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    Clinical Trial Results:
    A Phase 2a Study of Ataluren (PTC124) in Nonambulatory Patients with Nonsense-Mutation-Mediated Duchenne/Becker Muscular Dystrophy

    Summary
    EudraCT number
    2009-013169-24
    Trial protocol
    GB  
    Global end of trial date
    09 Jul 2010

    Results information
    Results version number
    v1(current)
    This version publication date
    11 Jul 2020
    First version publication date
    11 Jul 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    PTC124-GD-008-DMD
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01009294
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    PTC Therapeutics, Inc.
    Sponsor organisation address
    100 Corporate Court, South Plainfield, United States, 07080
    Public contact
    Medical Information, PTC Therapeutics, Inc., +011 44 1-866-562-4620, medinfo@ptcbio.com
    Scientific contact
    Medical Information, PTC Therapeutics International Limited, +353 19068700, medinfo@ptcbio.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000115-PIP01-09
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    23 Mar 2010
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    23 Mar 2010
    Global end of trial reached?
    Yes
    Global end of trial date
    09 Jul 2010
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to assess the safety and torlerability of ataluren in nonambulatory participants with Nonsense-Mutation-Mediated Duchenne/Becker Muscular Dystrophy (nmDBMD).
    Protection of trial subjects
    The trial was conducted in accordance with Declaration of Helsinki (revised version of Edinburgh, Scotland, 2000), FDA GCP regulations, and the International Conference on Harmonisation (ICH) GCP guidance documents.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    13 Jan 2010
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    5 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 6
    Worldwide total number of subjects
    6
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    3
    Adults (18-64 years)
    3
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 11 participants with nmDBMD and were nonambulatory signed the informed consent form and were screened for eligibility. Six of these participants were enrolled at 2 sites. Three of the participants were receiving chronic corticosteroid therapy and a stable corticosteroid regimen was to be maintained during the study.

    Pre-assignment
    Screening details
    When the Sponsor terminated the study, the participants were told to discontinue ataluren treatment, and to return all unused ataluren to the site for return to the Sponsor. Because of difficulty of traveling to the clinic for these nonambulatory participants, the planned final visits were not performed.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Ataluren
    Arm description
    Ataluren was provided as a vanilla-flavored powder to be mixed with water, apple juice, or milk. Study drug dosing was based on milligrams of drug per kilogram of body weight. The dose level for ataluren was 20 milligrams/kilograms (mg/kg) in the morning, 20 mg/kg at midday, and 40 mg/kg in the evening. Administration within 30 minutes after a meal was recommended. Study drug was taken for up to 50 days.
    Arm type
    Experimental

    Investigational medicinal product name
    Ataluren
    Investigational medicinal product code
    PTC124
    Other name
    Pharmaceutical forms
    Powder for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Ataluren was administered as per the dose and schedule specified in the respective arms.

    Number of subjects in period 1
    Ataluren
    Started
    6
    Received at Least 1 Dose of Study Drug
    6
    Completed
    0
    Not completed
    6
         Study discontinued by Sponsor
    6

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ataluren
    Reporting group description
    Ataluren was provided as a vanilla-flavored powder to be mixed with water, apple juice, or milk. Study drug dosing was based on milligrams of drug per kilogram of body weight. The dose level for ataluren was 20 milligrams/kilograms (mg/kg) in the morning, 20 mg/kg at midday, and 40 mg/kg in the evening. Administration within 30 minutes after a meal was recommended. Study drug was taken for up to 50 days.

    Reporting group values
    Ataluren Total
    Number of subjects
    6 6
    Age, Customized
    Units: Subjects
        12 to 17 years
    3 3
        18 to 20 years
    3 3
    Age continuous
    Units: years
        median (full range (min-max))
    17 (12 to 20) -
    Sex: Female, Male
    Units: Subjects
        Female
    0 0
        Male
    6 6

    End points

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    End points reporting groups
    Reporting group title
    Ataluren
    Reporting group description
    Ataluren was provided as a vanilla-flavored powder to be mixed with water, apple juice, or milk. Study drug dosing was based on milligrams of drug per kilogram of body weight. The dose level for ataluren was 20 milligrams/kilograms (mg/kg) in the morning, 20 mg/kg at midday, and 40 mg/kg in the evening. Administration within 30 minutes after a meal was recommended. Study drug was taken for up to 50 days.

