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Tropomyosin-related kinase A (TrkA) 抑制治疗膝关节骨关节炎疼痛:来自随机对照 2a 期试验的结果。

Tropomyosin-related kinase A (TrkA) inhibition for the treatment of painful knee osteoarthritis: results from a randomized controlled phase 2a trial.

机构信息

Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Roosevelt Drive Headington, Oxford, UK.

Astellas Pharma Global Development, Northbrook, IL, USA.

出版信息

Osteoarthritis Cartilage. 2019 Nov;27(11):1590-1598. doi: 10.1016/j.joca.2019.05.029. Epub 2019 Jul 26.

Abstract

OBJECTIVE

To investigate the TrkA inhibitor, ASP7962, for treatment of painful knee osteoarthritis.

DESIGN

Phase 2a, double-blind, placebo- and naproxen-controlled, double-dummy, parallel-group study. Adults with knee osteoarthritis were randomized (2:2:1) to ASP7962 (100 mg), placebo, or naproxen (500 mg) twice daily (BID) for 4 weeks. Primary endpoint: change from baseline to Week 4 in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscale score. Secondary endpoints: change from baseline to Weeks 1, 2, and End of Treatment (EoT) in WOMAC pain subscale score; change from baseline to Weeks 1, 2, 4, and EoT in WOMAC physical function and stiffness subscales, walking pain and WOMAC total scores; and change from baseline in daily average pain score.

RESULTS

215 participants were randomized (ASP7962 100 mg BID, n = 85; placebo, n = 87; naproxen 500 mg BID, n = 43). No significant difference was observed between ASP7962 and placebo in change from baseline to Week 4 in WOMAC pain subscale score (-0.14; 90% 2-sided CI: -0.62, 0.34; P = 0.316); a significant difference was observed between naproxen and placebo (-0.67; 80% 2-sided CI: -1.12, -0.23; P = 0.027). No differences were observed between ASP7962 and placebo in change from baseline in any WOMAC subscale score; statistically significant changes were observed between naproxen and placebo (P ≤ 0.01, all time points for all WOMAC endpoints). ASP7962 was safe and well-tolerated.

CONCLUSIONS

Four-week treatment with ASP7962 (100 mg BID) did not improve pain or physical function in individuals with painful knee osteoarthritis. ClinicalTrials.gov, NCT02611466; EudraCT Number, 2014-004996-22.

摘要

目的

研究 TrkA 抑制剂 ASP7962 治疗膝骨关节炎疼痛。

设计

2a 期、双盲、安慰剂对照、双模拟、平行组研究。膝关节骨关节炎成人患者随机(2:2:1)接受 ASP7962(100mg)、安慰剂或萘普生(500mg)每日 2 次(BID)治疗 4 周。主要终点:从基线到第 4 周时 Western Ontario 和 McMaster 大学骨关节炎指数(WOMAC)疼痛子量表评分的变化。次要终点:从基线到第 1、2 和治疗结束(EoT)时 WOMAC 疼痛子量表评分的变化;从基线到第 1、2、4 和 EoT 时 WOMAC 躯体功能和僵硬子量表、行走疼痛和 WOMAC 总分的变化;以及从基线开始时的每日平均疼痛评分的变化。

结果

215 名参与者被随机分组(ASP7962 100mg BID,n=85;安慰剂,n=87;萘普生 500mg BID,n=43)。从基线到第 4 周,ASP7962 与安慰剂在 WOMAC 疼痛子量表评分的变化上无显著差异(-0.14;90%双侧置信区间:-0.62,0.34;P=0.316);与安慰剂相比,萘普生的差异有统计学意义(-0.67;80%双侧置信区间:-1.12,-0.23;P=0.027)。从基线开始,ASP7962 与安慰剂在任何 WOMAC 子量表评分的变化上均无差异;与安慰剂相比,萘普生有统计学意义的变化(P≤0.01,所有 WOMAC 终点的所有时间点)。ASP7962 安全且耐受良好。

结论

接受 ASP7962(100mg BID)治疗 4 周并未改善疼痛或膝关节骨关节炎患者的躯体功能。ClinicalTrials.gov,NCT02611466;EudraCT 编号,2014-004996-22。

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