Mancini Maria, Shafai Gigi, Thaler Elizabeth, Donovan Joanne M, Finkel Richard S
Catabasis Pharmaceuticals, Inc., Boston, MA, USA.
St. Jude Children's Research Hospital, Memphis, TN, USA.
J Clin Pharm Ther. 2022 Jan;47(1):33-37. doi: 10.1111/jcpt.13478. Epub 2021 Jul 14.
There is limited information on acceptability of solid dosage forms by young patients with neuromuscular disorders such as Duchenne muscular dystrophy (DMD). Capsule size selection and ability to swallow the NF-κB inhibitor edasalonexent were assessed in males 4-7 years of age with DMD enrolled in clinical trials for a new therapeutic.
The Phase 3 PolarisDMD randomized, double-blind, placebo-controlled trial enrolled 131 patients from 8 countries. The Phase 2 MoveDMD trial enrolled 31 patients in the United States. As part of enrolment criteria, these trials assessed the ability to swallow softgel 100 mg (10 mm) or 250 mg (15 mm) capsules formulated with a phosphatidylcholine-containing coating. Supportive strategies included pill-swallowing techniques and aids.
Most (97%; 175/181) patients screened were able to swallow capsules. In Phase 2 and 3, respectively, 77% (24/31) and 61% (80/131) of enrolled patients selected the larger capsule and among those selecting the smaller capsule, most transitioned to the larger capsule. There were no obvious geographical differences in ability to swallow capsules and size selection was not correlated with age. Compliance was high (92%-98%) through 52 weeks of dosing with no discontinuations due to capsule burden.
Swallowing of capsules was not a barrier for drug administration in young patients with DMD. Capsule formulations may be an acceptable alternative to liquid formulations for children as young as 4 years of age.
关于杜氏肌营养不良症(DMD)等神经肌肉疾病的年轻患者对固体剂型的接受度信息有限。在参与一项新疗法临床试验的4至7岁DMD男性患者中,评估了胶囊尺寸选择以及吞咽核因子κB抑制剂依达赛珠单抗的能力。
3期北极星DMD随机、双盲、安慰剂对照试验纳入了来自8个国家的131名患者。2期MoveDMD试验在美国纳入了31名患者。作为入组标准的一部分,这些试验评估了吞咽用含磷脂酰胆碱包衣制成的100毫克(约10毫米)或250毫克(约15毫米)软胶囊的能力。支持策略包括吞服药丸的技巧和辅助工具。
大多数(97%;175/181)接受筛查的患者能够吞咽胶囊。在2期和3期,分别有77%(24/31)和61%(80/131)的入组患者选择了较大的胶囊,在选择较小胶囊的患者中,大多数转而选择了较大的胶囊。吞咽胶囊的能力没有明显的地域差异,尺寸选择与年龄无关。在长达52周的给药期内依从性很高(92%-98%),没有因胶囊负担而停药的情况。
对于患有DMD的年轻患者,吞咽胶囊并非给药的障碍。对于年仅4岁的儿童,胶囊剂型可能是液体剂型的可接受替代方案。