    Primary: Number of Participants With Treatment Emergent Adverse Events (TEAEs)

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    End point title
    Number of Participants With Treatment Emergent Adverse Events (TEAEs) [1]
    End point description
    A TEAE is any untoward medical occurrence or undesirable event(s) experienced in a participant that begins or worsens following administration of study drug, whether or not considered related to study drug by Investigator. A serious adverse event (SAE) was an adverse event (AE) resulting in any of the following outcomes or deemed significant for any other reason, death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), or persistent or significant disability/incapacity not related to nmDBMD. AEs included both SAEs and non-serious AEs. AEs classified according to National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0 and coded using the Medical Dictionary for Regulatory Activities (MedDRA). A summary of serious and all other non-serious AEs, regardless of causality, is located in the Reported Adverse Events module. Population included all enrolled participants who received at least 1 dose of study drug.
    End point type
    Primary
    End point timeframe
    Baseline up to Day 50
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Statistical analyses not applicable for this endpoint.
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: participants
        TEAEs
    1
        Treatment Emergent SAEs
    0
        AEs Related to Study Treatment
    0
    No statistical analyses for this end point

    Secondary: Time to Complete Upper Limb Function Tasks as Measured by the Jebsen Test

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    End point title
    Time to Complete Upper Limb Function Tasks as Measured by the Jebsen Test
    End point description
    Arm and hand function were assessed using the Jebsen test, a standardized clinical evaluation of tasks important to daily living. The test comprises of unilateral subtests performed with each hand (the dominant [DOM] hand and the non-DOM hand): moving and stacking light (250 grams) and heavy (500 grams) objects; picking up small, commonly encountered objects; stacking checkers; simulated feeding; simulated page turning; and writing. Participant performance of each task was timed. Longer time to complete the test indicates worse hand function. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable upper limb function tasks data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: seconds
    median (full range (min-max))
        Lifting Large Heavy Objects, DOM Hand, Baseline
    11 (5 to 120)
        Lifting Large Heavy Objects, DOM Hand, Week 6
    10 (9 to 11)
        Lifting Large Heavy Objects, Non-DOM Hand Baseline
    11 (5 to 120)
        Lifting Large Heavy Objects, Non-DOM Hand, Week 6
    11 (7 to 14)
        Lifting Large Light Objects, DOM Hand, Baseline
    9 (4 to 120)
        Lifting Large Light Objects, DOM Hand, Week 6
    15 (7 to 22)
        Lifting Large Light Objects, Non-DOM Hand Baseline
    7 (3 to 120)
        Lifting Large Light Objects, Non-DOM Hand, Week 6
    12 (6 to 18)
        Stacking Large Heavy Objects, DOM Hand, Baseline
    118 (10 to 120)
        Stacking Large Heavy Objects, DOM Hand, Week 6
    45 (27 to 63)
        Stacking Large Heavy Objects Non-DOM Hand Baseline
    120 (28 to 120)
        Stacking Large Heavy Objects, Non-DOM Hand, Week 6
    92 (63 to 120)
        Stacking Large Light Objects, DOM Hand, Baseline
    69 (5 to 120)
        Stacking Large Light Objects, DOM Hand, Week 6
    32 (22 to 42)
        Stacking Large Light Objects Non-DOM Hand Baseline
    23 (8 to 120)
        Stacking Large Light Objects, Non-DOM Hand, Week 6
    69 (18 to 120)
        Lifting Small Common Objects, DOM Hand, Baseline
    16 (7 to 120)
        Lifting Small Common Objects, DOM Hand, Week 6
    19 (18 to 19)
        Lifting Small Common Objects Non-DOM Hand Baseline
    13 (8 to 120)
        Lifting Small Common Objects, Non-DOM Hand, Week 6
    15 (12 to 17)
        Stacking Checkers, DOM Hand, Baseline
    7 (4 to 11)
        Stacking Checkers, DOM Hand, Week 6
    7 (6 to 7)
        Simulated Feeding, DOM Hand, Baseline
    22 (9 to 120)
        Simulated Feeding, DOM Hand, Week 6
    40 (15 to 64)
        Simulated Feeding, Non-DOM Hand, Baseline
    38 (12 to 120)
        Simulated Feeding, Non-DOM Hand, Week 6
    34 (20 to 47)
        Simulated Page Turning, DOM Hand, Baseline
    12 (4 to 24)
        Simulated Page Turning, DOM Hand, Week 6
    15 (9 to 21)
        Simulated Page Turning, Non-DOM Hand, Baseline
    13 (4 to 51)
        Simulated Page Turning, Non-DOM Hand, Week 6
    12 (6 to 18)
        Writing, DOM Hand, Baseline
    22 (11 to 120)
        Writing, DOM Hand, Week 6
    66 (11 to 120)
        Writing, Non-DOM Hand, Baseline
    47 (25 to 120)
        Writing, Non-DOM Hand, Week 6
    78 (36 to 120)
    No statistical analyses for this end point

