Oral ENT-01 Targets Enteric Neurons to Treat Constipation in Parkinson Disease : A Randomized Controlled Trial.


Journal

Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351

Informations de publication

Date de publication:
12 2022
Historique:
pubmed: 8 11 2022
medline: 22 12 2022
entrez: 7 11 2022
Statut: ppublish

Résumé

Parkinson disease (PD) is associated with α-synuclein (αS) aggregation within enteric neurons. ENT-01 inhibits the formation of αS aggregates and improved constipation in an open-label study in patients with PD. To evaluate the safety and efficacy of oral ENT-01 for constipation and neurologic symptoms in patients with PD and constipation. Randomized, placebo-controlled phase 2b study. (ClinicalTrials.gov: NCT03781791). Outpatient. 150 patients with PD and constipation. ENT-01 or placebo daily for up to 25 days. After baseline assessment of constipation severity, daily dosing was escalated to the prokinetic dose, the maximum dose (250 mg), or the tolerability limit, followed by a washout period. The primary efficacy end point was the number of complete spontaneous bowel movements (CSBMs) per week. Neurologic end points included dementia (assessed using the Mini-Mental State Examination [MMSE]) and psychosis (assessed using the Scale for the Assessment of Positive Symptoms adapted for PD [SAPS-PD]). The weekly CSBM rate increased from 0.7 to 3.2 in the ENT-01 group versus 0.7 to 1.2 in the placebo group ( Longer treatment periods need to be investigated in future studies. ENT-01 was safe and significantly improved constipation. Enterin, Inc.

Sections du résumé

BACKGROUND
Parkinson disease (PD) is associated with α-synuclein (αS) aggregation within enteric neurons. ENT-01 inhibits the formation of αS aggregates and improved constipation in an open-label study in patients with PD.
OBJECTIVE
To evaluate the safety and efficacy of oral ENT-01 for constipation and neurologic symptoms in patients with PD and constipation.
DESIGN
Randomized, placebo-controlled phase 2b study. (ClinicalTrials.gov: NCT03781791).
SETTING
Outpatient.
PATIENTS
150 patients with PD and constipation.
INTERVENTION
ENT-01 or placebo daily for up to 25 days. After baseline assessment of constipation severity, daily dosing was escalated to the prokinetic dose, the maximum dose (250 mg), or the tolerability limit, followed by a washout period.
MEASUREMENTS
The primary efficacy end point was the number of complete spontaneous bowel movements (CSBMs) per week. Neurologic end points included dementia (assessed using the Mini-Mental State Examination [MMSE]) and psychosis (assessed using the Scale for the Assessment of Positive Symptoms adapted for PD [SAPS-PD]).
RESULTS
The weekly CSBM rate increased from 0.7 to 3.2 in the ENT-01 group versus 0.7 to 1.2 in the placebo group (
LIMITATION
Longer treatment periods need to be investigated in future studies.
CONCLUSION
ENT-01 was safe and significantly improved constipation.
PRIMARY FUNDING SOURCE
Enterin, Inc.

Identifiants

pubmed: 36343348
doi: 10.7326/M22-1438
doi:

Banques de données

ClinicalTrials.gov
['NCT03781791']

Types de publication

Randomized Controlled Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1666-1674

Commentaires et corrections

Type : ErratumIn
Type : CommentIn

Auteurs

Michael Camilleri (M)

Mayo Clinic, Rochester, Minnesota (M.C.).

Thyagarajan Subramanian (T)

Penn State Hershey Medical Center, Hershey, Pennsylvania (T.S.).

Fernando Pagan (F)

Department of Neurology, Georgetown University Hospital, Washington, DC (F.P.).

Stuart Isaacson (S)

Parkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, Florida (S.I.).

Ramon Gil (R)

Parkinson's Disease Treatment Center of SW Florida, Port Charlotte, Florida (R.G.).

Robert A Hauser (RA)

USF Parkinson's Disease and Movement Disorder Center, Tampa, Florida (R.A.H.).

Mary Feldman (M)

Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (M.F.).

Mark Goldstein (M)

JEM Headlands Research Institute, Atlantis, Florida (M.G.).

Rajeev Kumar (R)

Rocky Mountain Movement Disorder Center, Englewood, Colorado (R.K.).

Daniel Truong (D)

The Parkinson's and Movement Disorder Institute, Fountain Valley, California (D.T.).

Nisha Chhabria (N)

Palm Beach Neurology and Premiere Research Institute, West Palm Beach, Florida (N.C.).

Benjamin L Walter (BL)

Parkinson's and Movement Disorders Center, Cleveland Clinic, Cleveland, Ohio (B.L.W.).

Jonathan Eskenazi (J)

SC3 Research Group, Pasadena, California (J.E.).

Robert Riesenberg (R)

Atlanta Center for Medical Research, Atlanta, Georgia (R.R.).

Daniel Burdick (D)

Booth Gardner Parkinson's Care Center, EvergreenHealth, Kirkland, Washington (D.B.).

Winona Tse (W)

Parkinson's and Movement Disorders Center, Icahn School of Medicine at Mount Sinai, New York, New York (W.T.).

Eric Molho (E)

Parkinson's Disease and Movement Center, Albany Medical College, Albany, New York (E.M.).

Bradley Robottom (B)

Raleigh Neurology Associates, Raleigh, North Carolina (B.R.).

Perminder Bhatia (P)

Neuro Pain Medical Center, Fresno, California (P.B.).

Srinath Kadimi (S)

Associated Neurologists of Southern Connecticut, Fairfield, Connecticut (S.K.).

Kevin Klos (K)

The Movement Disorder Clinic of Oklahoma, Tulsa, Oklahoma (K.K.).

David Shprecher (D)

Banner Sun Health Research Institute, Sun City, Arizona (D.S.).

Otto Marquez-Mendoza (O)

Elias Research - Pharmax Research of South Florida, Inc., Miami, Florida (O.M.).

Gonzalo Hidalgo (G)

The Neuromedical Clinic of Central Louisiana, Alexandria, Louisiana (G.H.).

Stephen Grill (S)

Parkinson's and Movement Disorders Center of Maryland, Elkridge, Maryland (S.G.).

George Li (G)

MEDSOL Clinical Research, Port Charlotte, Florida (G.L.).

Howard Mandell (H)

Metrolina Neurological Associates, Indian Land, South Carolina (H.M.).

Mary Hughes (M)

Premier Neurology, Greer, South Carolina (M.H.).

Sharisse Stephenson (S)

BTC Network, Neurologic Associates of North Texas, Dallas, Texas (S.S.).

Joel Vandersluis (J)

Elias Research, Neurology Diagnostics, Inc., Dayton, Ohio (J.V.).

Michael Pfeffer (M)

Allied Biomedical Neurologic Research Institute, Miami, Florida (M.P.).

Andrew Duker (A)

University of Cincinnati, Cincinnati, Ohio (A.D.).

Vikram Shivkumar (V)

University Physicians and Surgeons, Inc., Marshall Health, Huntington, West Virginia (V.S.).

William Kinney (W)

Enterin, Inc., Philadelphia, Pennsylvania (W.K.).

James MacDougall (J)

MacDougall Statistical Institute, Haverhill, Massachusetts (J.M.).

Michael Zasloff (M)

Medstar-Georgetown Transplant Institute, Washington, DC, and Enterin Research Institute and Enterin, Inc., Philadelphia, Pennsylvania (M.Z.).

Denise Barbut (D)

Enterin Research Institute and Enterin, Inc., Philadelphia, Pennsylvania (D.B.).

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