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Fosmetpantotenate Randomized Controlled Trial in Pantothenate Kinase-Associated Neurodegeneration

T. Klopstock, A. Videnovic, AT. Bischoff, C. Bonnet, L. Cif, C. Comella, M. Correa-Vela, ML. Escolar, JL. Fraser, V. Gonzalez, N. Hermanowicz, R. Jech, HA. Jinnah, T. Kmiec, A. Lang, MJ. Martí, S. Mercimek-Andrews, M. Monduy, GAM. Nimmo, B....

. 2021 ; 36 (6) : 1342-1352. [pub] 20201116

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc21018530

BACKGROUND: Pantothenate kinase-associated neurodegeneration (PKAN) currently has no approved treatments. OBJECTIVES: The Fosmetpantotenate Replacement Therapy pivotal trial examined whether treatment with fosmetpantotenate improves PKAN symptoms and stabilizes disease progression. METHODS: This randomized, double-blind, placebo-controlled, multicenter study evaluated fosmetpantotenate, 300 mg oral dose three times daily, versus placebo over a 24-week double-blind period. Patients with pathogenic variants of PANK2, aged 6 to 65 years, with a score ≥6 on the PKAN-Activities of Daily Living (PKAN-ADL) scale were enrolled. Patients were randomized to active (fosmetpantotenate) or placebo treatment, stratified by weight and age. The primary efficacy endpoint was change from baseline at week 24 in PKAN-ADL. RESULTS: Between July 23, 2017, and December 18, 2018, 84 patients were randomized (fosmetpantotenate: n = 41; placebo: n = 43); all 84 patients were included in the analyses. Six patients in the placebo group discontinued treatment; two had worsening dystonia, two had poor compliance, and two died of PKAN-related complications (aspiration during feeding and disease progression with respiratory failure, respectively). Fosmetpantotenate and placebo group PKAN-ADL mean (standard deviation) scores were 28.2 (11.4) and 27.4 (11.5) at baseline, respectively, and were 26.9 (12.5) and 24.5 (11.8) at week 24, respectively. The difference in least square mean (95% confidence interval) at week 24 between fosmetpantotenate and placebo was -0.09 (-1.69 to 1.51; P = 0.9115). The overall incidence of treatment-emergent serious adverse events was similar in the fosmetpantotenate (8/41; 19.5%) and placebo (6/43; 14.0%) groups. CONCLUSIONS: Treatment with fosmetpantotenate was safe but did not improve function assessed by the PKAN-ADL in patients with PKAN. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Biostatistics Retrophin Inc San Diego California USA

Child Neurology Department Children's Memorial Health Institute Warsaw Poland

Department of Child Neurology Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy

Department of Child Neurology Hospital Universitari Vall d'Hebron Barcelona Spain

Department of Child Neurology Oslo University Hospital Rikshospitalet Oslo Norway

Department of Neurology 1st Faculty of Medicine Charles University and General Faculty Hospital Prague Czech Republic

Department of Neurology Children's National Medical Center Washington District of Columbia USA

Department of Neurology Columbia University College of Physicians and Surgeons New York New York USA

Department of Neurology Hospital Clinic of Barcelona Barcelona Spain

Department of Neurology Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA

Department of Neurology Sorbonne University AP HP Salpêtrière Hospital Brain and Spine Institute Paris France

Department of Neurology Sorbonne University AP HP Salpêtrière Hospital Paris France

Department of Neurology University of California Irvine Irvine California USA

Department of Neurosurgery and Neurological Sciences Rush University Medical Center Chicago Illinois USA

Department of Neurosurgery CHRU de Montpellier Gui de Chauliac Hospital Montpellier France

Department of Neurosurgery University Hospital of Montpellier Gui de Chauliac Hospital Montpellier France

Department of Pediatrics Division of Child and Adolescent Neurology University of Texas at Houston Medical School Houston Texas USA

Department of Pediatrics University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA

Departments of Neurology and Human Genetics Emory University School of Medicine Atlanta Georgia USA

Division of Clinical and Metabolic Genetics Department of Pediatrics University of Toronto The Hospital for Sick Children Toronto Ontario Canada

Division of Clinical and Metabolic Genetics The Hospital for Sick Children University of Toronto Toronto Ontario Canada

Edmond J Safra Program in Parkinson's Disease and the Department of Medicine Toronto Western Hospital and the University of Toronto Toronto Ontario Canada

Friedrich Baur Institute at the Department of Neurology University Hospital LMU Munich Munich Germany

German Center for Neurodegenerative Diseases Munich Munich Germany

Movement Disorders Unit Hospital Clinic of Barcelona European Reference Network for Rare Neurological Diseases Barcelona Spain

Munich Cluster for Systems Neurology Munich Munich Germany

Neurology Nicklaus Children's Hospital Miami Florida USA

Rare Disease Institute Division of Genetics and Metabolism Children's National Medical Center Washington District of Columbia USA

Research and Development Retrophin Inc San Diego California USA

Citace poskytuje Crossref.org

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