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Muscular Dystrophy, DuchennePhase 3NCT01865084

A Study of Tadalafil for Duchenne Muscular Dystrophy

A Phase 3 study testing Tadalafil in people with Muscular Dystrophy, Duchenne, run by Eli Lilly and Company at 62 sites in 16 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The main purpose of this study is to determine if tadalafil can slow the decline in walking ability of boys who have Duchenne muscular dystrophy (DMD). The study will also assess the safety of tadalafil and any side effects that might be associated with it in boys who have DMD. Read more about this study

Who is it for?
Ages 7 to 14 years, men only
Conditions the study is for
Muscular Dystrophy, Duchenne
What is being tested?
Tadalafil
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
331 participants
Where
62 sitesin 16 countries
Study dates
Sep 2013to Mar 2016
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 7 to 14 years
  • Men only
  • No healthy volunteers
  • Child

Who may be able to join

  • Ambulant males with Duchenne muscular dystrophy (DMD) confirmed by typical clinical presentation (onset of clinical signs or symptoms before 6 years of age supported by an elevated serum creatinine kinase level, and ongoing difficulty with walking) together with either a record of a genetic confirmation of the DMD diagnosis, or a record of muscle biopsy showing near-complete dystrophin deficiency (excluding revertant fibers)
  • Receiving systemic corticosteroids for a minimum of 6 months immediately prior to screening, with no significant change in total daily dosage or dosing regimen (except those adjusting for weight changes) for a minimum of 3 months immediately prior to screening and a reasonable expectation that total daily dosage and dosing regimen will not change significantly (except for adjustments for weight) for the duration of the study
  • Able to complete the six minute walk distance (6MWD) test with results within 20% of each other at a minimum of 2 pre-randomization assessments
  • Left ventricular ejection fraction (LVEF) ≥50% as determined by echocardiogram
  • Written informed consent from parents/legal guardian will be obtained prior to any study procedure being performed. In addition, the child may be required to give documented assent, if capable.

Who cannot join

  • Symptomatic cardiomyopathy or heart failure
  • Change in prophylactic treatment for heart failure within 3 months prior to start of study treatment
  • Cardiac rhythm disorder
  • History of participation in gene or cell-based therapy , or antisense oligonucleotide or stop codon read-through therapy
  • Unable to take orally administered tablets
  • Use of any pharmacologic treatment, other than corticosteroids, that might have an effect on muscle strength within 3 months prior to the start of study treatment (for example, growth hormone, anabolic steroids including testosterone)
Show all 14Show fewer
  • New or changed treatment with herbal or dietary supplements being taken with an expectation of an effect on muscle strength or function during 1 month prior to first dose of study drug
  • Surgery that might have an effect on muscle strength or function within 3 months before study entry or planned surgery at any time during the study
  • Evidence of a lower limb injury that may affect performance on the 6MWD
  • Severe behavioral problems, including severe autism or attention deficit disorders, that may interfere with completion of the 6MWD
  • Any contraindication to tadalafil (use of any form of organic nitrate, either regularly and/or intermittently, or known serious hypersensitivity to tadalafil)
  • History of significant renal insufficiency or clinical evidence of cirrhosis
  • Have known allergy to any of the excipients in tadalafil tablets, notably lactose
  • Current Phosphodiesterase Type 5 (PDE5) inhibitor therapy or treatment within the past 6 months

Trial locations and contacts

62 sites in 16 countries.

62 sites in 16 countries

United States23 sites
  • Children's Hospital

    Aurora, Colorado, 80045

  • Carolinas Healthcare System

    Charlotte, North Carolina, 28203

  • Ann and Robert Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • Childrens Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Children's Medical Center Dallas

    Dallas, Texas, 75207

  • Duke University Medical Center

    Durham, North Carolina, 27705

  • University of Florida Health Science Center

    Gainesville, Florida, 32610

  • NW Florida Clinical Research Group

    Gulf Breeze, Florida, 32561

  • Pennsylvania State University College of Medicine

    Hershey, Pennsylvania, 17033

  • University of Iowa

    Iowa City, Iowa, 52242

  • University of Kansas Medical Center

    Kansas City, Kansas, 66160

  • Cedars Sinai Medical Center

    Los Angeles, California, 90048

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • Children of the King's Daughters

    Norfolk, Virginia, 23510

  • Nemours Children's Hospital

    Orlando, Florida, 32827

  • Childrens Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Childrens Hospital of Pittsburgh

    Pittsburgh, Pennsylvania, 15224

  • Oregon Health and Science University

    Portland, Oregon, 97239

  • University of California, Davis - Health Systems

    Sacramento, California, 95817

  • University of Utah School of Medicine

    Salt Lake City, Utah, 84132

  • Univ of Texas Health Science Center at San Antonio

    San Antonio, Texas, 78229

  • Seattle Children's Hospital Research Foundation

    Seattle, Washington, 98105

  • Washington University Medical Center

    St Louis, Missouri, 63110

Other trials in United States

Canada6 sites
  • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

    Calgary, Alberta, T3B 6A8

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    Halifax, Nova Scotia, B3K 6R8