    Secondary: Upper Limb Function as Measured by the Brooke Upper Extremity Functional Rating Scale

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    End point title
    Upper Limb Function as Measured by the Brooke Upper Extremity Functional Rating Scale
    End point description
    Upper extremity function was assessed using the Brooke Upper Extremity Functional Rating Scale, following standardized procedures. The Brooke Upper Extremity Functional Rating Scale graded arm and shoulder function from 1 to 6, with higher values indicating less function. A rating of "1" was used when the participant was able to abduct his arms in a full circle until they touch above his head, whereas a rating of "6" was used when the participant was unable to raise his hands to his mouth and had no useful function of hands. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable upper limb function tasks data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: score on a scale
    median (full range (min-max))
        Baseline
    3 (2 to 5)
        Week 6
    3 (3 to 3)
    No statistical analyses for this end point

    Secondary: Participant Activities of Daily Living as Assessed Using the Egen Klassifikation (EK) Scale

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    End point title
    Participant Activities of Daily Living as Assessed Using the Egen Klassifikation (EK) Scale
    End point description
    Activities of daily living after loss of ambulation were measured using the EK scale. The EK scale is an ordinal scale ranging from 0 to 30 points where 0 represents the highest level of independent function and 30 the lowest. The scale consists of 10 categories (each scored 0 to 3), involving different functional domains including 1) ability to use wheelchair, 2) ability to transfer from wheelchair, 3) ability to stand, 4) ability to balance in the wheelchair, 5) ability to move arms, 6) ability to use hands and arms when eating, 7) ability to turn in bed, 8) ability to cough, 9) ability to speak, and 10) physical well-being. The administration of the EK scale consisted of an interview of the participant to capture how he performs the tasks of daily life (as described by Categories 1 to 9) and how he perceives his wellbeing (as described by Category 10). Population included all enrolled participants who received at least 1 dose of study drug and with evaluable EK Scale data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: score on a scale
    median (full range (min-max))
        Ability to Use Wheelchair, Baseline
    2 (2 to 3)
        Ability to Use Wheelchair, Week 6
    1 (0 to 2)
        Ability to Transfer From Wheelchair, Baseline
    2 (2 to 3)
        Ability to Transfer From Wheelchair, Week 6
    2 (2 to 2)
        Ability to Stand, Baseline
    3 (1 to 3)
        Ability to Stand, Week 6
    2 (1 to 3)
        Ability to Balance in the Wheelchair, Baseline
    0 (0 to 3)
        Ability to Balance in the Wheelchair, Week 6
    0 (0 to 0)
        Ability to Move Arms, Baseline
    2 (0 to 3)
        Ability to Move Arms, Week 6
    1 (1 to 1)
        Ability to Use Hands/Arms When Eating, Baseline
    2 (1 to 3)
        Ability to Use Hands/Arms When Eating, Week 6
    2 (1 to 2)
        Ability to Turn in Bed, Baseline
    1 (0 to 3)
        Ability to Turn in Bed, Week 6
    1 (0 to 1)
        Ability to Cough, Baseline
    0 (0 to 0)
        Ability to Cough, Week 6
    0 (0 to 0)
        Ability to Speak, Baseline
    0 (0 to 0)
        Ability to Speak, Week 6
    0 (0 to 0)
        Physical Well-Being, Baseline
    0 (0 to 0)
        Physical Well-Being, Week 6
    1 (0 to 1)
    No statistical analyses for this end point

