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Published in: Current Treatment Options in Neurology 8/2018

01-08-2018 | Neuromuscular Disorders (C Fournier, Section Editor)

Current and Emerging Therapies for Duchenne Muscular Dystrophy

Authors: Megan Crone, MD, FRCPC, Jean K. Mah, MD, MSc, FRCPC

Published in: Current Treatment Options in Neurology | Issue 8/2018

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Abstract

Purpose of review

The purpose of this review is to summarize the current and emerging therapies for Duchenne muscular dystrophy (DMD).

Recent findings

Coinciding with new standardized care guidelines, there are a growing number of therapeutic options to treat males with DMD. Treatment of the underlying pathobiology, such as micro-dystrophin gene replacement, exon skipping, stop codon read-through agents, and utrophin modulators showed variable success in animal and human studies. Symptomatic therapies to target muscle ischemia, enhance muscle regeneration, prevent muscle fibrosis, inhibit myostatin, and reduce inflammation are also under investigation.

Summary

DMD is a complex, heterogeneous degenerative disease. The pharmacological and technological achievements made in recent years, plus timely supportive interventions will likely lead to an improved quality of life for many individuals with DMD.
Literature
1.
go back to reference Hoffman EP, Brown RH Jr, Kunkel LM. Dystrophin: the protein product of the Duchenne muscular dystrophy locus. Cell. 1987;51(6):919–28.CrossRefPubMed Hoffman EP, Brown RH Jr, Kunkel LM. Dystrophin: the protein product of the Duchenne muscular dystrophy locus. Cell. 1987;51(6):919–28.CrossRefPubMed
2.
go back to reference Emery AE. Population frequencies of inherited neuromuscular diseases—a world survey. Neuromuscul Disord. 1991;1(1):19–29.CrossRefPubMed Emery AE. Population frequencies of inherited neuromuscular diseases—a world survey. Neuromuscul Disord. 1991;1(1):19–29.CrossRefPubMed
3.
4.
go back to reference Koenig M, Monaco AP, Kunkel LM. The complete sequence of dystrophin predicts a rod-shaped cytoskeletal protein. Cell. 1988;53(2):219–28.CrossRefPubMed Koenig M, Monaco AP, Kunkel LM. The complete sequence of dystrophin predicts a rod-shaped cytoskeletal protein. Cell. 1988;53(2):219–28.CrossRefPubMed
5.
6.
go back to reference Aartsma-Rus A, Van Deutekom JCT, Fokkema IF, Van Ommen G-JB, Den Dunnen JT. Entries in the Leiden Duchenne muscular dystrophy mutation database: an overview of mutation types and paradoxical cases that confirm the reading-frame rule. Muscle Nerve. 2006;34(2):135–44. https://doi.org/10.1002/mus.20586.CrossRefPubMed Aartsma-Rus A, Van Deutekom JCT, Fokkema IF, Van Ommen G-JB, Den Dunnen JT. Entries in the Leiden Duchenne muscular dystrophy mutation database: an overview of mutation types and paradoxical cases that confirm the reading-frame rule. Muscle Nerve. 2006;34(2):135–44. https://​doi.​org/​10.​1002/​mus.​20586.CrossRefPubMed
7.
go back to reference Mah JK, Selby K, Campbell C, Nadeau A, Tarnopolsky M, McCormick A, et al. A population-based study of dystrophin mutations in Canada. Canadian Journal of Neurological Sciences / Journal Canadien Des Sciences Neurologiques. 2011;38(3):465–74. https://doi.org/10.1017/S0317167100011896. Mah JK, Selby K, Campbell C, Nadeau A, Tarnopolsky M, McCormick A, et al. A population-based study of dystrophin mutations in Canada. Canadian Journal of Neurological Sciences / Journal Canadien Des Sciences Neurologiques. 2011;38(3):465–74. https://​doi.​org/​10.​1017/​S031716710001189​6.
8.
go back to reference Koenig M, Beggs AH, Moyer M, Scherpf S, Heindrich K, Bettecken T, et al. The molecular basis for Duchenne versus Becker muscular dystrophy: correlation of severity with type of deletion. Am J Hum Genet. 1989;45(4):498–506. Koenig M, Beggs AH, Moyer M, Scherpf S, Heindrich K, Bettecken T, et al. The molecular basis for Duchenne versus Becker muscular dystrophy: correlation of severity with type of deletion. Am J Hum Genet. 1989;45(4):498–506.
