PLoS Medicine (Sep 2020)

Efficacy and safety of vamorolone in Duchenne muscular dystrophy: An 18-month interim analysis of a non-randomized open-label extension study.

  • Edward C Smith,
  • Laurie S Conklin,
  • Eric P Hoffman,
  • Paula R Clemens,
  • Jean K Mah,
  • Richard S Finkel,
  • Michela Guglieri,
  • Mar Tulinius,
  • Yoram Nevo,
  • Monique M Ryan,
  • Richard Webster,
  • Diana Castro,
  • Nancy L Kuntz,
  • Laurie Kerchner,
  • Lauren P Morgenroth,
  • Adrienne Arrieta,
  • Maya Shimony,
  • Mark Jaros,
  • Phil Shale,
  • Heather Gordish-Dressman,
  • Laura Hagerty,
  • Utkarsh J Dang,
  • Jesse M Damsker,
  • Benjamin D Schwartz,
  • Laurel J Mengle-Gaw,
  • Craig M McDonald,
  • CINRG VBP15 and DNHS Investigators

DOI
https://doi.org/10.1371/journal.pmed.1003222
Journal volume & issue
Vol. 17, no. 9
p. e1003222

Abstract

Read online

BackgroundTreatment with corticosteroids is recommended for Duchenne muscular dystrophy (DMD) patients to slow the progression of weakness. However, chronic corticosteroid treatment causes significant morbidities. Vamorolone is a first-in-class anti-inflammatory investigational drug that has shown evidence of efficacy in DMD after 24 weeks of treatment at 2.0 or 6.0 mg/kg/day. Here, open-label efficacy and safety experience of vamorolone was evaluated over a period of 18 months in trial participants with DMD.Methods and findingsA multicenter, open-label, 24-week trial (VBP15-003) with a 24-month long-term extension (VBP15-LTE) was conducted by the Cooperative International Neuromuscular Research Group (CINRG) and evaluated drug-related effects of vamorolone on motor outcomes and corticosteroid-associated safety concerns. The study was carried out in Canada, US, UK, Australia, Sweden, and Israel, from 2016 to 2019. This report covers the initial 24-week trial and the first 12 months of the VBP15-LTE trial (total treatment period 18 months). DMD trial participants (males, 4 to ConclusionsWe observed that vamorolone treatment was associated with improvements in some motor outcomes as compared with corticosteroid-naïve individuals over an 18-month treatment period. We found that fewer physician-reported AEs occurred with vamorolone than have been reported for treatment with prednisone and deflazacort, and that vamorolone treatment did not cause the stunting of growth seen with these corticosteroids. This Phase IIa study provides Class III evidence to support benefit of motor function in young boys with DMD treated with vamorolone 2.0 to 6.0 mg/kg/day, with a favorable safety profile. A Phase III RCT is underway to further investigate safety and efficacy.Trial registrationClinical trials were registered at www.clinicaltrials.gov, and the links to each trial are as follows (as provided in manuscript text): VBP15-002 [NCT02760264] VBP15-003 [NCT02760277] VBP15-LTE [NCT03038399].