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肾上腺髓质素在健康男性中的安全性、耐受性和药代动力学:一项随机、双盲、1期临床试验。

Safety, Tolerability, and Pharmacokinetics of Adrenomedullin in Healthy Males: A Randomized, Double-Blind, Phase 1 Clinical Trial.

作者信息

Kita Toshihiro, Kaji Yoshikazu, Kitamura Kazuo

机构信息

Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Souseikai Hakata Clinic, Fukuoka, Japan.

出版信息

Drug Des Devel Ther. 2020 Jan 6;14:1-11. doi: 10.2147/DDDT.S225220. eCollection 2020.

Abstract

BACKGROUND

Adrenomedullin (AM), an endogenous vasodilative peptide, has immunomodulative effects and acts as an accelerator of mucosal regeneration in the digestive tract. AM has shown beneficial effects in rodent models of inflammatory bowel disease and patients with ulcerative colitis. The present study aimed to evaluate the pharmacodynamic properties and safety of AM in healthy male adults in a phase 1 clinical trial.

METHODS

This phase 1, randomized, double-blind, single-center study was conducted on healthy males aged 20-65 years. Subjects received either a placebo, 3 ng/kg/min AM, 9 ng/kg/min AM, or 15 ng/kg/min AM via continuous 12-h intravenous infusion. Other subjects received either placebo or 15 ng/kg/min AM for 8 h per day for 7 days. Adverse events (AEs), vital signs, physical examinations, laboratory tests, electrocardiograms (ECG), and pharmacokinetics were assessed.

FINDINGS

All 24 subjects in the single-dose test completed the study. Of the 12 subjects in multiple dosing test, one from the AM group withdrew owing to a headache. No serious AEs were reported. Hemodynamic parameters were well maintained in all subjects. Slight ECG abnormalities were observed in the single-dose test. The plasma concentration of AM progressively increased in a dose-dependent manner and reached C at the end of administration. Plasma AM rapidly returned to baseline concentrations after termination, with a T of under 60 min.

INTERPRETATION

This is the first phase 1 trial in healthy men evaluating the safety of AM. Our results demonstrate the safety and tolerability of AM for subsequent Phase 2 trials.

摘要

背景

肾上腺髓质素(AM)是一种内源性血管舒张肽,具有免疫调节作用,可作为消化道黏膜再生的促进剂。AM在炎症性肠病的啮齿动物模型和溃疡性结肠炎患者中已显示出有益效果。本研究旨在通过一项1期临床试验评估AM在健康成年男性中的药效学特性和安全性。

方法

这项1期随机双盲单中心研究针对20 - 65岁的健康男性进行。受试者通过连续12小时静脉输注接受安慰剂、3 ng/kg/min AM、9 ng/kg/min AM或15 ng/kg/min AM。其他受试者每天接受安慰剂或15 ng/kg/min AM,持续8小时,共7天。评估不良事件(AE)、生命体征、体格检查、实验室检查、心电图(ECG)和药代动力学。

结果

单剂量试验中的所有24名受试者均完成了研究。在多次给药试验的12名受试者中,AM组有一名因头痛退出。未报告严重不良事件。所有受试者的血流动力学参数均保持良好。在单剂量试验中观察到轻微的心电图异常。AM的血浆浓度以剂量依赖性方式逐渐升高,并在给药结束时达到C。停药后血浆AM迅速恢复至基线浓度,T小于60分钟。

解读

这是首次在健康男性中评估AM安全性的1期试验。我们的结果证明了AM对后续2期试验的安全性和耐受性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37f1/6955635/7a5365ac86d1/DDDT-14-1-g0001.jpg

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