hyperglycemia are accepted measures of insulin resistance. Fasting glucose will be measured at baseline and Week 12.
Change in fasting serum concentration of insulin from baseline to Week 12
Glucocorticoids cause both acute and chronic insulin resistance, with serum elevations of both insulin and glucose. Measures of hyperinsulinemia and hyperglycemia are accepted measures of insulin resistance. Fasting insulin will be measured at baseline and Week 12.
Change in serum concentration of hemoglobin A1c (HbA1c) from baseline to Week 12
Glucocorticoids cause both acute and chronic insulin resistance, with serum elevations of both insulin and glucose. Measures of hyperinsulinemia and hyperglycemia are accepted measures of insulin resistance. Hemoglobin A1c (HbA1c) will be measured at baseline and Week 12.

Full Information

First Posted
November 9, 2021
Last Updated
September 29, 2022
Sponsor
ReveraGen BioPharma, Inc.
Collaborators
Santhera Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05185622
Brief Title
A Study to Assess Vamorolone in Boys Ages 2 to <4 Years and 7 to <18 Years With Duchenne Muscular Dystrophy (DMD)
Official Title
A Phase II Open-Label, Multiple Dose Study to Assess the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Exploratory Efficacy of Vamorolone in Boys Ages 2 to <4 Years and 7 to <18 Years With Duchenne Muscular Dystrophy (DMD)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 21, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ReveraGen BioPharma, Inc.
Collaborators
Santhera Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This Phase II study is an open-label, multiple dose study to evaluate the safety, tolerability, PK, PD, clinical efficacy, behavior and neuropsychology, and physical functioning vamorolone over a treatment period of 12 weeks in steroid-naïve boys ages 2 to <4 years, and glucocorticoid-treated and currently untreated boys ages 7 to <18 years with DMD.
Detailed Description
This Phase II study is an open-label, multiple dose study to evaluate the safety, tolerability, PK, PD, clinical efficacy, behavior and neuropsychology, and physical functioning of vamorolone administered orally at daily doses of 2.0 mg/kg and 6.0 mg/kg over a treatment period of 3 months in steroid-naïve boys ages 2 to <4, and glucocorticoid-treated and currently untreated boys ages 7 to <18 years with DMD. The study is comprised of a 5-week Pretreatment Screening Period; a 1-day Pretreatment Baseline Period; a 3-month open-label Treatment Period (Weeks 1-12); and a 4-week open-label Dose-tapering Period (Weeks 13-16) for subjects who will not transition directly to further vamorolone or standard of care (SoC) glucocorticoid treatment at the end of the study. Subjects will be enrolled into the study at the Screening Visit, at the time written informed consent is obtained. Within the 2 to <4 years age group, the initial 10 eligible subjects will be assigned to the 2.0 mg/kg/day treatment group at the Baseline Day -1 Visit. The subsequent 10 eligible subjects will be assigned to the 6.0 mg/kg/day treatment group at the Baseline Day -1 Visit. Within the 7 to <18 years age group, both corticosteroid-treated and untreated, the initial 12 eligible subjects will be assigned to the 2.0 mg/kg/day treatment group at the Baseline Day -1 Visit. The subsequent 12 eligible subjects will be assigned to the 6.0 mg/kg/day treatment group at the Baseline Day -1 Visit. The first 6 subjects in each age group at 2 mg/kg will serve as the PK/safety run-in cohorts. PK assessments will be performed at week 2 and together with the safety assessment during the first 4 weeks of treatment this will be the basis to confirm whether 2 and 6 mg/kg/day will be used in the subsequent patients or if a dose adjustment is needed to avoid over or under-exposure in patients for any of the two age groups. Glucocorticoid-treated subjects in the 7 to <18 years age group will take their final dose of SoC glucocorticoid therapy for DMD on Baseline Day -1, within 24 hours prior to administration of the first dose of vamorolone study medication. All subjects in both age groups will begin their assigned vamorolone treatment on Treatment Period Day 1, and will continue to receive their assigned vamorolone treatment throughout the duration of the 3 month Treatment Period (Weeks 1-12). At the end of the 3-month Treatment Period (Week 12), subjects will be given the option to receive vamorolone in an expanded access or compassionate use program, if possible, or to transition to SoC treatment for DMD (may include glucocorticoids). Subjects completing VBP15-006 and enrolling directly into the expanded access or compassionate use program or transitioning directly to SoC glucocorticoid treatment will not need to taper their vamorolone dose prior to participation in the expanded access or compassionate use program or initiation of SoC glucocorticoid treatment. All subjects who will not transition directly to further vamorolone or SoC glucocorticoid treatment will begin a 4 week open label Dose tapering Period during which the dose of study medication will be progressively reduced and discontinued.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Duchenne Muscular Dystrophy
Keywords
Duchenne Muscular Dystrophy, Becker Muscular Dystrophy, Duchenne and Becker Muscular Dystrophy, Muscular Dystrophy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
44 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Group 1
Arm Type
Experimental
Arm Description
Patients in Treatment Group 1 must be ages 2-<4 years and will receive Vamorolone at 2.0 mg/kg/day for the duration of the study. Treatment Group 1 will be enrolled prior to Treatment Group 2.