9.
go back to reference Monaco AP, Bertelson CJ, Liechti-Gallati S, Moser H, Kunkel LM. An explanation for the phenotypic differences between patients bearing partial deletions of the DMD locus. Genomics. 1988;2(1):90–5.CrossRefPubMed Monaco AP, Bertelson CJ, Liechti-Gallati S, Moser H, Kunkel LM. An explanation for the phenotypic differences between patients bearing partial deletions of the DMD locus. Genomics. 1988;2(1):90–5.CrossRefPubMed
12.
go back to reference Gao QQ, McNally EM. The dystrophin complex: structure, function, and implications for therapy. In: Terjung R, editor. Comprehensive physiology. Hoboken: John Wiley & Sons, Inc.; 2015. p. 1223–39.CrossRef Gao QQ, McNally EM. The dystrophin complex: structure, function, and implications for therapy. In: Terjung R, editor. Comprehensive physiology. Hoboken: John Wiley & Sons, Inc.; 2015. p. 1223–39.CrossRef
13.
go back to reference Muntoni F, Torelli S, Ferlini A. Dystrophin and mutations: one gene, several proteins, multiple phenotypes. Lancet Neurol. 2003;2(12):731–40.CrossRefPubMed Muntoni F, Torelli S, Ferlini A. Dystrophin and mutations: one gene, several proteins, multiple phenotypes. Lancet Neurol. 2003;2(12):731–40.CrossRefPubMed
16.
go back to reference Thomas GD. Functional muscle ischemia in Duchenne and Becker muscular dystrophy. Front Physiol. 2013;4:1–6.CrossRef Thomas GD. Functional muscle ischemia in Duchenne and Becker muscular dystrophy. Front Physiol. 2013;4:1–6.CrossRef
17.
go back to reference •• Bushby K, Finkel R, Birnkrant D, et al. Diagnosis and management of Duchenne muscular dystrophy part 1: diagnosis and pharmacological and psychosocial management. Lancet Neurol. 2010;9(1):77–93. These expert-led international guidelines provided recommendations for the diagnosis and medical management of Duchenne muscular dystrophy.CrossRefPubMed •• Bushby K, Finkel R, Birnkrant D, et al. Diagnosis and management of Duchenne muscular dystrophy part 1: diagnosis and pharmacological and psychosocial management. Lancet Neurol. 2010;9(1):77–93. These expert-led international guidelines provided recommendations for the diagnosis and medical management of Duchenne muscular dystrophy.CrossRefPubMed
18.
go back to reference McDonald CM, Henricson EK, Abresch RT, Han JJ, Escolar DM, Florence JM. The Cinrg investigators. The cooperative international neuromuscular research group Duchenne natural history study-a longitudinal investigation in the era of glucocorticoid therapy: design of protocol and the methods used: CINRG DMD study. Muscle Nerve. 2013;48(1):32–54. https://doi.org/10.1002/mus.23807.CrossRefPubMedPubMedCentral McDonald CM, Henricson EK, Abresch RT, Han JJ, Escolar DM, Florence JM. The Cinrg investigators. The cooperative international neuromuscular research group Duchenne natural history study-a longitudinal investigation in the era of glucocorticoid therapy: design of protocol and the methods used: CINRG DMD study. Muscle Nerve. 2013;48(1):32–54. https://​doi.​org/​10.​1002/​mus.​23807.CrossRefPubMedPubMedCentral
19.
go back to reference Darras B, Menache-Starobinski C, Hinton V, Kunkel L. Dystrinopathies. Chapter 30. In: Darras B, Jones H, Ryan M, De Vivo D, eds. Neuromuscular disorders of infancy, childhood, and adolescence a clinicians approach, 2nd edn. London: Elsevier, 2015; 551–92. Darras B, Menache-Starobinski C, Hinton V, Kunkel L. Dystrinopathies. Chapter 30. In: Darras B, Jones H, Ryan M, De Vivo D, eds. Neuromuscular disorders of infancy, childhood, and adolescence a clinicians approach, 2nd edn. London: Elsevier, 2015; 551–92.
21.
go back to reference Leibowitz D, Dubowitz V. Intellect and behavior in Duchenne muscular dystrophy. Develop Med Child Neurol. 1981;23:577–90.CrossRefPubMed Leibowitz D, Dubowitz V. Intellect and behavior in Duchenne muscular dystrophy. Develop Med Child Neurol. 1981;23:577–90.CrossRefPubMed
22.
go back to reference Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord. 2002;12(10):926–9.CrossRefPubMed Eagle M, Baudouin SV, Chandler C, Giddings DR, Bullock R, Bushby K. Survival in Duchenne muscular dystrophy: improvements in life expectancy since 1967 and the impact of home nocturnal ventilation. Neuromuscul Disord. 2002;12(10):926–9.CrossRefPubMed
23.
go back to reference Judge DP, Kass DA, Thompson WR, Wagner KR. Pathophysiology and therapy of cardiac dysfunction in Duchenne muscular dystrophy. Am J Cardiovasc Drugs. 2011;11(5):287–94.CrossRefPubMed Judge DP, Kass DA, Thompson WR, Wagner KR. Pathophysiology and therapy of cardiac dysfunction in Duchenne muscular dystrophy. Am J Cardiovasc Drugs. 2011;11(5):287–94.CrossRefPubMed
24.
go back to reference Nigro G, Comi LI, Politano L, Bain RJI. The incidence and evolution of cardiomyopathy in Duchenne muscular dystrophy. Int J Cardiol. 1990;26(3):271–7.CrossRefPubMed Nigro G, Comi LI, Politano L, Bain RJI. The incidence and evolution of cardiomyopathy in Duchenne muscular dystrophy. Int J Cardiol. 1990;26(3):271–7.CrossRefPubMed
25.
