Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, Minnesota, USA.
Vanda Pharmaceuticals, Washington, District of Columbiam, USA.
Aliment Pharmacol Ther. 2022 Jul;56(2):224-230. doi: 10.1111/apt.17065. Epub 2022 May 29.
BACKGROUND: Tradipitant, an NK1 receptor antagonist, improved symptoms in patients with gastroparesis. It is unclear whether these effects are mediated centrally (e.g., vomiting centre) or on gastric functions. As a class, NK1 antagonists may retard gastric emptying (GE) or increase fasting and postprandial gastric volumes (GV). AIM: To evaluate the effects of tradipitant relative to placebo on gastric motor functions, satiation, postprandial symptoms, and pharmacokinetics. METHODS: We conducted a randomised, double-blind, placebo-controlled, single-centre study of tradipitant 85 mg or matching placebo b.i.d. for 9 consecutive days in 24 healthy volunteers. During the last 2 days of treatment, participants underwent scintigraphic measurements of GE of 320 kcal egg meal, fasting and postprandial GV by SPECT, and satiation by nutrient drink ingested to maximum tolerated volume (MTV) and symptoms 30 min later. Treatments were compared by Wilcoxon rank sum test. The study had 80% power to detect group differences of 23.6% in GV and 29.2% in GE T . RESULTS: The two groups of healthy participants were well balanced based on demographic features, age, and BMI. There were nonsignificant positive correlations between blood levels of tradipitant and accommodation GV and GE at 4 h. There were no significant effects of tradipitant, 85 mg b.i.d. for 9 days compared to placebo on GE, GV, satiation, or symptoms 30 min after MTV. CONCLUSION: Tradipitant, 85 mg b.i.d., does not significantly affect gastric motor functions (GV or GE). Importantly, there was no retardation of GE by tradipitant, which is important in relation to its potential use in patients with gastroparesis. CLINIC TRIALS REGISTRY: ClinicalTrials.gov #NCT04849559.
背景:Tradipitant 是一种 NK1 受体拮抗剂,可改善胃轻瘫患者的症状。这些作用是否通过中枢(例如,呕吐中枢)或胃功能介导尚不清楚。作为一类药物,NK1 拮抗剂可能会延迟胃排空(GE)或增加空腹和餐后胃容量(GV)。
目的:评估Tradipitant 相对于安慰剂对胃动力功能、饱腹感、餐后症状和药代动力学的影响。
方法:我们进行了一项随机、双盲、安慰剂对照、单中心研究,24 名健康志愿者连续 9 天每天接受Tradipitant 85mg 或匹配安慰剂 bid 治疗。在治疗的最后 2 天,参与者接受了放射性核素闪烁扫描测量 320kcal 鸡蛋餐的 GE、SPECT 测量空腹和餐后 GV 以及通过摄入最大耐受量(MTV)的营养饮料测量饱腹感,并在 30 分钟后测量症状。通过 Wilcoxon 秩和检验比较治疗效果。该研究有 80%的效能检测到 GV 的组间差异为 23.6%和 GE T 的组间差异为 29.2%。
结果:两组健康参与者在人口统计学特征、年龄和 BMI 方面具有良好的均衡性。Tradipitant 的血药水平与 4 小时时的适应 GV 和 GE 呈正相关,但无统计学意义。与安慰剂相比,连续 9 天每天接受Tradipitant 85mg bid 治疗并未显著影响 GE、GV、饱腹感或 MTV 后 30 分钟的症状。
结论:Tradipitant,85mg bid,对胃动力功能(GV 或 GE)没有显著影响。重要的是,Tradipitant 没有延迟 GE,这对于其在胃轻瘫患者中的潜在应用非常重要。
临床试验注册号:ClinicalTrials.gov #NCT04849559。
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