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Barrocas P, Vieira ACF, Almeida H, Teixeira J, Gomes MJ, Chevalier E, Soares-da-Silva P, Vasconcelos T. Over-blending effect of lubricants on capsules manufacturing: a simple and fast wettability technique to predict batch dissolution performance. Pharm Dev Technol 2023; 28:363-370. [PMID: 36987819 DOI: 10.1080/10837450.2023.2196332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Mixing/blending is a crucial operation in the manufacturing of solid drug products in the pharmaceutical industry. Although usually described and controlled in specific steps, blending is also inherent to other operations such as transference of materials and equipment feeding systems. This study aimed to investigate a simple and fast wettability testing procedure capable to foresee potential over-blending effects of lubricants occurring during manufacturing of solid dosage forms. An industrial batch blend was submitted to two mixing mechanisms studies (diffusion and shear) during increasing time periods, and the developed wettability testing procedure was applied to assess their impact on blend water uptake. Capsules filled with these blends were tested for dissolution and disintegration. The method was applied to capsules with known dissolution results manufactured at industrial scale. Results demonstrated that processes inducing shear stress led to less permeable blends with consequent retardation on capsules dissolution of at least 35% in the tested timepoints and obtained study metrics above 500 s. Moreover, disintegration testing was not able to detect non-compliant dissolutions, while the proposed wettability testing procedure proved to be able to identify performance failures. Wettability results correlate the effect of mixing mechanisms to capsules dissolution performance, evidencing that this technique can be applied in pharmaceutical industry to evaluate possible over-blending effects.
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Affiliation(s)
- P Barrocas
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
| | - A C F Vieira
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
| | - H Almeida
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
| | - J Teixeira
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
| | - M J Gomes
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
| | - E Chevalier
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
| | - P Soares-da-Silva
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
- Dept. of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal
- MedinUp - Center for Drug Discovery and innovative medicine, University of Porto, Portugal
| | - T Vasconcelos
- BIAL - Portela & Ca., S.A., R&D Area, Trofa, Portugal
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Loureiro AI, Fernandes-Lopes C, Bonifácio MJ, Sousa F, Kiss LE, Soares-da-Silva P. Metabolism and disposition of opicapone in the rat and metabolic enzymes phenotyping. Pharmacol Res Perspect 2021; 10:e00891. [PMID: 34939338 PMCID: PMC8929358 DOI: 10.1002/prp2.891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/11/2022] Open
Abstract
Opicapone (2,5‐dichloro‐3‐(5‐(3,4‐dihydroxy‐5‐nitrophenyl)‐1,2,4‐oxadiazol‐3‐yl)‐4,6‐dimethylpyridine 1‐oxide) is a selective catechol‐O‐methyltransferase inhibitor that has been granted marketing authorization in Europe, Japan, and United States. The present work describes the metabolism and disposition of opicapone in the rat obtained in support to its development and regulatory filling. Plasma levels and elimination of total radioactivity were determined after oral and intravenous administration of [14C]‐opicapone. The maximum plasma concentrations of opicapone‐related radioactivity were reached at early time points followed by a gradual return to baseline with a biphasic elimination. Fecal excretion was the primary route of elimination of total radioactivity. Quantitative distribution of drug‐related radioactivity demonstrated that opicapone and related metabolites did not distribute to the central nervous system. Opicapone was extensively metabolized in rats resulting in more than 20 phase I and phase II metabolites. Although O‐glucuronidation, ‐sulfation, and ‐methylation of the nitrocatechol moiety were the principal metabolic pathways, small amount of the N‐acetyl derivative was detected, as a result of reduction of the nitro group and subsequent conjugation. Other metabolic transformations included N‐oxide reduction to the pyridine derivative and reductive cleavage of 1,2,4‐oxadiazole ring followed by further conjugative reactions. Reaction phenotyping studies suggested that SULT 1A1*1 and *2 and UGT1A7, UGT1A8, UGT1A9, and UGT1A10 may be involved in opicapone sulfation and glucuronidation, respectively. However, the reductive metabolic pathways mediated by gut microflora cannot be excluded. Opicapone, in the rat, was found to be rapidly absorbed, widely distributed to peripheric tissues, metabolized mainly via conjugative pathways at the nitro catechol ring, and primarily excreted via feces.
