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1.
Sensors (Basel) ; 23(4)2023 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-36850429

RESUMO

Large-scale production of graphene nanosheets (GNSs) has led to the availability of solution-processable GNSs on the commercial scale. The controlled vacuum filtration method is a scalable process for the preparation of wafer-scale films of GNSs, which can be used for gas sensing applications. Here, we demonstrate the use of this deposition method to produce functional gas sensors, using a chemiresistor structure from GNS solution-based techniques. The GNS suspension was prepared by liquid-phase exfoliation (LPE) and transferred to a polyvinylidene fluoride (PVDF) membrane. The effect of non-covalent functionalization with Co-porphyrin and Fe-phthalocyanines on the sensor properties was studied. The pristine and functionalized GNS films were characterized using different techniques such as Raman spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscopy (AFM), X-ray diffraction (XRD), and electrical characterizations. The morphological and spectroscopic analyses both confirm that the molecules (Co-porphyrin and Fe-phthalocyanine) were successfully adsorbed onto the GNSs surface through π-π interactions. The chemiresistive sensor response of functionalized GNSs toward the low concentrations of nitrogen dioxide (NO2) (0.5-2 ppm) was studied and compared with those of the film of pristine GNSs. The tests on the sensing performance clearly showed sensitivity to a low concentration of NO2 (5 ppm). Furthermore, the chemical modification of GNSs significantly improves NO2 sensing performance compared to the pristine GNSs. The sensor response can be modulated by the type of adsorbed molecules. Indeed, Co-Por exhibited negative responsiveness (the response of Co-Por-GNS sensors and pristine GNS devices was 13.1% and 15.6%, respectively, after exposure to 0.5 ppm of NO2). Meanwhile, Fe-Phc-GNSs induced the opposite behavior resulting in an increase in the sensor response (the sensitivity was 8.3% and 7.8% of Fe-Phc-GNSs and pristine GNSs, respectively, at 0.5 ppm NO2 gas).

2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 45(3): 440-444, 2023 Jun.
Artigo em Zh | MEDLINE | ID: mdl-37407532

RESUMO

Objective To investigate the causes of false-positive results in the 68Ga-labeled fibroblast activation protein inhibitor (68Ga-FAPI-04) PET/CT imaging. Methods The imaging data of 547 patients undergoing 68Ga-FAPI-04 PET/CT examination in the Department of Nuclear Medicine of the Affiliated Hospital of Southwest Medical University from September 2020 to May 2021 were retrospectively collected.Two experienced nuclear medicine diagnostic physicians analyzed the clinical data,relevant imaging examinations,laboratory examinations,pathological results and follow-up results of the patients with false-positive results. Results The 68Ga-FAPI-04 PET/CT imaging of 547 patients showed false-positive results in 99 (18.1%) patients,including 56 males and 43 females.The postoperative pathological examination confirmed false-positive results in 13 patients,including 1 patient of thyroiditis,2 patients of pulmonary tuberculosis,1 patient of bone tuberculosis,2 patients of pulmonary inflammatory pseudotumor,1 patient of pulmonary sarcoidosis,1 patient of pulmonary benign fibroma,1 patient of organic pneumonia,2 patients of renal angiomyolipoma,1 patient of mass pancreatitis,and 1 patient of pancreatic mucinous cystadenoma.The medical history,relevant imaging examination,and long-term follow-up confirmed false-positive results in 86 patients.Specifically,the false-positive uptake in the neck,chest,abdomen,bone joint,and skin occurred in 8 (9.3%),13 (15.1%),5 (5.8%),57 (66.3%),and 3 (3.5%) patients,respectively.Inflammation-related uptake appeared in 83 (83.8%) patients with false-positive imaging results,of which arthritis (23 patients) and osteophyte (29 patients) were the most common.Sixteen (16.2%) patients showed the false-positive uptake related to fibroblasts. Conclusion 68Ga-FAPI-04 PET/CT imaging will show non-malignant tumor false-positive results,which are mainly associated with inflammation and fibroblasts.


Assuntos
Angiomiolipoma , Neoplasias Renais , Quinolinas , Feminino , Masculino , Humanos , Radioisótopos de Gálio , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Estudos Retrospectivos , Fibroblastos , Inflamação , Fluordesoxiglucose F18
3.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 45(4): 634-639, 2023 Aug.
Artigo em Zh | MEDLINE | ID: mdl-37654144

RESUMO

Objective To compare the efficiency of 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA-11) and 18F-labeled sodium fluoride (18F-NaF) PET/CT in the diagnosis of bone metastasis in the patients with prostate cancer.Methods The prostate cancer patients suspected of bone metastasis who underwent 68Ga-PSMA-11 PET/CT and 18F-NaF PET/CT from January 2018 to January 2021 were included in this study.The number of lesions,maximum standardized uptake value (SUVmax),and tumor-to-background (T/B) ratio were compared between the two methods.Results 18F-NaF PET/CT detected more metastases than 68Ga-PSMA-11 PET/CT (310 vs.264,P<0.001).The median SUVmax[23.2 (16.4,33.4) vs.4.1 (2.5,5.6)] and median T/B ratio[7.0 (4.9,9.9) vs.6.7 (3.7,9.6)] of 18F-NaF PET/CT were higher than those of 68Ga-PSMA-11 PET/CT (all P<0.001).With the number of lesions as the indicator,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of 18F-NaF PET/CT were 100.0%,92.0%,92.0%,98.7%,and 100.0% respectively,and those of 68Ga-PSMA-11 PET/CT were 85.2%,94.0%,79.2%,98.9%,and 50.5%,respectively.Conclusion 18F-NaF PET/CT is superior to 68Ga-PSMA-11 PET/CT in the detection of bone metastases of prostate cancer.