Arm Title
Treatment Group 2
Arm Type
Experimental
Arm Description
Patients in Treatment Group 2 must be ages 2-<4 years and will receive Vamorolone at 6.0 mg/kg/day for the duration of the study. Treatment Group 2 will be enrolled after Treatment Group 1.
Arm Title
Treatment Group 3
Arm Type
Experimental
Arm Description
Patients in Treatment Group 3 must be ages 7-<18 years and must be steroid untreated at entry. Treatment Group 3 will receive Vamorolone at 2.0 mg/kg/day for the duration of the study.
Arm Title
Treatment Group 4
Arm Type
Experimental
Arm Description
Patients in Treatment Group 4 must be ages 7-<18 years and must be on a stable dose of steroid for 3 months prior to entry. Treatment Group 4 will receive Vamorolone at 2.0 mg/kg/day for the duration of the study.
Arm Title
Treatment Group 5
Arm Type
Experimental
Arm Description
Patients in Treatment Group 5 must be ages 7-<18 years and must be steroid untreated at entry. Treatment Group 3 will receive Vamorolone at 6.0 mg/kg/day for the duration of the study.
Arm Title
Treatment Group 6
Arm Type
Experimental
Arm Description
Patients in Treatment Group 6 must be ages 7-<18 years and must be on a stable dose of steroid for 3 months prior to entry. Treatment Group 4 will receive Vamorolone at 6.0 mg/kg/day for the duration of the study.
Intervention Type
Drug
Intervention Name(s)
Vamorolone
Other Intervention Name(s)
VBP15
Intervention Description
Oral administration of vamorolone for 12 weeks.
Primary Outcome Measure Information:
Title
Change in Body Mass Index (BMI) from baseline to Week 12
Description
Body Mass Index is a measure of weight adjusted for height.
Time Frame
12 weeks
Title
Change in Body Mass Index (BMI) z-score from baseline to Week 12
Description
Body Mass Index z-scores is a measure of relative weight adjusted for child age and sex.
Time Frame
12 weeks
Title
Change in Weight from baseline to each of the scheduled on treatment and post-treatment assessment time points
Description
Body weight will be assessed at each of the scheduled time points.
Time Frame
Week 2, Week 6, Week 12, Week 16
Title
Change in Height from baseline to Week 12
Description
Standing height will be assessed for subjects ages 2-<4 years; height calculated from ulnar length in subjects ages 7-<18.
Time Frame
Week 12
Title
Change in Height z score from baseline to Week 12
Description
Standing height will be assessed for subjects ages 2-<4 years; height calculated from ulnar length in subjects ages 7-<18.
Time Frame
Week 12
Title
Change in sitting blood pressure from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Description
Sitting blood pressure will be assessed at scheduled on-treatment and post-treatment time points.
Time Frame
Day 1, Week 2, Week 6, Week 12, Week 16
Title
Change in heart rate from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Description
Heart rate will be assessed at scheduled on-treatment and post-treatment time points.
Time Frame
Day 1, Week 2, Week 6, Week 12, Week 16
Title
Change in respiratory rate from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Description
Respiratory rate will be assessed at scheduled on-treatment and post-treatment time points.
Time Frame
Day 1, Week 2, Week 6, Week 12, Week 16
Title
Change in body temperature from baseline to each of the scheduled on-treatment and post-treatment assessment time points
Description
Body temperature will be assessed at scheduled on-treatment and post-treatment time points.
Time Frame
Day 1, Week 2, Week 6, Week 12, Week 16
Title
Number of participants with Cushingoid features
Description
Cushingoid features measured by the presence of buffalo hump obesity, striations, adiposity, hypertension, diabetes, or osteoporosis. Change from baseline to each of the scheduled on-treatment and post-treatment assessment time points.
