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Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Ongoing therapeutic trials and outcome measures for Duchenne muscular dystrophy
Alessandra Govoni1, Francesca Magri, Simona Brajkovic
1Neuroscience Section, Neurology Unit, Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Italy Via Francesco Sforza 35, 20122, Milan, Italy.
Abstract:
Muscular dystrophy is a heterogeneous group of genetic disorders characterised by progressive muscle tissue degeneration. No effective treatment has been discovered for these diseases. Preclinical and clinical studies aimed at the development of new therapeutic approaches have been carried out, primarily in subjects affected with dystrophinopathies (Duchenne and Becker muscular dystrophy). In this review, we outline the current therapeutic approaches and past and ongoing clinical trials, highlighting both the advantages and limits of each one. The experimental designs of these trials were based on different rationales, including immunomodulation, readthrough strategies, exon skipping, gene therapy, and cell therapy. We also provide an overview of available outcome measures, focusing on their reliability in estimating meaningful clinical improvement in order to aid in the design of future trials. This perspective is extremely relevant to the field considering the recent development of novel therapeutic approaches that will result in an increasing number of clinical studies over the next few years.
Insights
This review examines current and past therapeutic strategies for muscular dystrophy, a progressive genetic muscle-wasting disease. It evaluates clinical trials for dystrophinopathies, focusing on future treatment development and outcome measures.
Area of Science:
- Neurology
- Genetics
- Pharmacology
Background:
- Muscular dystrophy comprises genetic disorders causing progressive muscle degeneration.
- Currently, no definitive treatments exist for these debilitating conditions.
- Research focuses on developing novel therapeutic strategies, particularly for dystrophinopathies like Duchenne and Becker muscular dystrophy.
Purpose of the Study:
- To review existing and emerging therapeutic approaches for muscular dystrophy.
- To analyze past and ongoing clinical trials, assessing their strengths and limitations.
- To provide an overview of outcome measures for evaluating treatment efficacy in clinical studies.
Main Methods:
- Literature review of preclinical and clinical studies on muscular dystrophy treatments.
- Analysis of experimental designs based on immunomodulation, readthrough, exon skipping, gene therapy, and cell therapy.
- Evaluation of outcome measures for clinical trial design in muscular dystrophy.
Main Results:
- Various therapeutic strategies are under investigation, each with unique advantages and limitations.
- Clinical trials have explored diverse approaches including gene and cell therapies.
- Reliable outcome measures are crucial for assessing meaningful clinical improvement.
Conclusions:
- The development of effective muscular dystrophy treatments is ongoing, with gene and cell therapies showing promise.
- Careful selection of outcome measures is essential for future clinical trial success.
- Continued research and clinical studies are vital for advancing muscular dystrophy therapeutics.
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