    Secondary: Shoulder, Elbow, and Wrist Passive and Active Range of Motion as Measured by Goniometry

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    End point title
    Shoulder, Elbow, and Wrist Passive and Active Range of Motion as Measured by Goniometry
    End point description
    Goniometry was performed to test active and passive range-of motion (RoM) of the left (L) and right (R) shoulder, elbow, and wrist following standardized procedures. The observed angle for passive and active motion for each joint was measured in degrees (0-180). Greater degree of motion indicates better response. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable range of motion data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: degrees
    median (full range (min-max))
        L Elbow Extension, Supine Passive RoM, Baseline
    -10 (-20 to 0)
        L Elbow Extension, Supine Passive RoM, Week 6
    -15 (-15 to -15)
        R Elbow Extension, Supine Passive RoM. Baseline
    -13 (-25 to 0)
        R Elbow Extension, Supine Passive RoM, Week 6
    -20 (-20 to -20)
        L Elbow Flexion, Sitting Active RoM, Baseline
    115 (0 to 140)
        L Elbow Flexion, Sitting Active RoM, Week 6
    -10 (-20 to 0)
        R Elbow Flexion, Sitting Active RoM, Baseline
    120 (0 to 140)
        R Elbow Flexion, Sitting Active RoM, Week 6
    70 (0 to 140)
        L Elbow Flexion, Supine Passive RoM, Baseline
    133 (120 to 140)
        L Elbow Flexion, Supine Passive RoM, Week 6
    138 (130 to 145)
        R Elbow Flexion, Supine Passive RoM, Baseline
    135 (110 to 140)
        R Elbow Flexion, Supine Passive RoM, Week 6
    135 (125 to 145)
        L Shoulder Abduction, Sitting Active RoM, Baseline
    18 (0 to 55)
        L Shoulder Abduction, Sitting Active RoM, Week 6
    0 (0 to 0)
        R Shoulder Abduction, Sitting Active RoM, Baseline
    20 (0 to 70)
        R Shoulder Abduction, Sitting Active RoM, Week 6
    5 (0 to 10)
        L Shoulder Abduction, Supine Passive RoM, Baseline
    170 (105 to 180)
        L Shoulder Abduction, Supine Passive RoM, Week 6
    175 (170 to 180)
        R Shoulder Abduction, Supine Passive RoM, Baseline
    180 (120 to 180)
        R Shoulder Abduction, Supine Passive RoM, Week 6
    175 (170 to 180)
        L Shoulder Flexion, Sitting Active RoM, Baseline
    10 (0 to 45)
        L Shoulder Flexion, Sitting Active RoM, Week 6
    10 (0 to 20)
        R Shoulder Flexion, Sitting Active RoM, Baseline
    10 (0 to 80)
        R Shoulder Flexion, Sitting Active RoM, Week 6
    0 (0 to 0)
        L Shoulder Flexion, Supine Passive RoM, Baseline
    165 (160 to 180)
        L Shoulder Flexion, Supine Passive RoM, Week 6
    170 (160 to 180)
        R Shoulder Flexion, Supine Passive RoM, Baseline
    170 (150 to 180)
        R Shoulder Flexion, Supine Passive RoM, Week 6
    175 (170 to 180)
        L Wrist Extension, Sitting Active RoM, Baseline
    68 (20 to 80)
        L Wrist Extension, Sitting Active RoM, Week 6
    63 (55 to 70)
        R Wrist Extension, Sitting Active RoM, Baseline
    65 (30 to 90)
        R Wrist Extension, Sitting Active RoM, Week 6
    73 (70 to 75)
        L Wrist Extension, Sitting Passive RoM, Baseline
    73 (40 to 100)
        L Wrist Extension, Sitting Passive RoM, Week 6
    73 (60 to 85)
        R Wrist Extension, Sitting Passive RoM, Baseline
    78 (55 to 90)
        R Wrist Extension, Sitting Passive RoM, Week 6
    78 (70 to 85)
        L Wrist Flexion, Sitting Passive RoM, Baseline
    75 (35 to 95)
        L Wrist Flexion, Sitting Passive RoM, Week 6
    75 (60 to 90)
        R Wrist Flexion, Sitting Passive RoM, Baseline
    80 (35 to 90)
        R Wrist Flexion, Sitting Passive RoM, Week 6
    68 (45 to 90)
    No statistical analyses for this end point