Time Frame
Week 6, Week 12, Week 16
Title
Number of participants with abnormal blood laboratory test results
Description
Blood samples will be collected from subjects for the analysis of clinical chemistry parameters, including White Blood cells (WBCs), Red Blood Cells, (RBCs), hemoglobin, Platelets, Sodium, Potassium, Chloride, Calcium, Inorganic Phosphorus, Blood Urea Nitrogen (BUN), Creatinine, Total Protein, Albumin, Bicarbonate, Lactate Dehydrogenase (LDH), Cystatin C, Total Bilirubin, Uric Acid, Glucose, Alkaline Phosphatase (ALP), Gamma Glutamyl Transferase (GGT), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Creatine kinase (CK), Lipase, Amylase, Vitamin D, Triglycerides, Total cholesterol, Low Density Lipoprotein (LDL) and High density Lipoprotein (HDL). Change from baseline to each of the scheduled on treatment and post-treatment time points will be assessed.
Time Frame
Day 1, Week 6, Week 12, Week 16
Title
Number of participants with abnormal urine laboratory test results
Description
Urine biomarkers will include protein, glucose, ketones, leukocyte esterase, White Blood Cells (WBCs), Red Blood Cells, (RBCs) and bacteria and will be assessed by dipstick and microscopic analysis. Change from baseline to each of the scheduled on treatment and post-treatment time points will be assessed.
Time Frame
Day 1, Week 6, Week 12, Week 16
Title
Number of participants with abnormal ECGs
Description
12-lead 1electrocardiogram (ECG) as recorded after subject has rested quietly in a supine position for at least 5 minutes. ECG components are QRS duration, PR [PQ] interval, RR interval, QT interval and QTc. Change from baseline to Week 12
Time Frame
Week 12
Title
Number of participants with Glaucoma
Description
Glaucoma as by measured by ocular pressure.Week 12 assessments compared to baseline.
Time Frame
12 weeks
Title
Number of participants with Cataracts
Description
Cataracts as measured by the presence of partial or complete opacity of the crystalline lens of one or both eyes. Week 12 assessments compared to baseline.
Time Frame
12 weeks
Title
Number of Participants with Adverse Events as Assessed by Common Terminology Criteria for Adverse Events version 4.03 (CTCAE v4.03)
Description
An Adverse Event is any untoward medical occurrence in a subject and does not necessarily have to have a causal relationship with the intervention. Pre-existing conditions that worsen during the study are to be reported as AEs.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Area under the Curve infinity (AUCinf) following oral administration
Description
The pre-dose and post-dose plasma concentration measurements of vamorolone at Day 1 and Week 2 will be used for comparison of drug exposures by age group, dose level, and glucocorticoid treatment at entry (7 to <18 years only).
Time Frame
Day 1, Week 2
Title
Change in morning cortisol concentration from baseline to Week 12
Description
Adrenal suppression is directly associated with risk of adrenal crisis, delay of puberty and stunting of growth. Measurement of morning cortisol concentrations will reflect the degree of adrenal suppression. Cortisol measures falling below 3.6 µg/dL (or 100 nM) will be considered to be indicative of the development of adrenal suppression.
Time Frame
Week 12
Title
Change in fasting serum concentration of glucose from baseline to Week 12
Description
Glucocorticoids cause both acute and chronic insulin resistance, with serum elevations of both insulin and glucose. Measures of hyperinsulinemia and hyperglycemia are accepted measures of insulin resistance. Fasting glucose will be measured at baseline and Week 12.
Time Frame
Week 12
Title
Change in fasting serum concentration of insulin from baseline to Week 12
Description
Glucocorticoids cause both acute and chronic insulin resistance, with serum elevations of both insulin and glucose. Measures of hyperinsulinemia and hyperglycemia are accepted measures of insulin resistance. Fasting insulin will be measured at baseline and Week 12.
Time Frame
Week 12
Title
Change in serum concentration of hemoglobin A1c (HbA1c) from baseline to Week 12
Description
Glucocorticoids cause both acute and chronic insulin resistance, with serum elevations of both insulin and glucose. Measures of hyperinsulinemia and hyperglycemia are accepted measures of insulin resistance. Hemoglobin A1c (HbA1c) will be measured at baseline and Week 12.
Time Frame
Week 12
Other Pre-specified Outcome Measures:
Title
Change in Bayley Scales of Infant and Toddler Development-III (Bayley-III) Gross Motor scale (ages 2 to <4 years only) from baseline to Week 12
Description
The Bayley-III Gross Motor scale is a functional assessment which was chosen as an accurate reflection of muscle strength for subjects with DMD ages 2 to <4 years. The minimum score value is 0 and the maximum score value is 72. Higher scores mean a better outcome.
