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Tolerability and efficacy of the monoaminergic stabilizer (−)-OSU6162 (PNU-96391A) in Huntington’s disease: a double-blind cross-over study

Published online by Cambridge University Press:  23 June 2014

Angelica Kloberg*
Affiliation:
A Carlsson Research AB, Sahlgrenska Science Park, Gothenburg, Sweden
Radu Constantinescu
Affiliation:
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Marie Karin Lena Nilsson
Affiliation:
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Maria Lizzie Carlsson
Affiliation:
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Arvid Carlsson
Affiliation:
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Jan Wahlström
Affiliation:
Department of Medical and Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
Sara Haghighi
Affiliation:
Department of Neurology, Sahlgrenska University Hospital, Gothenburg/Skaraborg Hospital, Skövde, Sweden
*
Dr. Angélica Kloberg, PhD, A Carlsson Research AB, Sahlgrenska Science Park, Medicinaregatan 8A, vån 2, lab SE 413 46 Gothenburg, Sweden. Tel: +46-31-7411892; E-mail: [email protected]

Abstract

Objective

To evaluate the safety (primary objective) and efficacy (secondary objective) of (−)-OSU6162 in Huntington’s disease (HD).

Methods

In a double-blind, cross-over trial, patients with HD were randomly assigned to start treatment on either (−)-OSU6162 or placebo. After 4 weeks, those patients who initially received active drug were switched to placebo for another 4 weeks, and vice versa. During the first week the (−)-OSU6162 dose was 15 mg twice daily, during the second week 30 mg twice daily, and during the last 2 weeks 45 mg twice daily. Motor, cognitive, mental and social functions were rated by the clinical investigator or by self-assessment, using established rating scales.

Results

Fifteen patients fulfilling inclusion and exclusion criteria completed the study. (−)-OSU6162 was well tolerated by all patients and no adverse effects were observed. (−)-OSU6162 treatment significantly improved the Short Form 36 Vitality score, mainly due to an improvement of the individual item ‘worn-out’ (VT3). In addition, an improvement of depressive symptoms was found using Beck Depression Inventory. In contrast to a general trend of improvement in several non-motor variables only small and non-significant differences between (−)-OSU6162 and placebo were found regarding motor functions.

Conclusions

(−)-OSU6162 offers promise for the treatment of HD, as a drug with good tolerability, capable of improving the patients’ experienced non-motor functions such as energy and mood and thus alleviating symptoms of great importance for their quality of life.

Type
Original Articles
Copyright
© Scandinavian College of Neuropsychopharmacology 2014 

