Disease progression rates in ambulatory Duchenne muscular dystrophy by steroid type, patient age and functional status

J Comp Eff Res. 2023 Apr;12(4):e220190. doi: 10.57264/cer-2022-0190. Epub 2023 Feb 7.

Abstract

Aim: To examine benefits of corticosteroids for Duchenne muscular dystrophy (DMD) by age and disease progression. Methods: Data from daily steroid users (placebo-treated) were pooled from four phase 2b/3 trials in DMD. Outcomes assessed overall and among subgroups included changes from baseline to 48 weeks in six-minute walk distance (6MWD), timed function tests and North Star Ambulatory Assessment total score. Results: Among 231 patients receiving deflazacort (n = 127) or prednisone (n = 104), observed differences in 6MWD favoring deflazacort over prednisone were significant for patients with relatively older age (≥8-years-old), greater disease progression (baseline timed stand from supine ≥5 s), or longer corticosteroid use (>3 years). Conclusion: Daily deflazacort had greater benefits than daily prednisone particularly among older/more progressed patients.

Keywords: Duchenne muscular dystrophy; clinical outcomes; deflazacort; disease milestones; efficacy; prednisone/prednisolone.

Publication types

  • Clinical Trial, Phase II
  • Clinical Trial, Phase III
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Child
  • Disease Progression
  • Functional Status
  • Humans
  • Muscular Dystrophy, Duchenne* / drug therapy
  • Prednisone / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Prednisone