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    London, Ontario, N6C 2V5

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    Ottawa, Ontario, K1H 8L1

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    Vancouver, British Columbia, V6H 3V4

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    Winnipeg, Manitoba, R3A 1R9

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Germany5 sites
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    Dresden, 01307

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    Essen, 45122

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    Freiburg im Breisgau, 79106

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    Göttingen, 37075

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    Munich, 80337

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Italy4 sites
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    Genova, 16147

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    Milan, 20122

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    Padova, 35128

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    Rome, 00165

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Japan4 sites
  • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

    Aichi, 467-8602

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    Nagano, 390-8621

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    Saitama, 349-0196

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    Tokyo, 187-8551

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Spain4 sites
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    Barcelona, 08025

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    Donostia / San Sebastian, 20014

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    Madrid, 28046

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    Valencia, 46026

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Belgium3 sites
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    Ghent, 9000

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    Leuven, 3000

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    Liège, 4000

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France2 sites
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    Angers, 49933

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    Nantes, 44093

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Netherlands2 sites
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    Leiden, 2300 RC

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    Nijmegen, 6500 HB

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Taiwan2 sites
  • For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

    Kaohsiung City, 807

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    Taipei, 100

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Turkey (Türkiye)2 sites
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    Adana, 01330

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    Ankara, 06100

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Argentina1 site
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    Caba, C1204AAD

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Puerto Rico1 site
  • University of Puerto Rico, Medical Sciences Campus

    San Juan, 000935

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Russia1 site
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    Moscow, 125412

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South Korea1 site
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    Seoul, 110-744

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United Kingdom1 site
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    Oxford, Oxfordshire, OX3 9DU

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About this study

Official title: A Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial of Tadalafil for Duchenne Muscular Dystrophy

The main purpose of this study is to determine if tadalafil can slow the decline in walking ability of boys who have Duchenne muscular dystrophy (DMD). The study will also assess the safety of tadalafil and any side effects that might be associated with it in boys who have DMD. Participants will receive study treatment (tadalafil or placebo) for the first 48 weeks of the study, and can then continue into an open label extension (OLE) that consists of two periods during which all participants will receive tadalafil. In OLE period 1, all participants will receive tadalafil for 48 weeks. Participants completing OLE period 1 will continue into OLE period 2 and will receive tadalafil for at least another 48 weeks.

Being tested
Tadalafil, Placebo
Medical subject headings
Muscular Dystrophy, Duchenne

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TadalafilDrug

    Also called LY450190, Cialis

    Administered orally

  • PlaceboDrug

    Also called Administered orally

Study groups in NCT01865084
Study groupRoleWhat they receive
PlaceboExperimentalPlacebo taken orally once daily.
Receives: Drug: Placebo
0.3 mg/kg TadalafilExperimental0.3 milligram per kilogram (mg/kg) tadalafil taken orally once daily.
Receives: Drug: Tadalafil
0.6 mg/kg TadalafilExperimental0.6 mg/kg tadalafil taken orally once daily.
Receives: Drug: Tadalafil

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in Six Minute Walk Distance (6MWD) in Meters

    6MWD measured the distance in meters a participant was able to walk in 6 minutes. The study used 6MWD procedure modified specifically for use in boys with Duchenne muscular dystrophy (DMD), including standardized verbal encouragement at specific intervals to maintain attention to the test, and use of a "safety chaser" to walk behind the participant during testing (McDonald et al., 2010a). The LS mean (LSM) change from baseline, standard error was derived using mixed model repeated measures (MMRM) methodology with factors for pooled country, treatment, visit, treatment-by-visit interaction and baseline 6MWD as a covariate.

    Measured: Baseline, Week 48

Secondary outcomes (6)
  1. Change From Baseline in the North Star Ambulatory Assessment (NSAA) Global Score

    The NSAA is a functional scale specifically designed for ambulant boys with DMD that can provide additional information on motor functions important in maintaining normal ambulation and other activities important to everyday life. The NSAA is a 17-item evaluation of standing, ability to transition from lying to sitting, sitting to standing, and other mobility assessments. Each of the 17 items is evaluated on an ordinal scale of 0, 1, or 2, with higher scores reflecting better performance on the assessment, for a total maximum score of 34. This score was transformed to a 0 to 100 scale for the key analysis (referred to as linearized), with higher transformed scores reflecting better performance.The LS mean (LSM) change from baseline standard error was derived using mixed model repeated measures methodology (MMRM) with factors for pooled country, treatment, visit, treatment-by-visit interaction and Day 1 value as baseline covariate.

