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A Pharmacokinetic Study of Oral Deflazacort in Children and Adolescent Subjects With Duchenne Muscular Dystrophy

Primary Purpose

Duchenne Muscular Dystrophy

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Deflazacort
Sponsored by
PTC Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Duchenne Muscular Dystrophy focused on measuring Pediatric, Adolescent, Deflazacort

Eligibility Criteria

4 Years - 16 Years (Child)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • In the opinion of the investigator, the subject is capable of understanding and complying with protocol requirements.
  • The subject or, when applicable, the subject's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
  • If above the age of 7, the subject signs and dates a written, informed assent form (IAF) and any required privacy authorization prior to the initiation of any study procedures.
  • The subject must have confirmed diagnosis of Duchenne Muscular Dystrophy defined as muscle biopsy and dystrophin analyses consistent with DMD or DNA mutation and analysis by PCR or Southern blot techniques to detect gene deletions as well as:

    1. onset of weakness before 5 years of age;
    2. proximal muscle weakness;
    3. increased serum creatine kinase more than 10 times the upper limit of normal (ULN);
  • The subject is male and aged 4 to 16 years, inclusive.
  • The subject weighs at least 13 kg and has a Body Mass Index (BMI) of ≤ 40.
  • Willingness and ability to comply with scheduled visits, oral drug administration, and study procedures including blood sample draws (total blood volume collected not to exceed 50 mL for the study duration or 25 mL on any single study day [≤ 3 mL/kg])
  • The subject has a life expectancy of >1 year.
  • Up to date on all childhood vaccinations, specifically varicella vaccine (chicken pox).
  • Baseline health is judged to be stable based on medical history, physical examination, laboratory profiles, vital signs, or ECGs at screening, as deemed by the Investigator.
  • Continuous non smoker who has not used nicotine containing products for at least 3 months prior to the first dose.
  • The subject is able to take tablets.

Exclusion Criteria:

  • The subject has received any investigational compound and/or has participated in another clinical study within 90 days prior to study treatment with the exception of observational cohort studies or non-interventional studies.
  • The subject has received deflazacort within 30 days or previous discontinued deflazacort due to an intolerable reaction.
  • The subject is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in the conduct of this study (e.g. spouse, parent, child, sibling) or may consent under duress.
  • Any significant finding on the Columbia suicide severity rating scale (C SSRS) for subjects (ages 12-16, inclusive), in the opinion of the PI, warrants exclusion from this study.
  • The subject has, in the judgment of the investigator, clinically significant abnormal clinical chemistry laboratory parameters that may affect safety at Screening.
  • The subject has, in the judgment of the investigator, a history or current medical condition that could affect safety including, but not limited to:

    1. Major renal or hepatic impairment
    2. Immunosuppression or other contraindications for corticosteroid treatment
    3. History of chronic systemic fungal or viral infections
    4. Diabetes mellitus
    5. Idiopathic hypocalcuria
    6. Symptomatic cardiomyopathy at screening
  • The subject has a history of hypersensitivity or allergic reaction to steroids or their formulations including, but not limited to lactose, sucrose, etc.
  • Inability to take tablets as assessed by site investigator.
  • Unable to refrain from or anticipates the use of:

    • Any medications at least 4 hours before and after dosing on PK Days 1 and 8.
    • Any vitamins, vitamins with minerals, and/or meal supplementation (e.g., Ensure, Boost, etc.) at least 4 hours before and after dosing on PK Days 1 and 8.
    • Any drug, including prescription and non prescription medications, and herbal remedies known to be significant inhibitors of CYP 3A4 enzymes and/or P gp for 14 days prior to the first dose of study drug and throughout the study. Appropriate sources will be consulted by the PI or designee to confirm lack of pharmacokinetic/pharmacodynamic interaction with study drug. Acetaminophen may be permitted during the study (doses to be based upon appropriate age/weight ranges.
    • Any drugs known to be significant inducers of CYP 3A4 enzymes and/or P gp for 28 days prior to the first dose of study drug and throughout the study. Appropriate sources will be consulted by the PI or designee to confirm lack of PK/pharmacodynamics interaction with study drug.
  • Subject is mentally or legally incapacitated or has significant emotional problems at the time of screening visit or expected during the conduct of the study.
  • History of any illness that, in the opinion of the PI, might confound the results of the study or poses an additional risk to the subject by their participation in the study.
  • Positive urine drug or alcohol results at screening or check in.
  • Positive urine cotinine at screening.
  • Positive results at screening for HIV, HBsAg, or HCV.
  • Hemoglobin level below the lower limit of normal at screening.
  • Donation of blood or significant blood loss within 56 days prior to the first dose of study drug.

