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一项关于拉曲匹定治疗亨廷顿病的随机、安慰剂对照试验。

A randomized, placebo-controlled trial of latrepirdine in Huntington disease.

作者信息

Kieburtz Karl, McDermott Michael P, Voss Tiffini S, Corey-Bloom Jody, Deuel Lisa M, Dorsey E Ray, Factor Stewart, Geschwind Michael D, Hodgeman Karen, Kayson Elise, Noonberg Sarah, Pourfar Michael, Rabinowitz Karen, Ravina Bernard, Sanchez-Ramos Juan, Seely Lynn, Walker Francis, Feigin Andrew

机构信息

Department of Neurology, University of Virginia, Charlottesville, VA 22908, USA.

出版信息

Arch Neurol. 2010 Feb;67(2):154-60. doi: 10.1001/archneurol.2009.334.

Abstract

OBJECTIVES

To evaluate the safety and tolerability of latrepirdine in Huntington disease (HD) and explore its effects on cognition, behavior, and motor symptoms.

DESIGN

Double-blind, randomized, placebo-controlled trial.

SETTING

Multicenter outpatient trial.

PARTICIPANTS

Ninety-one participants with mild to moderate HD enrolled at 17 US and UK centers from July 18, 2007, through July 16, 2008.

INTERVENTION

Latrepirdine, 20 mg 3 times daily (n = 46), or matching placebo (n = 45) for a 90-day treatment period.

MAIN OUTCOME MEASURES

The primary outcome variable was tolerability, defined as the ability to complete the study at the assigned drug dosage. Secondary outcome variables included score changes from baseline to day 90 on the Unified Huntington's Disease Rating Scale (UHDRS), the Mini-Mental State Examination (MMSE), and the Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog).

RESULTS

Latrepirdine was well tolerated (87% of the patients given latrepirdine completed the study vs 82% in the placebo group), and adverse event rates were comparable in the 2 groups (70% in the latrepirdine group and 80% in the placebo group). Treatment with latrepirdine resulted in improved mean MMSE scores compared with stable performance in the placebo group (treatment effect, 0.97 points; 95% confidence interval, 0.10-1.85; P = .03). No significant treatment effects were seen on the UHDRS or the ADAS-cog.

CONCLUSIONS

Short-term administration of latrepirdine is well tolerated in patients with HD and may have a beneficial effect on cognition. Further investigation of latrepirdine is warranted in this population with HD.

摘要

目的

评估拉曲匹定在亨廷顿病(HD)中的安全性和耐受性,并探讨其对认知、行为和运动症状的影响。

设计

双盲、随机、安慰剂对照试验。

地点

多中心门诊试验。

参与者

2007年7月18日至2008年7月16日期间,在美国和英国17个中心招募的91名轻度至中度HD患者。

干预措施

拉曲匹定,每日3次,每次20毫克(n = 46),或匹配的安慰剂(n = 45),治疗期为90天。

主要结局指标

主要结局变量为耐受性,定义为按指定药物剂量完成研究的能力。次要结局变量包括从基线到第90天统一亨廷顿病评定量表(UHDRS)、简易精神状态检查表(MMSE)和阿尔茨海默病评估量表认知分量表(ADAS-cog)的评分变化。

结果

拉曲匹定耐受性良好(接受拉曲匹定治疗的患者中有87%完成了研究,而安慰剂组为82%),两组不良事件发生率相当(拉曲匹定组为70%,安慰剂组为80%)。与安慰剂组表现稳定相比,拉曲匹定治疗使MMSE平均得分有所提高(治疗效果为0.97分;95%置信区间为0.10 - 1.85;P = 0.03)。在UHDRS或ADAS-cog上未观察到显著的治疗效果。

结论

HD患者短期服用拉曲匹定耐受性良好,可能对认知有有益影响。有必要对HD患者群体进一步研究拉曲匹定。

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