Clinical Assistant Professor, Clinical Pharmacy Department, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
Clinical Professor of Psychiatry & Behavioral Sciences, Department of Psychiatry and Behavioral Science, New York Medical College, Valhalla, NY, USA.
Expert Opin Investig Drugs. 2022 Aug;31(8):773-780. doi: 10.1080/13543784.2022.2096006. Epub 2022 Jul 6.
Agitation is common in patients with Alzheimer's disease (AD). Although nonpharmacologic de-escalation strategies are recommended as first-line treatment, medication is often needed to treat agitation. Currently, there are no FDA-approved medications for this indication. Psychotropics used to treat agitation include antipsychotics, which are notable for their efficacy but also their potential to cause serious side effects. AXS-05, a combination of dextromethorphan and bupropion, is currently being investigated for this indication.
This review will discuss the pharmacology of AXS-05 and available clinical trial results from completed Phase I and Phase II/III studies assessing the potential for this compound to treat agitation in patients with AD. Ongoing research investigating AXS-05 for this indication will also be highlighted. Resources used for this review include PubMed, Embase, clinicaltrials.gov, and literature available on the manufacturer's website.
Early released clinical trial data indicate that AXS-05 may be a useful option to treat agitation in patients with AD and that it appears to be generally well tolerated. AXS-05 may be especially helpful for patients with comorbid depression, when considering available data from separate phase III studies assessing the efficacy and safety of this compound in the treatment of depression.
阿尔茨海默病(AD)患者常出现激越症状。虽然推荐使用非药物性降级策略作为一线治疗,但通常需要药物治疗激越症状。目前,尚无 FDA 批准用于该适应症的药物。用于治疗激越的精神药物包括抗精神病药,它们具有显著的疗效,但也有引起严重副作用的潜力。AXS-05 是右美沙芬和安非他酮的组合,目前正在研究用于该适应症。
本文将讨论 AXS-05 的药理学,以及评估该化合物治疗 AD 患者激越的已完成 I 期和 II/III 期临床试验的现有临床结果。还将突出介绍正在进行的用于该适应症的 AXS-05 研究。本综述使用的资源包括 PubMed、Embase、clinicaltrials.gov 以及制造商网站上的可用文献。
早期发布的临床试验数据表明,AXS-05 可能是治疗 AD 患者激越的一种有用选择,且总体耐受性良好。考虑到单独的 III 期研究评估了该化合物在治疗抑郁症方面的疗效和安全性的可用数据,AXS-05 对伴有共病抑郁症的患者可能特别有帮助。