Sitzia Clementina, Meregalli Mirella, Belicchi Marzia, Farini Andrea, Arosio Maddalena, Bestetti Denise, Villa Chiara, Valenti Luca, Brambilla Paolo, Torrente Yvan
Stem Cell Laboratory, Unit of Neurology, Department of Pathophysiology and Transplantation, Centro Dino Ferrari, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Service of Physiotherapy, San Raffaele Scientific Institute, Milan, Italy.
Front Neurol. 2019 Jul 23;10:755. doi: 10.3389/fneur.2019.00755. eCollection 2019.
Nutritional compounds can exert both anti-inflammatory and anti-oxidant effects. Since these events exacerbate the pathophysiology of muscular dystrophies, we investigated nutraceutical supplementation as an adjuvant therapy in dystrophic patients, to low costs and easy route of administration. Moreover, this treatment could represent an alternative therapeutic strategy for dystrophic patients who do not respond to corticosteroid treatment. A 24 weeks randomized double-blind placebo-controlled clinical study was aimed at evaluating the safety and efficacy of daily oral administration of flavonoids- and omega3-based natural supplement (FLAVOMEGA) in patients affected by muscular dystrophy with recognized muscle inflammation. We screened 60 patients diagnosed for Duchenne (DMD), Facioscapulohumeral (FSHD), and Limb Girdle Muscular Dystrophy (LGMD). Using a computer-generated random allocation sequence, we stratified patients in a 2:1:1 ratio (DMD:FSHD:LGMD) to one of two treatment groups: continuous FLAVOMEGA, continuous placebo. Of 29 patients included, only 24 completed the study: 15 were given FLAVOMEGA, 14 placebo. FLAVOMEGA was well tolerated with no reported adverse events. Significant treatment differences in the change from baseline in 6 min walk distance (6MWD; secondary efficacy endpoint) ( = 0.033) and in isokinetic knee extension ( = 0.039) (primary efficacy endpoint) were observed in LGMD and FSHD subjects. Serum CK levels (secondary efficacy endpoint) decreased in all FLAVOMEGA treated groups with significant difference in DMD subjects ( = 0.039). Although the small number of patients and the wide range of disease severity among patients reduced statistical significance, we obtained an optimal profile of safety and tolerability for the compound, showing valuable data of efficacy in primary and secondary endpoints. NCT03317171 Retrospectively registered 25/10/2017.
营养化合物可发挥抗炎和抗氧化作用。由于这些情况会加剧肌肉萎缩症的病理生理过程,我们研究了营养补充剂作为营养不良患者辅助治疗的方法,其成本低廉且给药途径简便。此外,这种治疗方法可能为对皮质类固醇治疗无反应的营养不良患者提供一种替代治疗策略。一项为期24周的随机双盲安慰剂对照临床研究旨在评估每日口服基于类黄酮和ω-3的天然补充剂(FLAVOMEGA)对患有公认肌肉炎症的肌肉萎缩症患者的安全性和有效性。我们筛选了60名被诊断为杜氏肌营养不良症(DMD)、面肩肱型肌营养不良症(FSHD)和肢带型肌营养不良症(LGMD)的患者。使用计算机生成的随机分配序列,我们将患者按2:1:1的比例(DMD:FSHD:LGMD)分层到两个治疗组之一:持续服用FLAVOMEGA组、持续服用安慰剂组。在纳入的29名患者中,只有24名完成了研究:15名服用FLAVOMEGA,14名服用安慰剂。FLAVOMEGA耐受性良好,未报告不良事件。在LGMD和FSHD受试者中,观察到6分钟步行距离(6MWD;次要疗效终点)(P = 0.033)和等速膝关节伸展(P = 0.039)(主要疗效终点)相对于基线变化有显著的治疗差异。所有服用FLAVOMEGA治疗组的血清肌酸激酶(CK)水平(次要疗效终点)均下降,DMD受试者有显著差异(P = 0.039)。尽管患者数量较少且患者疾病严重程度范围较广降低了统计显著性,但我们获得了该化合物最佳的安全性和耐受性概况,在主要和次要终点显示出有价值的疗效数据。NCT03317171于2017年10月25日进行回顾性注册。