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一种新型、起效更快的纳洛酮鼻腔干粉制剂,用于治疗阿片类药物过量。

A Novel Faster-Acting, Dry Powder-Based, Naloxone Intranasal Formulation for Opioid Overdose.

机构信息

Nasus Pharma, Harakevet 29, 6618306, Tel Aviv, Israel.

Pharma Medica Research Inc., 6100 Belgrave Rd, Mississauga, ON, L5R 0B7, Canada.

出版信息

Pharm Res. 2022 May;39(5):963-975. doi: 10.1007/s11095-022-03247-5. Epub 2022 Apr 6.

Abstract

OBJECTIVE

To examine the pharmacokinetics and safety of FMXIN001, a new intranasal powder-based naloxone formulation, in comparison to Narcan® nasal liquid spray.

METHODS

FMXIN001, was developed by blending drug microspheres with larger lactose monohydrate particles, that serve as diluent and carrier, as well as a disaggregating agent. Scanning electron microscopy and X-ray were used to characterize the formulation and in vitro deposition was investigated using a nasal cast. We compared the pharmacokinetics and safety of FMXIN001 versus Narcan® in two clinical trials: a pilot study with 14 healthy adults and a pivotal trial in 42 healthy adults (NCT04713709). The studies were open-label, single-dose, randomized, two-period, two-treatment, two-sequence crossover studies to assess the pharmacokinetics and safety of FMXIN001 versus Narcan® nasal spray.

RESULTS

FMXIN001 comprises naloxone microspheres (5-30 μM) and lactose particles (40-240 μM). Upon in vitro testing, naloxone deposits mainly to the middle turbinates region and the upper part of the nasal cavity of a nasal cast. In human subjects, FMXIN001 produced significantly higher exposure at the initial time points of 4, 10, and 30 min, post-administration, compared to Narcan®. Both treatments were safe and well tolerated. FMXIN001, powder-based spray, results in similar overall exposure to Narcan®, but with more rapid absorption in the first 30 min.

CONCLUSIONS

FMXIN001 is expected to have a shorter onset of action for a more effective therapeutic intervention to manage opioid overdose. Rapid administration of naloxone in cases of opioid overdose is imperative, given the alarming increase in mortality rates.

摘要

目的

研究新型鼻腔粉末状纳洛酮制剂 FMXIN001 的药代动力学和安全性,并与 Narcan®鼻喷剂进行比较。

方法

FMXIN001 是通过将药物微球与较大的乳糖一水合物颗粒混合制成的,后者作为稀释剂和载体,以及分散剂。扫描电子显微镜和 X 射线用于对制剂进行特征描述,并使用鼻腔铸型研究体外沉积情况。我们在两项临床试验中比较了 FMXIN001 与 Narcan®的药代动力学和安全性:一项包含 14 名健康成年人的初步研究和一项包含 42 名健康成年人的关键性试验(NCT04713709)。这些研究均为开放标签、单次剂量、随机、两周期、两治疗、两序列交叉研究,旨在评估 FMXIN001 与 Narcan®鼻喷剂的药代动力学和安全性。

结果

FMXIN001 由纳洛酮微球(5-30 μm)和乳糖颗粒(40-240 μm)组成。在体外试验中,纳洛酮主要沉积在鼻腔铸型的中鼻甲区域和鼻腔上部。在人体研究中,与 Narcan®相比,FMXIN001 在给药后 4、10 和 30 分钟的初始时间点产生了显著更高的暴露量。两种治疗方法均安全且耐受良好。FMXIN001,粉末状喷雾,其总体暴露量与 Narcan®相似,但在前 30 分钟内吸收更快。

结论

FMXIN001 有望具有更快的起效时间,在治疗阿片类药物过量方面更有效。在阿片类药物过量的情况下,快速给予纳洛酮至关重要,因为死亡率令人震惊地增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/722a/9160115/56958cf2a628/11095_2022_3247_Fig1_HTML.jpg

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