go back to reference •• Bushby K, Finkel R, Birnkrant D, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177–89. These expert-led international guidelines provided recommendations for the multidisciplinary management of Duchenne muscular dystrophy.CrossRefPubMed •• Bushby K, Finkel R, Birnkrant D, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol. 2010;9(2):177–89. These expert-led international guidelines provided recommendations for the multidisciplinary management of Duchenne muscular dystrophy.CrossRefPubMed
26.
go back to reference •• Birnkrant D, Bushby K, Bann C, Alman B, Apkon S, Blackwell A, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol. 2018;17:347–61. This expert-led guideline, updated from 2010, reflects the current literature with particular attention to respiratory, endocrinological, and rehabilitation care. •• Birnkrant D, Bushby K, Bann C, Alman B, Apkon S, Blackwell A, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol. 2018;17:347–61. This expert-led guideline, updated from 2010, reflects the current literature with particular attention to respiratory, endocrinological, and rehabilitation care.
27.
go back to reference Suresh S, Wales P, Dakin C, Harris M-A, Cooper DGM. Sleep-related breathing disorder in Duchenne muscular dystrophy: disease spectrum in the paediatric population. J Paediatr Child Health. 2005;41(9–10):500–3.CrossRefPubMed Suresh S, Wales P, Dakin C, Harris M-A, Cooper DGM. Sleep-related breathing disorder in Duchenne muscular dystrophy: disease spectrum in the paediatric population. J Paediatr Child Health. 2005;41(9–10):500–3.CrossRefPubMed
28.
go back to reference Ragette R, Mellies U, Schwake C, Voit T, Teschler H. Patterns and predictors of sleep disordered breathing in primary myopathies. Thorax. 2002;57(8):724–8.CrossRefPubMedPubMedCentral Ragette R, Mellies U, Schwake C, Voit T, Teschler H. Patterns and predictors of sleep disordered breathing in primary myopathies. Thorax. 2002;57(8):724–8.CrossRefPubMedPubMedCentral
30.
go back to reference Rodillo EB, Fernandez-Bermejo E, Heckmatt JZ, Dubowitz V. Prevention of rapidly progressive scoliosis in Duchenne muscular dystrophy by prolongation of walking with orthoses. J Child Neurol. 1988;3(4):269–74.CrossRefPubMed Rodillo EB, Fernandez-Bermejo E, Heckmatt JZ, Dubowitz V. Prevention of rapidly progressive scoliosis in Duchenne muscular dystrophy by prolongation of walking with orthoses. J Child Neurol. 1988;3(4):269–74.CrossRefPubMed
31.
go back to reference Nallamilli B, Ankala A, Hegde M. Molecular diagnosis of Duchenne muscular dystrophy. Curr Protoc Hum Genet. 2014;83:9251–92529.CrossRef Nallamilli B, Ankala A, Hegde M. Molecular diagnosis of Duchenne muscular dystrophy. Curr Protoc Hum Genet. 2014;83:9251–92529.CrossRef
33.
go back to reference Center for Disease Control. Survival of males diagnosed with Duchenne/Becker muscular dystrophy (DBMD) by years of birth—muscular dystrophy surveillance tracking and research network. MMWR. 2009;58(40):1119–22. Center for Disease Control. Survival of males diagnosed with Duchenne/Becker muscular dystrophy (DBMD) by years of birth—muscular dystrophy surveillance tracking and research network. MMWR. 2009;58(40):1119–22.
36.
37.
go back to reference Moxley RT, Ashwal S, Pandya S, Connolly A, Florence J, Mathews K, et al. Practice parameter: corticosteroid treatment of Duchenne dystrophy report of the quality standards subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2005;64(1):13–20. Moxley RT, Ashwal S, Pandya S, Connolly A, Florence J, Mathews K, et al. Practice parameter: corticosteroid treatment of Duchenne dystrophy report of the quality standards subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2005;64(1):13–20.
39.
go back to reference Gloss D, Moxley RT, Ashwal S, Oskoui M. Practice guideline update summary: corticosteroid treatment of Duchenne muscular dystrophy report of the guideline development subcommittee of the American Academy of Neurology. Neurology. 2016;86(5):465–72.CrossRefPubMedPubMedCentral Gloss D, Moxley RT, Ashwal S, Oskoui M. Practice guideline update summary: corticosteroid treatment of Duchenne muscular dystrophy report of the guideline development subcommittee of the American Academy of Neurology. Neurology. 2016;86(5):465–72.CrossRefPubMedPubMedCentral
40.
go back to reference Angelini C, Peterle E. Old and new therapeutic developments in steroid treatment in Duchenne muscular dystrophy. Acta Myologica. 2012;31(1):9–15.PubMedPubMedCentral Angelini C, Peterle E. Old and new therapeutic developments in steroid treatment in Duchenne muscular dystrophy. Acta Myologica. 2012;31(1):9–15.PubMedPubMedCentral
41.