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Affiliation(s)
- Ana I Loureiro
- Department of Research and Development, BIAL-Portela & Cª. S.A., S Mamede do Coronado, Portugal
| | - Carlos Fernandes-Lopes
- Department of Research and Development, BIAL-Portela & Cª. S.A., S Mamede do Coronado, Portugal
| | - Maria João Bonifácio
- Department of Research and Development, BIAL-Portela & Cª. S.A., S Mamede do Coronado, Portugal
| | - Filipa Sousa
- Department of Research and Development, BIAL-Portela & Cª. S.A., S Mamede do Coronado, Portugal
| | - László E Kiss
- Department of Research and Development, BIAL-Portela & Cª. S.A., S Mamede do Coronado, Portugal
| | - Patricio Soares-da-Silva
- Department of Research and Development, BIAL-Portela & Cª. S.A., S Mamede do Coronado, Portugal.,Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal.,MedInUp-Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
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Monni L, Kraus L, Dipper-Wawra M, Soares-da-Silva P, Maier N, Schmitz D, Holtkamp M, Fidzinski P. In vitro and in vivo anti-epileptic efficacy of eslicarbazepine acetate in a mouse model of KCNQ2-related self-limited epilepsy. Br J Pharmacol 2021; 179:84-102. [PMID: 34605012 DOI: 10.1111/bph.15689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/26/2021] [Accepted: 09/08/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE The KCNQ2 gene encodes for the Kv 7.2 subunit of non-inactivating potassium channels. KCNQ2-related diseases range from autosomal dominant neonatal self-limited epilepsy, often caused by KCNQ2 haploinsufficiency, to severe encephalopathies caused by KCNQ2 missense variants. In vivo and in vitro effects of the sodium channel blocker eslicarbazepine acetate (ESL) and eslicarbazepine metabolite (S-Lic) in a mouse model of self-limited neonatal epilepsy as a first attempt to assess the utility of ESL in the KCNQ2 disease spectrum was investigated. EXPERIMENTAL APPROACH Effects of S-Lic on in vitro physiological and pathological hippocampal neuronal activity in slices from mice carrying a heterozygous deletion of Kcnq2 (Kcnq2+/- ) and Kcnq2+/+ mice were investigated. ESL in vivo efficacy was investigated in the 6-Hz psychomotor seizure model in both Kcnq2+/- and Kcnq2+/+ mice. KEY RESULTS S-Lic increased the amplitude and decreased the incidence of physiological sharp wave-ripples in a concentration-dependent manner and slightly decreased gamma oscillations frequency. 4-Aminopyridine-evoked seizure-like events were blocked at high S-Lic concentrations and substantially reduced in incidence at lower concentrations. These results were not different in Kcnq2+/+ and Kcnq2+/- mice, although the EC50 estimation implicated higher efficacy in Kcnq2+/- animals. In vivo, Kcnq2+/- mice had a lower seizure threshold than Kcnq2+/+ mice. In both genotypes, ESL dose-dependently displayed protection against seizures. CONCLUSIONS AND IMPLICATIONS S-Lic slightly modulates hippocampal oscillations and blocks epileptic activity in vitro and in vivo. Our results suggest that the increased excitability in Kcnq2+/- mice is effectively targeted by S-Lic high concentrations, presumably by blocking diverse sodium channel subtypes.
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Affiliation(s)
- Laura Monni
- Clinical and Experimental Epileptology, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Centre, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Larissa Kraus
- Clinical and Experimental Epileptology, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Life Sciences Institute, Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthias Dipper-Wawra
- Clinical and Experimental Epileptology, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Berlin, Germany
| | - Patricio Soares-da-Silva
- Division of Research and Development, BIAL - Portela & CA S. A, da Siderurgia Nacional, São Mamede do Coronado, Portugal.,Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University Porto, Porto, Portugal.,MedInUP, Centre for Drug Discovery and Innovative Medicines, University Porto, Porto, Portugal
| | - Nikolaus Maier
- Neuroscience Research Centre, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dietmar Schmitz
- Neuroscience Research Centre, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Martin Holtkamp
- Clinical and Experimental Epileptology, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Berlin, Germany
| | - Pawel Fidzinski
- Clinical and Experimental Epileptology, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Centre, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
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Rocha JF, Santos A, Gama H, Moser P, Falcão A, Pressman P, Wallace Hayes A, Soares-da-Silva P. Safety, Tolerability, and Pharmacokinetics of FAAH Inhibitor BIA 10-2474: A Double-Blind, Randomized, Placebo-Controlled Study in Healthy Volunteers. Clin Pharmacol Ther 2021; 111:391-403. [PMID: 33998672 PMCID: PMC9292215 DOI: 10.1002/cpt.2290] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 04/12/2021] [Indexed: 11/20/2022]
Abstract
This study evaluated the safety, tolerability, pharmacokinetics, and pharmacodynamics of BIA 10‐2474, a fatty acid amide hydrolase (FAAH) inhibitor, after first administration to healthy male and female participants. Participants (n = 116) were recruited into this phase I, double‐blind, randomized, placebo‐controlled, single ascending dose and multiple ascending dose (10‐day) study. The primary outcome was the safety and tolerability of BIA 10‐2474. Secondary outcomes were pharmacokinetics of BIA 10‐2474 and pharmacodynamics, considering plasma concentrations of anandamide and three other fatty acid amides (FAAs) and leukocyte FAAH activity. Single oral doses of 0.25–100 mg and repeated oral doses of 2.5–50 mg were evaluated. BIA 10‐2474 was well tolerated up to 100 mg as a single dose and up to 20 mg once daily for 10 days. In the cohort receiving repeated administrations of 50 mg, there were central nervous system adverse events in five of six participants, one with fatal outcome, which led to early termination of the study. BIA 10‐2474 showed a linear relationship between dose and area under plasma concentration‐time curve (AUC) across the entire dose range and reached steady state within 5–6 days of administration, with an accumulation ratio, based on AUC0–24h, of <2 on Day 10. BIA 10‐2474 was rapidly absorbed with a mean terminal elimination half‐life of 8–10 hours (Day 10). BIA 10‐2474 caused reversible, dose‐related increases in plasma FAAs. In conclusion, we propose that these data, as well as the additional data generated since the clinical trial was stopped, do not provide a complete mechanistic explanation for the tragic fatality.
