Department of Pharmaceutical Sciences, Regis University School of Pharmacy , Denver, Colorado.
Expert Opin Pharmacother. 2020 May;21(7):841-851. doi: 10.1080/14656566.2020.1732350. Epub 2020 Mar 5.
Duchenne muscular dystrophy (DMD) is the result of X-chromosome-linked mutations to the dystrophin protein gene that prevent the normal development and repair of muscles leading to muscle deterioration. The condition affects nearly 1 in 3,500 males worldwide. Current therapeutics have not been sufficient in providing a cure or resulting in a significant extension in life expectancy, but many therapeutic options are currently under investigation.
This article provides an overview of the current and emerging therapies for DMD giving particular focus to synthetic therapeutic options. The authors further provide their expert opinion.
Many discrepancies in primary outcomes of trials have led to questions of efficacy for medications, as well as difficulty in securing FDA approval. A standardization of primary outcome strategies, as well as better access to investigational medications, may alleviate some of the controversy and pressures that exist on medication approvals. Many trials have identified cohorts who responded more favorably to medications, despite a lack of significance in the overall intent-to-treat populations. This indicates that more medication screening and personalized treatment with patient-specific targeting might deliver more clinically significant results.
杜氏肌营养不良症(DMD)是由于 X 染色体上的肌营养不良蛋白基因突变导致肌肉正常发育和修复受阻,从而导致肌肉恶化。这种情况在全球每 3500 名男性中就有 1 人受到影响。目前的治疗方法还不足以治愈疾病或显著延长预期寿命,但许多治疗方法正在研究中。
本文概述了 DMD 的现有和新兴治疗方法,特别关注了合成治疗方法。作者进一步提供了他们的专家意见。
许多试验的主要结果存在差异,导致人们对药物的疗效产生疑问,同时也难以获得 FDA 批准。标准化主要结果策略,以及更好地获得研究性药物,可能会减轻药物批准方面存在的一些争议和压力。许多试验确定了对药物反应更有利的队列,尽管在总体意向治疗人群中缺乏显著性。这表明,进行更多的药物筛选和针对患者特定靶点的个性化治疗可能会带来更具临床意义的结果。