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左旋多巴吸入粉(CVT - 301,Inbrija)用于帕金森病患者的一项为期12个月、剂量水平设盲的安全性和有效性研究。

A 12-month, dose-level blinded safety and efficacy study of levodopa inhalation powder (CVT-301, Inbrija) in patients with Parkinson's disease.

作者信息

Farbman Eric S, Waters Cheryl H, LeWitt Peter A, Rudzińska Monika, Klingler Michael, Lee Angela, Qian Jenny, Oh Charles, Hauser Robert A

机构信息

Roseman University of Health Sciences, Las Vegas, NV, USA.

Columbia University Medical Center, New York, NY, USA.

出版信息

Parkinsonism Relat Disord. 2020 Dec;81:144-150. doi: 10.1016/j.parkreldis.2020.10.029. Epub 2020 Oct 17.

Abstract

INTRODUCTION

CVT-301 (Inbrija®) is a levodopa inhalation powder for on-demand treatment of OFF episodes in Parkinson's disease patients treated with carbidopa/levodopa. Safety and efficacy results of a 12-month, dose-level blinded extension study of a phase 3 trial (SPAN℠-PD) of CVT-301 are presented.

METHODS

Patients were receiving oral carbidopa/levodopa and adjunctive CVT-301 treatment, blinded to dose (60 mg or 84 mg, N = 325). Study visits occurred every 3 months. Pulmonary function was assessed by spirometry. Other safety assessments included dyskinesia and adverse events (AEs). Secondary objectives of the study included maintenance of improvement assessments for occurrence of an ON state during the 60-min post-dose period, change in total daily OFF time, and Patient Global Impression of Change (PGIC).

RESULTS

Most frequent AEs (≥5%) were cough (15.4%), fall (13.1%), upper respiratory tract infection (7.1%), and dyskinesia (5.1%). Severe AEs (>1 event) were cough (1.9%) and dyskinesia (0.6%). Twelve-month mean changes from baseline for FEV, FVC, and DL were -0.092 L, -0.097 L, and -0.922 mL/min/mmHg, respectively. At 12 months, 73.0% of patients on 84 mg achieved an ON state within 60 min. Total daily OFF time was reduced by 0.55 h (month 1) and 0.88 h (month 12) for the 84 mg dose. Percentage of patients self-reported as improved by PGIC was 65.5-91.9% over 12 months.

CONCLUSION

CVT-301 was generally well-tolerated. Twelve-month decline in pulmonary function was consistent with a prior PD control group. Exploratory efficacy results showed CVT-301 maintained improvement at achieving ON states in patients experiencing OFF episodes, decreasing daily OFF time, and maintaining improvement in PGIC.

摘要

简介

CVT-301(Inbrija®)是一种左旋多巴吸入粉,用于按需治疗接受卡比多巴/左旋多巴治疗的帕金森病患者的“关”期发作。本文介绍了CVT-301的一项3期试验(SPAN℠-PD)为期12个月的剂量水平盲法扩展研究的安全性和有效性结果。

方法

患者接受口服卡比多巴/左旋多巴和辅助CVT-301治疗,对剂量(60毫克或84毫克,N = 325)不知情。每3个月进行一次研究访视。通过肺活量测定法评估肺功能。其他安全性评估包括异动症和不良事件(AE)。该研究的次要目标包括在给药后60分钟内对“开”期发作的改善维持评估、每日总“关”期时间的变化以及患者总体变化印象(PGIC)。

结果

最常见的不良事件(≥5%)为咳嗽(15.4%)、跌倒(13.1%)、上呼吸道感染(7.1%)和异动症(5.1%)。严重不良事件(>1例)为咳嗽(1.9%)和异动症(0.6%)。FEV、FVC和DL从基线开始的12个月平均变化分别为-0.092升、-0.097升和-0.922毫升/分钟/毫米汞柱。在12个月时,84毫克剂量组中73.0%的患者在60分钟内达到“开”期状态。84毫克剂量组的每日总“关”期时间在第1个月减少了0.55小时,在第12个月减少了0.88小时。在12个月内,自我报告通过PGIC改善的患者百分比为65.5 - 91.9%。

结论

CVT-301总体耐受性良好。肺功能的12个月下降与先前的帕金森病对照组一致。探索性疗效结果显示,CVT-301在经历“关”期发作的患者中实现“开”期状态方面维持改善,减少每日“关”期时间,并在PGIC方面维持改善。

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