La maladie de Parkinson au Canada (serveur d'exploration)

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Bromocriptine Mesylate Attenuates Amyotrophic Lateral Sclerosis: A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Research in Japanese Patients

Identifieur interne : 001E79 ( Ncbi/Merge ); précédent : 001E78; suivant : 001E80

Bromocriptine Mesylate Attenuates Amyotrophic Lateral Sclerosis: A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Research in Japanese Patients

Auteurs : Eiichiro Nagata [Japon] ; Mieko Ogino [Japon] ; Kounosuke Iwamoto [Japon] ; Yasuhisa Kitagawa [Japon] ; Yasuo Iwasaki [Japon] ; Fumihito Yoshii [Japon] ; Joh-E. Ikeda [Japon, Canada]

Source :

RBID : PMC:4765990

Abstract

Objective

Bromocriptine mesylate (BRC), a dopamine D2 receptor agonist has been shown to confer neuroprotection, sustained motor function and slowed disease progression in mouse models of amyotrophic lateral sclerosis (ALS) Here we report a first in human trial in ALS.

Design

A multicenter, Riluzole add-on, randomized, double-blind, placebo controlled 102-week extension BRC clinical trial.

Methods

The trial was conducted between January 2009 and March 2012 on 36 Japanese ALS patients. A 12-week treatment with Riluzole observational period was followed by combined treatment (Riluzole + BRC; n = 29 or Riluzole + placebo; n = 7). The dosing commenced at 1.25 mg/day increasing in steps at two weeks intervals to a maximum of 15 mg/day. The efficacy of BRC was evaluated by comparing BRC and placebo groups upon completion of stepwise dosing at 14 weeks 2 points (1st endpoint) and upon completion or discontinuation of the study (2nd endpoint) of the dosing.

Results

Statistics analyses revealed a marginal BRC treatment efficacy with P≦20%to placebo by 1st and 2nd endpoint analysis. In the 1st endpoint analysis, BRC group was significantly effective on the scores of ALSAQ40-communicaton (P = 1.2%), eating and drinking (P = 2.2%), ALSFRS-R total (P = 17.6%), grip strength (P = 19.8%) compared to the placebo group. In the 2nd endpoint analysis, differences between the scores of Limb Norris Scale (P = 18.3%), ALSAQ40-communication (P = 11.9%), eating and drinking (P = 13.6%), and neck forward-bent test (P = 15.4%) of BRC group were detected between the two groups. There was no significant difference between the treatment groups for adverse events or serious drug reactions incidence.

Conclusions

BRC sustains motoneuronal function at least in part through BRC treatment. Further analysis involving a Phase 2b or 3 clinical trial is required but BRC currently shows promise for ALS treatment.