    Secondary: Force Exerted During Elbow Flexion and Extension, Shoulder Abduction, Hand Grip, Key Grip, and Finger Pinch as Assessed by Myometry

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    End point title
    Force Exerted During Elbow Flexion and Extension, Shoulder Abduction, Hand Grip, Key Grip, and Finger Pinch as Assessed by Myometry
    End point description
    Upper extremity myometry was performed using a hand-held dynamometer following standardized procedures. Evaluators judged the strength of each muscle using a scoring system. Bilateral assessments were done, and 3 measurements were recorded from each muscle group on each side, when possible. When the measurements were done in duplicate or triplicate, the best value was used. Greater value indicates better measurement. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable myometry data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: score on a scale
    median (full range (min-max))
        Left Elbow Extension, Supine, Baseline
    12 (2 to 26)
        Left Elbow Extension, Supine, Week 6
    16 (14 to 18)
        Right Elbow Extension, Supine, Baseline
    12 (1 to 26)
        Right Elbow Extension, Supine, Week 6
    15 (13 to 16)
        Left Elbow Flexion, Supine, Baseline
    7 (1 to 20)
        Left Elbow Flexion, Supine, Week 6
    5 (2 to 7)
        Right Elbow Flexion, Supine, Baseline
    7 (0 to 23)
        Right Elbow Flexion, Supine, Week 6
    9 (3 to 14)
        Left Finger Pinch, Sitting, Baseline
    10 (3 to 20)
        Left Finger Pinch, Sitting, Week 6
    6 (2 to 9)
        Right Finger Pinch, Sitting, Baseline
    10 (5 to 22)
        Right Finger Pinch, Sitting, Week 6
    7 (5 to 8)
        Left Hand Grip, Sitting, Baseline
    13 (5 to 23)
        Left Hand Grip, Sitting, Week 6
    13 (5 to 20)
        Right Hand Grip, Sitting, Baseline
    15 (7 to 34)
        Right Hand Grip, Sitting, Week 6
    23 (16 to 29)
        Left Key Grip, Sitting, Baseline
    13 (5 to 27)
        Left Key Grip, Sitting, Week 6
    15 (8 to 22)
        Right Key Grip, Sitting, Baseline
    11 (5 to 24)
        Right Key Grip, Sitting, Week 6
    18 (6 to 30)
        Left Shoulder Abduction, Sitting, Baseline
    10 (0 to 30)
        Left Shoulder Abduction, Sitting, Week 6
    15 (14 to 15)
        Right Shoulder Abduction, Sitting, Baseline
    12 (0 to 25)
        Right Shoulder Abduction, Sitting, Week 6
    14 (14 to 14)
    No statistical analyses for this end point

    Secondary: Time to Complete Hand Fine Motor Coordination and Dexterity Tasks as Measured by 9-Hole Peg Test (9HPT)

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    End point title
    Time to Complete Hand Fine Motor Coordination and Dexterity Tasks as Measured by 9-Hole Peg Test (9HPT)
    End point description
    Hand fine motor coordination and dexterity were assessed using the 9HPT using standardized procedures. The 9HPT is a unilateral test in which 9 pegs were placed in a board and then removed with the dominate and non-dominate hand within a 5-minute time limit. The amount of time required to put the pegs in the holes and remove them again with each hand was recorded. Each test was conducted twice per hand. Longer time to complete the test indicates worse hand fine motor coordination and dexterity. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable 9HPT data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: seconds
    median (full range (min-max))
        Dominant Hand, Baseline
    37 (21 to 233)
        Dominant Hand, Week 6
    38 (34 to 40)
        Non-Dominant Hand, Baseline
    40 (3 to 51)
        Non-Dominant Hand, Week 6
    37 (35 to 46)
    No statistical analyses for this end point