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Affiliation(s)
- José-Francisco Rocha
- Research & Development Division, BIAL - Portela & Cª - S.A., Mamede do Coronado, Portugal
| | - Ana Santos
- Research & Development Division, BIAL - Portela & Cª - S.A., Mamede do Coronado, Portugal
| | - Helena Gama
- Research & Development Division, BIAL - Portela & Cª - S.A., Mamede do Coronado, Portugal
| | - Paul Moser
- Research & Development Division, BIAL - Portela & Cª - S.A., Mamede do Coronado, Portugal
| | - Amílcar Falcão
- Laboratory of Pharmacology, Faculty of Pharmacy, University Coimbra, Coimbra, Portugal
| | - Peter Pressman
- The Daedalus Institute, The Daedalus Foundation, San Clemente, California, USA
| | - A Wallace Hayes
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Patricio Soares-da-Silva
- Research & Development Division, BIAL - Portela & Cª - S.A., Mamede do Coronado, Portugal.,Dept. Biomedicine, Pharmacology & Therapeutics Unit, Faculty of Medicine, University Porto, Porto, Portugal.,MedInUP - Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
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Ebersbach G, Rascol O, Ferreira J, Costa R, Rocha J, Magalhães D, Soares-da-Silva P. Efficacy/safety of opicapone in Parkinson's disease patients according to duration of motor fluctuations: post-hoc analysis of BIPARK-I and II. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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6
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Lees A, Reichmann H, Rocha J, Magalhães D, Soares-da-Silva P. Onset of drug-related adverse events in Parkinson's disease patients treated with opicapone in clinical practice: OPTIPARK post-hoc analysis. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Foltynie T, Tolosa E, Ferreira J, Antonini A, Lees A, Ebersbach G, Rascol O, Rocha JF, Magalhães D, Soares-da-Silva P. Characteristics, treatment patterns and disease burden of people with Parkinson's disease in the Parkinson's disease real-world impact assessment (PRISM) study. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ferreira J, Lees A, Ebersbach G, Santos A, Magalhães D, Rocha JF, Soares-da-Silva P. Efficacy of opicapone versus entacapone in catechol-O-methyltransferase inhibitor-naïve Parkinson's disease patients recently diagnosed with motor fluctuations: a post-hoc conservative analysis. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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9
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Rascol O, Poewe W, Ferreira J, Lees A, Santos AT, Magalhães D, Rocha J, Soares-da-Silva P. Efficacy of opicapone in patients with Parkinson's disease with levodopa dose reduction: a pooled post-hoc analysis of BIPARK-I and II. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Magalhaes L, Guimaraes A, Santos A, Gama H, Soares-da-Silva P. DRUG-DRUG INTERACTION STUDY BETWEEN ZAMICASTAT AND WARFARIN IN HEALTHY SUBJECTS. Chest 2020. [DOI: 10.1016/j.chest.2020.08.1928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lew M, Hauser R, Isaacson S, Ferreira J, Serbin M, Farahmand K, Olson K, Klepitskaya O, Rocha F, Soares-da-Silva P, Liang G. Efficacy of opicapone in Parkinson's patients with motor fluctuations and ON Hoehn & Yahr ≤2.5: post hoc analysis of BIPARK-1. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Reichmann H, Lees A, Rocha J, Magalhães D, Soares-da-Silva P. Opicapone in clinical practice in Parkinson's disease patients with motor fluctuations: findings from the OPTIPARK study. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bonifacio MJ, Sousa F, Igreja B, Loureiro AI, Pires NM, Soares-da-Silva P. Zamicastat is a noncompetitive Dopamine‐β‐hydroxylase inhibitor that modulates sympathetic nervous system activity. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Loureiro AI, Rebouta J, Bonifacio MJ, Soares-da-Silva P. In vitro
Species Different Metabolism and CYP Phenotyping of Zamicastast. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rocha F, Poewe W, Rascol O, Lees A, Ferreira J, Santos A, Magalhaes D, Soares-da-Silva P. Opicapone odds ratio in relative off-time reduction: A post-hoc analysis from combined BIPARK-I and II data. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ferreira J, Lees A, Poewe W, Rascol O, Santos A, Magalhaes D, Rocha F, Soares-da-Silva P. Switching entacapone ‘non-responders’ to open-label opicapone: Change in absolute off-time following the 1-year extension BIPARK-I study. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rocha F, Stocchi F, Lees A, Ferreira J, Poewe W, Rascol O, Santos A, Magalhaes D, Soares-da-Silva P. Efficacy of opicapone in Parkinson’s disease patients with ‘early’ motor fluctuations: Patient and clinical global impression of change from the BIPARK-I double-blind experience. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Costa R, Ferreira J, Lees A, Tolosa E, Poewe W, Ikedo F, Magalhaes D, Rocha F, Soares-da-Silva P. Incidence of treatment-emergent adverse events in Parkinson's disease patients according to gender: Post-hoc analysis from double-blind combined BIPARK-I and II data. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rocha F, Ferreira J, Lees A, Tolosa E, Stocchi F, Santos A, Magalhaes D, Soares-da-Silva P, Savic N. Switching from double-blind entacapone or placebo to open-label opicapone: UPDRS-II and III results from patients who ended 1-year BIPARK-I extension on opicapone 50 mg. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hauser R, Rascol O, Poewe W, Ferreira J, Lees A, Klepitskaya O, Liang G, Santos A, Magalhaes D, Rocha F, Soares-da-Silva P. Opicapone as a levodopa sparing agent: Pooled analysis of BIPARK-I and II double-blind trials. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lees A, Ferreira J, Antonini A, Reichmann H, Costa R, Magalhaes D, Rocha F, Soares-da-Silva P. Efficacy of opicapone in Parkinson’s disease patients according to baseline presence of dyskinesia: A post-hoc analysis from combined BIPARK-I and II. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Santos A, Lees A, Ferreira J, Rascol O, Antonini A, Gama H, Magalhaes D, Rocha F, Soares-da-Silva P. Influence of disease severity in the efficacy response of Parkinson's disease patients with motor fluctuations: Post-hoc analysis from combined BIPARK-I and II. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Costa R, Lees A, Ferreira J, Rascol O, Stocchi F, Ikedo F, Magalhaes D, Rocha F, Soares-da-Silva P. Incidence of treatment-emergent adverse events in Parkinson's disease patients according to baseline dopamine agonist use: Post-hoc analysis from double-blind combined BIPARK-I and II data. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lees A, Ferreira J, Rascol O, Poewe W, Tolosa E, Gama H, Magalhaes D, Rocha F, Soares-da-Silva P. Efficacy of opicapone in Parkinson’s disease patients according to baseline rasagiline use: A post-hoc analysis from combined BIPARK-I and II. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lees A, Ferreira J, Rascol O, Poewe W, Stocchi F, Santos A, Magalhaes D, Rocha F, Soares-da-Silva P. Efficacy of opicapone in Parkinson’s disease patients according to baseline pramipexole use: A post-hoc analysis from combined BIPARK-I and II. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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26
