To assess the safety and pharmacokinetics of lisdexamfetamine dimesylate (LDX), a d-amphetamine prodrug, this double-blind study enrolled adults with clinically stable schizophrenia who were adherent (≥12 weeks) to antipsychotic pharmacotherapy. The participants received placebo or ascending LDX doses (50, 70, 100, 150, 200, and 250 mg) daily for 5 days at each dose (dose periods, 1-6; days, 1-5). Of the 31 enrolled participants, 27 completed the study (placebo, n = 6; LDX, n = 21). Treatment-emergent adverse events (AEs) were reported by 4 participants receiving placebo and by 23 participants receiving LDX (all doses) with no serious AEs while on active treatment. For all periods, the mean postdose change on day 5 (up to 12 hours postdose) in systolic and diastolic blood pressure and pulse, respectively, ranged from -4.62 to 8.05 mm Hg, -3.67 to 4.43 mm Hg, and -3.57 to 14.43 beats per minute for placebo and -3.83 to 11.25 mm Hg, -1.55 to 5.80 mm Hg, and -0.36 to 21.26 beats per minute for LDX. With ascending LDX dose, the mean (SD) maximum plasma concentration for LDX-derived d-amphetamine ranged from 51.68 (10.28) to 266.27 (56.55) ng/mL. The area under the plasma concentration-time curve for 24 hours ranged from 801.8 (170.2) to 4397.9 (1085.9) ng[BULLET OPERATOR]h/mL. The d-amphetamine maximum plasma concentration and area under the plasma concentration-time curve increased linearly with ascending LDX dose. Antipsychotic agents did not markedly affect d-amphetamine pharmacokinetics. Over a wide range of ascending doses, LDX safety profile in adults with schizophrenia was consistent with previous findings with no unexpected treatment-emergent AEs. Pulse tended to increase with LDX dose; overall, blood pressure did not increase with LDX dose. Consistent with previous studies, pharmacokinetic parameters increased linearly with increasing LDX dose.

译文

:为评估d-苯异丙胺前药赖氨苯丙胺二甲磺酸酯(LDX)的安全性和药代动力学,该双盲研究招募了坚持抗精神病药物疗法(≥12周)且临床稳定的精神分裂症患者。参与者每天接受安慰剂或递增剂量的LDX(50、70、100、150、200和250 mg),每种剂量持续5天(剂量周期为1-6;第1-5天)。在31名参与者中,有27名完成了研究(安慰剂,n = 6; LDX,n = 21)。在接受积极治疗时,有4名接受安慰剂的受试者和23名接受LDX(所有剂量)的受试者报告了治疗紧急不良事件(AE)。在所有期间,第5天(给药后最多12小时)的平均给药后收缩压和舒张压和脉搏变化范围为-4.62至8.05 mm Hg,-3.67至4.43 mm Hg和-3.57至14.43对于安慰剂,每分钟搏动为-3.83至11.25毫米汞柱,对于-1.55至5.80毫米汞柱,对于LDX为-0.36至21.26每分钟搏动。随着LDX剂量的增加,源自LDX的d-苯异丙胺的平均(SD)最大血浆浓度范围为51.68(10.28)至266.27(56.55)ng / mL。 24小时血浆浓度-时间曲线下的面积范围为801.8(170.2)至4397.9(1085.9)ng [BULLET OPERATOR] h / mL。 d-苯丙胺最大血浆浓度和血浆浓度-时间曲线下的面积随LDX剂量的增加而线性增加。抗精神病药对d-苯异丙胺的药代动力学没有明显影响。在广泛的剂量范围内,成人精神分裂症的LDX安全性与以前的发现一致,没有意外的治疗紧急事件。脉搏随LDX剂量的增加而增加;总体而言,血压并未随LDX剂量而增加。与以前的研究一致,药代动力学参数随LDX剂量的增加而线性增加。

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