    Secondary: Forced Vital Capacity (FVC) as Measured by Spirometry

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    End point title
    Forced Vital Capacity (FVC) as Measured by Spirometry
    End point description
    Pulmonary function was assessed as FVC in participants by spirometry using a study-specific spirometer. Multiple tests were conducted, if needed. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable spirometry data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: liters
    median (full range (min-max))
        Baseline
    1 (0.82 to 2.95)
        Week 6
    0 (0 to 0)
    No statistical analyses for this end point

    Secondary: Systolic and Diastolic Function as Measured by Echocardiography with Tissue Doppler

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    End point title
    Systolic and Diastolic Function as Measured by Echocardiography with Tissue Doppler
    End point description
    Cardiac function was assessed by echocardiography, which included standard parameters (for example, ejection fraction, left ventricle diastolic and systolic dimensions), as well as parameters integrating Doppler flow analysis with imaging to evaluate perturbations in wall motion. A standardized data collection process harmonized data from all participating institutions and allowed for centralized review. Since the study was terminated early, echocardiography data were not collected after the start of study drug administration. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable echocardiography data.
    End point type
    Secondary
    End point timeframe
    Week 24 and Week 48
    End point values
    Ataluren
    Number of subjects analysed
    0 [2]
    Units: millimeters
    arithmetic mean (standard deviation)
        Week 24
    ( )
        Week 48
    ( )
    Notes
    [2] - Study terminated early and echocardiography data were not collected after start of study drug.
    No statistical analyses for this end point

    Secondary: Heart Rate as Assessed by Radial Pulse

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    End point title
    Heart Rate as Assessed by Radial Pulse
    End point description
    Heart rate was measured with the radial pulse. Following the Jebsen test, the participant rested for 5 minutes in a sitting position, and the heart rate for the last minute of this rest period was collected as the resting heart rate. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable heart rate data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: beats per minute
    median (full range (min-max))
        Baseline
    88 (72 to 120)
        Week 6
    100 (97 to 102)
    No statistical analyses for this end point

    Secondary: Verbal Memory and Attention as Assessed by the Digit Span Task

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    End point title
    Verbal Memory and Attention as Assessed by the Digit Span Task
    End point description
    A series of digits (0-9) were presented to the participant in an auditory format only. The task had 2 parts: in the Forward Condition, the participant was requested to repeat back the digits in the order they were presented, and in the Backward Condition, he was requested to reverse the order of presentation. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable verbal memory and attention data. The test was repeated until the participant had 0 correct responses, which was up to 7 times for the Forward Condition and up to 5 times for the Backward Condition at Baseline and at Week 6.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: correct responses
        Forward Condition, 1 Correct Response, Baseline
    4
        Forward Condition, 1 Correct Response, Week 6
    1
        Forward Condition, 2 Correct Responses, Baseline
    19
        Forward Condition, 2 Correct Responses, Week 6
    4
        Backward Condition, 1 Correct Response, Baseline
    4
        Backward Condition, 1 Correct Response, Week 6
    2
        Backward Condition, 2 Correct Responses, Baseline
    6
        Backward Condition, 2 Correct Responses, Week 6
    0
    No statistical analyses for this end point