Trial Registration

UMIN Clinical Trials UMIN000008527


Url:
DOI: 10.1371/journal.pone.0149509
PubMed: 26910108
PubMed Central: 4765990

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PMC:4765990

Le document en format XML

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<title>Objective</title>
<p>Bromocriptine mesylate (BRC), a dopamine D2 receptor agonist has been shown to confer neuroprotection, sustained motor function and slowed disease progression in mouse models of amyotrophic lateral sclerosis (ALS) Here we report a first in human trial in ALS.</p>
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<title>Design</title>
<p>A multicenter, Riluzole add-on, randomized, double-blind, placebo controlled 102-week extension BRC clinical trial.</p>
</sec>
<sec id="sec003">
<title>Methods</title>
<p>The trial was conducted between January 2009 and March 2012 on 36 Japanese ALS patients. A 12-week treatment with Riluzole observational period was followed by combined treatment (Riluzole + BRC; n = 29 or Riluzole + placebo; n = 7). The dosing commenced at 1.25 mg/day increasing in steps at two weeks intervals to a maximum of 15 mg/day. The efficacy of BRC was evaluated by comparing BRC and placebo groups upon completion of stepwise dosing at 14 weeks 2 points (1
<sup>st</sup>
endpoint) and upon completion or discontinuation of the study (2
<sup>nd</sup>
endpoint) of the dosing.</p>
</sec>
<sec id="sec004">
<title>Results</title>
<p>Statistics analyses revealed a marginal BRC treatment efficacy with P≦20%to placebo by 1
<sup>st</sup>
and 2
<sup>nd</sup>
endpoint analysis. In the 1
<sup>st</sup>
endpoint analysis, BRC group was significantly effective on the scores of ALSAQ40-communicaton (P = 1.2%), eating and drinking (P = 2.2%), ALSFRS-R total (P = 17.6%), grip strength (P = 19.8%) compared to the placebo group. In the 2
<sup>nd</sup>
endpoint analysis, differences between the scores of Limb Norris Scale (P = 18.3%), ALSAQ40-communication (P = 11.9%), eating and drinking (P = 13.6%), and neck forward-bent test (P = 15.4%) of BRC group were detected between the two groups. There was no significant difference between the treatment groups for adverse events or serious drug reactions incidence.</p>
</sec>
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<p>BRC sustains motoneuronal function at least in part through BRC treatment. Further analysis involving a Phase 2b or 3 clinical trial is required but BRC currently shows promise for ALS treatment.</p>
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<p>UMIN Clinical Trials
<ext-link ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000005640&language=E">UMIN000008527</ext-link>
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<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group>
<journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher>
<publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26910108</article-id>
<article-id pub-id-type="pmc">4765990</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0149509</article-id>
<article-id pub-id-type="publisher-id">PONE-D-15-29010</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Neurology</subject>
<subj-group>
<subject>Neurodegenerative Diseases</subject>
<subj-group>
<subject>Motor Neuron Diseases</subject>
<subj-group>
<subject>Amyotrophic Lateral Sclerosis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
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<subject>Chemistry</subject>
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<subject>Catecholamines</subject>
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<subject>Dopamine</subject>
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<subject>Organic Compounds</subject>
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<subject>Amines</subject>
<subj-group>
<subject>Catecholamines</subject>
<subj-group>
<subject>Dopamine</subject>
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</subj-group>
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<subject>Neurotransmitters</subject>
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<subject>Catecholamines</subject>
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<subject>Dopamine</subject>
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<subject>Neuroscience</subject>
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<subj-group>
<subject>Catecholamines</subject>
<subj-group>
<subject>Dopamine</subject>
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</subj-group>
</subj-group>
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</subj-group>
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<subject>Biology and Life Sciences</subject>
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<subject>Biochemistry</subject>
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<subject>Hormones</subject>
