GlaxoSmithKline, Uxbridge, Middlesex, UK.
Int J Geriatr Psychiatry. 2011 May;26(5):536-44. doi: 10.1002/gps.2562. Epub 2010 Sep 24.
To estimate the treatment effects of SB-742457 and donepezil in Alzheimer disease (AD) in a contemporary clinical trial.
Randomized, controlled, parallel-group, exploratory study with a 4-week, single-blind, placebo run-in phase and 24-week, double-blind treatment phase. Primary endpoints were Clinician's Interview-Based Impression of Change with caregiver input (CIBIC+) and the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog).
One hundred ninety eight subjects with mild-to-moderate probable AD (MMSE scores 12-26) were randomized; 196 were included in the intent-to-treat population (placebo, n = 61; SB-742457 35 mg/day, n = 68; donepezil 10 mg/day, n = 67), and 161 completed. Drug-placebo treatment differences in CIBIC+ score at week 24 were -0.17 (90% confidence interval [CI]: -0.50, 0.16) for SB-742457 and -0.28 (90% CI: -0.61, 0.05) for donepezil. Drug-placebo treatment differences (90% CI) in change from baseline ADAS-Cog score at Week 24 were -0.4 (-2.2, 1.4) for SB-742457 and -1.2 (-3.0, 0.6) for donepezil. All treatments were generally safe and well tolerated.
In this exploratory study, SB-742457 and donepezil were associated with improvements in global function. Treatment effect on cognition for both SB-742457 and donepezil was smaller than those previously observed in previous clinical studies with donepezil.
在一项当代临床试验中评估 SB-742457 和多奈哌齐治疗阿尔茨海默病(AD)的疗效。
这是一项随机、对照、平行分组、探索性研究,包括 4 周的单盲、安慰剂导入期和 24 周的双盲治疗期。主要终点为基于临床医生访谈的变化印象与照料者输入的联合评估(CIBIC+)和阿尔茨海默病评估量表认知子量表(ADAS-Cog)。
共纳入 198 例轻度至中度可能的 AD 患者(MMSE 评分 12-26),随机分为安慰剂组(n=61)、SB-742457 35mg/天组(n=68)和多奈哌齐 10mg/天组(n=67)。196 例患者被纳入意向治疗人群,其中 161 例完成了研究。24 周时,CIBIC+评分的药物-安慰剂治疗差异分别为 SB-742457 组为-0.17(90%置信区间:-0.50,0.16),多奈哌齐组为-0.28(90%置信区间:-0.61,0.05)。24 周时 ADAS-Cog 评分从基线的变化的药物-安慰剂治疗差异(90%置信区间)分别为 SB-742457 组为-0.4(-2.2,1.4),多奈哌齐组为-1.2(-3.0,0.6)。所有治疗均安全且耐受性良好。
在这项探索性研究中,SB-742457 和多奈哌齐均与整体功能的改善相关。与多奈哌齐此前的临床研究相比,SB-742457 和多奈哌齐对认知的治疗效果较小。