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一项1b期研究,旨在调查阿普舒地(ASP8062)与丁丙诺啡/纳洛酮在阿片类药物使用障碍患者中的潜在相互作用。

A phase 1b study to investigate the potential interactions between ASP8062 and buprenorphine/naloxone in patients with opioid use disorder.

作者信息

Ito Mototsugu, Walzer Mark, Beth Blauwet Mary, Spence Anna, Heo Nakyo, Kelsh Debra, Blahunka Paul, Erdman Jay, Nour Alsharif Mohamad, Marek Gerard J

机构信息

Development Project Management, Astellas Pharma Global Development, Inc., Northbrook, IL, USA.

Clinical Pharmacology and Exploratory Development, Astellas Pharma Global Development, Inc., Northbrook, IL, USA.

出版信息

J Psychopharmacol. 2023 Feb;37(2):144-154. doi: 10.1177/02698811221149657. Epub 2023 Feb 3.

Abstract

BACKGROUND

There is an unmet need for therapeutics with greater efficacy and tolerability for the treatment of opioid use disorder (OUD). ASP8062 is a novel compound with positive allosteric modulator activity on the γ-aminobutyric acid type B receptor under development for use with standard-of-care treatment for patients with OUD.

AIMS

To investigate the safety, tolerability, interaction potential, and pharmacokinetics (PK) of ASP8062 in combination with buprenorphine/naloxone (B/N; Suboxone).

METHODS

In this phase 1, randomized, double-masked, placebo-controlled study, patients with OUD began B/N (titrated to 16/4 mg/day) treatment upon enrollment (induction, Days 1-4; maintenance, Days 5-18; downward titration, Days 19-26; and discharge, Day 27). On Day 12, patients received a single dose of ASP8062 60 mg or placebo with B/N and underwent safety and PK assessments. Primary endpoints included frequency and severity of treatment-emergent adverse events (TEAEs), clinical laboratory tests, respiratory depression, and suicidal ideation. Secondary endpoints investigated the impact of ASP8062 on B/N PK.

RESULTS

Eighteen patients were randomized and completed the study (ASP8062, = 12; placebo, = 6). With this sample size typical for phase 1 drug-drug interaction studies, ASP8062 was well tolerated; most TEAEs were mild in severity, and none led to treatment withdrawal. ASP8062 did not enhance substance use-related TEAEs, respiratory depression, or suicidal ideation and did not have a clinically significant impact on the PK of B/N.

CONCLUSIONS

In this phase 1 study, ASP8062 was safe, well tolerated, and did not enhance respiratory suppression induced by buprenorphine.

TRIAL REGISTRATION

Clinicaltrials.gov identifier: NCT04447287.

摘要

背景

对于治疗阿片类物质使用障碍(OUD)而言,人们对疗效更佳且耐受性更好的治疗方法仍有未满足的需求。ASP8062是一种新型化合物,对γ-氨基丁酸B型受体具有正变构调节剂活性,正在开发用于与OUD患者的标准治疗联合使用。

目的

研究ASP8062与丁丙诺啡/纳洛酮(B/N;舒倍生)联合使用时的安全性、耐受性、相互作用潜力和药代动力学(PK)。

方法

在这项1期随机、双盲、安慰剂对照研究中,OUD患者在入组时开始接受B/N治疗(滴定至16/4毫克/天)(诱导期,第1 - 4天;维持期,第5 - 18天;向下滴定期,第19 - 26天;出院,第27天)。在第12天,患者接受一剂60毫克ASP8062或安慰剂与B/N联合给药,并进行安全性和PK评估。主要终点包括治疗中出现的不良事件(TEAE)的频率和严重程度、临床实验室检查、呼吸抑制和自杀意念。次要终点研究ASP8062对B/N PK的影响。

结果

18名患者被随机分组并完成研究(ASP8062组,n = 12;安慰剂组,n = 6)。对于1期药物相互作用研究而言,该样本量具有代表性,ASP8062耐受性良好;大多数TEAE严重程度为轻度,无一导致治疗中断。ASP8062未增强与物质使用相关的TEAE、呼吸抑制或自杀意念,且对B/N的PK没有临床显著影响。

结论

在这项1期研究中,ASP8062安全、耐受性良好,且未增强丁丙诺啡引起的呼吸抑制。

试验注册

Clinicaltrials.gov标识符:NCT04447287。

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