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<subject>Catecholamines</subject>
<subj-group>
<subject>Dopamine</subject>
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<subject>Physiology</subject>
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<subject>Physiological Processes</subject>
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<subject>Eating</subject>
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<subject>Drug Therapy</subject>
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</subj-group>
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<subject>Research and Analysis Methods</subject>
<subj-group>
<subject>Research Design</subject>
<subj-group>
<subject>Clinical Research Design</subject>
<subj-group>
<subject>Adverse Events</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Biology and Life Sciences</subject>
<subj-group>
<subject>Cell Biology</subject>
<subj-group>
<subject>Oxidative Stress</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Gastroenterology and Hepatology</subject>
<subj-group>
<subject>Gastrointestinal Infections</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Pathology and Laboratory Medicine</subject>
<subj-group>
<subject>Signs and Symptoms</subject>
<subj-group>
<subject>Nausea</subject>
</subj-group>
</subj-group>
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<title-group>
<article-title>Bromocriptine Mesylate Attenuates Amyotrophic Lateral Sclerosis: A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Research in Japanese Patients</article-title>
<alt-title alt-title-type="running-head">Safety and Efficacy of Bromocriptine in Japanese ALS</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Nagata</surname>
<given-names>Eiichiro</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ogino</surname>
<given-names>Mieko</given-names>
</name>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Iwamoto</surname>
<given-names>Kounosuke</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kitagawa</surname>
<given-names>Yasuhisa</given-names>
</name>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Iwasaki</surname>
<given-names>Yasuo</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yoshii</surname>
<given-names>Fumihito</given-names>
</name>
<xref ref-type="aff" rid="aff005">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ikeda</surname>
<given-names>Joh-E.</given-names>
</name>
<xref ref-type="aff" rid="aff006">
<sup>6</sup>
</xref>
<xref ref-type="aff" rid="aff007">
<sup>7</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author">
<collab>ALS Consortium Investigators</collab>
<xref ref-type="author-notes" rid="fn001">
<sup></sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001">
<label>1</label>
<addr-line>Department of Neurology, Tokai University School of Medicine, Isehara, Japan</addr-line>
</aff>
<aff id="aff002">
<label>2</label>
<addr-line>Department of Neurology, Kitasato University School of Medicine, Sagamihara, Japan</addr-line>
</aff>
<aff id="aff003">
<label>3</label>
<addr-line>Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan</addr-line>
</aff>
<aff id="aff004">
<label>4</label>
<addr-line>Department of Neurology, Tokai University Hachioji Hospital, Tokyo, Japan</addr-line>
</aff>
<aff id="aff005">
<label>5</label>
<addr-line>Department of Neurology, Tokai University Oiso Hospital, Kanagawa, Japan</addr-line>
</aff>
<aff id="aff006">
<label>6</label>
<addr-line>Molecular Neurology, Faculty of Medicine, Kitasato University School of Medicine, Sagamihara, Japan</addr-line>
</aff>
<aff id="aff007">
<label>7</label>
<addr-line>Department of Pediatrics, Faculty of Medicine, University of Ottawa, ARC/Children’s Hospital of Eastern Ontario, Ottawa, Canada</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Wang</surname>
<given-names>Yun</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>National Health Research Institutes, TAIWAN</addr-line>
</aff>
<author-notes>
<fn fn-type="conflict" id="coi001">
<p>
<bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001">
<p>Conceived and designed the experiments: JEI. Performed the experiments: EN MO KI YK YI FY. Analyzed the data: EN FY JEI. Contributed reagents/materials/analysis tools: EN MO KI YK YI FY JEI. Wrote the paper: EN FY JEI.</p>
</fn>
<fn fn-type="other" id="fn001">
<p>¶ Membership of the ALS Consortium Investigators is listed in the Acknowledgments.</p>
</fn>
<corresp id="cor001">* E-mail:
<email>joh-e@mgcheo.med.uottawa.ca</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>24</day>
<month>2</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection">
<year>2016</year>
</pub-date>
<volume>11</volume>
<issue>2</issue>
<elocation-id>e0149509</elocation-id>
<history>
<date date-type="received">
<day>9</day>
<month>7</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>1</day>