go back to reference Henricson EK, Abresch RT, Cnaan A, Hu F, Duong T, Arrieta A, et al. The cooperative international neuromuscular research group Duchenne natural history study: glucocorticoid treatment preserves clinically meaningful functional milestones and reduces rate of disease progression as measured by manual muscle testing: CINRG DMD natural history study. Muscle Nerve. 2013;48(1):55–67. https://doi.org/10.1002/mus.23808. Henricson EK, Abresch RT, Cnaan A, Hu F, Duong T, Arrieta A, et al. The cooperative international neuromuscular research group Duchenne natural history study: glucocorticoid treatment preserves clinically meaningful functional milestones and reduces rate of disease progression as measured by manual muscle testing: CINRG DMD natural history study. Muscle Nerve. 2013;48(1):55–67. https://​doi.​org/​10.​1002/​mus.​23808.
42.
go back to reference Pane M, Fanelli L, Mazzone ES, Olivieri G, D’Amico A, Messina S, et al. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: a multicentric longitudinal study using the performance of upper limb test. Neuromuscul Disord. 2015;25(10):749–53. https://doi.org/10.1016/j.nmd.2015.07.009. Pane M, Fanelli L, Mazzone ES, Olivieri G, D’Amico A, Messina S, et al. Benefits of glucocorticoids in non-ambulant boys/men with Duchenne muscular dystrophy: a multicentric longitudinal study using the performance of upper limb test. Neuromuscul Disord. 2015;25(10):749–53. https://​doi.​org/​10.​1016/​j.​nmd.​2015.​07.​009.
43.
go back to reference Schara U, Mortier J, Mortier W. Long-term steroid therapy in Duchenne muscular dystrophy positive results versus side effects. J Clin Neuromuscul Dis. 2001;2(4):179–83.CrossRefPubMed Schara U, Mortier J, Mortier W. Long-term steroid therapy in Duchenne muscular dystrophy positive results versus side effects. J Clin Neuromuscul Dis. 2001;2(4):179–83.CrossRefPubMed
44.
go back to reference McAdam LC, Mayo AL, Alman BA, Biggar WD. The Canadian experience with long term deflazacort treatment in Duchenne muscular dystrophy. Acta Myologica. 2012;31(1):16–20.PubMedPubMedCentral McAdam LC, Mayo AL, Alman BA, Biggar WD. The Canadian experience with long term deflazacort treatment in Duchenne muscular dystrophy. Acta Myologica. 2012;31(1):16–20.PubMedPubMedCentral
46.
go back to reference Raman SV, Hor KN, Mazur W, Halnon NJ, Kissel JT, He X, et al. Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2015;14(2):153–61. Raman SV, Hor KN, Mazur W, Halnon NJ, Kissel JT, He X, et al. Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2015;14(2):153–61.
48.
go back to reference Passamano L, Taglia A, Palladino A, Viggiano E, D’AMBROSIO P, Scutifero M, et al. Improvement of survival in Duchenne muscular dystrophy: retrospective analysis of 835 patients. Acta Myologica. 2012;31(2):121–5. Passamano L, Taglia A, Palladino A, Viggiano E, D’AMBROSIO P, Scutifero M, et al. Improvement of survival in Duchenne muscular dystrophy: retrospective analysis of 835 patients. Acta Myologica. 2012;31(2):121–5.
49.
go back to reference Hoogerwaard E, van der Wouw P, Wilde A, Bakker P, Ippel P, Oosterwijk J, et al. Cardiac involvement in carriers of Duchenne and Becker muscular dystrophy. Neuromuscul Disord. 1999;9:347–51. Hoogerwaard E, van der Wouw P, Wilde A, Bakker P, Ippel P, Oosterwijk J, et al. Cardiac involvement in carriers of Duchenne and Becker muscular dystrophy. Neuromuscul Disord. 1999;9:347–51.
52.
go back to reference Birnkrant, D. J., Bushby, K. M. D., Amin, R. S., Bach, J. R., Benditt, J. O., Eagle, M., … Kravitz, R. M. The respiratory management of patients with Duchenne muscular dystrophy: a DMD care considerations working group specialty article. Pediatr Pulmonol, 2010;45(8), 739–748. doi: https://doi.org/10.1002/ppul.21254 Birnkrant, D. J., Bushby, K. M. D., Amin, R. S., Bach, J. R., Benditt, J. O., Eagle, M., … Kravitz, R. M. The respiratory management of patients with Duchenne muscular dystrophy: a DMD care considerations working group specialty article. Pediatr Pulmonol, 2010;45(8), 739–748. doi: https://​doi.​org/​10.​1002/​ppul.​21254
53.
