Santhera Starts Phase III Study (SIDEROS) with Raxone in Patients with Duchenne Muscular Dystrophy Using Glucocorticoids

"We first observed the efficacy of Raxone in slowing the rate of respiratory function decline in DMD patients in both glucocorticoid-using and non-using patients in the phase II DELPHI study," commented Thomas Meier, PhD, CEO of Santhera. "The successful Phase III DELOS trial which enrolled glucocorticoid non-using patients then confirmed a clinically relevant and statistically significant benefit of Raxone treatment on pulmonary function. The now initiated Phase III SIDEROS trial is designed to confirm the efficacy of Raxone in patients experiencing respiratory function decline that are currently taking glucocorticoids. If successful, this study will provide data that support use of Raxone in all DMD patients experiencing respiratory decline irrespective of their glucocorticoid use. The high level of interest from investigators and the patient community should allow us to recruit this study quickly."

"We are hopeful that this phase III trial is the final step in the development program with Raxone in DMD," said Gunnar Buyse, MD, PhD, Professor of Child Neurology at the University Hospitals Leuven (Belgium) and SIDEROS PI and Lead Investigator for Europe. "Following the exploratory phase II program and the successful phase III DELOS trial, I am grateful that Santhera is committed in exploring the full therapeutic potential of Raxone for patients with DMD."

"Maintaining pulmonary function in patients with DMD has only recently become a prominent therapeutic objective in DMD, particularly in non-ambulatory patients," added Oscar Henry Mayer, MD, Medical Director of the Pulmonary Function Testing Laboratory at the Children's Hospital of Philadelphia and Lead Investigator for US. "A patient and caregiver survey conducted by Parent Project Muscular Dystrophy clearly demonstrated that the DMD community highly values treatment options for pulmonary complications."

About the SIDEROS Trial
SIDEROS is a phase III, double-blind, randomized, placebo-controlled trial with Raxone in approximately 260 DMD patients receiving concomitant glucocorticoids. Patients with declining respiratory function on any stable glucocorticoid treatment scheme and irrespective of the underlying dystrophin mutation or ambulatory status will be eligible. Study participants will receive either Raxone (900 mg/day; given as 2 tablets 3 times a day with meals) or placebo for 78 weeks (18 months). The primary endpoint of the trial is change from baseline to week 78 in forced vital capacity % predicted (FVC%p). Secondary endpoints include changes from baseline in % predicted peak expiratory flow (PEF%p), time to first 10% decline in FVC and change from baseline in inspiratory flow reserve. Patients completing the trial will be offered the opportunity to enroll in an open label extension study where all patients receive Raxone. The study will be conducted at about 50 centers in the United States and Europe. Patients wishing to enroll in the study should contact their neuromuscular clinic physician. Further information about the study is available under www.clinicaltrials.gov.

About Raxone^® (Idebenone) in Duchenne Muscular Dystrophy and Regulatory Status
Duchenne muscular dystrophy (DMD) is one of the most common and devastating types of muscle degeneration and results in rapidly progressive muscle weakness. DMD is characterized by a loss of the protein dystrophin, leading to cell damage, impaired calcium homeostasis, elevated oxidative stress and reduced energy production in muscle cells. This results in progressive muscle weakness and wasting and early morbidity and mortality due to respiratory failure.

Idebenone is a synthetic short-chain benzoquinone and a cofactor for the enzyme NAD(P)H:quinone oxidoreductase (NQO1) capable of stimulating mitochondrial electron transport, reducing and scavenging reactive oxygen species (ROS) and supplementing cellular energy levels.

DELOS was a phase III, double-blind, placebo-controlled trial which randomized 64 patients, not taking concomitant glucocorticoids, to receive either Raxone (900 mg/day) or matching placebo. The trial met its primary endpoint and demonstrated that Raxone can slow the loss of respiratory function and reduces bronchopulmonary complications. The positive outcome of the phase III DELOS study was published: Buyse et al., The Lancet 2015, 385:1748-1757; McDonald et al., Neuromuscular Disorders 2016, 26: 473-480 and Buyse et al., Pediatric Pulmonology 2016: http://dx.doi.org/10.1002/ppul.23547.