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SAGE-217,一种新型 GABA 受体正向变构调节剂:在随机、I 期剂量发现研究中的临床药理学和耐受性。

SAGE-217, A Novel GABA Receptor Positive Allosteric Modulator: Clinical Pharmacology and Tolerability in Randomized Phase I Dose-Finding Studies.

机构信息

Sage Therapeutics, Inc., 215 First Street, Cambridge, MA, 02412, USA.

Clinical Develoment, Biogen, Cambridge, MA, USA.

出版信息

Clin Pharmacokinet. 2020 Jan;59(1):111-120. doi: 10.1007/s40262-019-00801-0.

Abstract

BACKGROUND

SAGE-217, a novel γ-aminobutyric acid A (GABA) receptor positive allosteric modulator, was evaluated in phase I, double-blind, placebo-controlled, single ascending dose (SAD) and multiple ascending dose (MAD) studies to assess the safety and pharmacokinetics (PK) of SAGE-217 following administration as an oral solution.

METHODS

In the SAD study, subjects were randomized 6:2 to a single dose of SAGE-217 or placebo. Doses ranged from 0.25 to 66 mg across nine cohorts. In the MAD study, subjects were randomized 9:3 and received SAGE-217 (15, 30, or 35 mg) or placebo once daily for 7 days. In both studies, PK, maximum tolerated dose (MTD; against predetermined criteria), safety, and tolerability were assessed.

RESULTS

A total of 108 healthy volunteers enrolled in the studies-72 subjects in the SAD study and 36 subjects in the MAD study. SAGE-217 was orally bioavailable, with a terminal-phase half-life of 16-23 h and a t of approximately 1 h. The MTDs for the oral solution of SAGE-217 in the SAD and MAD studies were determined to be 55 and 30 mg daily, respectively. In both studies, SAGE-217 was generally well tolerated, and no serious adverse events (SAEs) were reported. Most AEs were mild, dose-dependent, transient, occurred around the t, and related to drug pharmacology.

CONCLUSIONS

SAGE-217 was generally well tolerated, and its PK profile was well characterized. Based on this profile, SAGE-217 has been advanced into multiple phase II clinical programs and pivotal studies of major depressive disorder and postpartum depression.

摘要

背景

SAGE-217 是一种新型的γ-氨基丁酸 A(GABA)受体正变构调节剂,在 I 期、双盲、安慰剂对照、单次递增剂量(SAD)和多次递增剂量(MAD)研究中进行了评估,以评估 SAGE-217 作为口服溶液给药后的安全性和药代动力学(PK)。

方法

在 SAD 研究中,受试者按 6:2 的比例随机分配至单剂量 SAGE-217 或安慰剂。剂量范围为 9 个队列中的 0.25 至 66mg。在 MAD 研究中,受试者按 9:3 的比例随机分配,并接受 SAGE-217(15、30 或 35mg)或安慰剂,每日一次,共 7 天。在两项研究中,评估了 PK、最大耐受剂量(MTD;根据预定标准)、安全性和耐受性。

结果

共有 108 名健康志愿者参加了这些研究-72 名受试者参加了 SAD 研究,36 名受试者参加了 MAD 研究。SAGE-217 口服生物利用度高,终末半衰期为 16-23h,t 约为 1h。SAGE-217 口服溶液在 SAD 和 MAD 研究中的 MTD 分别确定为 55 和 30mg 每日。在两项研究中,SAGE-217 总体耐受性良好,未报告严重不良事件(SAE)。大多数不良事件为轻度、剂量依赖性、短暂性、发生在 t 附近,与药物药理学相关。

结论

SAGE-217 总体耐受性良好,其 PK 特征得到了很好的描述。基于该特征,SAGE-217 已进入多项 II 期临床计划和重度抑郁症和产后抑郁症的关键性研究。

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