Deflazacort versus prednisone/prednisolone for maintaining motor function and delaying loss of ambulation: A post HOC analysis from the ACT DMD trial

Muscle Nerve. 2018 Nov;58(5):639-645. doi: 10.1002/mus.26191. Epub 2018 Sep 27.

Abstract

Introduction: ACT DMD was a 48-week trial of ataluren for nonsense mutation Duchenne muscular dystrophy (nmDMD). Patients received corticosteroids for ≥6 months at entry and stable regimens throughout study. This post hoc analysis compares efficacy and safety for deflazacort and prednisone/prednisolone in the placebo arm.

Methods: Patients received deflazacort (n = 53) or prednisone/prednisolone (n = 61). Endpoints included change from baseline in 6-minute walk distance (6MWD), timed function tests, estimated age at loss of ambulation (extrapolated from 6MWD).

Results: Mean changes in 6MWD were -39.0 m (deflazacort; 95% confidence limit [CL], -68.85, -9.17) and -70.6 m (prednisone/prednisolone; 95% CL, -97.16, -44.02). Mean changes in 4-stair climb were 3.79 s (deflazacort; 95% CL, 1.54, 6.03) and 6.67 s (prednisone/prednisolone; 95% CL, 4.69, 8.64).

Conclusions: This analysis, limited by its post hoc nature, suggests greater preservation of 6MWD and 4-stair climb with deflazacort vs. prednisone/prednisolone. A head-to-head comparison will better define these differences. Muscle Nerve 58: 639-645, 2018.

Keywords: deflazacort; muscular dystrophy; prednisolone; prednisone; walking.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Age Factors
  • Anti-Inflammatory Agents / therapeutic use*
  • Child
  • Double-Blind Method
  • Dystrophin / genetics
  • Female
  • Humans
  • Male
  • Muscular Dystrophy, Duchenne / drug therapy*
  • Muscular Dystrophy, Duchenne / genetics
  • Muscular Dystrophy, Duchenne / physiopathology*
  • Prednisolone / therapeutic use*
  • Prednisone / therapeutic use*
  • Pregnenediones / therapeutic use*
  • Walk Test
  • Walking / physiology

Substances

  • Anti-Inflammatory Agents
  • DMD protein, human
  • Dystrophin
  • Pregnenediones
  • Prednisolone
  • deflazacort
  • Prednisone