56.
go back to reference Fairclough RJ, Wood MJ, Davies KE. Therapy for Duchenne muscular dystrophy: renewed optimism from genetic approaches. Nat Rev Genet. 2013;14(6):373–8.CrossRefPubMed Fairclough RJ, Wood MJ, Davies KE. Therapy for Duchenne muscular dystrophy: renewed optimism from genetic approaches. Nat Rev Genet. 2013;14(6):373–8.CrossRefPubMed
60.
go back to reference Malerba A, Boldrin L, Dickson G. Long-term systemic administration of unconjugated morpholino oligomers for therapeutic expression of dystrophin by exon skipping in skeletal muscle: implications for cardiac muscle integrity. Nucleic Acid Therapeutics (Formerly Oligonucleotides). 2011;21(4):293–8. https://doi.org/10.1089/nat.2011.0306.CrossRef Malerba A, Boldrin L, Dickson G. Long-term systemic administration of unconjugated morpholino oligomers for therapeutic expression of dystrophin by exon skipping in skeletal muscle: implications for cardiac muscle integrity. Nucleic Acid Therapeutics (Formerly Oligonucleotides). 2011;21(4):293–8. https://​doi.​org/​10.​1089/​nat.​2011.​0306.CrossRef
61.
go back to reference Van Deutekom JC, Janson AA, Ginjaar IB, Frankhuizen WS, Aartsma-Rus A, Bremmer-Bout M, et al. Local dystrophin restoration with antisense oligonucleotide PRO051. N Engl J Med. 2007;357(26):2677–86. Van Deutekom JC, Janson AA, Ginjaar IB, Frankhuizen WS, Aartsma-Rus A, Bremmer-Bout M, et al. Local dystrophin restoration with antisense oligonucleotide PRO051. N Engl J Med. 2007;357(26):2677–86.
62.
go back to reference Goemans NM, Tulinius M, van den Akker JT, Burm BE, Ekhart PF, Heuvelmans N, et al. Systemic administration of PRO051 in Duchenne’s muscular dystrophy. N Engl J Med. 2011;364(16):1513–22. Goemans NM, Tulinius M, van den Akker JT, Burm BE, Ekhart PF, Heuvelmans N, et al. Systemic administration of PRO051 in Duchenne’s muscular dystrophy. N Engl J Med. 2011;364(16):1513–22.
64.
go back to reference Voit T, Topaloglu H, Straub V, Muntoni F, Deconinck N, Campion G, et al. Safety and efficacy of drisapersen for the treatment of Duchenne muscular dystrophy (DEMAND II): an exploratory randomized placebo-controlled phase 2 study. Lancet Neurol. 2014;13(10):987–99. Voit T, Topaloglu H, Straub V, Muntoni F, Deconinck N, Campion G, et al. Safety and efficacy of drisapersen for the treatment of Duchenne muscular dystrophy (DEMAND II): an exploratory randomized placebo-controlled phase 2 study. Lancet Neurol. 2014;13(10):987–99.
65.
go back to reference Rowel K, Lim Q, Maruyama R, Yokota T. Eteplirsen in the treatment of Duchenne muscular dystrophy. Drug Design Development and Therapt. 2017;11:533–45.CrossRef Rowel K, Lim Q, Maruyama R, Yokota T. Eteplirsen in the treatment of Duchenne muscular dystrophy. Drug Design Development and Therapt. 2017;11:533–45.CrossRef
66.
go back to reference Flanigan K, Voit T, Rosales X, Servais L, Kraus J, Wardell C, et al. Pharmacokinetics and safety of single doses of drisapersen in non-ambulant subjects with Duchenne muscular dystrophy: results of a double-blind randomized clinical trial. Neuromuscul Disord. 2014;24:16–24.CrossRefPubMed Flanigan K, Voit T, Rosales X, Servais L, Kraus J, Wardell C, et al. Pharmacokinetics and safety of single doses of drisapersen in non-ambulant subjects with Duchenne muscular dystrophy: results of a double-blind randomized clinical trial. Neuromuscul Disord. 2014;24:16–24.CrossRefPubMed
67.
go back to reference • Mendell J, Rodino-Klapac K, Sahenk Z. Eteplirsen for the treatment of Duchenne muscular dystrophy. Ann Neurol. 2013;74(5):637–47. This double-blinded placebo controlled study evaluated eteplirsen; it was the first FDA approved treatment for DMD.CrossRefPubMed • Mendell J, Rodino-Klapac K, Sahenk Z. Eteplirsen for the treatment of Duchenne muscular dystrophy. Ann Neurol. 2013;74(5):637–47. This double-blinded placebo controlled study evaluated eteplirsen; it was the first FDA approved treatment for DMD.CrossRefPubMed
68.
go back to reference Yu X, Bao B, Echigoya Y, Yokota T. Dystrophin-deficient large animal models: translation research and exon skipping. Am J Transl Res. 2015;7(8):1314–31.PubMedPubMedCentral Yu X, Bao B, Echigoya Y, Yokota T. Dystrophin-deficient large animal models: translation research and exon skipping. Am J Transl Res. 2015;7(8):1314–31.PubMedPubMedCentral
69.
go back to reference Hodgkinson, L. (2016). Biosimilar Medicines Group-14th Annual Medicines for Europe Conference (April 28-29, 2016-London, UK). Drugs of today (Barcelona, Spain: 1998) 52, 309. Hodgkinson, L. (2016). Biosimilar Medicines Group-14th Annual Medicines for Europe Conference (April 28-29, 2016-London, UK). Drugs of today (Barcelona, Spain: 1998) 52, 309.