Time Frame
Week 12
Title
Change in Performance of Upper Limb (PUL) test (7 to <18 years only) from baseline to Week 12
Description
The Performance of Upper Limb is a functional assessment which was chosen as an accurate reflection of muscle strength for subjects with DMD ages 7 to <18 years. The minimum score value is 0 and the maximum score value is 42. Higher scores mean a better outcome.
Time Frame
Week 12
Title
Change in Personal Adjustment and Role Skills Scale, ed. 3 (PARS III) questionnaire from baseline to Week 12
Description
The PARS III is a scale designed to assess behavior and measure psychosocial adjustment of children with chronic physical illnesses. The PARS III will be completed by the parent(s)/guardian(s) at the Screening and Week 12 Visits. The minimum score value is 28 and the maximum score value is 112. Higher scores mean better personal adjustment.
Time Frame
Week 12
Title
Change in Pediatric Outcome Data Collection Instrument (PODCI) from baseline to Week 12
Description
Physical functioning will be measured using the Pediatric Outcomes Data Collection Instrument (PODCI). The minimum score value is 0 and the maximum score value is 100. Higher scores mean a better outcome.
Time Frame
Week 12
Title
Study Medication Acceptability Assessment (ages 7 to <18 years only) at each of the scheduled study assessment time points
Description
Subjects in the 7 to <18 years age group will complete the Study Medication Acceptability Assessment. The minimum score value is 2 and the maximum score value is 10. Higher scores mean the medication is more acceptable.
Time Frame
Week 6, Week 12
Title
Ease of Study Medication Administration Assessment (ages 2 to <4 years only) at each of the scheduled study assessment time points
Description
The parent(s)/legal guardian(s) of each subject in the 2 to <4 years age group will be asked to complete the Ease of Study Medication Administration Assessment. The minimum score value is 2 and the maximum score value is 10. Higher scores mean the medication is easier to administer.
Time Frame
Week 6, Week 12
Title
Change in concentration of serum osteocalcin from baseline to Week 12
Description
Measures of serum osteocalcin are reflective of bone formation, and measures of serum C terminal peptide fragment of collagen 1 (CTX) are reflective of bone reabsorption. Ratios of osteocalcin and CTX predict later clinical safety concerns of osteopenia and bone fragility.
Time Frame
Week 12
Title
Change in concentration of serum aminoterminal propeptide of type I collagen (P1NP) from baseline to Week 12
Description
Measures of serum P1NP are reflective of bone formation.
Time Frame
Week 12
Title
Change in serum concentration of C terminal peptide fragment of collagen 1 (CTX) from baseline to Week 12
Description
Measures of serum osteocalcin are reflective of bone formation, and measures of serum CTX are reflective of bone reabsorption. Ratios of osteocalcin and CTX predict later clinical safety concerns of osteopenia and bone fragility.
Time Frame
Week 12

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject's parent(s) or legal guardian(s) has (have) provided written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization, where applicable, prior to any study-related procedures; participants will be asked to give written or verbal assent according to local requirements; Subject has a centrally confirmed (by TRiNDS central genetic counselor[s]) diagnosis of DMD, defined as: Dystrophin immunofluorescence and/or immunoblot showing complete dystrophin deficiency, and clinical picture consistent with typical DMD, OR Identifiable mutation within the DMD gene (deletion/duplication of one or more exons), where reading frame can be predicted as 'out-of-frame,' and clinical picture consistent with typical DMD, OR Complete dystrophin gene sequencing showing an alteration (point mutation, duplication, other) that is expected to preclude production of the dystrophin protein (i.e., nonsense mutation, deletion/duplication leading to a downstream stop codon), with a clinical picture consistent with typical DMD; Subject is male, 2 to <4 years or 7 to <18 years of age at time of enrollment in the study; If 7 to <18 years of age and currently taking standard of care glucocorticoids for treatment of DMD, subject has been taking standard of care glucocorticoids at stable dose for at least 3 months prior to enrollment in the study, and will continue the same stable dose regimen through the date of the Baseline Day -1 Visit. [Note: Inhaled and/or topical glucocorticoids are permitted if last use is at least 4 weeks prior to enrollment or if administered at stable dose beginning at least 4 weeks prior to enrollment and anticipated to be used at the stable dose regimen for the duration of the study]; If 7 to <18 years of age, and not currently glucocorticoid-treated, subject has not received oral glucocorticoids or other oral immunosuppressive agents for at least 3 months prior to enrollment. [Note: Inhaled and/or topical glucocorticoids are permitted if last use is at least 4 weeks prior to enrollment or if administered at stable dose beginning at least 4 weeks prior to enrollment and anticipated to be used at the stable dose regimen for the duration of the study]; Clinical laboratory test results are within the normal range