    Secondary: HRQL as Measured by the PedsQL Inventory Generic Core Scale

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    End point title
    HRQL as Measured by the PedsQL Inventory Generic Core Scale
    End point description
    Health-related quality of life (HRQL) was measured by the Pediatric Quality of Life Inventory (PedsQL) Inventory Generic Core Scale. The generic core module comprised of 23 questions evaluating physical, emotional, social, and school functioning. Examples of items in each of the generic core module scales included: “It is hard for me to run”; “I feel sad or blue”; “I cannot do things that other kids my age can do;” and “It is hard to pay attention in class.” Each of the generic core module items was scored on a 5-point response scale from 0 (never a problem) to 4 (almost always a problem). The appropriate age-specific version was completed. PedsQL Inventory Generic Core Scale data at Week 6 is presented. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable PedsQL Inventory Generic Core Scale data at Week 6.
    End point type
    Secondary
    End point timeframe
    Week 6
    End point values
    Ataluren
    Number of subjects analysed
    2
    Units: units on a scale
    median (full range (min-max))
        Participant-Reported, Health and Activities
    4 (0 to 4)
        Participant-Reported, Feelings
    1 (0 to 2)
        Participant-Reported, Getting along with Others
    2 (0 to 4)
        Participant-Reported, School
    1 (0 to 2)
        Parent-Reported, Physical Functioning
    4 (0 to 4)
        Parent-Reported, Emotional Functioning
    0 (0 to 2)
        Parent-Reported, Social Functioning
    1 (0 to 4)
        Parent-Reported, School Functioning
    1 (0 to 2)
    No statistical analyses for this end point

    Secondary: HRQL as Measured by the PedsQL Multidimensional Fatigue Scale

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    End point title
    HRQL as Measured by the PedsQL Multidimensional Fatigue Scale
    End point description
    Health-related quality of life (HRQL) was measured by the Pediatric Quality of Life Inventory (PedsQL) Multidimensional Fatigue Scale. The fatigue-specific module comprised of 18 questions evaluating general fatigue, sleep/rest fatigue, and cognitive fatigue. Fatigue-specific module obtains information relating to items such as: “I feel too tired to do things that I like to do”; “I spend a lot of time in bed”; and “I have trouble remembering more than one thing at a time.” Each of the fatigue-specific module items was scored on a 5-point response scale from 0 (never a problem) to 4 (almost always a problem). The appropriate age-specific version was completed. PedsQL Multidimensional Fatigue Scale data at Week 6 is presented. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable PedsQL Multidimensional Fatigue Scale data at Week 6.
    End point type
    Secondary
    End point timeframe
    Week 6
    End point values
    Ataluren
    Number of subjects analysed
    2
    Units: units on a scale
    median (full range (min-max))
        Participant-Reported, General Fatigue
    1 (0 to 3)
        Participant-Reported, Sleep/Rest Fatigue
    1 (0 to 2)
        Participant-Reported, Cognitive Fatigue
    1 (0 to 3)
        Parent-Reported, General Fatigue
    1 (0 to 4)
        Parent-Reported, Sleep/Rest Fatigue
    0 (0 to 2)
        Parent-Reported, Cognitive Fatigue
    1 (0 to 2)
    No statistical analyses for this end point

    Secondary: HRQL as Measured by the INQoL

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    End point title
    HRQL as Measured by the INQoL
    End point description
    HRQL was measured by the Individualized Neuromuscular Quality of Life Questionnaire (INQoL). The INQoL consisted of 45 questions within 10 sections. Four of the sections evaluate key muscle disease symptoms (that is, weakness, locking [myotonia], pain, and fatigue), 5 sections evaluate the degree and importance of the impact of muscle disease on particular areas of life, and 1 section asks about the positive and negative effects of treatment. A higher score indicates greater symptom impact or worse HRQL, with a range of 0-7. Since the study was terminated early, INQoL data were not collected. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable INQoL data.
    End point type
    Secondary
    End point timeframe
    Week 24 and Week 48
    End point values
    Ataluren
    Number of subjects analysed
    0 [3]
    Units: units on a scale
    arithmetic mean (standard deviation)
        Week 24
    ( )
        Week 48
    ( )
    Notes
    [3] - Study terminated early and INQoL data were not collected.
    No statistical analyses for this end point