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Rocha F, Tolosa E, Ferreira J, Rascol O, Poewe W, Santos A, Magalhaes D, Soares-da-Silva P. Effect of opicapone in Parkinson’s disease patients with ‘early’ motor fluctuations: Parkinson’s disease questionnaire (PDQ-39) analysis from the BIPARK-I double-blind experience. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Costa R, Ferreira J, Lees A, Tolosa E, Poewe W, Ikedo F, Diogo M, Rocha F, Soares-da-Silva P. Incidence of treatment-emergent adverse events in Parkinson's Disease patients according to baseline body mass index: Post-hoc analysis from double-blind combined BIPARK-I and II data. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferreira J, Lees A, Rascol O, Poewe W, Ikedo F, Magalhaes D, Rocha F, Soares-da-Silva P. Switching from double-blind entacapone or placebo to open-label opicapone: change in OFF-/ON-time from patients who ended the 1-year BIPARK-I extension on opicapone 50 mg. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferreira JJ, Lees A, Rocha JF, Poewe W, Rascol O, Soares-da-Silva P. Long-term efficacy of opicapone in fluctuating Parkinson's disease patients: a pooled analysis of data from two phase 3 clinical trials and their open-label extensions. Eur J Neurol 2019; 26:953-960. [PMID: 30681754 PMCID: PMC6593852 DOI: 10.1111/ene.13914] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/21/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to evaluate the efficacy of the catechol-O-methyltransferase inhibitor opicapone (25 and 50 mg) as adjunct therapy to levodopa in a pooled population of Parkinson's disease patients who participated in the pivotal double-blind trials of opicapone and their 1-year open-label extensions. METHODS Data (placebo, opicapone 25 mg and opicapone 50 mg) from the BIPARK-1 and BIPARK-2 double-blind and open-label studies were combined. The studies had similar designs, eligibility criteria and assessment methods. The primary efficacy variable in both double-blind studies was the change from baseline in absolute OFF time based on patient diaries. RESULTS Double-blind treatment with opicapone (25 and 50 mg) significantly reduced absolute daily OFF time from a baseline of 6.1-6.6 h. The mean (and 95% confidence interval) treatment effect versus placebo was -35.1 (-62.1, -8.2) min (P = 0.0106) for the 25 mg dose and -58.1 (-84.5, -31.7) min (P < 0.0001) for the 50 mg dose. Reductions in OFF time were mirrored by significant increases in ON time without troublesome dyskinesia (P < 0.05 and P < 0.0001 for the 25 and 50 mg doses, respectively). No significant differences were observed for ON time with troublesome dyskinesia. Patient diary results from the open-label phase indicated a maintenance of effect for patients previously treated with opicapone 50 mg. The group previously treated with the 25 mg dose benefitted with further optimization of therapy during the open-label phase, whilst switching from placebo to opicapone led to significant reductions in OFF time and increased ON time. CONCLUSIONS Over at least 1 year of open-label therapy, opicapone consistently reduced OFF time and increased ON time without increasing the frequency of troublesome dyskinesia.
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Affiliation(s)
- J J Ferreira
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Torres Vedras, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal
| | - A Lees
- Reta Lila Weston Institute, University College London, London, UK
| | - J-F Rocha
- Department of Research and Development, BIAL - Portela & Ca SA, S. Mamede do Coronado, Portugal
| | - W Poewe
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - O Rascol
- Clinical Investigation Centre CIC1436, Departments of Clinical Pharmacology and Neurosciences, NS-Park/FCRIN Network, University Hospital of Toulouse, INSERM, University Toulouse 3, Toulouse, France
| | - P Soares-da-Silva
- Department of Research and Development, BIAL - Portela & Ca SA, S. Mamede do Coronado, Portugal.,Department of Pharmacology and Therapeutics, Faculty of Medicine, University Porto, Porto, Portugal.,Center for Drug Discovery and Innovative Medicines, MedInUP, University Porto, Porto, Portugal
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Gidal BE, Jacobson MP, Ben-Menachem E, Carreño M, Blum D, Soares-da-Silva P, Falcão A, Rocha F, Moreira J, Grinnell T, Ludwig E, Fiedler-Kelly J, Passarell J, Sunkaraneni S. Exposure-safety and efficacy response relationships and population pharmacokinetics of eslicarbazepine acetate. Acta Neurol Scand 2018; 138:203-211. [PMID: 29732549 PMCID: PMC6099471 DOI: 10.1111/ane.12950] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2018] [Indexed: 11/27/2022]
Abstract
Objectives Eslicarbazepine acetate (ESL) is a once‐daily (QD) oral antiepileptic drug (AED) for focal‐onset seizures (FOS). Pharmacokinetic (PK) and pharmacodynamic (PD) models were developed to assess dose selection, identify significant AED drug interactions, and quantitate relationships between exposure and safety and efficacy outcomes from Phase 3 trials of adjunctive ESL. Methods Eslicarbazepine (the primary active metabolite of ESL) population PK was evaluated using data from 1351 subjects enrolled in 14 studies (11 Phase 1 and three Phase 3 studies) after multiple oral doses ranging from 400 to 1200 mg. Population PK and PD models related individual eslicarbazepine exposures to safety outcomes and efficacy responses. Results Eslicarbazepine PK was described by a one‐compartment model with linear absorption and elimination. The probability of a treatment‐emergent adverse event (TEAE; dizziness, headache, or somnolence) was higher with an initial dose of ESL 800 mg than with an initial dose of ESL 400 mg QD. Body weight, sex, region, and baseline use of carbamazepine (CBZ) or lamotrigine were also found to influence the probability of TEAEs. Eslicarbazepine exposure influenced serum sodium concentration, standardized seizure frequency, and probability of response; better efficacy outcomes were predicted in patients not from Western Europe (WE; vs WE patients) and those not taking CBZ (vs taking CBZ) at baseline. Conclusions Pharmacokinetic and PK/PD modeling were implemented during the development of ESL for adjunctive treatment of FOS in adults. This quantitative approach supported decision‐making during the development of ESL, and contributed to dosing recommendations and labeling information related to drug interactions.
