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A Phase III Double-blind Study With Idebenone in Patients With Duchenne Muscular Dystrophy (DMD) Taking Glucocorticoid Steroids (SIDEROS)

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ClinicalTrials.gov Identifier: NCT02814019
Recruitment Status : Recruiting
First Posted : June 27, 2016
Last Update Posted : November 29, 2017
Information provided by (Responsible Party):
Santhera Pharmaceuticals

Brief Summary:
The purpose of the study is to assess the efficacy of idebenone in delaying the loss of respiratory function in patients with DMD receiving concomitant glucocorticoid steroids

Condition or disease Intervention/treatment Phase
Duchenne Muscular Dystrophy (DMD) Drug: Idebenone 150 mg film-coated tablets Drug: placebo Phase 3

Detailed Description:

The SIDEROS trial is a randomized, placebo controlled, parallel group study of the efficacy of idebenone in delaying the loss of respiratory function, whilst also monitoring safety and tolerability of idebenone in at least 266 DMD patients taking stable dose of concomitant glucocorticoid steroids.

The study treatment period will be 18 months/ 78 weeks and the idebenone dose will be 900 mg/day. Participants can use deflazacort or prednisolone and be on any dose regimen.

Since glucocorticoid steroids are widely used in ambulant boys from an early age until late into teenage and even adult years, this study will not take age and ambulatory status into account and will only exclude patients that need daytime ventilator assistance.

The schedule of assessments will include a Screening Visit and up to 9 protocol visits, including a Follow-up Visit.

A Screening Visit will take place a maximum of 6 weeks prior to the Baseline Visit (Visit 1, study day -1). Beginning at Baseline, the patient will receive study medication to be taken at home, and will undergo regular assessments in the clinic throughout the study period until Visit 8 at Week 78 at which time the study will be completed and medication discontinued.

All patients completing Visit 8/Week 78, and considered eligible by the Investigator will be able to participate in an open-label extension study (SIDEROS-E) and will continue to receive idebenone until the SIDEROS-E is terminated or Marketing Authorization is obtained for idebenone in DMD, whichever occurs first. The duration of the SIDEROS-E study will be defined in a separate protocol.

For all patients not participating in the extension study (SIDEROS-E), a Follow-up Visit (Visit 9/Follow-up Visit) will take place 4 weeks after end of Treatment at Visit 8/Week 78 or after premature discontinuation of study medication.

Each hospital visit will include efficacy assessments (respiratory function assessed by hospital-based spirometry, oxygen saturation, end-tidal CO2) and safety assessments (adverse events, concomitant medication, physical examination, vital signs, safety laboratory evaluations). In addition, respiratory function will be assessed weekly at home with a hand-held device in order to closely monitor respiratory function between hospital visits.

The study medication, all medical procedures and laboratory testing, and the visits to the study centre are free of charge. In addition the patients will receive a travel allowance to cover reasonable expenses to and from the study centre. Participants will not otherwise be compensated for this study.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 266 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase III Double-blind, Randomized, Placebo-Controlled Study Assessing the Efficacy, Safety and Tolerability of Idebenone in Patients With Duchenne Muscular Dystrophy Receiving Glucocorticoid Steroids
Study Start Date : September 2016
Estimated Primary Completion Date : July 2019
Estimated Study Completion Date : August 2019

Arm Intervention/treatment
Experimental: idebenone 150 mg film-coated tablets
900 mg idebenone/day (2 tablets to be taken 3 times a day with meals)
Drug: Idebenone 150 mg film-coated tablets
Placebo Comparator: placebo
matching placebo tablets
Drug: placebo

Primary Outcome Measures :
  1. Change From Baseline in Forced Vital Capacity percent predicted (FVC %p) at Week 78 [ Time Frame: 78 weeks ]
    Delaying the loss of respiratory function in patients with DMD receiving glucocorticoid steroids as measured by changes in FVC %p from Baseline to Week 78 using hospital based spirometry.

Secondary Outcome Measures :
  1. Change From Baseline in Percent Predicted Peak Expiratory Flow (PEF %p) at Week 78 [ Time Frame: 78 weeks ]

    Delaying the loss of respiratory function in patients with DMD receiving glucocorticoid steroids as measured by:

    •The change from Baseline to Week 78 in PEF %p assessed by hospital-based spirometry measurements

  2. Change From Baseline in Forced Vital Capacity (FVC) at Week 78 [ Time Frame: 78 weeks ]

    Delaying the loss of respiratory function in patients with DMD receiving glucocorticoid steroids as measured by:

    •The time to first 10% decline in FVC (L) during the 78-week treatment period, assessed by hospital-based spirometry measurements