70.
go back to reference Alter J, Lou F, Rabinowitz A, Yin H, Rosenfeld J, Wilton SD, et al. Systemic delivery of morpholino oligonucleotide restores dystrophin expression bodywide and improves dystrophic pathology. Nat Med. 2006;12:175–7. Alter J, Lou F, Rabinowitz A, Yin H, Rosenfeld J, Wilton SD, et al. Systemic delivery of morpholino oligonucleotide restores dystrophin expression bodywide and improves dystrophic pathology. Nat Med. 2006;12:175–7.
71.
go back to reference Betts C, Saleh AF, Arzumanov AA, Hammond SM, Godfrey C, Coursindel T, et al. Pip6-PMO, a new generation of peptide-oligonucleotide conjugates with improved cardiac exon skipping activity for DMD treatment. Molecular Therapy - Nucleic Acids. 2012;38:1–13. https://doi.org/10.1038/mtna.2012.30. Betts C, Saleh AF, Arzumanov AA, Hammond SM, Godfrey C, Coursindel T, et al. Pip6-PMO, a new generation of peptide-oligonucleotide conjugates with improved cardiac exon skipping activity for DMD treatment. Molecular Therapy - Nucleic Acids. 2012;38:1–13. https://​doi.​org/​10.​1038/​mtna.​2012.​30.
72.
go back to reference Goyenvalle A, Griffith G, Babbs A, Andaloussi SE, Ezzat K, Avril A, et al. Functional correction in mouse models of muscular dystrophy using exon-skipping tricyclo-DNA oligomers. Nat Med. 2015;21(3):270–5. https://doi.org/10.1038/nm.3765. Goyenvalle A, Griffith G, Babbs A, Andaloussi SE, Ezzat K, Avril A, et al. Functional correction in mouse models of muscular dystrophy using exon-skipping tricyclo-DNA oligomers. Nat Med. 2015;21(3):270–5. https://​doi.​org/​10.​1038/​nm.​3765.
73.
go back to reference Cirak S, Feng L, Anthony K, Arechavala-Gomeza V, Torelli S, Sewry C, et al. Restoration of the dystrophin-associated glycoprotein complex after exon skipping therapy in Duchenne muscular dystrophy. Mol Ther. 2012;20(2):462–7. https://doi.org/10.1038/mt.2011.248. Cirak S, Feng L, Anthony K, Arechavala-Gomeza V, Torelli S, Sewry C, et al. Restoration of the dystrophin-associated glycoprotein complex after exon skipping therapy in Duchenne muscular dystrophy. Mol Ther. 2012;20(2):462–7. https://​doi.​org/​10.​1038/​mt.​2011.​248.
74.
go back to reference Wagner K, Hamed S, Hadley D, et al. Gentamicin treatment of Duchenne and Becker muscular dystrophy due to nonsend mutations. Ann Neurol. 2001;49(6):706–11.CrossRefPubMed Wagner K, Hamed S, Hadley D, et al. Gentamicin treatment of Duchenne and Becker muscular dystrophy due to nonsend mutations. Ann Neurol. 2001;49(6):706–11.CrossRefPubMed
75.
go back to reference Politano L, Nigro G, Nigro V et al. Gentamicin administration in Duchenne patients with premature stop codon Preliminary results. Acta Myol 2003;(1):15–21. Politano L, Nigro G, Nigro V et al. Gentamicin administration in Duchenne patients with premature stop codon Preliminary results. Acta Myol 2003;(1):15–21.
76.
go back to reference Malik V, Rodino-Klapac LR, Viollet L, Mendell JR. Aminoglycoside-induced mutation suppression (stop codon readthrough) as a therapeutic strategy for Duchenne muscular dystrophy. Ther Adv Neurol Disord. 2010;3(6):379–89.CrossRefPubMedPubMedCentral Malik V, Rodino-Klapac LR, Viollet L, Mendell JR. Aminoglycoside-induced mutation suppression (stop codon readthrough) as a therapeutic strategy for Duchenne muscular dystrophy. Ther Adv Neurol Disord. 2010;3(6):379–89.CrossRefPubMedPubMedCentral
77.
go back to reference Malik V, Rodino-Klapac L, Viollet L, Wall C, King W, al-Dahhak R, et al. Gentamicin-induced read through of stop codons in Duchenne muscular dystrophy. Ann Neurol. 2010;67(6):771–80. Malik V, Rodino-Klapac L, Viollet L, Wall C, King W, al-Dahhak R, et al. Gentamicin-induced read through of stop codons in Duchenne muscular dystrophy. Ann Neurol. 2010;67(6):771–80.
78.
go back to reference Yokota T, Lu QL, Partridge T, Kobayashi M, Nakamura A, Takeda S, et al. Efficacy of systemic morpholino exon- skipping in Duchenne dystrophy dogs. Ann Neurol. 2003;65:667–76. Yokota T, Lu QL, Partridge T, Kobayashi M, Nakamura A, Takeda S, et al. Efficacy of systemic morpholino exon- skipping in Duchenne dystrophy dogs. Ann Neurol. 2003;65:667–76.
