Reilmann Ralf, Rouzade-Dominguez Marie-Laure, Saft Carsten, Süssmuth Sigurd D, Priller Josef, Rosser Anne, Rickards Hugh, Schöls Ludger, Pezous Nicole, Gasparini Fabrizio, Johns Donald, Landwehrmeyer Georg Bernhard, Gomez-Mancilla Baltazar
George-Huntington-Institute, Münster, Germany; Institute for Clinical Radiology, University of Münster, Münster, Germany; Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
Mov Disord. 2015 Mar;30(3):427-31. doi: 10.1002/mds.26174. Epub 2015 Feb 17.
This study investigated the hypothesis that AFQ056 (mavoglurant), a selective metabotropic glutamate receptor 5 antagonist, reduces chorea in Huntington's disease (HD).
This 32-day randomized, double-blind, parallel-group, proof-of-concept study investigated AFQ056 (25-150 mg [incremental doses], twice-daily) versus placebo in patients with HD. Primary efficacy assessments were the chorea-sum score and orientation index (nondominant hand) from the quantitative motor (Q-Motor) grasping task at day 28. Key secondary efficacy assessments included finger-tapping in the Unified Huntington's Disease Rating Scale-Total Motor Score and Q-Motor measures. Safety and tolerability were assessed.
Overall, 42 patients were randomized. At day 28, no improvement was observed on the primary efficacy assessments (P > 0.10) with AFQ056 versus placebo. The Q-Motor speeded-tapping interonset interval variability was reduced with AFQ056 versus placebo for the nondominant hand (P = 0.01). The incidence of adverse events was 66.7% with AFQ056 and 57.1% with placebo.
AFQ056 did not reduce choreatic movements in HD, but was well tolerated. The clinical relevance of the Q-Motor findings (speeded-tapping) are unknown and may warrant further investigation.
本研究调查了一种假设,即选择性代谢型谷氨酸受体5拮抗剂AFQ056(马沃格伦特)可减轻亨廷顿舞蹈症(HD)中的舞蹈样动作。
这项为期32天的随机、双盲、平行组概念验证研究,对HD患者使用AFQ056(25 - 150毫克[递增剂量],每日两次)与安慰剂进行对比研究。主要疗效评估指标为第28天时定量运动(Q - 运动)抓握任务中的舞蹈样动作总分和定向指数(非优势手)。关键次要疗效评估包括统一亨廷顿舞蹈症评定量表 - 总运动评分中的手指敲击和Q - 运动测量。对安全性和耐受性进行了评估。
总体而言,42例患者被随机分组。在第28天时,与安慰剂相比,AFQ056在主要疗效评估方面未观察到改善(P > 0.10)。与安慰剂相比,AFQ056使非优势手的Q - 运动快速敲击发作间期变异性降低(P = 0.01)。AFQ056组不良事件发生率为66.7%,安慰剂组为57.1%。
AFQ056未能减轻HD中的舞蹈样动作,但耐受性良好。Q - 运动研究结果(快速敲击)的临床相关性尚不清楚,可能需要进一步研究。