Pimavanserin:小说精神病药物批准治疗帕金森病。

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小猫AK,哈洛韦尔SA Saklad SR, Evoy客

Pimavanserin:小说精神病药物批准治疗帕金森病。

创新> 2018 1;2月15日(1 - 2):16 - 22。

PubMed ID
29497575 (在PubMed
]
文摘

目的:Pimavanserin是第一个美国食品和药物管理局(FDA)批准的治疗帕金森病精神病(PDP)。本文综述了安全、功效和药理数据pimavanserin及其在治疗中的作用。方法的研究:最初的文学来源被确定通过MEDLINE pimavanserin搜索(1946 - 2016年9月)和acp - 103(原分子的名称)。参考评审和寻找FDA.gov和clinicaltrials.gov产生额外的研究。英语研究的pimavanserin PDP评估。动物研究被排除在外。随机对照试验(相关的)优先。结果:四个相关的标识。在每个,pimavanserin耐受良好,很少有副作用,没有运动症状的恶化。二期试验显示一个无意义的阳性症状量表评估的趋势(SAPS)改善(p = 0.09),有显著的好处在二级功效标记。 However, two Phase III trials, including one that was terminated early, failed to show significant SAPS improvement. A third Phase III trial with an improved research design utilized a nine-item subset of the SAPS, the SAPS-PD, as the primary outcome and demonstrated that pimavanserin 40mg was effective in improving PDP compared to placebo (p=0.0014, effect size=0.50). Secondary outcomes were also significantly improved: Clinical Global Impression of Severity (CGI-S) (p=0.0007, effect size=0.52) and Clinical Global Impression of Improvement (CGI-I) (p=0.0011, effect size=0.51), caregiver burden (p=0.0016, effect size=0.50), nighttime sleep (p=0.0446, effect size=0.31), and daytime wakefulness (p=0.012, effect size=0.39). Conclusion: Evidence suggests pimavanserin attenuates PDP symptoms with few adverse effects and little risk of worsening motor function. With limited treatment options for PDP, pimavanserin represents an important therapeutic innovation.

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