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Observational study of clinical outcomes for testosterone treatment of pubertal delay in Duchenne muscular dystrophy

Lookup NU author(s): Dr Claire Wood, Dr Timothy Cheetham, Dr Kieren Hollingsworth, Dr Michela Guglieri, Dr Anna Mayhew, Professor Volker Straub

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2019 The Author(s). Background: Adolescents with DMD treated with chronic high dose GC therapy typically have profound pubertal delay. Testosterone, the main circulating androgen in men, promotes virilisation and growth with associated accrual of fat-free muscle mass and bone mineral content. Testosterone therapy is routinely used to mimic the normal stages of pubertal development in patients with hypogonadotrophic hypogonadism, androgen deficiency secondary to testicular disease and in constitutional delay of growth and puberty (CDGP). Improved life expectancy in DMD has meant that more adolescents are eligible for testosterone supplementation but there is little objective data regarding the impact of this treatment on muscle structure and function, bone integrity and overall well-being. Methods: This is a single centre observational clinical trial (NCT02571205) that aims to follow the progress of 15 adolescents with Duchenne muscular dystrophy and delayed puberty as they are managed with incremental testosterone therapy to induce puberty. Subjects will all be treated with a steadily increasing dose of testosterone administered by injection every 4 weeks and data will be collected to help us determine the effectiveness and tolerability of the described treatment regimen. We will use the data to explore the effects of testosterone on pubertal development, growth, muscle strength and function, bone mineral density, body composition with a detailed record of any adverse events. We will also carry out interviews to explore the boys' views on the tolerability of the regimen. The study will last for 27 months in total for each participant. Discussion: Our experience has indicated that testosterone treatment in adolescents with DMD is liked and well tolerated but we have not collected objective data on a specific treatment regimen and there is no current consensus. Testosterone supplementation is not part of the standard of care of pubertal delay in DMD but inclusion in future protocols may be appropriate depending on the results of this trial.


Publication metadata

Author(s): Wood CL, Cheetham TD, Hollingsworth KG, Guglieri M, Ailins-Sahun Y, Punniyakodi S, Mayhew A, Straub V

Publication type: Article

Publication status: Published

Journal: BMC Pediatrics

Year: 2019

Volume: 19

Issue: 1

Online publication date: 25/04/2019

Acceptance date: 10/04/2019

ISSN (electronic): 1471-2431

Publisher: BioMed Central Ltd.

URL: https://doi.org/10.1186/s12887-019-1503-x

DOI: 10.1186/s12887-019-1503-x

PubMed id: 31023296


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