  3. Change from Baseline in Inspiratory Flow Reserve (IFR) at Week 78 [ Time Frame: 78 weeks ]

    Delaying the loss of respiratory function in patients with DMD receiving glucocorticoid steroids as measured by:

    •The change from Baseline to Week 78 in IFR assessed by hospital-based spirometry measurements

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Male patients with a 30% ≤ FVC ≤ 80% of predicted value at Screening and at Baseline.
  2. Minimum 10 years old at Screening
  3. Signed and dated Informed Consent Form.
  4. Documented diagnosis of DMD (severe dystrophinopathy) and clinical features consistent of typical DMD at diagnosis. DMD should be confirmed by mutation analysis in the dystrophin gene or by substantially reduced levels of dystrophin protein (i.e. absent or <5% of normal) on Western blot or immunostaining.
  5. Chronic use of systemic glucocorticoid steroids for DMD related conditions continuously for at least 12 months prior to Baseline without any dose adjustments on a mg/kg basis in the last 6 months (only dose adjustment determined by weight changes are allowed).
  6. Ability to provide reliable and reproducible repeat FVC within 15% of the screening assessment at Baseline.
  7. Patients assessed by the Investigator as willing and able to comply with the requirements of the study, possess the required cognitive abilities and are able to swallow study medication.
  8. Patients who have been immunized with 23-valent pneumococcal polysaccharide vaccine or any other pneumococcal polysaccharide vaccine as per national recommendations, as well as annually immunized with inactivated influenza vaccine.

Exclusion Criteria:

  1. Symptomatic heart failure (defined as Stage C by ACCF/AHA guideline or NYHA III-IV) and/or symptomatic ventricular arrhythmias.
  2. Ongoing participation in any other therapeutic trial and/or intake of any investigational drug within 90 days prior to Baseline (only exception allowed is use of Deflazacort in US as part of the Expanded Access Program).
  3. Prior or ongoing exon-skipping or read-through therapy for DMD.
  4. Planned or expected spinal fixation surgery during the study period (as judged by the Investigator, i.e. due to rapidly progressing scoliosis), prior spinal fixation surgery is allowed if it took place more than 6 months prior to Screening.
  5. Asthma, bronchitis/COPD, bronchiectasis, emphysema, pneumonia or presence of any other non-DMD respiratory illness that affects respiratory function.
  6. Chronic use of beta2-agonists or any use of other bronchodilating/bronchoconstricting medication (inhaled steroids, sympathomimetics, anti-cholinergics, antihistamines); chronic use is defined as a daily intake for more than 14 days.
  7. Any bronchopulmonary illness that required treatment with antibiotics within 3 months prior to Screening.
  8. Moderate or severe hepatic impairment (Child-Pugh class B [7 to 9 points] or Child-Pugh class C [10 to 15 points]) or severe renal impairment (eGFR <30 mL/min/1.73 m2).
  9. Prior or ongoing medical condition or laboratory abnormality which in the Investigator's opinion may put the patient at significant risk, may confound the study results or may interfere significantly with the patient's participation in the study (please see below Note).
  10. History of or current drug or alcohol abuse or use of any tobacco/marijuana products/smoking.
  11. Known individual hypersensitivity to idebenone or to any of the ingredients/excipients of the study medication.
  12. Daytime ventilator assistance (defined as use of any assisted ventilation while awake).

Note: Patients who suffer from a severe, unstable condition including (but not limited to) cancer, auto-immune diseases, hematological diseases, metabolic disorders or immunodeficiencies, and who are at risk of an aggravation unrelated to the study condition, can only be included in the study if accepted in writing by the Sponsor's Senior Clinical Research Physician.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02814019

