Velden Walter J F M van der, van Iersel Thijs M P, Blijlevens Nicole M A, Donnelly J Peter
Department of Haematology, Radboud University Nijmegen Medical Centre, The Netherlands.
BMC Med. 2009 Sep 8;7:44. doi: 10.1186/1741-7015-7-44.
The treatment of patients with haematological malignancies by means of haematopoietic stem cell transplantation (HSCT) is often accompanied by life threatening infections. With emerging antimicrobial resistance there is an increased need for new agents, with a beneficial safety profile. Therefore we evaluated the safety of the promising new antimicrobial peptide human lactoferrrin 1-11 (hLF1-11) in healthy volunteers and patients.
We undertook a sequential, randomised, double-blind, placebo-controlled study using ascending single (0.005, 0.05, 0.5, 5 mg) and multiple intravenous doses (0.5, 5 mg) in healthy volunteers, and open-label, single intravenous 5 mg doses in autologous HSCT recipients.
Single and multiple doses of hLF1-11 were tolerable up to 5 mg intravenously in healthy volunteers, while 5 mg single dose was tolerable in patients. Elevations in transaminases possibly related to treatment were reversible and not serious.
The new antimicrobial hLF1-11 is well tolerated in healthy volunteers with repeated daily doses up to 5 mg. The side-effect profile is very favourable for an antimicrobial, the only undesirable effect being a possible elevation of transaminases, which may be related to hLF1-11 although the current data do not allow conclusive interpretation of treatment relationship. A lower dose is recommended for the forthcoming multiple dosing studies in HSCT patients.
ClinicalTrials.gov: nct00509938.
通过造血干细胞移植(HSCT)治疗血液系统恶性肿瘤患者时,常伴有危及生命的感染。随着抗菌药物耐药性的出现,对具有良好安全性的新型药物的需求日益增加。因此,我们评估了有前景的新型抗菌肽人乳铁蛋白1 - 11(hLF1 - 11)在健康志愿者和患者中的安全性。
我们进行了一项序贯、随机、双盲、安慰剂对照研究,在健康志愿者中采用递增单次静脉注射剂量(0.005、0.05、0.5、5毫克)和多次静脉注射剂量(0.5、5毫克),在自体HSCT受者中采用开放标签单次静脉注射5毫克剂量。
在健康志愿者中,静脉注射高达5毫克的hLF1 - 11单次和多次剂量均可耐受,而在患者中5毫克单次剂量可耐受。可能与治疗相关的转氨酶升高是可逆的且不严重。
新型抗菌药物hLF1 - 11在健康志愿者中每日重复剂量高达5毫克时耐受性良好。对于一种抗菌药物而言,其副作用情况非常有利,唯一不良影响可能是转氨酶升高,这可能与hLF1 - 11有关,尽管目前的数据无法对治疗关系进行确定性解释。在即将进行的HSCT患者多次给药研究中,建议使用较低剂量。
ClinicalTrials.gov:nct00509938