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一项随机、双盲、安慰剂对照、多剂量、平行组临床试验,旨在评估替度鲁肽对健康受试者液体胃排空的影响。

A randomized, double-blind, placebo-controlled, multiple-dose, parallel-group clinical trial to assess the effects of teduglutide on gastric emptying of liquids in healthy subjects.

作者信息

Berg Jolene Kay, Kim Eric H, Li Benjamin, Joelsson Bo, Youssef Nader N

机构信息

DaVita Clinical Research, 825 S, 8th Street, Suite 300, Minneapolis, MN 55404, USA.

出版信息

BMC Gastroenterol. 2014 Feb 12;14:25. doi: 10.1186/1471-230X-14-25.

Abstract

BACKGROUND

Teduglutide, a recombinant analog of human glucagon-like peptide (GLP)-2, is a novel therapy recently approved for the treatment of adult patients with short bowel syndrome who are dependent on parenteral support. Previous studies assessing the effect of GLP-2 on gastric emptying in humans have yielded inconsistent results, with some studies showing no effect and others documenting a GLP-2-dependent delay in gastric emptying. The primary objective of this study was to assess the effect of teduglutide on gastric emptying of liquids in healthy subjects, as measured by the pharmacokinetics of acetaminophen.

METHODS

This double-blind, parallel-group, single-center study enrolled and randomized 36 healthy subjects (22 men, 14 women) to receive subcutaneous doses of teduglutide 4 mg or placebo (2:1 ratio; 23:13) once daily on Days 1 through 10 in the morning. Gastric emptying of a mixed nutrient liquid meal was assessed by measuring acetaminophen levels predose and at 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 3.5, 4, 5, 6, 8, 10, 12, and 14 hours after administration of 1000 mg acetaminophen on Days 0 and 10. The primary study endpoint was a pharmacokinetic analysis of acetaminophen absorption in subjects receiving teduglutide or placebo.

RESULTS

No significant differences in gastric emptying of liquids (acetaminophen area under the concentration [AUC] vs time curve from time 0 to the last measurable concentration, AUC extrapolated to infinity, maximum concentration [Cmax], and time to Cmax) were observed on Day 10 in subjects receiving teduglutide 4 mg versus subjects receiving placebo. There were no serious adverse events (AEs), deaths, or discontinuations due to an AE reported during the study.

CONCLUSIONS

Teduglutide 4 mg/day for 10 days does not affect gastric emptying of liquids in healthy subjects as measured by acetaminophen pharmacokinetics. No unexpected safety signals were observed.

TRIAL REGISTRATION

This study was registered at ClinicalTrials.gov, identifier NCT01209351.

摘要

背景

替度鲁肽是一种重组人胰高血糖素样肽(GLP)-2类似物,是最近获批用于治疗依赖肠外营养支持的短肠综合征成年患者的新型疗法。此前评估GLP-2对人体胃排空影响的研究结果并不一致,一些研究显示无影响,而另一些研究则记录了GLP-2依赖性胃排空延迟。本研究的主要目的是通过对乙酰氨基酚的药代动力学来评估替度鲁肽对健康受试者液体胃排空的影响。

方法

这项双盲、平行组、单中心研究纳入了36名健康受试者(22名男性,14名女性),并将其随机分组,在第1至10天的早晨每天一次皮下注射4mg替度鲁肽或安慰剂(比例为2:1;23:13)。通过在第0天和第10天服用1000mg对乙酰氨基酚之前及之后0.25、0.5、0.75、1、1.25、1.5、2、3、3.5、4、5、6、8、10、12和14小时测量对乙酰氨基酚水平,评估混合营养液餐的胃排空情况。主要研究终点是接受替度鲁肽或安慰剂的受试者中对乙酰氨基酚吸收的药代动力学分析。

结果

在第10天,接受4mg替度鲁肽的受试者与接受安慰剂的受试者相比,液体胃排空(对乙酰氨基酚浓度-时间曲线下面积[AUC]、外推至无穷大的AUC、最大浓度[Cmax]和达峰时间)无显著差异。研究期间未报告严重不良事件(AE)、死亡或因AE导致的停药情况。

结论

以对乙酰氨基酚药代动力学衡量,连续10天每天服用4mg替度鲁肽不影响健康受试者的液体胃排空。未观察到意外的安全信号。

试验注册

本研究已在ClinicalTrials.gov注册,标识符为NCT01209351。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce72/3928318/c261b032516b/1471-230X-14-25-1.jpg

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