Contact: Jodi Wolff sideros@santhera.com

  Hide Study Locations
United States, Alabama
University of Alabama Recruiting
Birmingham, Alabama, United States, 35233
Principal Investigator: Bradley Troxler, MD         
United States, Arizona
Phoenix Children's Hospital Recruiting
Phoenix, Arizona, United States, 85016
Principal Investigator: James Woodward, MD         
Banner University of Arizona Medical Center Recruiting
Tucson, Arizona, United States
Principal Investigator: Cori Daines, MD         
United States, Arkansas
Arkansas Children's Hospital Recruiting
Little Rock, Arkansas, United States, 72202
Principal Investigator: Vikki Stefans, MD         
United States, California
David Geffen School of Medicine at UCLA Recruiting
Los Angeles, California, United States, 90095
Principal Investigator: Perry Shieh, MD         
Childrens Hospital of Los Angeles Not yet recruiting
Los Angeles, California, United States
Principal Investigator: Leigh Maria Ramos Platt         
UC Davis Department of Physical Medicine and Rehabilitation Recruiting
Sacramento, California, United States
Principal Investigator: Craig McDonald, MD         
Loma Linda University Healthcare Recruiting
San Bernardino, California, United States
Principal Investigator: David Michelson         
United States, Florida
Shriners Hospitals for Children-Tampa Recruiting
Tampa, Florida, United States
Principal Investigator: Marisia Couluris, MD         
United States, Georgia
Rare Disease Research Recruiting
Atlanta, Georgia, United States
Principal Investigator: Han Phan, MD         
United States, Indiana
Indiana University Recruiting
Indianapolis, Indiana, United States
Principal Investigator: Marcia Felker, MD         
United States, Iowa
University of Iowa Recruiting
Iowa City, Iowa, United States, 52242
Principal Investigator: Kathy Mathews, MD         
United States, Kansas
University of Kansas Recruiting
Fairway, Kansas, United States, 66160
Principal Investigator: Jeff Statland, MD         
United States, Maryland
Johns Hopkins University Recruiting
Baltimore, Maryland, United States
Principal Investigator: Thomas Crawford, MD         
United States, Massachusetts
Children's Hospital Boston Recruiting
Boston, Massachusetts, United States
Principal Investigator: Basil Darras, MD         
United States, Minnesota
Gillette Children's Specialty Healthcare Recruiting
Saint Paul, Minnesota, United States
Principal Investigator: Stephen A Smith, MD         
United States, North Carolina
Neurosciences Institute, Neurology - Charlotte Carolinas Healthcare System Recruiting
Charlotte, North Carolina, United States
Principal Investigator: Benjamin Brooks, MD         
United States, Ohio
Cincinnati Children's Hospital Not yet recruiting
Cincinnati, Ohio, United States
Principal Investigator: Cuixia Tian, MD         
MetroHealth Medical Center Recruiting
Cleveland, Ohio, United States, OH 44109
Principal Investigator: Andre Prochoroff, MD         
United States, Pennsylvania
Children's Hospital of Philadelphia Recruiting
Philadelphia, Pennsylvania, United States, 19104-1771
Principal Investigator: Oscar Mayer, MD         
United States, Tennessee
Wesley Neurology Clinic Recruiting
Memphis, Tennessee, United States
Principal Investigator: Tulio Bertorini, MD         
United States, Texas
Cook Children's Medical Center Recruiting
Fort Worth, Texas, United States, 76104
Principal Investigator: Warren Marks, MD         
United States, Utah
University of Utah Recruiting
Salt Lake City, Utah, United States
Principal Investigator: Russell Butterfield, MD         
Gottfried von Preyer'sches Kinderspital Recruiting
Wien, Austria
Principal Investigator: Bernert Guenther, MD         
University Hospital Leuven Recruiting
Leuven, Belgium, 3000
Principal Investigator: Gunnar Buyse, MD         
Centre de Référence Neuromusculaire, CHR Citadelle Recruiting
Liège, Belgium, 4000
Principal Investigator: Laurent Servais, MD         
Service de neuropédiatrie Pôle Pédiatrie CHRU de Lille - Hôpital Jeanne de Flandre Recruiting
Lille, France, 59037
Principal Investigator: Jean-Marie Cuisset, MD         
CHRU de Montpellier - Hôpital Gui de Chauliac Recruiting
Montpellier, France
Principal Investigator: Ulrike Walther-Louvier, MD         
Hôpital Hôtel Dieu Recruiting
Nantes, France
Principal Investigator: Yann Pereon         
I-Motion - Plateforme d'essais cliniques pédiatriques Hôpital Armand Trousseau bâtiment Lemariey porte 20 Recruiting
Paris, France
Principal Investigator: Teresa Gidaro, MD         
Hôpital des enfants Recruiting
Toulouse, France, 31059
Principal Investigator: Claude Cancès, MD         
Universitätsmedizin Berlin Campus Virchow-Klinikum Recruiting
Berlin, Germany, 13353