79.
go back to reference Cirak S, Arechavala-Gomeza V, Guglieri M, Feng L, Torelli S, Anthony K, et al. Exon skipping and dystrophin restoration in patients with Duchenne muscular dystrophy after systemic phosphorodiamidate morpholino oligomer treatment: an open-label, phase 2, dose-escalation study. Lancet. 2011;378:595–605. Cirak S, Arechavala-Gomeza V, Guglieri M, Feng L, Torelli S, Anthony K, et al. Exon skipping and dystrophin restoration in patients with Duchenne muscular dystrophy after systemic phosphorodiamidate morpholino oligomer treatment: an open-label, phase 2, dose-escalation study. Lancet. 2011;378:595–605.
82.
go back to reference Haas M, Vlcek V, Balabanov P, Salmonson T, Bakchine S, Markey G, et al. European Medicines Agency review of Ataluren for the treatment of ambulant patients aged 5 years and older with Duchenne muscular dystrophy resulting from a nonsense mutation in the dystrophin gene. Neuromuscul Disord. 2015;25(1):5–13. https://doi.org/10.1016/j.nmd.2014.11.011. Haas M, Vlcek V, Balabanov P, Salmonson T, Bakchine S, Markey G, et al. European Medicines Agency review of Ataluren for the treatment of ambulant patients aged 5 years and older with Duchenne muscular dystrophy resulting from a nonsense mutation in the dystrophin gene. Neuromuscul Disord. 2015;25(1):5–13. https://​doi.​org/​10.​1016/​j.​nmd.​2014.​11.​011.
89.
go back to reference Cossu G, Previtali SC, Napolitano S, Cicalese MP, Tedesco FS, Nicastro F, et al. Intra-arterial transplantation of hla-matched donor mesioangioblasts in Duchenne muscular dystrophy. EMBO Mol Med. 2015;7(12):1513–28. Cossu G, Previtali SC, Napolitano S, Cicalese MP, Tedesco FS, Nicastro F, et al. Intra-arterial transplantation of hla-matched donor mesioangioblasts in Duchenne muscular dystrophy. EMBO Mol Med. 2015;7(12):1513–28.
92.
go back to reference Ricotti V, Spinty S, Roper H, Hughes I, Tejura B, Robinson N, et al. Safety, tolerability, and pharmacokinetics of SMT C1100, a 2-Arylbenzoxazole utrophin modulator, following single-and multiple-dose administration to pediatric patients with Duchenne muscular dystrophy. PLoS One. 2016;11(4):1–16.e0152840 Ricotti V, Spinty S, Roper H, Hughes I, Tejura B, Robinson N, et al. Safety, tolerability, and pharmacokinetics of SMT C1100, a 2-Arylbenzoxazole utrophin modulator, following single-and multiple-dose administration to pediatric patients with Duchenne muscular dystrophy. PLoS One. 2016;11(4):1–16.e0152840
93.
go back to reference Buyse GM, Goemans N, van den Hauwe M, Thijs D, de Groot IJM, Schara U, et al. Idebenone as a novel, therapeutic approach for Duchenne muscular dystrophy: results from a 12-month, double-blind, randomized placebo-controlled trial. Neuromuscul Disord. 2011;21(6):396–405. https://doi.org/10.1016/j.nmd.2011.02.016. Buyse GM, Goemans N, van den Hauwe M, Thijs D, de Groot IJM, Schara U, et al. Idebenone as a novel, therapeutic approach for Duchenne muscular dystrophy: results from a 12-month, double-blind, randomized placebo-controlled trial. Neuromuscul Disord. 2011;21(6):396–405. https://​doi.​org/​10.​1016/​j.​nmd.​2011.​02.​016.
95.
go back to reference Buyse GM, Voit T, Schara U, Straathof CS, D’Angelo MG, Bernert G, et al. Efficacy of idebenone on respiratory function in patients with Duchenne muscular dystrophy not using glucocorticoids (DELOS): a double-blind randomised placebo-controlled phase 3 trial. Lancet. 2015;385(9979):1748–57. Buyse GM, Voit T, Schara U, Straathof CS, D’Angelo MG, Bernert G, et al. Efficacy of idebenone on respiratory function in patients with Duchenne muscular dystrophy not using glucocorticoids (DELOS): a double-blind randomised placebo-controlled phase 3 trial. Lancet. 2015;385(9979):1748–57.
96.
go back to reference Heier CR, Damsker JM, Yu Q, Dillingham BC, Huynh T, Van der Meulen JH, et al. VBP15, a novel anti-inflammatory and membrane-stabilizer, improves muscular dystrophy without side effects: VBP15 improves muscular dystrophy. EMBO Molecular Medicine. 2013;5(10):1569–85. https://doi.org/10.1002/emmm.201302621. Heier CR, Damsker JM, Yu Q, Dillingham BC, Huynh T, Van der Meulen JH, et al. VBP15, a novel anti-inflammatory and membrane-stabilizer, improves muscular dystrophy without side effects: VBP15 improves muscular dystrophy. EMBO Molecular Medicine. 2013;5(10):1569–85. https://​doi.​org/​10.​1002/​emmm.​201302621.
