Duchenne muscular dystrophy: promising early-stage clinical trials to watch

Expert Opin Investig Drugs. 2024 Mar;33(3):201-217. doi: 10.1080/13543784.2024.2313105. Epub 2024 Feb 6.

Abstract

Introduction: Current therapies are unable to cure Duchenne muscular dystrophy (DMD), a severe and common form of muscular dystrophy, and instead aim to delay disease progression. Several treatments currently in phase I trials could increase the number of therapeutic options available to patients.

Areas covered: This review aims to provide an overview of current treatments undergoing or having recently undergone early-stage trials. Several exon-skipping and gene therapy approaches are currently being investigated at the clinical stage to address an unmet need for DMD treatments. This article also covers Phase I trials from the last 5 years that involve inhibitors, small molecules, a purified synthetic flavanol, a cell-based therapy, and repurposed cardiac or tumor medications.

Expert opinion: With antisense oligonucleotide (AON) treatments making up the majority of conditionally approved DMD therapies, most of the clinical trials occurring within the last 5 years have also evaluated exon-skipping AONs. The approval of Elevidys, a micro-dystrophin therapy, is reflected in a recent trend toward gene transfer therapies in phase I DMD clinical trials, but their safety and efficacy are being established in this phase of development. Other Phase I clinical-stage approaches are diverse, but have a range in efficacy, safety, and endpoint measures.

Keywords: Clinical trial; Duchenne muscular dystrophy (DMD); antisense oligonucleotide; exon-skipping therapy; gene therapy; micro-dystrophin; mini-dystrophin; phase I.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Genetic Therapy
  • Humans
  • Muscular Dystrophy, Duchenne* / genetics
  • Muscular Dystrophy, Duchenne* / therapy
  • Oligonucleotides, Antisense / therapeutic use
  • RNA Splicing

Substances

  • Oligonucleotides, Antisense