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日本急性心力衰竭患者使用重组人松弛素的多中心、随机、双盲、安慰剂对照II期研究

Multicenter, Randomized, Double-Blinded, Placebo-Controlled Phase II Study of Serelaxin in Japanese Patients With Acute Heart Failure.

作者信息

Sato Naoki, Takahashi Wataru, Hirayama Atsushi, Ajioka Masayoshi, Takahashi Naoto, Okishige Kaoru, Wang XingLi, Maki Akio, Maruyama Hideki, Ebinger Ursula, Yamaguchi Masayuki, Pang Yinuo, Matsumoto Hiroki, Kawana Masatoshi

机构信息

Cardiology and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital.

出版信息

Circ J. 2015;79(6):1237-47. doi: 10.1253/circj.CJ-15-0227. Epub 2015 Apr 24.

Abstract

BACKGROUND

Serelaxin, a recombinant form of human relaxin-2, is in development for treating acute heart failure (AHF) and a Phase II study in Japanese AHF patients was conducted.

METHODS AND RESULTS

A randomized, double-blind, placebo-controlled study of serelaxin at 10 and 30 µg·kg(-1)·day(-1)continuous intravenous infusion for up to 48 h, added to standard care for Japanese AHF patients. Primary endpoints were adverse events (AEs) through Day 5, serious AEs (SAEs) through Day 14, and serelaxin pharmacokinetics. Secondary endpoints included changes in systolic blood pressure (SBP) and cardiorenal biomarkers. A total of 46 patients received the study drug and were followed for 60 days. The observed AE profile was comparable between the groups, with no AEs of concern. Dose-dependent increase in the serum concentration of serelaxin was observed across the 2 dose rates of serelaxin. A greater reduction in SBP was observed with serelaxin 30 µg·kg(-1)·day(-1)vs. placebo (-7.7 [-16.4, 1.0] mmHg). A greater reduction in NT-proBNP was noted with serelaxin (-50.8% and -54.9% for 10 and 30 µg·kg(-1)·day(-1), respectively at Day 2).

CONCLUSIONS

Serelaxin was well tolerated in this study with Japanese AHF patients, with no AEs of concern and favorable beneficial trends on efficacy. These findings support further evaluation of serelaxin 30 µg·kg(-1)·day(-1)in this patient population.

摘要

背景

重组人松弛素-2(Serelaxin)正在研发用于治疗急性心力衰竭(AHF),并在日本AHF患者中开展了一项II期研究。

方法与结果

一项随机、双盲、安慰剂对照研究,对日本AHF患者在标准治疗基础上加用Serelaxin,以10和30μg·kg⁻¹·天⁻¹持续静脉输注长达48小时。主要终点为至第5天的不良事件(AE)、至第14天的严重不良事件(SAE)以及Serelaxin的药代动力学。次要终点包括收缩压(SBP)和心肾生物标志物的变化。共有46例患者接受了研究药物治疗,并随访60天。各治疗组间观察到的AE情况具有可比性,无值得关注的AE。在Serelaxin的2个剂量率下均观察到Serelaxin血清浓度呈剂量依赖性增加。与安慰剂相比,Serelaxin 30μg·kg⁻¹·天⁻¹组的SBP下降幅度更大(-7.7[-16.4,1.0]mmHg)。在第2天,Serelaxin组的NT-proBNP下降幅度更大(10和30μg·kg⁻¹·天⁻¹组分别为-50.8%和-54.9%)。

结论

在本研究中,日本AHF患者对Serelaxin耐受性良好,无值得关注的AE,且在疗效方面有良好的有益趋势。这些发现支持在该患者群体中进一步评估Serelaxin 30μg·kg⁻¹·天⁻¹。

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