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一项评估新型皮质增强剂 IRL752 在帕金森病痴呆中的安全性和耐受性的 2a 期临床试验。

A Phase 2a Trial Investigating the Safety and Tolerability of the Novel Cortical Enhancer IRL752 in Parkinson's Disease Dementia.

机构信息

Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

出版信息

Mov Disord. 2020 Jun;35(6):1046-1054. doi: 10.1002/mds.28020. Epub 2020 Mar 21.

Abstract

BACKGROUND

IRL752 is a novel small-molecule compound that acts to regioselectively enhance norepinephrine, dopamine, and acetylcholine neurotransmission in the cerebral cortex.

OBJECTIVE

The primary objective of the trial was to investigate the safety and tolerability of IRL752 in patients with Parkinson's disease and dementia.

METHODS

Patients with Parkinson's disease and dementia were randomized to IRL752 or placebo treatment (3:1 ratio) for 28 days. The study drug was given as an adjunct treatment to the patients' regular stable antiparkinsonian medication. Dosing was individually titrated for 14 days after which the dose was kept stable for an additional 14 days.

RESULTS

A total of 32 patients were randomized to treatment, and 29 patients completed the 4-week treatment. Adverse events were generally mild and transient and were mostly reported during the dose titration phase. There were 2 serious adverse events, and none of them were related to the experimental treatment. The average dose achieved in the stable dose phase was 600 mg daily, yielding a 2-hour postdose plasma concentration of about 4 μM on day 28. Exploratory assessment of secondary outcomes indicated efficacy for symptoms and signs known to be poorly responsive to levodopa.

CONCLUSIONS

IRL752 appears to be safe and well tolerated for a 4-week treatment in patients with Parkinson's disease and dementia. © 2020 International Parkinson and Movement Disorder Society.

摘要

背景

IRL752 是一种新型小分子化合物,可选择性地增强大脑皮层中的去甲肾上腺素、多巴胺和乙酰胆碱神经传递。

目的

试验的主要目的是研究 IRL752 在帕金森病和痴呆患者中的安全性和耐受性。

方法

帕金森病和痴呆患者随机分为 IRL752 或安慰剂治疗(3:1 比例)28 天。研究药物作为附加治疗给予患者常规稳定的抗帕金森病药物。在 14 天的剂量滴定后,剂量保持稳定 14 天。

结果

共有 32 名患者随机接受治疗,29 名患者完成了 4 周的治疗。不良事件通常是轻微和短暂的,主要发生在剂量滴定阶段。有 2 例严重不良事件,均与实验治疗无关。稳定剂量阶段的平均剂量为每天 600 毫克,第 28 天的 2 小时后血浆浓度约为 4 μM。对已知对左旋多巴反应不佳的症状和体征的次要结局进行的探索性评估表明具有疗效。

结论

IRL752 在帕金森病和痴呆患者中进行 4 周治疗时似乎安全且耐受良好。©2020 国际帕金森病和运动障碍学会。

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