Clinical Study to Evaluate the Efficacy and Safety of Givinostat in Ambulant Patients With Duchenne Muscular Dystrophy

This was a phase 3, randomised, double-blind, placebo-controlled, multicentre study to evaluate the efficacy and safety of givinostat in ambulant subjects with DMD. This study included ambulant male paediatric subjects aged ≥ 6 years at baseline affected by DMD. A total of 179 male ambulant subjects was randomized 2:1 (givinostat: placebo). Subjects were stratified for their concomitant use of steroids in 4 strata: 1. Deflazacort daily regimen 2. Deflazacort intermittent regimen 3. Other steroids daily regimen 4. Other steroids intermittent regimen. The study duration was planned to be 19 months. Givinostat or placebo oral suspension (10 mg/mL) was administered orally as 2 oral doses daily while the subject were in fed state, according to the child's weight. Study drug should have been permanently stopped if any of the following occurred: * severe drug-related diarrhoea; * any drug-related Serious Adverse Event; * QTcF \>500 msec; * platelets count ≤50 x 10\^9/L. * white blood cells ≤2.0 x 10\^9/L * hemoglobin ≤8.0 g/dL Study drug should have been temporarily stopped if any of the following occurred: * moderate or severe diarrhoea. * platelets count \<75 x 10\^9/L but \>50 x 10\^9/L (the treatment should been temporarily stopped and a platelets count was to be performed and re-tested until platelets normalized); * white blood cell \<3.0 x 10\^9/L but \>2.0 x 10\^9/L (the treatment should be temporarily stopped and white blood cells had to be measured by 1 week and re-tested until white blood cells normalized); * hemoglobin \<10.0 g/dL but \> 8.0 g/dL (the treatment should be temporarily stopped and hemoglobin had to be measured by 1 week and re-tested until hemoglobin normalized); * Triglycerides \>300 mg/dL (3.42 mmol/L) in fasting condition (the treatment should be temporarily stopped and triglycerides measured every 2 weeks until triglycerides returned to levels below 300mg/dL (3.42 mmol/L) In case the study drug was temporarily stopped, the study drug could be resumed at a level 20% smaller than the one at which the Adverse Event leading to temporary stop occurred, once platelets and/or white blood cell and/or hemoglobin normalized and/or triglycerides returned to levels below 300 mg/dL (3.42 mmol/L) or diarrhoea was mild. In addition, in case a subject had a consistent (e.g., at least 2 consecutive evaluations) platelets count ≤150 x 10\^9/L and didn't meet the stopping criteria for platelets, the Investigator should have to reduce the dose by 20% of the current dose. Only one dose reduction was allowed during the treatment period. This trial design a single planned interim analysis. The interim was governed by an IDMC in order to solely assess futility.