    Measured: Baseline, Week 48

  2. Change From Baseline in Timed Function Tests in Seconds

    Timed function tests included time it took to rise from floor, walk 10 meters, ascend 4 stairs, and descend 4 stairs.The lower the time in seconds taken, the better the performance. The LS mean change from baseline, standard error, was derived using mixed model repeated measures methodology (MMRM) with factors for pooled country, treatment, visit, treatment-by-visit interaction and Day 1 value as baseline covariate.

    Measured: Baseline, Week 48

  3. Time to Persistent 10% Worsening in 6MWD

    Time on study until the 6MWD becomes 10% less than the baseline 6MWD and continues at that level or lower until the end of study.

    Measured: Baseline through Week 48

  4. Time to Persistent 10% Worsening in Timed Function Tests (TFT)

    Time on study until the TFT becomes 10% worse than the baseline TFT and continues at that level or lower until the end of study. The time to persistent 10% worsening is the observed time after baseline until the first observed timepoint where their time used for the TFTs is >110% of the baseline time and all the time values observed afterward are also >110% of baseline. If the participant discontinues prior to experiencing persistent worsening, this outcome for the participant is censored at the date of discontinuation of the double-blind period.

    Only participants with complete evaluable data were analyzed. Complete evaluable data was defined as having baseline measurement, complete dates at evaluable visits and a post-baseline measurement at each evaluable visit.

    Measured: Baseline through Week 48

  5. Change From Baseline in Pediatric Outcomes Data Collection Instrument (PODCI) Scores

    PODCI includes a Global Functioning Scale and 5 core scales:Upper Extremity and Physical Function,Transfer/Basic Mobility, Sports/Physical Functioning, Pain/Comfort,and Happiness.The Global Functioning Scale is the mean of the mean scores from 4 of the 5 core scales (all except the happiness core scale).The following PODCI scores were prespecified in the protocol for analysis: Global Functioning, Upper Extremity and Physical Function,Transfer/Basic Mobility, and Sports/Physical Functioning. The Global Functioning Scale and each of the core scales were standardized so that a score of "0" represents a poor outcome/worse health, while "100" is the best possible outcome/best health (i.e., complete range of each score is 0 to 100, with higher scores representing better functioning). The LS mean (LSM) change from baseline,standard error was derived using MMRM with factors for pooled country, treatment, visit, treatment-by-visit interaction and baseline PODC scale as covariate.

    Measured: Baseline, Week 48

  6. Pharmacokinetics (PK): Apparent Clearance (CL/F) of Tadalafil

    The data reported are population estimate and inter-patient variability.

    Measured: Weeks 4, 12, 24 and 36: -1 Hour up to 24 Hours Postdose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 May 2013 (estimated)
  2. Study startSep 2013
  3. Primary completionDec 2015
  4. Study completionMar 2016

Why it stopped: The study is being terminated for lack of efficacy

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
331 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01865084
Sponsor's protocol ID
15122
Other IDs
H6D-MC-LVJJ
Status last verified
Sep 2019
First submitted
24 May 2013
Last updated
9 Oct 2019
Data monitoring committee
Yes
Individual data sharing
Yes: Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.

Publications

  • McDonald CM, Henricson EK, Han JJ, Abresch RT, Nicorici A, Elfring GL, Atkinson L, Reha A, Hirawat S, Miller LL. The 6-minute walk test as a new outcome measure in Duchenne muscular dystrophy. Muscle Nerve. 2010 Apr;41(4):500-10. doi: 10.1002/mus.21544.

    PubMed 19941337
  • Cox D, Byrne B, Hammers DW, Landry J, Sweeney HL. Effect of Tadalafil on cardiac function and left ventricular dimensions in Duchenne muscular dystrophy: safety and cardiac MRI substudy results from a randomized, placebo-controlled trial. BMC Cardiovasc Disord. 2025 Apr 11;25(1):276. doi: 10.1186/s12872-025-04727-3.

    PubMed 40217158
  • Victor RG, Sweeney HL, Finkel R, McDonald CM, Byrne B, Eagle M, Goemans N, Vandenborne K, Dubrovsky AL, Topaloglu H, Miceli MC, Furlong P, Landry J, Elashoff R, Cox D; Tadalafil DMD Study Group. A phase 3 randomized placebo-controlled trial of tadalafil for Duchenne muscular dystrophy. Neurology. 2017 Oct 24;89(17):1811-1820. doi: 10.1212/WNL.0000000000004570. Epub 2017 Sep 29.

    PubMed 28972192

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tadalafil in people with Muscular Dystrophy, Duchenne, run by Eli Lilly and Company at 62 sites in 16 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 9 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 62 sites in United States, Canada, Germany, Italy, Japan and 11 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Mar 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Six Minute Walk Distance (6MWD) in Meters (time frame: Baseline, Week 48). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01865084, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Oct 2019.

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