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Affiliation(s)
- B. E. Gidal
- School of Pharmacy; University of Wisconsin-Madison; Madison WI USA
| | - M. P. Jacobson
- Department of Neurology; Lewis Katz School of Medicine; Temple University; Philadelphia PA USA
| | | | - M. Carreño
- Epilepsy Unit, Hospital Clínic; Barcelona Spain
| | - D. Blum
- Sunovion Pharmaceuticals Inc.; Marlborough MA USA
| | - P. Soares-da-Silva
- BIAL - Portela & C , S.A.; S. Mamede do Coronado Portugal
- Faculty of Medicine; Department of Pharmacology & Therapeutics; University of Porto; Porto Portugal
| | - A. Falcão
- Faculty of Pharmacy; Laboratory of Pharmacology; University of Coimbra; Coimbra Portugal
| | - F. Rocha
- BIAL - Portela & C , S.A.; S. Mamede do Coronado Portugal
| | - J. Moreira
- BIAL - Portela & C , S.A.; S. Mamede do Coronado Portugal
| | - T. Grinnell
- Sunovion Pharmaceuticals Inc.; Marlborough MA USA
| | - E. Ludwig
- Cognigen Corporation; a Simulations Plus company; Buffalo NY USA
| | - J. Fiedler-Kelly
- Cognigen Corporation; a Simulations Plus company; Buffalo NY USA
| | - J. Passarell
- Cognigen Corporation; a Simulations Plus company; Buffalo NY USA
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Ferreira JJ, Lees AJ, Poewe W, Rascol O, Rocha JF, Keller B, Soares-da-Silva P. Effectiveness of opicapone and switching from entacapone in fluctuating Parkinson disease. Neurology 2018; 90:e1849-e1857. [PMID: 29695590 DOI: 10.1212/wnl.0000000000005557] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/12/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of opicapone as add-on to levodopa and the effects of switching from entacapone over 1 year of treatment in patients with fluctuating Parkinson disease. METHODS After completion of a placebo- and entacapone-controlled double-blind study of opicapone (5, 25, or 50 mg), 495 patients continued to a 1-year extension phase in which patients were treated with opicapone. Patients began with once-daily opicapone 25 mg for 1 week, followed by individually tailored levodopa and/or opicapone dose adjustments. The primary efficacy variable was the change from baseline in absolute "off" time based on patient diaries. Other outcomes included proportion of responders, scale-based assessments, and standard safety assessments. RESULTS One year of treatment with opicapone reduced "off" time by a half-hour (33.8 minutes) vs the open-label baseline and >2 hours (126.9 minutes) vs the double-blind baseline. Whereas patients who were originally treated with opicapone 50 mg in the double-blind phase maintained their efficacy, switching treatments led to further decreases in "off" time (-64.9, -39.3, -27.5, and -23.0 minutes for switching from placebo, entacapone, and opicapone 5 and 25 mg, respectively). Dyskinesia was the most frequently reported adverse event (14.5%) and was managed by adjustment of dopaminergic therapy. No new safety concerns were observed with long-term opicapone administration. CONCLUSION Long-term use of opicapone provided sustained efficacy over 1 year. Switching from entacapone to opicapone led to enhanced efficacy under the conditions of the study. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that for patients with Parkinson disease and end-of-dose motor fluctuations, long-term use (52 weeks) of opicapone is well tolerated and reduces "off" time.
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Affiliation(s)
- Joaquim J Ferreira
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal
| | - Andrew J Lees
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal
| | - Werner Poewe
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal
| | - Olivier Rascol
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal
| | - José-Francisco Rocha
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal
| | - Birgit Keller
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal
| | - Patricio Soares-da-Silva
- From the Instituto de Medicina Molecular (J.J.F.), Faculty of Medicine, University of Lisbon; CNS-Campus Neurológico Sénior (J.J.F.), Torres Vedras, Portugal; University College London (A.J.L.), Reta Lila Weston Institute, UK; Department of Neurology (W.P.), Medical University Innsbruck, Austria; Université de Toulouse (O.R.), CHU de Toulouse, Institut National de la Santé et de la Recherche Médicale, Department of Neurosciences and Clinical Pharmacology, Clinical Investigation Center 1436, and NeuroToul Center of Excellence in Neurodegeneration France; Department of Research and Development (J.-F.R., P.S.-d.-S.), BIAL-Portela & Ca SA, S. Mamede do Coronado, Portugal; Department of Biostatistics (B.K.), Clinipace Worldwide, Eschborn, Germany; and Department of Pharmacology and Therapeutics (P.S.-d.-S.), Faculty of Medicine, University Porto, Portugal.
