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在 COPD 患者中研究纳夫替诺尔(AZD8871):一项随机、双盲、I 期研究,评估单次使用新型吸入长效双重药理学支气管扩张剂的安全性和药效学。

Navafenterol (AZD8871) in patients with COPD: a randomized, double-blind, phase I study evaluating safety and pharmacodynamics of single doses of this novel, inhaled, long-acting, dual-pharmacology bronchodilator.

机构信息

The Medicines Evaluation Unit, Centre for Respiratory and Allergy Medicine, University of Manchester, University Hospital of South Manchester NHS Foundation Trust, M23 9QZ, Manchester, UK.

Research and Early Development, Respiratory, Inflammation and Autoimmune, BioPharmaceuticals R&D, AstraZeneca, Barcelona, Spain.

出版信息

Respir Res. 2020 Sep 9;21(Suppl 1):102. doi: 10.1186/s12931-020-01347-7.

Abstract

BACKGROUND

Navafenterol (AZD8871) is a dual-pharmacology muscarinic antagonist βagonist (MABA) molecule in development for the treatment of chronic obstructive pulmonary disease (COPD). The pharmacodynamics, safety and tolerability of single doses of navafenterol were investigated in patients with moderate to severe COPD.

METHODS

This was a randomized, five-way complete cross-over study. Patients received single doses of navafenterol 400 μg, navafenterol 1800 μg and placebo (all double-blind) and indacaterol 150 μg and tiotropium 18 μg (both open-label active comparators). The primary pharmacodynamic endpoint was change from baseline in trough forced expiratory volume in 1 s (FEV) on day 2. Safety and tolerability were monitored throughout.

RESULTS

Thirty-eight patients were randomized and 28 (73.7%) completed the study. Navafenterol 400 μg and 1800 μg demonstrated statistically significant improvements vs placebo in change from baseline in trough FEV (least squares mean [95% confidence interval]: 0.111 [0.059, 0.163] L and 0.210 [0.156, 0.264] L, respectively, both P < .0001). The changes were significantly greater with navafenterol 1800 μg vs the active comparators (least squares mean treatment difference: 0.065-0.069 L, both P < .05). The frequency of treatment-emergent adverse events was similar for placebo and the active comparators (range 34.4-37.5%), slightly higher for navafenterol 400 μg (52.9%), and lowest for navafenterol 1800 μg (22.6%).

CONCLUSIONS

Both doses of navafenterol demonstrated sustained bronchodilation over 24 h. Navafenterol was well tolerated and no safety concerns were raised.

TRIAL REGISTRY

ClinicalTrials.gov ; No.: NCT02573155 ; URL: www.clinicaltrials.gov . Registered 9th October, 2015.

摘要

背景

Navafenterol(AZD8871)是一种正在开发用于治疗慢性阻塞性肺疾病(COPD)的双重药理学毒蕈碱拮抗剂-β激动剂(MABA)分子。在中重度 COPD 患者中研究了单剂量 navafenterol 的药效学、安全性和耐受性。

方法

这是一项随机、五向完全交叉研究。患者接受 navafenterol 400μg、navafenterol 1800μg 和安慰剂(均为双盲)以及 indacaterol 150μg 和 tiotropium 18μg(均为开放标签活性对照)的单剂量治疗。主要药效学终点是第 2 天从基线到谷值用力呼气量 1 秒(FEV1)的变化。整个过程中监测安全性和耐受性。

结果

38 名患者被随机分组,28 名(73.7%)完成了研究。与安慰剂相比,navafenterol 400μg 和 1800μg 均显示出谷值 FEV1 从基线的显著改善(最小二乘均值[95%置信区间]:0.111[0.059,0.163]L 和 0.210[0.156,0.264]L,均 P<.0001)。navafenterol 1800μg 与活性对照物相比,变化明显更大(最小二乘均值治疗差异:0.065-0.069L,均 P<.05)。安慰剂和活性对照物的治疗后不良事件发生率相似(范围为 34.4-37.5%),navafenterol 400μg 略高(52.9%),navafenterol 1800μg 最低(22.6%)。

结论

navafenterol 的两种剂量均在 24 小时内持续支气管扩张。navafenterol 耐受性良好,未出现安全性问题。

试验注册

ClinicalTrials.gov;编号:NCT02573155;网址:www.clinicaltrials.gov。2015 年 10 月 9 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8836/7487995/f1b667c24d2a/12931_2020_1347_Fig1_HTML.jpg

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