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对1期临床试验中服用安慰剂的正常健康志愿者的选定安全参数进行的系统评价和汇总分析。

A Systematic Review and Pooled Analysis of Select Safety Parameters Among Normal Healthy Volunteers Taking Placebo in Phase 1 Clinical Trials.

作者信息

Young Tina C, Srinivasan Subasree, Vetter Marion L, Sethuraman Venkat, Bhagwagar Zubin, Zwirtes Ricardo, Narasimhan Premkumar, Chuang Tilda, Smyth Brendan J

机构信息

Bristol-Myers Squibb, Princeton, NJ, USA.

Yale University and Alexion Pharmaceuticals, New Haven, CT, USA.

出版信息

J Clin Pharmacol. 2017 Sep;57(9):1079-1087. doi: 10.1002/jcph.913. Epub 2017 May 16.

Abstract

A systematic review of the Bristol-Myers Squibb normal healthy volunteers (NHVs) database identified phase 1 trials that included NHVs administered placebo with the aim of characterizing normal inter- and intraindividual safety parameter variability. Twenty-five single and multiple ascending dose studies, median duration 28 (2 to 63) days, were included in the pooled analysis (355 NHVs). Laboratory evaluations, vital signs, electrocardiograms, and adverse events were assessed. The most commonly occurring adverse event was headache (28 [7.9%] NHVs; 519.5 events/100 person-years). During the dosing period (on placebo), evaluations showed 5.1 events/100 measures of alanine aminotransferase and 7.3 events/100 measures of creatine kinase 1× above the upper limit of normal. Alanine aminotransferase and creatine kinase elevations occurred in 28 (7.9%) and 39 (11.0%) NHVs, respectively; 105 (30.3%) NHVs had low and 46 (13.3%) had high diastolic blood pressure. This analysis may inform future study designs and provide a context for interpretation of safety signals in early phase clinical trials.

摘要

对百时美施贵宝正常健康志愿者(NHV)数据库进行的一项系统评价,确定了1期试验,这些试验纳入了接受安慰剂的NHV,目的是描述个体间和个体内正常安全参数的变异性。汇总分析纳入了25项单剂量和多剂量递增研究,中位持续时间为28(2至63)天(355名NHV)。对实验室评估、生命体征、心电图和不良事件进行了评估。最常见的不良事件是头痛(28名[7.9%]NHV;519.5起事件/100人年)。在给药期(服用安慰剂期间),评估显示,每100次丙氨酸转氨酶测量中有5.1起事件,每100次肌酸激酶测量中有7.3起事件高于正常上限1倍。丙氨酸转氨酶和肌酸激酶升高分别发生在28名(7.9%)和39名(11.0%)NHV中;105名(30.3%)NHV舒张压偏低,46名(13.3%)NHV舒张压偏高。该分析可为未来的研究设计提供参考,并为早期临床试验中安全信号的解读提供背景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fefb/5573961/bd09bef0f4d0/JCPH-57-1079-g001.jpg

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