Steroid treatments for Duchenne (and possibly non-Duchenne) muscular dystrophy may depend on the clock (Weekly prednisone taken at 7 - 9 PM may be best)

Medical Xpress / Cincinnati Children's Hospital Medical Center / Science Advances ^ | Feb. 18, 2022 | Mattia Quattrocelli et al

[ConservativeMind]

Each year, about 20,000 children are diagnosed with Duchenne muscular dystrophy, a rare genetic condition that causes progressive muscle weakness and other systemic damage.

Duchenne primarily affects males and is usually diagnosed by age 4. While a variety of therapies can slow progression and extend life expectancy, the disease has no cure yet. Those born with Duchenne seldom live beyond their mid-20s.

In 2017, researchers learned that weekly doses of prednisone, a widely prescribed steroid, appear to provide better support for weakening muscles compared to daily doses while also reducing the significant side effects induced by daily intake. Now, a new study reports that the time of day for providing the drug may be crucial to the effectiveness of such treatments.

Potential tool for precision dosing

In mice, the researchers found that once-weekly prednisone doses administered at the start of the light period (approximately 7 am) promoted muscle function. The team observed that the treatment boosted nutrient utilization and strengthened mitochondrial bioenergetics in muscle. It also increased endurance and improved muscle mass and muscle force. However, these responses were lost when dosing occurred in the dark period.

With mice being primarily nocturnal, their circadian clocks vary considerably from humans, so the specific time of day that achieves the most beneficial effect would be different for humans than for mice.

This study focused exclusively on prednisone and muscle tissue.

Another clinical trial with once-weekly prednisone in non-Duchenne forms of muscular dystrophy is ongoing. This trial is adapting the time of drug intake based on the new findings reported here.

Patients were instructed to take the drug in the evening after their last meal (between 7-9 pm). "Results from the trial are still pending and hopefully will inform our refinement of chronopharmacology approaches for muscular dystrophies and other conditions," Quattrocelli says.

[ConservativeMind]

A simple timing tweak may provide big benefits.

[ConservativeMind]

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[Pontiac]

A simple timing tweak may provide big benefits.

I recall reading about a study years ago that showed that tolerance of chemotherapy treatments could be raised by timing the therapy to the patient’s circadian rhythm.