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Araújo AM, Machado HS, Falcão AC, Soares-da-Silva P. Reliability of body-weight scalars on the assessment of propofol induction dose in obese patients. Acta Anaesthesiol Scand 2018; 62:464-473. [PMID: 29159892 DOI: 10.1111/aas.13039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Obese patients require specific perioperative care when compared with non-obese patients. The present study aimed to analyse the ability of size descriptors to estimate propofol induction dose in class II and III obese patients. METHODS A cross-sectional study on adult patients with body mass index (BMI) equal to or greater than 35 kg/m2 and on adult patients with BMI lower than 35 kg/m2 was carried out. General anaesthesia was induced with remifentanil, propofol and rocuronium. Propofol infusion was started at 2000 mg/h until loss of consciousness. Bioelectrical impedance analysis and Brice modified interview was completed during pre- and post-operative evaluation, respectively. Measurements of propofol plasma concentration were performed using gas chromatography/ion trap-mass spectrometry. RESULTS Forty patients were enrolled in the study. The median values of fat free mass (FFM) in BMI < 35 kg/m2 and BMI ≥ 35 kg/m2 groups were 70% and 55% of total body weight, respectively. Our results did not demonstrate a strong correlation level between the studied size descriptors and propofol induction dose in both groups. Nevertheless, when propofol doses were normalized by FFM, an apparent convergence of the empirical cumulative distribution functions was observed. CONCLUSION None of the size descriptors was seen to be an effective predictor of the propofol induction dose in class II and III obese patients when a fixed infusion rate was used. Due to the observed variability between patients, guiding propofol induction dose against a clinical endpoint of unconsciousness appears more appropriate in order to avoid side effects related both with under or overdosing of propofol.
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Affiliation(s)
- A. M. Araújo
- Department of Anesthesiology, Intensive Care and Emergency; Centro Hospitalar do Porto; Porto Portugal
| | - H. S. Machado
- Department of Anesthesiology, Intensive Care and Emergency; Centro Hospitalar do Porto; Porto Portugal
- Instituto de Ciências Biomédicas Abel Salazar; University of Porto; Porto Portugal
| | - A. C. Falcão
- Laboratory of Pharmacology; Faculty of Pharmacy; University of Coimbra; Coimbra Portugal
| | - P. Soares-da-Silva
- Department of Biomedicine; Unit of Pharmacology and Therapeutics; Faculty of Medicine; University of Porto; Porto Portugal
- MedInUP; Center for Drug Discovery and Innovative Medicines; University of Porto; Porto Portugal
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Jóźwiak S, Veggiotti P, Moreira J, Gama H, Rocha F, Soares-da-Silva P. Effects of adjunctive eslicarbazepine acetate on neurocognitive functioning in children with refractory focal-onset seizures. Epilepsy Behav 2018; 81:1-11. [PMID: 29454255 DOI: 10.1016/j.yebeh.2018.01.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/07/2018] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE This was a phase-II, randomized, double-blind (DB), placebo-controlled study aimed to evaluate neurocognitive effects of eslicarbazepine acetate (ESL) as adjunctive therapy in pediatric patients with refractory focal-onset seizures (FOS). METHODS Children (6-16years old) with FOS were randomized (2:1) to ESL or placebo. Treatment started at 10mg/kg/day, was up-titrated up to 30mg/kg/day (target dose), and maintained for 8weeks, followed by one-year open-label follow-up. The primary endpoint was change from baseline to the end of maintenance period in the composite Power of Attention assessed with the Cognitive Drug Research (CDR) system. Behavioral and emotional functioning and quality of life (QOL), secondary endpoints, were assessed with Child Health Questionnaire-Parent Form 50 (CHQ-PF50), Child Behavior Checklist (CBCL), and Raven's Standard Progressive Matrices (SPM). Efficacy was evaluated through changes in standardized seizure frequency (SF), responder rate, and proportion of seizure-free patients. Safety was evaluated by the incidence of treatment-emergent adverse events (TEAEs). RESULTS One hundred and twenty-three patients were randomized. A noninferiority analysis failed to reject the null hypothesis that the change from baseline in the Power of Attention score in the ESL group was at least 121ms inferior to the placebo group for all age groups. The CDR scores showed no differences between placebo and ESL in Power of Attention (1868.0 vs 1759.5), Continuity of Attention (1.136 vs -1.786), Quality of Working Memory (-0.023 vs -0.024), and Speed of Memory (-263.4 vs -249.6). Nonsignificant differences between placebo and ESL were seen for CHQ-PF50, CBCL scores, and Raven's SPM. Episodic Memory Index showed significant negative effect on ESL. Efficacy results favored the ESL group (SF least square [LS] means 1.98 vs 4.29). The TEAEs had a similar incidence between treatment groups (41.0% vs 47.5%). CONCLUSIONS Overall ESL did not produce statistically significant effects on neurocognitive and behavioral functioning in patients with epilepsy aged 6 to 16years. Additionally, ESL was effective in reducing seizure frequency and was well-tolerated.
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Affiliation(s)
- Sergiusz Jóźwiak
- Department of Child Neurology, Warsaw Medical University, Warsaw, Poland; Department of Neurology and Epileptology, The Children's Memorial Health Institute, Warsaw, Poland
| | - P Veggiotti
- Child Neurology Department, V. Buzzi Hospital, Milan, Italy; L. Sacco Department, University of Milan, Milan, Italy
| | - J Moreira
- BIAL - Portela & Cª. S.A., Coronado (S. Romão e S. Mamede), Portugal
| | - H Gama
- BIAL - Portela & Cª. S.A., Coronado (S. Romão e S. Mamede), Portugal
| | - F Rocha
- BIAL - Portela & Cª. S.A., Coronado (S. Romão e S. Mamede), Portugal
| | - P Soares-da-Silva
- BIAL - Portela & Cª. S.A., Coronado (S. Romão e S. Mamede), Portugal; Department of Biomedicine, Pharmacology and Therapeutics Unit, Faculty of Medicine, University Porto, Porto, Portugal; MedInUP - Center for Drug Discovery and Innovative Medicines, University Porto, Porto, Portugal.
