Full market-approved drugs are lacking in Duchenne muscular dystrophy (DMD). MRI muscle fat fraction (FF) is a potential surrogate endpoint in clinical trials but is acceptable to regulators only if related to clinically meaningful milestones. Any biological parameter that consistently changes with age will inherently correlate with functional parameters in a progressive disease. It is thus imperative for such a parameter to have additional predictive value to age in order to function as biomarker.

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