Efficacy, Safety and Tolerability of Givinostat in Non-ambulant Patients With Duchenne Muscular Dystrophy

NCT ID: NCT05933057

Last Updated: 2025-05-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

138 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-19

Study Completion Date

2028-02-29

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a randomised, double-blind, placebo-controlled, multicentre study to evaluate the efficacy, safety, and tolerability of givinostat in non-ambulant male paediatric (aged 9 to \<18 years) patients with DMD. 138 patients will be randomised 2:1 to givinostat or placebo and will be treated for 18 months.

* Planned screening duration: approximately 4 weeks (±14 days)
* Planned treatment duration: 18 months (approximately 72 weeks)
* Planned follow-up duration: 4 weeks (±7 days) (for patients not participating in the long-term safety study)
* Total duration of study participation: up to 83 weeks (ie, 20-21 months)

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Duchenne muscular dystrophy is a rare, progressive, debilitating and life-threatening condition for which there is a critical need for novel therapies that are effective and well-tolerated in all DMD patients. Steroids are generally recognised as the standard of care in the general DMD population; however, they are not suitable for all patients.

Givinostat, a HDAC inhibitor, was developed for the treatment of DMD based on: (i) the role that increased HDAC activity is thought to exert in contributing to DMD pathogenesis; and (ii) givinostat's ability to counter the pathophysiological and degenerative mechanisms causing muscle insufficiency in boys with DMD.

This study will evaluate the efficacy, safety, and tolerability of givinostat in non-ambulant patients to further corroborate data from the completed phase 3 pivotal study of givinostat in ambulant patients with DMD (ie, Study DSC/14/2357/48, NCT02851797). Primary Objective of the study is to demonstrate the efficacy of givinostat in reducing muscle decline in non-ambulant DMD patients, as measured by Performance of the Upper Limb (PUL) 2.0. Secondary Objectives of the study are to evaluate the safety and tolerability of givinostat in non-ambulant DMD patients, and to further explore the efficacy of givinostat in non-ambulant DMD patients.

A total of 138 patients are planned for enrolment. Patients will be randomised 2:1 to givinostat or placebo and will be treated for 18 months.

The study will be comprised of:

* A screening period, during which eligibility will be confirmed within 4 weeks (±14 days)
* A baseline visit, during which randomisation will be performed
* A double-blind treatment period, during which patients will receive either givinostat or placebo for 18 months (approximately 72 weeks)
* An end of study visit, occurring at Week 72 (±7 days) at the end of the treatment period. At the end of study visit, all the patients (regardless of treatment arm) will be offered enrolment in the long-term safety study DSC/14/2357/51 (NCT03373968) during which they will receive givinostat.
* A follow-up visit, for those patients not consenting to participation in the long-term safety study, that will occur 4 weeks after the end of study visit (ie, Week 76 ±7 days).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Duchenne Muscular Dystrophy

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Givinostat

Patients will receive concomitant corticosteroid treatment as part of the standard of care.

Group Type EXPERIMENTAL

Givinostat

Intervention Type DRUG

Givinostat has to be administered twice daily in a fed state according to a flexible dose regimen based on patient weight. Starting dose could be reduced based on predefined safety rules.

Placebo

Patients will receive concomitant corticosteroid treatment as part of the standard of care.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo, manufactured to mimic givinostat, has to be administered twice daily in a fed state according to a flexible dose regimen based on patient weight. Starting dose could be reduced based on predefined safety rules.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Givinostat

Givinostat has to be administered twice daily in a fed state according to a flexible dose regimen based on patient weight. Starting dose could be reduced based on predefined safety rules.

Intervention Type DRUG

Placebo

Placebo, manufactured to mimic givinostat, has to be administered twice daily in a fed state according to a flexible dose regimen based on patient weight. Starting dose could be reduced based on predefined safety rules.

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

ITF2357

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Patients must satisfy all the following criteria:

1. Children and adolescent males aged ≥ 9 to \<18 years at screening (patients ≥ 18 years of age at screening will not be enrolled into the study)
2. Are able to give informed assent and/or consent in writing signed by the patient and/or parent/legal guardian (according to local regulations)
3. A genetic diagnosis of DMD
4. Non-ambulant, defined as being wheelchair bound and:

1. Unable to perform the 10-meter walk/run test (10MWT), or
2. Unable to complete the 10MWT in 30 seconds or less, without any support or devices
5. Performance of the Upper Limb test (PUL version 2.0) entry item scores 3 to 6
6. If on medication for DMD-associated cardiomyopathy (eg, ACE inhibitor, β-blocker, diuretics), stable for ≥1 month immediately prior to start of study treatment, if any
7. Stable corticosteroids, defined as:

1. Receiving systemic corticosteroids for a minimum of 6 months immediately prior to start of study treatment
2. No significant change in dose or dosing regimen (except for adjustments due to body weight change) for a minimum of 6 months immediately prior to start of study treatment
8. Willing to use adequate contraception. Effective contraceptive methods must be used from randomisation visit through 3 months after the last dose of study drug, and include the following:

1. True abstinence (ie, absence of any sexual intercourse), when in line with the preferred and usual lifestyle of the patient. Periodic abstinence (eg, calendar, ovulation, post-ovulation, and symptothermal methods) and withdrawal are not acceptable methods of contraception
2. Condom with spermicide and the female partner must use an effective method of contraception, such as an oral, transdermal, injectable or implanted hormonal contraceptive; intrauterine device; bilateral tubal occlusion, or a diaphragm or a barrier method of contraception in conjunction with spermicidal jelly such as for example cervical cap with spermicide jelly.

