口服ANS-6637(一种ALDH2抑制剂)对酒精使用障碍成人提示诱导的渴望、安全性和酒精消费的初步影响:一项概念验证、随机、人体实验室试验

IF 2.1 4区 医学 Q3 SUBSTANCE ABUSE
Stephanie S O'Malley, Robert Miranda, Sarah W Book, Thomas H Chun, Thomas Liss, Robert J Malcolm, Srinivas B Muvvala, Hayley Treloar Padovano, Joseph P Schacht, Brent Blackburn, Ivan Diamond, Janet Ransom, Megan L Ryan, Daniel E Falk, Raye Z Litten
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引用次数: 0

摘要

目的:我们评估口服ANS-6637治疗酒精使用障碍(AUD)的安全性、有效性和患者依从性。ANS-6637是一种选择性、可逆的醛脱氢酶2 (ALDH2)抑制剂。方法:在一项为期5周的多地点临床试验中,一项3组、双盲、随机、概念验证的人类实验室研究测试了每日200毫克和600毫克ANS-6637与安慰剂在寻求治疗的成年AUD患者中的对比。服药1周后,受试者完成酒精提示反应测试。治疗期间进行饮水和安全评估;其他探索性结果在治疗结束1周后测量。结果:81名计划参与者中的43人入组后,由于3名女性肝酶临床显著、可逆性升高,研究终止。酒精存在时与ALDH2抑制一致的不良事件(心率/心悸、潮红、恶心)是剂量依赖性的。线索诱导的渴望程度组间差异不显著;与安慰剂相比,200毫克和600毫克剂量的效应量(Cohen’s d)分别为0.71和0.06。次要终点组间无显著差异;对于连续饮酒的结果,与安慰剂相比,600毫克剂量的Cohen的d值在0.31到0.57之间。结论:ANS-6637的肝毒性导致早期终止,降低了检验假设的能力。效应大小估计与选择性抑制ALDH2可能减少渴望和饮酒的假设是一致的,但是由于样本量小,这些估计可能不可靠。需要对非肝毒性选择性和可逆性ALDH2抑制剂进行进一步的研究来评估这种AUD药物治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preliminary effects of oral ANS-6637, an ALDH2 inhibitor, on cue-induced craving, safety and alcohol consumption among adults with alcohol use disorder: a proof-of-concept, randomized, human laboratory trial.

Aims: We evaluated the safety, efficacy, and patient adherence to oral ANS-6637, a selective, reversible inhibitor of aldehyde dehydrogenase 2 (ALDH2), for treating alcohol use disorder (AUD).

Methods: A 3-arm, double-blind, randomized, proof-of-concept human laboratory study embedded in a 5-week multisite clinical trial tested 200 mg and 600 mg daily doses of ANS-6637 compared to placebo in treatment-seeking adults with AUD. After 1 week of medication, participants completed an alcohol cue reactivity session. Drinking and safety assessments were measured during treatment; other exploratory outcomes were measured 1 week after treatment ended.

Results: The study was terminated following enrollment of 43 of 81 planned participants due to clinically significant, reversible increases in liver enzymes in three women. Adverse events consistent with ALDH2 inhibition in the presence of alcohol (heart rate/palpitations, flushing, nausea) were dose dependent. Group differences in cue-elicited craving were not significant; effect sizes (Cohen's d) comparing the 200 mg and 600 mg doses to placebo were .71 and .06, respectively. Secondary endpoints did not differ significantly between groups; Cohen's d ranged from .31 to .57 for the 600 mg dose compared to placebo for continuous drinking outcomes.

Conclusions: Findings of liver toxicity with ANS-6637 led to early termination and reduced power to test hypotheses. Effect size estimates are consistent with the hypothesis that selective ALDH2 inhibition may reduce craving and drinking, however these estimates may be unreliable due to the small sample size. Additional research with non-hepatotoxic selective and reversible ALDH2 inhibitors is needed to evaluate this approach to AUD pharmacotherapy.

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来源期刊
Alcohol and alcoholism
Alcohol and alcoholism 医学-药物滥用
CiteScore
4.70
自引率
3.60%
发文量
62
审稿时长
4-8 weeks
期刊介绍: About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.
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