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雌激素受体β激动剂LY500307未能改善继发于良性前列腺增生的前列腺肿大男性的症状。

Estrogen receptor beta agonist LY500307 fails to improve symptoms in men with enlarged prostate secondary to benign prostatic hypertrophy.

作者信息

Roehrborn C G, Spann M E, Myers S L, Serviss C R, Hu L, Jin Y

机构信息

UT Southwestern Medical Center at Dallas, Dallas, TX, USA.

Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA.

出版信息

Prostate Cancer Prostatic Dis. 2015 Mar;18(1):43-8. doi: 10.1038/pcan.2014.43. Epub 2014 Nov 4.

Abstract

BACKGROUND

To assess the efficacy and safety of LY500307, a selective estrogen receptor beta agonist, on lower urinary tract symptoms (LUTS) in patients with enlarged prostate secondary to BPH.

METHODS

In a randomized, double-blind, placebo-controlled, parallel phase 2, efficacy and safety study, eligible patients with moderate to severe LUTS and prostatic enlargement (⩾30 ml) were randomized to placebo or LY500307 at 1, 3, 10 and 25 mg once daily for 24 weeks. Primary efficacy end point was change in total International Prostate Symptoms Score (IPSS) after 24 weeks. Secondary end points included changes in total prostate volume (TPV) that served as a proof of concept end point, as well as IPSS quality of life, maximum peak urine flow rate (Qmax) and PSA and safety (adverse events, laboratory test).

RESULTS

A total of 414 patients were randomized when the study was terminated because of insufficient TPV reduction, based on a priori defined interim analysis. The IPSS mean change from baseline to end point was -3.4±6.8 in the placebo group and -1.3±6.6, -2.6±7.0, -3.7±6.7 and -4.4±5.7 in the 1, 3, 10 and 25 mg LY500307-treated groups, respectively (P>0.05). Similarly, no treatment effect was observed for any of the secondary efficacy measures. Incidence of adverse events was comparable between treatment groups, and no clinically meaningful changes in laboratory tests were observed.

CONCLUSIONS

LY500307 was well tolerated in BPH patients with LUTS at doses up to 25 mg once daily for 24 weeks. The study was terminated early because of inadequate efficacy.

摘要

背景

评估选择性雌激素受体β激动剂LY500307对良性前列腺增生继发前列腺肿大患者下尿路症状(LUTS)的疗效和安全性。

方法

在一项随机、双盲、安慰剂对照、平行2期疗效和安全性研究中,符合条件的中重度LUTS和前列腺肿大(≥30 ml)患者被随机分为安慰剂组或LY500307组,剂量分别为1、3、10和25 mg,每日一次,共24周。主要疗效终点是24周后国际前列腺症状评分(IPSS)总分的变化。次要终点包括用作概念验证终点的前列腺总体积(TPV)变化,以及IPSS生活质量、最大尿流率(Qmax)、前列腺特异性抗原(PSA)和安全性(不良事件、实验室检查)。

结果

基于预先定义的中期分析,由于TPV降低不足,研究终止时共有414例患者被随机分组。安慰剂组从基线到终点的IPSS平均变化为-3.4±6.8,1、3、10和25 mg LY500307治疗组分别为-1.3±6.6、-2.6±7.0、-3.7±6.7和-4.4±5.7(P>0.05)。同样,任何次要疗效指标均未观察到治疗效果。各治疗组不良事件发生率相当,实验室检查未观察到有临床意义的变化。

结论

LY500307在每日一次剂量高达25 mg、持续24周的LUTS良性前列腺增生患者中耐受性良好。该研究因疗效不足提前终止。

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