Completed Heart, Stroke & Blood Brain & Nervous System

Advanced antisense oligonucleotide technology for exon skipping in Duchenne muscular dystrophy

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A new generation of molecular drugs, never before tested in humans, will be given to nine boys with Duchenne muscular dystrophy to see if they can repair the faulty gene in both skeletal and heart muscle. Duchenne muscular dystrophy affects 1 in every 3500 live male births, or 250,000 people worldwide. Current antisense oligonucleotide drugs act like temporary molecular patches on the mutated DMD gene, restoring some dystrophin protein to skeletal muscle. But they require repeated doses and cannot reach the heart muscle efficiently—a critical gap, since heart failure is a leading cause of death in these patients. If successful, this trial could transform treatment for Duchenne by delivering the repair drug to the heart for the first time, potentially slowing or preventing cardiac decline alongside improvements in limb and breathing muscles. The MDEX Consortium, a UK-based group of preclinical scientists and clinicians, will first complete safety studies before administering the optimised drug to nine patients. This is an early-stage clinical test of a fundamentally new chemistry, not a proven therapy—but it directly addresses the heart-targeting problem that has limited all previous exon-skipping approaches.

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Duchenne muscular dystrophy (DMD) is the most common lethal variant of muscular dystrophy, and affects 1 in every 3500 live male births or 250,000 people world-wide. Recent encouraging clinical trials have used antisense oligonucleotides (AOs) which, like “molecular velcros”, are able to temporarily repair the mutated DMD gene and restore the lost dystrophin protein to the muscles of DMD patients. However this approach requires repeated administration of the AO drug in order to achieve some repair of the gene in the skeletal muscle; in addition the heart muscle cannot be targeted efficiently with the current AO chemistries. New generation AOs, never tried before in the human, are able to dramatically improve skeletal and cardiac muscle uptake of these molecules in animal models of DMD and significantly improve their therapeutic efficacy. In this study the MDEX Consortium, a world-leading group of preclinical scientists and clinicians based in the UK developing state-of-the-art therapies for neuromuscular disease plans to focus on the development and optimisation of a safe new generation AO drug which we intend to administer to a group of 9 patients affected by DMD after appropriate safety studies.

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