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Footnotes

Deceased

References

1.Petersén, Å, Björkqvist, M. Hypothalamic-edocrine aspects in Huntington’s disease. Euro J Neurosci 2006;24:961967.Google Scholar
2.Walker, FO. Huntington’s disease. Lancet 2007;369:218228.CrossRefGoogle ScholarPubMed
3.Paleacu, D. Tetrabenazine in the treatment of Huntington’s disease. Neuropsychiatr Dis Treat 2007;3:545551.Google Scholar
4.Rung, JP, Rung, E, Helgeson, Let al. Effects of (–)-OSU6162 and ACR16 on motor activity in rats, indicating a unique mechanism of dopaminergic stabilization. J Neural Trasm 2008;115:899908.Google Scholar
5.Carlsson, ML, Burstein, ES, Kloberg, Aet al. I. In vivo evidence for partial agonist effects of (–)-OSU6162 and (+)-OSU6162 on 5-HT2A serotonin receptors. J Neural Trasm 2011;118:15111522.Google Scholar
6.Burstein, ES, Carlsson, ML, Owens, Met al. II. In vitro evidence that (–)-OSU6162 and (+)-OSU6162 produce their behavioral effects through 5-HT2A serotonin and D2 dopamine receptors. J Neural Transm 2011;118:15231533.Google Scholar
7.Tedroff, J, Ekesbo, A, Sonesson, C, Waters, N, Carlsson, A. Long-lasting improvement following (–)-OSU6162 in a patient with Huntington’s disease. Neurology 1999;53:16051606.Google Scholar
8.de Yebenes, JG, Landwehrmeyer, B, Squitieri, Fet al. Pridopidine for the treatment of motor function in patients with Huntington’s disease (MermaiHD): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet Neurol 2011;10:10491057.CrossRefGoogle ScholarPubMed
9.The Huntington Study Group HART Investigators. A randomized, double-blind, placebo-controlled trial of pridopidine in Huntington’s disease. Mov Disord 2013;28:14071415.Google Scholar
10.Landwehrmeyer, GB, Marder, K, Biilmann-Ronn, Bet al. Effects of the dopaminergic stabilizer pridopidine on motor symptoms in Huntington’s disease: a meta-analysis. Clin Genet 2011;80(Suppl. 1):48. (Abstract).Google Scholar
11. European Huntington’s Disease Network: www.euro-hd.netGoogle Scholar
12.Shoulson, I, Kurlan, R, Rubin, A. Assessment of functional capacity in neurodegenerative movement disorders: Huntington’s disease as a prototype. In: Munsat T, editor. Quantification of Neurologic Deficit. Stoneham, MA: Butterworths, 1989. p. 271283.Google Scholar
13.Sonesson, C, Lin, CH, Hansson, Let al. Substituted (S)-phenylpiperidines and rigid congeners as preferential dopamine autoreceptor antagonists: synthesis and structure-activity relationships. J Med Chem 1994;37:27352753.CrossRefGoogle ScholarPubMed
14.Huntington Study Group. Unified Huntington’s Disease Rating Scale: reliability and consistency. Mov Disord 1996;11:136142.Google Scholar
15.Ware, JE, Snow, KK, Kosinski, Met al. SF-36 Health Survey: manual and interpretation guide. Boston: The Health Institute, New England Medical Centre, 1993.Google Scholar
16. Website: www.alswh.org.au, ALSWH (Australian Longitudinal Study on Women’s Health). Additional site information: For Researchers/Data/Data Dictionary Supplement/ Section 2, Core Survey Dataset/ 2.3 Health-related Quality of Life Variables, SF-36 (http://www.alswh.org.au/for-researchers/data/data-dictionary-supplement).Google Scholar
17.Altman, DG. Practical Statistics for Medical Research, 1st edn. London: Chapman and Hall, 1991.Google Scholar
18.Hodges, JL Jr, Lehmann, EL. Hodges-Lehmann estimators. In: Kotz S, Johnson NL, READ CB, editors. Encyclopedia of Statistical Sciences, Volume 3. New York: John Wiley & Sons, 1983. p. 463465.Google Scholar
19.Hollander, M, Wolfe, DA. Nonparametric Statistical Methods, 2nd edn. New York: John Wiley & Sons, 1999.Google Scholar
20.Suchman, AL, Ader, R. Pharmacodynamics and drug action. Classic conditioning and placebo effects in crossover studies. Clin Pharmacol Ther 1992;52:372377.CrossRefGoogle Scholar
21.Faria, V, Fredrikson, M, Furumark, T. Imaging the placebo response: a neurofunctional review. Eur Neuropsychopharmacol 2008;18:473485.Google Scholar
22.Elbourne, DR, Altman, DG, Higgins, JPTet al. Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol 2002;31:140149.Google Scholar
23.Johansson, B, Carlsson, A, Carlsson, MLet al. Placebo-controlled cross-over study of the monoaminergic stabiliser (–)-OSU6162 in mental fatigue following stroke or traumatic brain injury. Acta Neuropsychiatrica 2012;24:266274.Google Scholar
24.Svensson, KA, Falcone, JF, Johansson, AMet al. The actions of the dopamine stabilizer ACR16, but not (–)-OSU6162, in behavioral and neurochemical assays are not dependent on the presence of functional D2 receptors. Society for Neuroscience Annual Meeting, 9–13 November 2009, San Diego.Google Scholar
25.Natesan, S, Svensson, KA, Reckless, GEet al. The dopamine stabilizers (S)-(–)-(3-methanesulfonyl-phenyl)-1-propyl-piperidine [(–)-OSU6162] and 4-(3-methanesulfonylphenyl)-1-propyl-piperidine (ACR16) show high in vivo D2 receptor occupancy, antipsychotic-like efficacy, and low potential for motor side effects in the rat. J Pharmacol Exp Ther 2006;318:810818.CrossRefGoogle Scholar
26.Tolboom, N, Berendse, HW, Leysen, JEet al. The dopamine stabilizer (–)-OSU6162 occupies a subpopulation of striatal dopamine D2/D3 receptors: an [11C]-raclopride PET study in healthy human subjects. 2014. Submitted to Neuropsychopharmacology, minor revision.Google Scholar
27.Rodriguez, CA, Azie, NE, Adams, Get al. Single oral dose safety, tolerability, and pharmacokinetics of PNU-96391 in healthy volunteers. J Clin Pharmacol 2004;44:276283.CrossRefGoogle ScholarPubMed
28.Ruiz, C, Casarejos, MJ, Rubio, Iet al. The dopaminergic stabilizer, (–)-OSU6162, rescues striatal neurons with normal and expanded polyglutamine chains in huntingtin protein from exposure to free radicals and mitochondrial toxins. Brain Res 2012;1459:100112.Google Scholar