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Trinka E, Kowacs P, Ben-Menachem E, Elger C, Moreira J, Pinto R, Ikedo F, Pereira A, Rocha JF, Soares-da-Silva P. PO046 Safety and tolerability of eslicarbazepine acetate as monotherapy in patients with newly diagnosed partial-onset seizures. J Neurol Neurosurg Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ben-Menachem E, Trinka E, Kowacs P, Elger C, Moreira J, Pinto R, Ikedo F, Pereira A, Rocha JF, Soares-da-Silva P. PO043 Efficacy of eslicarbazepine acetate versus controlled-release carbamazepine as monotherapy in patients with newly diagnosed partial-onset seizures. J Neurol Psychiatry 2017. [DOI: 10.1136/jnnp-2017-abn.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bonifácio M, Sousa F, Soares-da-Silva P. Opicapone improves the effects of l-dopa on the mptp-induced parkinson’s-like syndrome in cynomolgus monkeys. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lees A, Ferreira J, Poewe W, Rascol O, Santos A, Ikedo F, Oliveira I, Rocha J, Soares-da-Silva P. Off- and on-time responder post-HOC analyses of pooled opicapone phase III studies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ferreira J, Lees A, Rascol O, Poewe W, Santos A, Ikedo F, Oliveira I, Rocha J, Soares-da-Silva P. Switching entacapone or placebo to opicapone Open-label: Efficacy results of the BIPARK-I 1-year extension study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Costa R, Magalhães L, Gama H, Oliveira I, Moreira J, Rocha F, Ikedo F, Soares-da-Silva P. A pooled post-hoc analysis of change in depressive symptoms in patients with refractory partial-onset seizures treated with eslicarbazepine acetate as adjuntive therapy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Igreja B, Pires N, Moser P, Soares-da-Silva P. Abstract P477: Effect of Zamicastat on Blood Pressure and Heart Rate - Comparison Between Acute and Repeated Dosing in the SHR. Hypertension 2017. [DOI: 10.1161/hyp.70.suppl_1.p477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The sympathetic nervous system (SNS) can alter blood pressure by modulation of cardiac output, peripheral vascular resistance and renal function. One strategy for the modulation of sympathetic nerve function is to reduce the biosynthesis of norepinephrine (NE) via inhibition of dopamine β-hydroxylase (DβH), the enzyme that catalyses the conversion of dopamine to NE in sympathetic nerves. Zamicastat is a new peripheral DβH inhibitor that decreases NE levels in sympathetically innervated tissues and slows down the drive of SNS. In order to compare the effect of zamicastat on blood pressure and heart rate after acute and repeated dosing in spontaneously hypertensive rats (SHR), male adult SHR were implanted with telemetry devices (TA11PA-C40, DSI). Zamicastat (30 mg/kg p.o.) was given either as a single dose (n=8) or once a day for five days (n=6). On day 1, the maximal effect (E
max
) of zamicastat on systolic blood pressure (SBP) was attained 15h after dosing. E
max
was similar in the acute and repeated dosing groups: -21.1±3.9 and -22.0±8.2 mmHg, respectively. In the acute treatment group, a gradual return of the SBP to the high baseline levels was observed over time. On the other hand, in the repeat dosing group the E
max
were consistent across the five administrations -22.0±8.2, -25.2±7.9, -22.0±7.5, -20.0±6.0 and -16.1±2.8 mmHg, respectively day 1 to 5. On day 5, after reaching E
max
a gradual return of SBP to baseline levels was also observed. The effect of zamicastat on diastolic blood pressure was similar with an E
max
of -18.4±3.5 mmHg in the acute dosing group and -18.8±8.7, -19.2±7.2, -18.2±6.6, -19.6±6.6 and -15.7±4.7 mmHg over the five days of administration in the repeated dosing group. Zamicastat did not affect heart rate under each dosing regimen. In conclusion, there is no tachyphylaxis or sensitization to the cardiovascular effects of zamicastat in this model and blood pressure returns to basal levels after zamicastat treatment discontinuation.
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Affiliation(s)
- Andrew J. Lees
- Reta Lila Weston Institute of Neurological Studies, University College London, London, England
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Lees AJ, Ferreira J, Rascol O, Poewe W, Rocha JF, McCrory M, Soares-da-Silva P. Opicapone as Adjunct to Levodopa Therapy in Patients With Parkinson Disease and Motor Fluctuations. JAMA Neurol 2017; 74:197-206. [DOI: 10.1001/jamaneurol.2016.4703] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Andrew J. Lees
- Reta Lila Weston Institute, University College London, London, England
| | - Joaquim Ferreira
- Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisbon, Portugal
| | - Olivier Rascol
- Department of Clinical Pharmacology, Institut National de la Santé et de la Recherche Medicale (INSERM) and University Hospital of Toulouse, Toulouse, France4Department of Neurosciences, INSERM and University Hospital of Toulouse, Toulouse, France
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - José-Francisco Rocha
- Department of Research and Development, BIAL–Portela & Ca SA, Sao Mamede do Coronado, Portugal
| | | | - Patricio Soares-da-Silva
- Department of Research and Development, BIAL–Portela & Ca SA, Sao Mamede do Coronado, Portugal8Department of Pharmacology and Therapeutics, University Porto, Porto, Portugal
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Ferreira J, Lees A, Lopes N, Santos A, Rocha JF, Soares-da-Silva P. Pooled efficacy of opicapone as adjunctive therapy to levodopa in patients with Parkinson’s disease and motor fluctuations. Parkinsonism Relat Disord 2016. [DOI: 10.1016/j.parkreldis.2015.10.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ferreira J, Lees A, Santos A, Lopes N, Rocha JF, Soares-da-Silva P. One-year follow-up of opicapone's efficacy and safety in patients with Parkinson’s disease and motor fluctuations (BIPARK I). Parkinsonism Relat Disord 2016. [DOI: 10.1016/j.parkreldis.2015.10.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Igreja B, Wright LC, Soares-da-Silva P. Sustained high blood pressure reduction with etamicastat, a peripheral selective dopamine β-hydroxylase inhibitor. ACTA ACUST UNITED AC 2015; 10:207-16. [PMID: 26803288 DOI: 10.1016/j.jash.2015.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 12/03/2015] [Accepted: 12/16/2015] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to evaluate the influence of chronic inhibition of dopamine ß-hydroxylase by etamicastat on the development of hypertension in the spontaneously hypertensive rat (SHR) and the sustainability of effects on the systolic and diastolic blood pressure in the SHR and the normotensive Wistar-Kyoto rat (WKY). WKY and SHR received etamicastat (10 mg/kg/d) from 5 weeks of age for 35 weeks in drinking water, and cardiovascular assessments were performed on a weekly basis. Etamicastat reduced systolic and diastolic blood pressure when SHRs reached the age of 16 weeks with mean decreases of 37 and 32 mm Hg, respectively, for the subsequent for 24 weeks of treatment, but did not prevent the increase in blood pressure (BP) aged between 5 and 11 week. The BP lowering effect of etamicastat in SHR was reversible on discontinuation and quickly resumed after reinstatement of therapy and was not accompanied by changes in heart rate. Etamicastat affected neither BP nor heart rate in WKY during 36 weeks of treatment. Etamicastat reduced urinary excretion of norepinephrine to a similar extent in WKY and SHR, accompanied by significant increases in urinary dopamine in SHR. Chronic administration of etamicastat did not adversely affected development of animals. Chronic dopamine ß-hydroxylase inhibition with etamicastat effectively decreases BP, although does not prevent the development of hypertension in the SHR.