Exclusion Criteria

Patients will be excluded from the study if they satisfy any of the following criteria:

1. Exposure to another investigational drug within 3 months prior to start of study treatment.
2. Have exposure to any dystrophin restoration product (eg, Ataluren, Exon skipping) within 6 months prior to the start of study treatment
3. Having received any gene therapy (eg, AAV Micro-dystrophin delivery) prior to start of study treatment
4. Use of any pharmacologic treatment or supplement (other than corticosteroids), that might have had an effect on muscle strength or function within 3 months prior to the start of study treatment (eg, growth hormone); vitamin D, calcium and any other supplements will be allowed
5. Use of testosterone, unless used as a replacement therapy for the treatment of delayed puberty. The testosterone dose and regimen should be stable within 6 months prior to the start of study treatment, and circulating testosterone levels should be within the normal ranges for the patient's age
6. Elbow-flexion contractures \>30° in the dominant arm
7. Inability to perform consistent PUL 2.0 measurement within ±2 points without shoulder domain or within ±3 points with shoulder domain during paired testing at screening
8. Forced Vital Capacity % of predicted \<40%
9. Requirement for daytime ventilator assistance (Note: Night ventilator assistance and use of bi-level positive airway pressure therapy is allowed)
10. Episode of respiratory failure within the 8 weeks prior to screening
11. Symptomatic cardiomyopathy or heart failure and/or left ventricular ejection fraction \<45%
12. Baseline corrected QT interval using Fredericia's formula (QTcF) \>450 msec (as the mean of 3 consecutive readings 5 minutes apart) or history of additional risk factors for torsades de pointes (eg, heart failure, hypokalaemia, or family history of long QT syndrome)
13. Major surgical procedure (including scoliosis surgery) planned within 1 year of the start of study treatment
14. Poorly controlled asthma or underlying lung disease such as bronchitis, bronchiectasis, emphysema, recurrent pneumonia that in the opinion of the Investigator might impact respiratory function
15. Platelets, white blood cells, and/or haemoglobin \< lower limit of normal (LLN) at screening (Note: for abnormal screening laboratory test results \[\<LLN\], the platelets count, white blood cell, and haemoglobin will be repeated once; if the repeat test result is still \<LLN, the patient should be excluded)
16. Fasting triglycerides \>300 mg/dL (3.42 mmol/L) at screening (Note: if the value is \>300 mg/dL, the triglycerides will be repeated once; if the repeated test result is still \>300 mg/dL, the patient should be excluded)
17. Current or history of liver disease or impairment, including but not limited to a baseline elevated total bilirubin (ie, \>1.5 × upper limit of normal \[ULN\]), unless secondary to Gilbert disease or pattern consistent with Gilbert disease
18. Inadequate renal function, as defined by serum Cystatin C result \>2 × ULN (Note: if the value is \>2 × ULN, the serum Cystatin C will be repeated once; if the repeated test result is still \>2 × ULN, the patient should be excluded)
19. Positive test for hepatitis B surface antigen, hepatitis C antibody, or human immunodeficiency virus at screening
20. Hypersensitivity to any component of study medication
21. Sorbitol intolerance or malabsorption, or have the hereditary form of fructose intolerance
22. Diagnosis of other uncontrolled neurological diseases or presence of relevant uncontrolled somatic disorders that are not related to DMD, based on Investigator judgement
23. Psychiatric illness or social situations rendering the potential patient unable to understand and comply with the muscle function tests and/or with the study protocol procedures, based on Investigator judgement
24. Have contraindications to MRI scan (eg, claustrophobia, metal implants, or uncontrolled seizure disorder), based on Investigator's judgement.
Minimum Eligible Age

9 Years

Maximum Eligible Age

17 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Fortrea

INDUSTRY

Sponsor Role collaborator

Italfarmaco

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Universitaire Ziekenhuizen Leuven

Leuven, , Belgium

Site Status RECRUITING

British Columbia Children's Hospital

Vancouver, British Columbia, Canada

Site Status RECRUITING

The University of Western Ontario - Children's Health Research Institute

London, Ontario, Canada

Site Status RECRUITING

University of Ottawa - Children's Hospital of Eastern Ontario

Ottawa, Ontario, Canada

Site Status RECRUITING

University of Toronto - Holland Bloorview Kids Rehabilitation Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