Sites / Locations

  • UCLA
  • Lurie Children's Hospital
  • University of Rochester Medical Center
  • University of Utah

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Deflazacort

Arm Description

This is an open label and single period study , dosed with 0.9mg/kg Deflazacort.

Outcomes

Primary Outcome Measures

The area under the plasma concentration time curve, from time 0 to the last measurable concentration non-zero, for single-state pharmacokinetics on Day 1 of deflazacort and 21-desacetyl-DFZ, the active metabolite
The area under the plasma concentration time curve, from time 0 to the last measurable concentration non-zero, for single-state pharmacokinetics on Day 1 of deflazacort and 21-desacetyl-DFZ, the active metabolite
The area under the plasma concentration versus time curve over the final dosing interval for steady state pharmacokinetics on Day 8 of deflazacort and 21-desacetyl-DFZ, the active metabolite
The area under the plasma concentration versus time curve over the final dosing interval for steady state pharmacokinetics on Day 8 of deflazacort and 21-desacetyl-DFZ, the active

Secondary Outcome Measures

Number of participants with adverse events as a measure of safety and tolerability
To assess the safety and tolerability of single-dose and steady-state deflazacort in DMD subjects.

Full Information

First Posted
September 22, 2014
Last Updated
August 15, 2017
Sponsor
PTC Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02251600
Brief Title
A Pharmacokinetic Study of Oral Deflazacort in Children and Adolescent Subjects With Duchenne Muscular Dystrophy
Official Title
A Multi-center Study to Evaluate the Pharmacokinetics of 21-Desacetyldeflazacort and the Safety of Deflazacort After Oral Administration of Deflazacort Tablets to Children and Adolescent Subjects With Duchenne Muscular Dystrophy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
December 2014 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
October 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PTC Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Study to characterize the single-state and steady-state dosing of oral deflazacort in pediatric and adolescents subjects.
Detailed Description
This is an open label, single period study in 24 male DMD subjects consisting of children (ages 4-12, inclusive) and adolescents (ages 13-16, inclusive) with at least 12 subjects between the ages of 4-12 (children). Subjects taking maintenance corticosteroid therapy will be required to take their dose of corticosteroid 24 hours (± 2 hours) prior to the first dose of deflazacort on Day 1. Subjects receiving deflazacort as maintenance corticosteroid therapy must take their last dose at least 30 days prior to the first dose of deflazacort on Day 1. Concomitant corticosteroid therapy will be prohibited during the study while the subject is taking deflazacort. On Day 1, a single oral dose of deflazacort under fasting conditions will be administered in the CRU followed by blood sampling for plasma analysis of DFZ and 21-desacetyl-DFZ for 8 hours. Following the 8 hour PK sample on Day 1, subjects will be given medication to take at home for once-daily, morning dosing on Days 2 through 7 (+2 days). On Day 8 (+2 days), subjects will return for a PK sample predose and an 8th oral dose of deflazacort under fasting conditions which will be administered in the CRU followed by PK sampling for 8 hours. Safety will be monitored throughout the study by repeated clinical and laboratory evaluations on Days 1 and 8 (+2 days). Subjects will be contacted via telephone approximately 7 days (± 1 day) following study drug administration on Day 8 (+2 days) for a follow-up assessment to determine if any adverse event (AE) has occurred since the last study visit. Subjects who terminate the study early will be contacted if the Principal Investigator (PI) deems necessary. Subjects that complete this study or receive at least one dose of study medication will be eligible for an open-label extension study with deflazacort treatment conducted under a separate protocol.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Duchenne Muscular Dystrophy
Keywords
Pediatric, Adolescent, Deflazacort

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Deflazacort
Arm Type
Experimental
Arm Description
This is an open label and single period study , dosed with 0.9mg/kg Deflazacort.
Intervention Type
Drug
Intervention Name(s)
Deflazacort
Other Intervention Name(s)
DFZ
Intervention Description
Oral deflazacort administered once daily at 0.9 mg/kg for eight days
Primary Outcome Measure Information:
Title
The area under the plasma concentration time curve, from time 0 to the last measurable concentration non-zero, for single-state pharmacokinetics on Day 1 of deflazacort and 21-desacetyl-DFZ, the active metabolite
Description
The area under the plasma concentration time curve, from time 0 to the last measurable concentration non-zero, for single-state pharmacokinetics on Day 1 of deflazacort and 21-desacetyl-DFZ, the active metabolite
Time Frame
Day 1, Day 8
Title
The area under the plasma concentration versus time curve over the final dosing interval for steady state pharmacokinetics on Day 8 of deflazacort and 21-desacetyl-DFZ, the active metabolite
Description
The area under the plasma concentration versus time curve over the final dosing interval for steady state pharmacokinetics on Day 8 of deflazacort and 21-desacetyl-DFZ, the active
Time Frame
Day 8
Secondary Outcome Measure Information:
Title
Number of participants with adverse events as a measure of safety and tolerability
Description
To assess the safety and tolerability of single-dose and steady-state deflazacort in DMD subjects.
Time Frame
Day 1-8