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Affiliation(s)
- Bruno Igreja
- Department of Research and Development, BIAL-Portela & C(a), S.A., Portugal
| | - Lyndon C Wright
- Department of Research and Development, BIAL-Portela & C(a), S.A., Portugal
| | - Patricio Soares-da-Silva
- Department of Research and Development, BIAL-Portela & C(a), S.A., Portugal; Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal; MedInUP-Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal.
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Costa R, Lopes N, Gama H, Sousa R, Nunes T, Soares-da-Silva P. SAFETY AND EFFICACY OF ESLICARBAZEPINE ACETATE IN ELDERLY PATIENTS. J Neurol Neurosurg Psychiatry 2015. [DOI: 10.1136/jnnp-2015-312379.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PurposeTo evaluate the safety/tolerability and efficacy of eslicarbazepine acetate (ESL) as adjunctive therapy in elderly patients with partial-onset seizures (POS).MethodPhase III, multicentre, open-label, non-controlled study in patients aged ≥65 years with ≥2 POS during an 8-week baseline and treated with 1–2 antiepileptic drugs. Following baseline, patients entered a 26-week maintenance period. ESL was initiated at 400 mg once-daily and adjusted (400–1200 mg/day) based on individual response. Safety/tolerability evaluations included treatment-emergent adverse events (TEAEs), vital signs, 12-lead electrocardiogram and physical/neurological examinations. Efficacy evaluations included change in standardised seizure frequency (SSF; seizure frequency/4 weeks).ResultsOf the 72 patients included, 47 (65.3%) experienced 152 TEAEs; most commonly, dizziness (12.5%), somnolence (9.7%), fatigue (8.3%), convulsion (8.3%) and hyponatraemia (8.3%). Three patients died of cardiac failure, glioblastoma multiforme and ischaemic stroke (relationship unlikely/not related). Overall, 16 (22.2%) patients discontinued due to TEAEs. Incidence of clinically significant findings was low for vital signs, electrocardiogram and physical/neurological examinations. SSF decreased from 2.9 at baseline to 1.2 during the maintenance period (median relative change: –54.1%).ConclusionOnce-daily ESL (400–1200 mg) as adjunctive therapy in elderly subjects with POS did not raise major safety concerns and was efficacious. Supported by Bial.
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Falcão A, Moreira J, Pinto R, Rocha J, Soares-da-Silva P. Eslicarbazepine acetate as add-on therapy for partial seizures in children: an integrated evaluation. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rocha J, Moreira P, Pinto R, Soares-da-Silva P. A placebo-controlled trial of eslicarbazepine acetate add-on therapy for partial seizures in children. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
1. The disposition etamicastat was evaluated in the Cynomolgus monkey after intravenous and oral administration of [(14)C]-etamicastat. The pharmacokinetics of etamicastat and its N-acetylated metabolite BIA 5-961 were also evaluated in monkeys and dogs. 2. In the monkey, 7 days after intravenous and oral administration of [(14)C]-etamicastat, 76.6-91.1% of the etamicastat-related radioactivity had been excreted mainly in urine. The radioactivity peaked in plasma between 4- and 8-h post-dosing followed by a quick decline and a slow terminal phase (half-life of 68.7 h). The calculated oral bioavailability for etamicastat was 46.1%. Etamicastat was quickly absorbed in monkeys and dogs with a half-life ranging from 5.2 to 9.9 h in monkeys and 6.9 to 11.4 h in dogs over. 3. The N-acetylated metabolite of etamicastat, represented 4-7% of the extent of exposure of etamicastat in the monkey, but was not found detectable in dogs. Gender did not influence etamicastat exposure and the concentration versus time curves fitted a dose-dependent pharmacokinetics in the dog, but not in the monkey. 4. In conclusion, etamicastat is rapidly absorbed and primarily excreted via urine in monkeys. Similarly, to humans, monkeys, unlike dogs, N-acetylate etamicastat and evidence that etamicastat pharmacokinetics is less than dose proportional.
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Affiliation(s)
- A I Loureiro
- a Department of Research and Development , BIAL - Portela & Ca. S.A., S Mamede do Coronado , Portugal and
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