    Secondary: Muscle Fragility as Determined by Serum Creatine Kinase (CK) Levels

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    End point title
    Muscle Fragility as Determined by Serum Creatine Kinase (CK) Levels
    End point description
    Blood samples collected for chemistry assays were used to quantify serum CK concentrations. Serum CK was assessed as a potential biomarker for muscle fragility, with a reduction in serum CK considered to be a positive outcome. The reference range was based on the age of the participant. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable CK data.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 6
    End point values
    Ataluren
    Number of subjects analysed
    6
    Units: units/liter (U/L)
    median (full range (min-max))
        CK Levels (Reference Range 18-198 U/L), Baseline
    1217 (614 to 2136)
        CK Levels (Reference Range 18-198 U/L), Week 6
    764 (764 to 764)
        CK Levels (Reference Range 18-363 U/L), Baseline
    2605 (1413 to 3797)
        CK Levels (Reference Range 18-363 U/L), Week 6
    0 (0 to 0)
        CK Levels (Reference Range 18-408 U/L), Baseline
    2343 (2343 to 2343)
        CK Levels (Reference Range 18-408 U/L), Week 6
    2753 (2753 to 2753)
    No statistical analyses for this end point

    Secondary: Gastrocnemius Muscle Dystrophin Expression as Determined by Immunofluoresence or by Western Blotting Techniques

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    End point title
    Gastrocnemius Muscle Dystrophin Expression as Determined by Immunofluoresence or by Western Blotting Techniques
    End point description
    The gastrocnemius muscle was to be biopsied from 1 leg to assess for the production of dystrophin at Week 36. The production of dystrophin was to be measured by immunofluorescene staining of the sarcolemmal membrane or by Western blotting techniques with an antibody to the C-terminal portion of the dystrophin protein (excluding revertant fibers). Since the study was terminated early, gastrocnemius muscle dystrophin expression data were not collected after the start of study drug administration. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable dystrophin production data.
    End point type
    Secondary
    End point timeframe
    Week 36
    End point values
    Ataluren
    Number of subjects analysed
    0 [4]
    Units: percent of cells
        arithmetic mean (standard deviation)
    ( )
    Notes
    [4] - Study terminated early. Data for this outcome measure were not collected after start of study drug.
    No statistical analyses for this end point

    Secondary: Study Drug Compliance

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    End point title
    Study Drug Compliance
    End point description
    Study drug compliance was assessed by the participant daily diary and quantification of used and unused study drug. Compliance was assessed in terms of the amount of drug actually taken relative to the amount that should have been taken during the study. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable study drug compliance data.
    End point type
    Secondary
    End point timeframe
    Baseline to Day 50
    End point values
    Ataluren
    Number of subjects analysed
    4
    Units: participants
        Missed 0 Doses
    1
        Missed 1 Dose
    2
        Missed 2 Doses
    0
        Missed 3 Doses
    0
        Missed 4 Doses
    1
        Missed >5 Doses
    0
    No statistical analyses for this end point

    Secondary: Pharmacokinetics: Ataluren Plasma Exposure

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    End point title
    Pharmacokinetics: Ataluren Plasma Exposure
    End point description
    Blood for ataluren concentrations over a 24-hour period was to be collected on Days 2 and 3 of Week 6. Analysis of the blood samples was to be conducted using a validated high performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) method. Since the study was terminated early, steady state data were not collected at Week 6. Population included all enrolled participants who received at least 1 dose of study drug and with evaluable plasma data.
    End point type
    Secondary
    End point timeframe
    0, 2, 3, 6, 8, 9, 12, 14, 15, and 24 hours after the morning dose
    End point values
    Ataluren
    Number of subjects analysed
    0 [5]
    Units: microgram/milliliters (μg/mL)
        arithmetic mean (standard deviation)
    ( )
    Notes
    [5] - Since the study was terminated early, steady state data were not collected at Week 6.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to Day 50
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    11.1
    Dictionary version
    11.1
    Reporting groups
    Reporting group title
    Ataluren
    Reporting group description
    Ataluren was provided as a vanilla-flavored powder to be mixed with water, apple juice, or milk. Study drug dosing was based on milligrams of drug per kilogram of body weight. The dose level for ataluren was 20 mg/kg in the morning, 20 mg/kg at midday, and 40 mg/kg in the evening. Administration within 30 minutes after a meal was recommended. Study drug was taken for up to 50 days.

    Serious adverse events
    Ataluren
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 6 (0.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Ataluren
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    1 / 6 (16.67%)
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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