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: In the opinion of the investigator, the subject is capable of understanding and complying with protocol requirements. The subject or, when applicable, the subject's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures. If above the age of 7, the subject signs and dates a written, informed assent form (IAF) and any required privacy authorization prior to the initiation of any study procedures. The subject must have confirmed diagnosis of Duchenne Muscular Dystrophy defined as muscle biopsy and dystrophin analyses consistent with DMD or DNA mutation and analysis by PCR or Southern blot techniques to detect gene deletions as well as: onset of weakness before 5 years of age; proximal muscle weakness; increased serum creatine kinase more than 10 times the upper limit of normal (ULN); The subject is male and aged 4 to 16 years, inclusive. The subject weighs at least 13 kg and has a Body Mass Index (BMI) of ≤ 40. Willingness and ability to comply with scheduled visits, oral drug administration, and study procedures including blood sample draws (total blood volume collected not to exceed 50 mL for the study duration or 25 mL on any single study day [≤ 3 mL/kg]) The subject has a life expectancy of >1 year. Up to date on all childhood vaccinations, specifically varicella vaccine (chicken pox). Baseline health is judged to be stable based on medical history, physical examination, laboratory profiles, vital signs, or ECGs at screening, as deemed by the Investigator. Continuous non smoker who has not used nicotine containing products for at least 3 months prior to the first dose. The subject is able to take tablets. Exclusion Criteria: The subject has received any investigational compound and/or has participated in another clinical study within 90 days prior to study treatment with the exception of observational cohort studies or non-interventional studies. The subject has received deflazacort within 30 days or previous discontinued deflazacort due to an intolerable reaction. The subject is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in the conduct of this study (e.g. spouse, parent, child, sibling) or may consent under duress. Any significant finding on the Columbia suicide severity rating scale (C SSRS) for subjects (ages 12-16, inclusive), in the opinion of the PI, warrants exclusion from this study. The subject has, in the judgment of the investigator, clinically significant abnormal clinical chemistry laboratory parameters that may affect safety at Screening. The subject has, in the judgment of the investigator, a history or current medical condition that could affect safety including, but not limited to: Major renal or hepatic impairment Immunosuppression or other contraindications for corticosteroid treatment History of chronic systemic fungal or viral infections Diabetes mellitus Idiopathic hypocalcuria Symptomatic cardiomyopathy at screening The subject has a history of hypersensitivity or allergic reaction to steroids or their formulations including, but not limited to lactose, sucrose, etc. Inability to take tablets as assessed by site investigator. Unable to refrain from or anticipates the use of: Any medications at least 4 hours before and after dosing on PK Days 1 and 8. Any vitamins, vitamins with minerals, and/or meal supplementation (e.g., Ensure, Boost, etc.) at least 4 hours before and after dosing on PK Days 1 and 8. Any drug, including prescription and non prescription medications, and herbal remedies known to be significant inhibitors of CYP 3A4 enzymes and/or P gp for 14 days prior to the first dose of study drug and throughout the study. Appropriate sources will be consulted by the PI or designee to confirm lack of pharmacokinetic/pharmacodynamic interaction with study drug. Acetaminophen may be permitted during the study (doses to be based upon appropriate age/weight ranges. Any drugs known to be significant inducers of CYP 3A4 enzymes and/or P gp for 28 days prior to the first dose of study drug and throughout the study. Appropriate sources will be consulted by the PI or designee to confirm lack of PK/pharmacodynamics interaction with study drug. Subject is mentally or legally incapacitated or has significant emotional problems at the time of screening visit or expected during the conduct of the study. History of any illness that, in the opinion of the PI, might confound the results of the study or poses an additional risk to the subject by their participation in the study. Positive urine drug or alcohol results at screening or check in. Positive urine cotinine at screening. Positive results at screening for HIV, HBsAg, or HCV. Hemoglobin level below the lower limit of normal at screening. Donation of blood or significant blood loss within 56 days prior to the first dose of study drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Katherine Smith, MD
Organizational Affiliation
Drug Safety Solutions/Celerion
Official's Role
Study Chair
Facility Information:
Facility Name
UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Lurie Children's Hospital
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Rochester Medical Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84112
Country
United States

12. IPD Sharing Statement

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A Pharmacokinetic Study of Oral Deflazacort in Children and Adolescent Subjects With Duchenne Muscular Dystrophy

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