97.
go back to reference Donovan J, Zimmer M, Offman E, Grant T, Jirousek M. A novel NF-KB inhibitor, Edasalonexent (CAT-1004) in development as a disease-modifying treatment for patients with Duchene muscular dystrophy: phase I safety, pharmacokinetics, and pharmacodynamics in adult subjects. Journal of Clin Pharm. 2017;57(5):627–39.CrossRef Donovan J, Zimmer M, Offman E, Grant T, Jirousek M. A novel NF-KB inhibitor, Edasalonexent (CAT-1004) in development as a disease-modifying treatment for patients with Duchene muscular dystrophy: phase I safety, pharmacokinetics, and pharmacodynamics in adult subjects. Journal of Clin Pharm. 2017;57(5):627–39.CrossRef
101.
go back to reference Escolar DM, Zimmerman A, Bertorini T, Clemens PR, Connolly AM, Mesa L, et al. Pentoxifylline as a rescue treatment for DMD a randomized double-blind clinical trial. Neurology. 2012;78(12):904–13. Escolar DM, Zimmerman A, Bertorini T, Clemens PR, Connolly AM, Mesa L, et al. Pentoxifylline as a rescue treatment for DMD a randomized double-blind clinical trial. Neurology. 2012;78(12):904–13.
103.
go back to reference Consalvi S, Mozzetta C, Bettica P, Germani M, Fiorentini F, Del Bene F, et al. Preclinical studies in the mdx mouse model of Duchenne muscular dystrophy with the histone deacetylase inhibitor givinostat. Mol Med. 2003;19(1):79–87. Consalvi S, Mozzetta C, Bettica P, Germani M, Fiorentini F, Del Bene F, et al. Preclinical studies in the mdx mouse model of Duchenne muscular dystrophy with the histone deacetylase inhibitor givinostat. Mol Med. 2003;19(1):79–87.
106.
go back to reference Hafner P, Bonati U, Erne B, Schmid M, Rubino D, Pohlman U, et al. Improved muscle function in Duchenne muscular dystrophy through l-arginine and metformin: an investigator-initiated, open-label, single-center, proof-of-concept-study. PLoS One. 2016;11(1):1–19.e0147634 Hafner P, Bonati U, Erne B, Schmid M, Rubino D, Pohlman U, et al. Improved muscle function in Duchenne muscular dystrophy through l-arginine and metformin: an investigator-initiated, open-label, single-center, proof-of-concept-study. PLoS One. 2016;11(1):1–19.e0147634
107.
go back to reference Tarnopolsky MA, Mahoney DJ, Vajsar J, Rodriguez C, Doherty TJ, Roy BD, et al. Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy. Neurology. 2004;62(10):1771–7. Tarnopolsky MA, Mahoney DJ, Vajsar J, Rodriguez C, Doherty TJ, Roy BD, et al. Creatine monohydrate enhances strength and body composition in Duchenne muscular dystrophy. Neurology. 2004;62(10):1771–7.
108.
109.
go back to reference Péladeau C, Ahmed A, Amirouche A, Crawford Parks TE, Bronicki LM, Ljubicic V, et al. Combinatorial therapeutic activation with heparin and AICAR stimulates additive effects on utrophin. An expression in dystrophic muscles. Hum Mol Genet. 2016;25(1):24–43. https://doi.org/10.1093/hmg/ddv444. Péladeau C, Ahmed A, Amirouche A, Crawford Parks TE, Bronicki LM, Ljubicic V, et al. Combinatorial therapeutic activation with heparin and AICAR stimulates additive effects on utrophin. An expression in dystrophic muscles. Hum Mol Genet. 2016;25(1):24–43. https://​doi.​org/​10.​1093/​hmg/​ddv444.
110.
go back to reference Cohn RD, van Erp C, Habashi JP, Soleimani AA, Klein EC, Lisi MT, et al. Angiotensin II type 1 receptor blockade attenuates TGF-β–induced failure of muscle regeneration in multiple myopathic states. Nat Med. 2007;13(2):204–10. https://doi.org/10.1038/nm1536. Cohn RD, van Erp C, Habashi JP, Soleimani AA, Klein EC, Lisi MT, et al. Angiotensin II type 1 receptor blockade attenuates TGF-β–induced failure of muscle regeneration in multiple myopathic states. Nat Med. 2007;13(2):204–10. https://​doi.​org/​10.​1038/​nm1536.
111.
112.
113.
Metadata
Title
Current and Emerging Therapies for Duchenne Muscular Dystrophy
Authors
Megan Crone, MD, FRCPC
Jean K. Mah, MD, MSc, FRCPC
Publication date
01-08-2018
Publisher
Springer US
Published in
Current Treatment Options in Neurology / Issue 8/2018
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-018-0513-6

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