Principal Investigator: Angela Kaindl         
Universitätsklinikum Essen Recruiting
Essen, Germany, 45147
Principal Investigator: Ulrike Schara         
Universitätsklinik Freiburg Zentrum für Kinderheilkunde und Jugendmedizin Recruiting
Freiburg, Germany
Principal Investigator: Janbernd Kirschner, MD         
Universitätsklinikum Hamburg-Eppendorf, Klinik für Kinder- und Jugendmedizin Recruiting
Hamburg, Germany, 20246
Principal Investigator: Jessika Johannsen         
Uniklinik Köln Recruiting
Köln, Germany
Principal Investigator: Sebahattin Cirak, MD         
Center for neuromuscular disorders Recruiting
Munich, Germany
Principal Investigator: Wolfgang Müller-Felber, MD         
Institute of Neurology at Schneider Children's Medical Center of Israel Not yet recruiting
Petah Tiqva, Israel, 4920235
Principal Investigator: Yoram Nevo, MD         
Fondazione IRCCS Eugenio Medea Recruiting
Bosisio Parini, Italy
Principal Investigator: Maria Grazia Nadia D'Angelo, MD         
Istituto Giannina Gaslini Recruiting
Genova, Italy
Principal Investigator: Claudio Bruno, MD         
Scientific Coordinator Nemo Sud Clinical Center Recruiting
Messina, Italy
Principal Investigator: Giuseppe Vita, MD         
Centro Clinico NEMO (NEuroMuscular Omnicentre), Niguarda Hospital Recruiting
Milano, Italy
Principal Investigator: Valeria Sansone, MD         
Servizio di Cardiomiologia e Genetica Medica, AOU Università degli Studi della Campania "Luigi Vanvitelli" Recruiting
Napoli, Italy, 80131
Principal Investigator: Luisa Politano, MD         
Reparto Di Neurologia dell'Osperdale Di Padova Recruiting
Padova, Italy, 35122
Principal Investigator: Elena Pegoraro         
Dipartimento di Clinica Neurologica e Psichiatrica dell'Età Evolutiva della Fondazione IRCCS "C. Mondino" di Pavia Recruiting
Pavia, Italy, 27100
Principal Investigator: Angela Berardinelli         
U.O.C. Neuropsichiatria Infantile Recruiting
Roma, Italy
Principal Investigator: Eugenio Mercuri, MD         
LUMC Recruiting
Leiden, Netherlands
Principal Investigator: Chiara Straathof, MD         
Radboud university medical centre Recruiting
Nijmegen, Netherlands
Principal Investigator: Imelda J M De Groot, MD         
Hospital Sant Joan de Déu Neuropediatra Recruiting
Barcelona, Spain, 08950
Principal Investigator: Andres Nascimiento, MD         
Hospital Universitari Vall D' Hebron Recruiting
Barcelona, Spain, 8950
Principal Investigator: Francina Munell, MD         
Hospital Universitario La Paz Not yet recruiting
Madrid, Spain, 28046
Principal Investigator: Samuel Pascual         
Hospital Universitario Virgen del Rocio Recruiting
Sevilla, Spain, 41013
Principal Investigator: Marcos Madruga         
Hospital La Fe de Valencia Recruiting
Valencia, Spain, 106 46026
Principal Investigator: Juan Jesus Vilchez, MD         
Sahlgrenska University Hospital Not yet recruiting
Gothenburg, Sweden
Principal Investigator: Mar Tulinius, MD         
Karolinska Universitetssjukhuset Not yet recruiting
Karolinska, Sweden
Principal Investigator: Thomas Sejersen, MD         
Center for neuromuscular disorders, Universitäts-Kinderspital beider Basel (UKBB) Recruiting
Basel, Switzerland, 4301
Principal Investigator: Andrea Klein, MD         
United Kingdom
Leeds Teaching Hospital NHS Trust Recruiting
Leeds, United Kingdom, LS1 3EX
Principal Investigator: Anne-Marie Childs         
UCL, National Hospital for Neurology and Neurosurgery Recruiting
London, United Kingdom, WC1 3BG
Principal Investigator: Rosaline Quinlivan         
Great Ormond Street Hospital for Children Recruiting
London, United Kingdom, WC1N 3JH
Principal Investigator: Pinki Munot         
John Walton Muscular Dystrophy Research Centre Recruiting
Newcastle, United Kingdom
Principal Investigator: Michela Guglieri, MD         
Robert Jones and Agnes Hunt Orthopaedic Hospital Recruiting
Oswestry, United Kingdom, SY10 7AG
Principal Investigator: Tracey Willis         
Sponsors and Collaborators
Santhera Pharmaceuticals

Additional Information:
Responsible Party: Santhera Pharmaceuticals
ClinicalTrials.gov Identifier: NCT02814019     History of Changes
Other Study ID Numbers: SNT-III-012
First Posted: June 27, 2016    Key Record Dates
Last Update Posted: November 29, 2017
Last Verified: November 2017

Keywords provided by Santhera Pharmaceuticals:
respiratory function in DMD

Additional relevant MeSH terms:
Muscular Dystrophies
Muscular Dystrophy, Duchenne
Muscular Disorders, Atrophic
Muscular Diseases
Musculoskeletal Diseases
Neuromuscular Diseases
Nervous System Diseases
Genetic Diseases, Inborn
Genetic Diseases, X-Linked
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Molecular Mechanisms of Pharmacological Action
Protective Agents
Growth Substances