Abstract
Background: The histamine H3 receptor plays a critical role in the negative neuromodulation of neurotransmitters involved in cognitive function. H3 receptor antagonists/inverse agonists have been shown to exert pro-cognitive effects in pre-clinical models. GSK239512 is a potent and selective H3 receptor antagonist developed for the treatment of cognitive dysfunction in neurodegenerative disorders. In this study we examined the safety, tolerability, pharmacokinetics and pro-cognitive effects of GSK239512 (oral) in patients with mild to moderate Alzheimer’s disease using ascending dose titration regimens.
Methods: The study was conducted in two parts. Part A was a single-blind, placebo run-in, flexible dose titration over 9 days in two cohorts, each consisting of two patients. Part B was a double-blind, randomised, placebo controlled, parallel group, which investigated 3 flexible dose titration regimens over 4 weeks in 3 cohorts, each consisting of eight patients.
Results: Overall, the 5/10/20/40μg and 10/20/40/80μg regimens were well-tolerated. The regimen of 20/40/80/150μg showed the poorest tolerability likely due to the higher starting dose. There were no clinically significant abnormalities in haematology, clinical chemistry, urinalysis parameters and cardiovascular parameters. GSK239512 had positive effects on tasks of attention and memory with effect sizes between 0.56 and 1.37.
Conclusions: GSK239512 displayed asatisfactory level of tolerability in patients with Alzheimer’s disease with evidence for positive effects on attention and memory. The findings suggest that a titration regimen with a starting dose of 5-10μg and a maximum dose of 80μg is likely to be a well-tolerated and potentially efficacious regimen for future clinical trials in patients with Alzheimer’s disease. These findings await replication in a larger study.
Keywords: Alzheimer’s disease, attention, cognition, H3 receptor, histamine, antagonist, memory, safety, tolerability
Current Alzheimer Research
Title:The Safety, Tolerability, Pharmacokinetics and Cognitive Effects of GSK239512, a Selective Histamine H3 Receptor Antagonist in Patients with Mild to Moderate Alzheimer’s Disease: A Preliminary Investigation
Volume: 10 Issue: 3
Author(s): Pradeep J. Nathan, Rebecca Boardley, Nicola Scott, Alienor Berges, Paul Maruff, Tharani Sivananthan, Neil Upton, Martin T. Lowy, Peter J. Nestor and Robert Lai
Affiliation:
Keywords: Alzheimer’s disease, attention, cognition, H3 receptor, histamine, antagonist, memory, safety, tolerability
Abstract: Background: The histamine H3 receptor plays a critical role in the negative neuromodulation of neurotransmitters involved in cognitive function. H3 receptor antagonists/inverse agonists have been shown to exert pro-cognitive effects in pre-clinical models. GSK239512 is a potent and selective H3 receptor antagonist developed for the treatment of cognitive dysfunction in neurodegenerative disorders. In this study we examined the safety, tolerability, pharmacokinetics and pro-cognitive effects of GSK239512 (oral) in patients with mild to moderate Alzheimer’s disease using ascending dose titration regimens.
Methods: The study was conducted in two parts. Part A was a single-blind, placebo run-in, flexible dose titration over 9 days in two cohorts, each consisting of two patients. Part B was a double-blind, randomised, placebo controlled, parallel group, which investigated 3 flexible dose titration regimens over 4 weeks in 3 cohorts, each consisting of eight patients.
Results: Overall, the 5/10/20/40μg and 10/20/40/80μg regimens were well-tolerated. The regimen of 20/40/80/150μg showed the poorest tolerability likely due to the higher starting dose. There were no clinically significant abnormalities in haematology, clinical chemistry, urinalysis parameters and cardiovascular parameters. GSK239512 had positive effects on tasks of attention and memory with effect sizes between 0.56 and 1.37.
Conclusions: GSK239512 displayed asatisfactory level of tolerability in patients with Alzheimer’s disease with evidence for positive effects on attention and memory. The findings suggest that a titration regimen with a starting dose of 5-10μg and a maximum dose of 80μg is likely to be a well-tolerated and potentially efficacious regimen for future clinical trials in patients with Alzheimer’s disease. These findings await replication in a larger study.
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Cite this article as:
J. Nathan Pradeep, Boardley Rebecca, Scott Nicola, Berges Alienor, Maruff Paul, Sivananthan Tharani, Upton Neil, T. Lowy Martin, J. Nestor Peter and Lai Robert, The Safety, Tolerability, Pharmacokinetics and Cognitive Effects of GSK239512, a Selective Histamine H3 Receptor Antagonist in Patients with Mild to Moderate Alzheimer’s Disease: A Preliminary Investigation, Current Alzheimer Research 2013; 10 (3) . https://dx.doi.org/10.2174/1567205011310030003
DOI https://dx.doi.org/10.2174/1567205011310030003 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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