在ALS中用普里多匹丁治疗:来自HEALEY ALS平台试验的亚组分析
Michal Geva1, Y Paul Goldberg1, Melanie L Leitner2
1Prilenia Therapeutics B.V., Naarden, The Netherlands.
Amyotrophic lateral sclerosis & frontotemporal degeneration
|December 17, 2025
概括
普里多皮丁在早期阶段的小组患者中显示出减缓肌缩侧面硬化症 (ALS) 进展的潜力. 这种西格玛-1受体激动剂在功能评分尺度和呼吸功能上显示出好处.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 肌缩侧面硬化 (ALS) 是一种进展性神经退行性疾病,治疗选择有限.
- 作为一种选择性西格玛-1受体激动剂,Pridopidine因其治疗ALS的潜力而受到研究.
- 之前的试验表明,在特定的患者亚组中可能有好处.
研究的目的:
- 为了对普罗多皮丁在患有确定的/可能的ALS和早期疾病 (发病后<18个月) 的快速进展的参与者中的疗效进行探索性分析.
- 进一步调查在治疗效果可能更明显的子组中的潜在治疗益处.
主要方法:
- 进行了一项随机,双盲,安慰剂控制的第二阶段试验 (HEALEY ALS平台试验,方案D).
- 参与者接受了普里多皮丁 (每天两次45毫克) 或安慰剂.
- 主要结局是ALS功能评分尺度修订 (ALSFRS-R) 总分;次要结局包括呼吸,腹筋和语音功能.
主要成果:
- 在D方案的163名参与者中,有72人符合子组标准.
- 在24周,普里多皮丁显著减缓了ALSFRS-R总得分 (32%,p=0.03) 和呼吸功能 (62%,p=0.03) 的下降.
- 呼吸不全 (88%的衰退减少,p=0.005),发音 (93%的衰退减少,p=0.0007) 和说话率 (70%的衰退减少,p=0.002) 均有显著的改善.
结论:
- 后期小组分析表明,对于确诊/可能患有ALS和早期疾病进展的患者来说,普里多匹丁具有治疗益处.
- 普里多皮丁耐受性良好,其安全性与安慰剂相比较.
- 这些发现支持在ALS的第三阶段临床试验中对普罗多匹丁的进一步调查.
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