<month>2</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>© 2016 Nagata et al</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Nagata et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0149509.pdf"></self-uri>
<abstract>
<sec id="sec001">
<title>Objective</title>
<p>Bromocriptine mesylate (BRC), a dopamine D2 receptor agonist has been shown to confer neuroprotection, sustained motor function and slowed disease progression in mouse models of amyotrophic lateral sclerosis (ALS) Here we report a first in human trial in ALS.</p>
</sec>
<sec id="sec002">
<title>Design</title>
<p>A multicenter, Riluzole add-on, randomized, double-blind, placebo controlled 102-week extension BRC clinical trial.</p>
</sec>
<sec id="sec003">
<title>Methods</title>
<p>The trial was conducted between January 2009 and March 2012 on 36 Japanese ALS patients. A 12-week treatment with Riluzole observational period was followed by combined treatment (Riluzole + BRC; n = 29 or Riluzole + placebo; n = 7). The dosing commenced at 1.25 mg/day increasing in steps at two weeks intervals to a maximum of 15 mg/day. The efficacy of BRC was evaluated by comparing BRC and placebo groups upon completion of stepwise dosing at 14 weeks 2 points (1
<sup>st</sup>
endpoint) and upon completion or discontinuation of the study (2
<sup>nd</sup>
endpoint) of the dosing.</p>
</sec>
<sec id="sec004">
<title>Results</title>
<p>Statistics analyses revealed a marginal BRC treatment efficacy with P≦20%to placebo by 1
<sup>st</sup>
and 2
<sup>nd</sup>
endpoint analysis. In the 1
<sup>st</sup>
endpoint analysis, BRC group was significantly effective on the scores of ALSAQ40-communicaton (P = 1.2%), eating and drinking (P = 2.2%), ALSFRS-R total (P = 17.6%), grip strength (P = 19.8%) compared to the placebo group. In the 2
<sup>nd</sup>
endpoint analysis, differences between the scores of Limb Norris Scale (P = 18.3%), ALSAQ40-communication (P = 11.9%), eating and drinking (P = 13.6%), and neck forward-bent test (P = 15.4%) of BRC group were detected between the two groups. There was no significant difference between the treatment groups for adverse events or serious drug reactions incidence.</p>
</sec>
<sec id="sec005">
<title>Conclusions</title>
<p>BRC sustains motoneuronal function at least in part through BRC treatment. Further analysis involving a Phase 2b or 3 clinical trial is required but BRC currently shows promise for ALS treatment.</p>
</sec>
<sec id="sec006">
<title>Trial Registration</title>
<p>UMIN Clinical Trials
<ext-link ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000005640&language=E">UMIN000008527</ext-link>
</p>
</sec>
</abstract>
<funding-group>
<funding-statement>This work was supported by Ministry of Health, Labor and Welfare, Japan (H20-ClinicalResearch-G-014).</funding-statement>
</funding-group>
<counts>
<fig-count count="10"></fig-count>
<table-count count="2"></table-count>
<page-count count="16"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>Data are available from UMIN website (
<ext-link ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000005640&language=E">https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000005640&language=E</ext-link>
).</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>Data are available from UMIN website (
<ext-link ext-link-type="uri" xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000005640&language=E">https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000005640&language=E</ext-link>
).</p>
</notes>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Canada</li>
<li>Japon</li>
</country>
<settlement>
<li>Tokyo</li>
</settlement>
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<country name="Japon">
<noRegion>
<name sortKey="Nagata, Eiichiro" sort="Nagata, Eiichiro" uniqKey="Nagata E" first="Eiichiro" last="Nagata">Eiichiro Nagata</name>
</noRegion>
<name sortKey="Ikeda, Joh E" sort="Ikeda, Joh E" uniqKey="Ikeda J" first="Joh-E." last="Ikeda">Joh-E. Ikeda</name>
<name sortKey="Iwamoto, Kounosuke" sort="Iwamoto, Kounosuke" uniqKey="Iwamoto K" first="Kounosuke" last="Iwamoto">Kounosuke Iwamoto</name>
<name sortKey="Iwasaki, Yasuo" sort="Iwasaki, Yasuo" uniqKey="Iwasaki Y" first="Yasuo" last="Iwasaki">Yasuo Iwasaki</name>
<name sortKey="Kitagawa, Yasuhisa" sort="Kitagawa, Yasuhisa" uniqKey="Kitagawa Y" first="Yasuhisa" last="Kitagawa">Yasuhisa Kitagawa</name>
<name sortKey="Ogino, Mieko" sort="Ogino, Mieko" uniqKey="Ogino M" first="Mieko" last="Ogino">Mieko Ogino</name>
<name sortKey="Yoshii, Fumihito" sort="Yoshii, Fumihito" uniqKey="Yoshii F" first="Fumihito" last="Yoshii">Fumihito Yoshii</name>
</country>
<country name="Canada">
<noRegion>
<name sortKey="Ikeda, Joh E" sort="Ikeda, Joh E" uniqKey="Ikeda J" first="Joh-E." last="Ikeda">Joh-E. Ikeda</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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{{Explor lien
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