Radin Daniel P, Cerne Rok, Witkin Jeffrey M, Lippa Arnold
RespireRx Pharmaceuticals Inc., Glen Rock, NJ, USA.
Clin Pharmacol Drug Dev. 2025 Jan;14(1):50-58. doi: 10.1002/cpdd.1475. Epub 2024 Sep 20.
AMPA-type glutamate receptors (AMPARs) mediate the majority of fast excitatory synaptic transmission in the mammalian brain. Ampakines, positive allosteric modulators of AMPAR, hold significant potential for the treatment of a wide range of neurological/neuropsychiatric disorders in which excitatory synaptic transmission is compromised. Low-impact ampakines are a distinct subset of ampakines that accelerate channel opening yet minimally affect receptor desensitization, which may explain their lack of seizurogenic effects at therapeutic doses in preclinical models. CX1739 is a low-impact ampakine that has shown efficacy in preclinical studies. The current clinical study examined the tolerability and pharmacokinetics of CX1739 in healthy male volunteers in a 2-part study. Part A was a single dose escalation study (100-1200 mg, 48 patients) and Part B was a multiple dose ascending study (300-600 mg BID for 7-10 days, 32 patients). CX1739 was well tolerated up to 900 mg once daily (QD) and 450 mg twice a day, with the prominent side effects being headache and nausea. Importantly, the half-life of CX1739 was 6-9 hours, and T was 1-5 hours. CX1739 C and AUC were dose-proportional. These findings thus set the stage for further explorations of this drug candidate in phase 2 clinical studies.
α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(AMPA)型谷氨酸受体(AMPARs)介导哺乳动物大脑中大部分快速兴奋性突触传递。安帕金是AMPAR的正性变构调节剂,在治疗多种兴奋性突触传递受损的神经/神经精神疾病方面具有巨大潜力。低影响安帕金是安帕金的一个独特子集,可加速通道开放,但对受体脱敏的影响最小,这可能解释了它们在临床前模型中治疗剂量下缺乏致痫作用的原因。CX1739是一种低影响安帕金,已在临床前研究中显示出疗效。当前的临床研究在一项分为两部分的研究中考察了CX1739在健康男性志愿者中的耐受性和药代动力学。A部分是单剂量递增研究(100 - 1200毫克,48例患者),B部分是多剂量递增研究(300 - 600毫克,每日两次,共7 - 10天,32例患者)。CX1739每日一次高达900毫克(QD)和每日两次450毫克时耐受性良好,主要副作用为头痛和恶心。重要的是,CX1739的半衰期为6 - 9小时,达峰时间为1 - 5小时。CX1739的血药浓度(C)和药时曲线下面积(AUC)与剂量成正比。因此,这些发现为该候选药物在2期临床研究中的进一步探索奠定了基础。