Centre Hospitalier Régional Universitaire de Lille

Lille, , France

Site Status RECRUITING

Centre hospitalier universitaire - Hôpitaux de Marseille

Marseille, , France

Site Status RECRUITING

Hôpital Armand-Trousseau - I-Motion

Paris, , France

Site Status RECRUITING

Charite-Universitaetsmedizin Berlin

Berlin, , Germany

Site Status RECRUITING

Universitaetsklinikum Freiburg

Freiburg im Breisgau, , Germany

Site Status RECRUITING

Associazione La Nostra Famiglia - IRCCS Eugenio Medea - Bosisio Parini

Lecco, , Italy

Site Status RECRUITING

Fondazione Serena Onlus - Azienda Ospedaliera Niguarda Ca' Granda - NeuroMuscular Omnicentre

Milan, , Italy

Site Status RECRUITING

Università degli Studi di Padova - Azienda Ospedaliera di Padova

Padua, , Italy

Site Status RECRUITING

Ospedale Pediatrico Bambino Gesù

Roma, , Italy

Site Status RECRUITING

Policlinico Universitario Agostino Gemelli - Università Cattolica del Sacro Cuore

Roma, , Italy

Site Status RECRUITING

Leids Universitair Medisch Centrum (LUMC)

Leiden, , Netherlands

Site Status RECRUITING

Radboud Universitair Medisch Centrum (Radboudumc)

Nijmegen, , Netherlands

Site Status RECRUITING

Newcastle upon Tyne Hospitals NHS Foundation Trust - Newcastle University

Newcastle upon Tyne, England, United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Oxford University Hospitals NHS Foundation Trust

Oxford, England, United Kingdom

Site Status WITHDRAWN

NHS Greater Glasgow and Clyde - Royal Hospital for Children

Glasgow, Scotland, United Kingdom

Site Status ACTIVE_NOT_RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Belgium Canada France Germany Italy Netherlands United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Italfarmaco Patient Advocacy

Role: CONTACT

+39 02 6443 1

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Role: primary

+3216348177

Role: primary

604-875-2345 ext. 6549

Role: primary

+1 519-685-8441

Role: primary

+1 613-737-7600 ext. 4017

Role: primary

Role: primary

+33 (3) 20 44 60 58

Role: primary

+33 4 91 38 68 17

Role: primary

+33 1 44 73 65 37

Role: primary

Role: primary

+49 (0)76127043000

Role: primary

+39031-877111

Role: primary

(+39) 0291433764

Role: primary

+39 049 8213622

Role: backup

Role: primary

+39 06 68592105

Role: backup

Role: primary

+39 0630158576

Role: primary

Role: primary

+31(0)650176591

References

Explore related publications, articles, or registry entries linked to this study.

Bettica P, Petrini S, D'Oria V, D'Amico A, Catteruccia M, Pane M, Sivo S, Magri F, Brajkovic S, Messina S, Vita GL, Gatti B, Moggio M, Puri PL, Rocchetti M, De Nicolao G, Vita G, Comi GP, Bertini E, Mercuri E. Histological effects of givinostat in boys with Duchenne muscular dystrophy. Neuromuscul Disord. 2016 Oct;26(10):643-649. doi: 10.1016/j.nmd.2016.07.002. Epub 2016 Jul 11.

Reference Type BACKGROUND
PMID: 27566866 (View on PubMed)

Consalvi S, Mozzetta C, Bettica P, Germani M, Fiorentini F, Del Bene F, Rocchetti M, Leoni F, Monzani V, Mascagni P, Puri PL, Saccone V. Preclinical studies in the mdx mouse model of duchenne muscular dystrophy with the histone deacetylase inhibitor givinostat. Mol Med. 2013 May 20;19(1):79-87. doi: 10.2119/molmed.2013.00011.

Reference Type BACKGROUND
PMID: 23552722 (View on PubMed)

Mercuri E, Vilchez JJ, Boespflug-Tanguy O, Zaidman CM, Mah JK, Goemans N, Muller-Felber W, Niks EH, Schara-Schmidt U, Bertini E, Comi GP, Mathews KD, Servais L, Vandenborne K, Johannsen J, Messina S, Spinty S, McAdam L, Selby K, Byrne B, Laverty CG, Carroll K, Zardi G, Cazzaniga S, Coceani N, Bettica P, McDonald CM; EPIDYS Study Group. Safety and efficacy of givinostat in boys with Duchenne muscular dystrophy (EPIDYS): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol. 2024 Apr;23(4):393-403. doi: 10.1016/S1474-4422(24)00036-X.

Reference Type BACKGROUND
PMID: 38508835 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2023-503521-19

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

U1111-1295-1799

Identifier Type: OTHER

Identifier Source: secondary_id

1008441

Identifier Type: OTHER

Identifier Source: secondary_id

277453

Identifier Type: OTHER

Identifier Source: secondary_id

DSC/14/2357/50

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

NS-050/NCNP-03 in Boys With DMD (Meteor50)
NCT06053814 RECRUITING PHASE1/PHASE2