at the Screening Visit, or if abnormal, are not clinically significant, in the opinion of the Investigator. [Notes: Serum gamma glutamyl transferase (GGT), creatinine, and total bilirubin all must be ≤ upper limit of the normal range at the Screening Visit. An abnormal vitamin D level that is considered clinically significant will not exclude a subject from participating]; Subject has evidence of chicken pox immunity as determined by: Presence of IgG antibodies to varicella, as documented by a positive test result from the local laboratory from blood collected during the Screening Period; OR Documentation, provided at the Screening Visit, that the subject has had 2 doses of varicella vaccine, with or without serologic evidence of immunity; the second of the 2 immunizations must have been given at least 14 days prior to assignment to a dose group; Subject and parent(s)/guardian(s) are willing and able to comply with scheduled visits, study drug administration plan, and study procedures. Exclusion Criteria: Subject has current or history of major renal or hepatic impairment, diabetes mellitus or immunosuppression; Subject has current or history of chronic systemic fungal or viral infections; Subject has used mineralocorticoid receptor agents, such as spironolactone, eplerenone, canrenone (canrenoate potassium), prorenone (prorenoate potassium), or mexrenone (mexrenoate potassium) within 4 weeks prior to enrollment; Subject has a history of primary hyperaldosteronism; Subject has evidence of symptomatic cardiomyopathy [Note: Asymptomatic cardiac abnormality on investigation would not be exclusionary]; If 2 to <4 years of age, subject is currently being treated or has received previous treatment with oral glucocorticoids or other immunosuppressive agents [Notes: Past transient use of oral glucocorticoids or other oral immunosuppressive agents for no longer than 1 month cumulative, with last use at least 3 months prior to enrollment, will be considered for eligibility on a case-by-case basis, unless discontinued for intolerance. Inhaled and/or topical glucocorticoids are permitted if last use is at least 4 weeks prior to enrollment or if administered at stable dose beginning at least 4 weeks prior to enrollment and anticipated to be used at the stable dose regimen for the duration of the study]; Subject has an allergy or hypersensitivity to the study medication or to any of its constituents; Subject has used idebenone within 4 weeks prior to enrollment; Subject has severe behavioral or cognitive problems that preclude participation in the study, in the opinion of the Investigator; Subject has previous or ongoing medical condition, medical history, physical findings or laboratory abnormalities that could affect safety, make it unlikely that treatment and follow-up will be correctly completed or impair the assessment of study results, in the opinion of the Investigator; Subject is taking (or has taken within 4 weeks prior to enrollment) herbal remedies and supplements which can impact muscle strength and function (e.g., Co-enzyme Q10, creatine, etc); Subject is taking (or has taken within 3 months prior to enrollment) any medication indicated for DMD, including Exondys51, Exondys53, Exondys45, Viltepso and Translarna; Subject has been administered a live attenuated vaccine within 14 days prior to the first dose of study medication; Subject is currently taking any other investigational drug or has taken any other investigational drug within 3 months prior to enrollment; Subject has previously been enrolled in the VBP15-006 study or any other vamorolone study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Eric P Hoffman, Ph.D.
Phone
301-762-7980
Email
eric.hoffman@reveragen.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean K Mah, M.D.
Organizational Affiliation
Alberta Children's Hospital Research Institute, University of Calgary
Official's Role
Study Chair
Facility Information:
Facility Name
Alberta's Children Hospital
City
Calgary
State/Province
Alberta
ZIP/Postal Code
AB T3B 6A8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julie Dao
Email
julie.dao@ucalgary.ca
First Name & Middle Initial & Last Name & Degree
Jean Mah, MD
Facility Name
British Columbia Children's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H 3N1
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kathryn Selby, MBChB
Phone
604-875-2345
Ext
2161
First Name & Middle Initial & Last Name & Degree
Nela Martic
Email
NMartic3@cw.bc.ca
Facility Name
Children's Hospital of Eastern Ontario
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L1
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laura Thompson
Email
LaThompson@cheo.on.ca
First Name & Middle Initial & Last Name & Degree
Hanns Lochmuller, MD
Facility Name
The Hospital for Sick Children
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1X8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ana Stosic
Email
ana.stosic@sickkids.ca
First Name & Middle Initial & Last Name & Degree
Hernan Gonorazky, MD

12. IPD Sharing Statement

Plan to Share IPD
No
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Learn more about this trial

A Study to Assess Vamorolone in Boys Ages 2 to <4 Years and 7 to <18 Years With Duchenne Muscular Dystrophy (DMD)

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