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用RT001(一种双氘代亚油酸乙酯)治疗婴儿神经轴索性营养不良:两例报告。

Treatment of infantile neuroaxonal dystrophy with RT001: A di-deuterated ethyl ester of linoleic acid: Report of two cases.

作者信息

Adams Darius, Midei Mark, Dastgir Jahannaz, Flora Christina, Molinari Robert J, Heerinckx Frederic, Endemann Sarah, Atwal Paldeep, Milner Peter, Shchepinov Mikhail S

机构信息

Atlantic Health System Goryeb Children's Hospital Morristown New Jersey USA.

Clinical Division Retrotope, Inc. Los Altos California USA.

出版信息

JIMD Rep. 2020 Mar 27;54(1):54-60. doi: 10.1002/jmd2.12116. eCollection 2020 Jul.

Abstract

BACKGROUND

Infantile neuroaxonal dystrophy (INAD) is a rare, autosomal recessive disease due to defects in and is associated with lipid peroxidation. RT001 is a di-deuterated form of linoleic acid that protects lipids from oxidative damage.

METHODS

We evaluated the pharmacokinetics (PK), safety, and effectiveness of RT001 in two subjects with INAD (subject 1: 34 months; subject 2: 10 months). After screening and baseline evaluations, subjects received 1.8 g of RT001 BD. PK analysis and clinical evaluations were made periodically.

MAIN FINDINGS

Plasma levels of deuterated linoleic acid (D2-LA), deuterated arachidonic acid (D2-AA), D2-LA to total LA, and D2-AA to total AA ratios were measured. The targeted plasma D2-LA ratio (>20%) was achieved by month 1 and maintained throughout the study. RBC AA-ratios were 0.11 and 0.18 at 6 months for subjects 1 and 2; respectively. No treatment-related adverse events occurred. Limited slowing of disease progression and some return of lost developmental milestones were seen.

CONCLUSIONS

Oral RT001 was administered safely in two subjects with INAD. Early findings suggest that the compound was well tolerated, metabolized and incorporated in the RBC membrane. A clinical trial is underway to assess efficacy.

摘要

背景

婴儿神经轴索性营养不良(INAD)是一种罕见的常染色体隐性疾病,由[具体基因名称缺失]缺陷引起,与脂质过氧化有关。RT001是亚油酸的双氘代形式,可保护脂质免受氧化损伤。

方法

我们评估了RT001在两名INAD患者(受试者1:34个月;受试者2:10个月)中的药代动力学(PK)、安全性和有效性。在筛选和基线评估后,受试者接受1.8克RT001,每日两次。定期进行PK分析和临床评估。

主要发现

测量了氘代亚油酸(D2-LA)、氘代花生四烯酸(D2-AA)、D2-LA与总LA的比例以及D2-AA与总AA的比例的血浆水平。在第1个月达到了目标血浆D2-LA比例(>20%),并在整个研究过程中保持。受试者1和受试者2在6个月时的红细胞AA比例分别为0.11和0.18。未发生与治疗相关的不良事件。观察到疾病进展有限减缓,一些失去的发育里程碑有所恢复。

结论

在两名INAD受试者中安全给予口服RT001。早期发现表明该化合物耐受性良好,可代谢并整合到红细胞膜中。正在进行一项临床试验以评估疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c590/7358664/5c5a90313d3f/JMD2-54-54-g001.jpg

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