AFQ056 Treatment of Levodopa-Induced Dyskinesias: Results of 2 Randomized Controlled Trials

被引:150
作者
Berg, Daniela [2 ,3 ]
Godau, Jana [2 ,3 ]
Trenkwalder, Claudia [4 ,5 ]
Eggert, Karla [6 ]
Csoti, Iiona [7 ]
Storch, Alexander [8 ]
Huber, Heiko [2 ,3 ]
Morelli-Canelo, Monica [4 ,5 ]
Stamelou, Maria [6 ]
Ries, Vincent [6 ]
Wolz, Martin [8 ]
Schneider, Christine [8 ]
Di Paolo, Therese [9 ,10 ]
Gasparini, Fabrizio [1 ]
Hariry, Sam [1 ]
Vandemeulebroecke, Marc [11 ]
Abi-Saab, Walid [1 ]
Cooke, Katy [12 ]
Johns, Donald [1 ]
Gomez-Mancilla, Baltazar [1 ]
机构
[1] Novartis Pharma AG, Neurosci Discovery, CH-4002 Basel, Switzerland
[2] Univ Tubingen, Hertie Inst Clin Brain Res, Tubingen, Germany
[3] German Ctr Neurodegenerat Dis, Tubingen, Germany
[4] Univ Gottingen, D-3400 Gottingen, Germany
[5] Paracelsus Elena Klin, Kassel, Germany
[6] Univ Marburg, Marburg, Germany
[7] Gertrudis Klin, Biskirchen, Germany
[8] Tech Univ Dresden, Dept Neurol, D-8027 Dresden, Germany
[9] Univ Laval, Med Ctr, Mol Endocrinol & Genom Res Ctr, Quebec City, PQ, Canada
[10] Univ Laval, Fac Pharm, Quebec City, PQ, Canada
[11] Novartis Pharma AG, Translat Sci Biostat, CH-4002 Basel, Switzerland
[12] Alpha Plus Med Commun Ltd, High Wycombe, Bucks, England
关键词
parkinsonism; levodopa; glutamate antagonists; dyskinesias; METABOTROPIC GLUTAMATE RECEPTORS; DOPA-INDUCED DYSKINESIAS; PARKINSONS-DISEASE; MONKEYS; ANTAGONIST; MODEL; AMANTADINE; BLOCKADE;
D O I
10.1002/mds.23616
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study objectives were to assess the efficacy, safety, and tolerability of AFQ056 in Parkinson's disease patients with levodopa-induced dyskinesia. Two randomized, double-blind, placebo-controlled, parallel-group, in-patient studies for Parkinson's disease patients with moderate to severe levodopa-induced dyskinesia (study 1) and severe levodopa-induced dyskinesia (study 2) on stable dopaminergic therapy were performed. Patients received 25-150 mg AFQ056 or placebo twice daily for 16 days (both studies). Study 2 included a 4-day down-titration. Primary outcomes were the Lang-Fahn Activities of Daily Living Dyskinesia Scale (study 1), the modified Abnormal Involuntary Movement Scale (study 2), and the Unified Parkinson's Disease Rating Scale-part III both studies). Secondary outcomes included the Unified Parkinson's Disease Rating Scale-part IV items 32-33. The primary analysis was change from baseline to day 16 on all outcomes. Treatment differences were assessed. Fifteen patients were randomized to AFQ056 and 16 to placebo in study 1; 14 patients were randomized to each group in study 2. AFQ056-treated patients showed significant improvements in dyskinesias on day 16 versus placebo (eg, Lang-Fahn Activities of Daily Living Dyskinesia Scale, P = .021 [study 1]; modified Abnormal Involuntary Movement Scale, P = .032 [study 2]). No significant changes were seen from baseline on day 16 on the Unified Parkinson's Disease Rating Scale-part III in either study. Adverse events were reported in both studies, including dizziness. Serious adverse events (most commonly worsening of dyskinesias, apparently associated with stopping treatment) were reported by 4 AFQ056-treated patients in study 1, and 3 patients (2 AFQ056-treated patient and 1 in the placebo group) in study 2. AFQ056 showed a clinically relevant and significant antidyskinetic effect without changing the antiparkinsonian effects of dopaminergic therapy. (C) 2010 Movement Disorder Society
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页码:1243 / 1250
页数:8
相关论文
共 19 条
  • [1] [Anonymous], DHEW PUBL
  • [2] Combined blockade of AMPA and NMDA glutamate receptors reduces levodopa-induced motor complications in animal models of PD
    Bibbiani, F
    Oh, JD
    Kielaite, A
    Collins, MA
    Smith, C
    Chase, TN
    [J]. EXPERIMENTAL NEUROLOGY, 2005, 196 (02) : 422 - 429
  • [3] Striatal dopamine- and glutamate-mediated dysregulation in experimental parkinsonism
    Chase, TN
    Oh, JD
    [J]. TRENDS IN NEUROSCIENCES, 2000, 23 (10) : S86 - S91
  • [4] Effects of group I metabotropic glutamate receptors blockade in experimental models of Parkinson's disease
    Dekundy, A
    Pietraszek, M
    Schaefer, D
    Cenci, MA
    Danysz, W
    [J]. BRAIN RESEARCH BULLETIN, 2006, 69 (03) : 318 - 326
  • [5] Levodopa-induced dyskinesias
    Fabbrini, Giovanni
    Brotchie, Jonathan M.
    Grandas, Francisco
    Nomoto, Masahiro
    Goetz, Christopher G.
    [J]. MOVEMENT DISORDERS, 2007, 22 (10) : 1379 - 1389
  • [6] Fahn S., 1987, RECENT DEV PARKINSON, V2
  • [7] EFFECT OF NONDOPAMINERGIC DRUGS ON L-DOPA-INDUCED DYSKINESIAS IN MPTP-TREATED MONKEYS
    GOMEZMANCILLA, B
    BEDARD, PJ
    [J]. CLINICAL NEUROPHARMACOLOGY, 1993, 16 (05) : 418 - 427
  • [8] Groiss S J, 2009, Ther Adv Neurol Disord, V2, P20, DOI 10.1177/1756285609339382
  • [9] Jankovic Joseph, 2008, Neuropsychiatr Dis Treat, V4, P743
  • [10] Reduction of L-DOPA-Induced Dyskinesia by the Selective Metabotropic Glutamate Receptor 5 Antagonist 3-[(2-Methyl-1,3-thiazol-4-yl)ethynyl]pyridine in the 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine-Lesioned Macaque Model of Parkinson's Disease
    Johnston, Tom H.
    Fox, Susan H.
    McIldowie, Matthew J.
    Piggott, Matthew J.
    Brotchie, Jonathan M.
    [J]. JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS, 2010, 333 (03) : 865 - 873