Litman Robert E, Smith Mark A, Doherty James J, Cross Alan, Raines Shane, Gertsik Lev, Zukin Stephen R
CBH Health, LLC, 9210 Corporate Blvd., Suite 110, Rockville, MD, United States; Georgetown University, 3700 O St. NW, Washington, DC 20057, United States.
AstraZeneca Pharmaceuticals, 1800 Concord Pike, Wilmington, DE 19542, United States; Teva Pharmaceuticals, 41 Moores Rd., Frazer, PA 19355, United States.
Schizophr Res. 2016 Apr;172(1-3):152-7. doi: 10.1016/j.schres.2016.02.001. Epub 2016 Feb 26.
Activation of metabotropic glutamate (mGluR2/3) receptors has been proposed as an alternative mechanism to dopaminergic-based antipsychotics to correct glutamatergic deficits hypothesized to underlie schizophrenia symptoms. This study investigates the efficacy and safety of AZD8529, a selective positive allosteric modulator (PAM) at the mGlu2 receptor, in symptomatic patients with schizophrenia.
Patients were randomized to receive AZD8529 40 mg, risperidone 4 mg, or placebo as monotherapy. Treatment lasted for 28 days, and clinical efficacy was assessed using Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) scores.
There were no significant differences between patients treated with AZD8529 versus placebo in change from baseline to endpoint in PANSS total, negative and positive symptom subscale, or CGI-S scores. In contrast, risperidone demonstrated significant efficacy relative to placebo.
These results do not support a role for the mGluR-2 PAM AZD8529 as an antipsychotic and indicate that positive modulation of mGluR type 2 receptors alone is not sufficient for antipsychotic effects in acutely ill schizophrenia patients.
代谢型谷氨酸(mGluR2/3)受体的激活已被提出作为基于多巴胺能的抗精神病药物的替代机制,以纠正被认为是精神分裂症症状基础的谷氨酸能缺陷。本研究调查了AZD8529(一种mGlu2受体的选择性正变构调节剂(PAM))在有症状的精神分裂症患者中的疗效和安全性。
患者被随机分配接受40毫克AZD8529、4毫克利培酮或安慰剂作为单一疗法。治疗持续28天,使用阳性和阴性症状量表(PANSS)和临床总体印象(CGI)评分评估临床疗效。
在从基线到终点的PANSS总分、阴性和阳性症状子量表或CGI-S评分方面,接受AZD8529治疗的患者与接受安慰剂治疗的患者之间没有显著差异。相比之下,利培酮相对于安慰剂显示出显著疗效。
这些结果不支持mGluR-2 PAM AZD8529作为抗精神病药物的作用,并表明单独对mGluR 2型受体的正向调节不足以对急性病精神分裂症患者产生抗精神病作用。