4.
Exp Brain Res ; 239(8): 2435-2444, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34106297

RESUMO

Hypothyroidism causes somatic, psychosocial and affective psychosis, including depression-like behaviors. In this study, (hypothyroidism group; HP group) adult male Sprague Dawley (SD) rats were induced to hypothyroidism after 5 weeks of exposure to 0.05% propylthiouracil (PTU) in potable water, control animals (CON group) were given the same amount of water. The following behavioral experiments were conducted, respectively: open-field test (OFT), forced swimming test (FST), tail suspension test (TST). TT[Formula: see text] and TT[Formula: see text] levels were measured after the behavior tests and the expression levels of 5-HT[Formula: see text] receptor and 5-HT[Formula: see text] receptor proteins were analyzed in the hippocampus and prefrontal cortex. The level of TT[Formula: see text] and TT[Formula: see text] in the HP group rats was much lower than that in the CON group. The hypothyroid rats also showed weight loss, much longer immobility time in tail suspension test and forced swimming test. Besides, 5 weeks of PTU administration was associated with significantly decreased expression levels of 5-HT[Formula: see text] receptor and 5-HT[Formula: see text] receptor proteins compared with control group, which were significantly negatively correlated with immobility time in FST and TST. In conclusion, our results suggest that hypothyroidism induces depressive behaviors through the influence of the serotonin system, and the decreased expression of the 5-HT[Formula: see text] receptor is an important cause of the depressive behaviors in hypothyroidism.


Assuntos
Depressão , Hipotireoidismo , Animais , Comportamento Animal , Depressão/etiologia , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/complicações , Masculino , Ratos , Ratos Sprague-Dawley , Receptor 5-HT2A de Serotonina , Serotonina , Natação
5.
Mult Scler ; 24(12): 1605-1616, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-28911260

RESUMO

BACKGROUND: Amiselimod, an oral selective sphingosine-1-phosphate 1 receptor modulator, suppressed disease activity dose-dependently without clinically relevant bradyarrhythmia in a 24-week phase 2, placebo-controlled study in relapsing-remitting multiple sclerosis. OBJECTIVE: To assess safety and efficacy of amiselimod over 96 weeks. METHODS: After completing the core study, patients on amiselimod continued at the same dose, whereas those on placebo were randomised 1:1:1 to amiselimod 0.1, 0.2 or 0.4 mg for another 72 weeks. Most patients receiving 0.1 mg were re-randomised to 0.2 or 0.4 mg upon availability of the core study results. RESULTS: Of 415 patients randomised in the core study, 367 (88.4%) entered and 322 (77.6%) completed the extension. One or more adverse events were reported in 303 (82.6%) of 367 patients: 'headache', 'lymphocyte count decreased', 'nasopharyngitis' and 'MS relapse' were most common (14.7%-16.9%). No serious opportunistic infection, macular oedema or malignancy was reported and no bradyarrhythmia of clinical concern was observed by Holter or 12-lead electrocardiogram. The dose-dependent effect of amiselimod on clinical and magnetic resonance imaging-related outcomes from the core study was sustained in those continuing on amiselimod and similarly observed after switching to active drug. CONCLUSION: For up to 2 years of treatment, amiselimod was well tolerated and dose-dependently effective in controlling disease activity.


Assuntos
Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Propanolaminas/administração & dosagem , Propanolaminas/efeitos adversos , Adulto , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptores de Lisoesfingolipídeo/efeitos dos fármacos , Tempo , Resultado do Tratamento
6.
Materials (Basel) ; 16(19)2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37834547

RESUMO

Many optoelectronic applications require organic semiconductor (OSC) materials with high electron affinity. In this work, a series of novel acceptor-donor-acceptor (A-D-A) materials with low-lying LUMO energy levels were designed and characterized. In this strategy, two acceptor dyes, bis-isatin and di-2-(2-oxindolin-3-ylidene) malononitrile, were connected by various π-bridges (benzene ring, benzo[c][1,2,5]thiadiazole, monothiophene, trithiophene). We varied the length of the π-conjugation of the central core and the linkage position of the acceptor core (4- vs. 6-position of the phenyl ring) to investigate the effect on the optical and electrochemical properties of the materials. We performed density functional theory (DFT) and time-dependent DFT (TD-DFT) studies to gain insight into the dyes' electronic properties by determining the energy levels. Our findings demonstrate that with increasing acceptor strength and π-conjugation length of the core, the wavelength of the longest absorption maximum as well as their respective extinction coefficients are enhanced, which results in band-gap reduction either by lowering the LUMO and/or raising the HOMO energy level of the molecules. The potential practical utility of these materials as electron-transport materials for perovskite solar cells (PSCs) has been demonstrated.

7.
Nanomaterials (Basel) ; 13(18)2023 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-37764530

RESUMO

2D materials possess great potential to serve as gas-sensing materials due to their large, specific surface areas and strong surface activities. Among this family, transition metal chalcogenide materials exhibit different properties and are promising candidates for a wide range of applications, including sensors, photodetectors, energy conversion, and energy storage. Herein, a high-shear mixing method has been used to produce multilayered MoS2 nanosheet dispersions. MoS2 thin films were manufactured by vacuum-assisted filtration. The structural morphology of MoS2 was studied using ς-potential, UV-visible, scanning electron microscopy (SEM), atomic force microscopy (AFM), energy-dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM), X-ray diffraction (XRD), and Raman spectroscopy (RS). The spectroscopic and microscopic analyses confirm the formation of a high-crystalline MoS2 thin film with good inter-sheet connectivity and relative thickness uniformity. The thickness of the MoS2 layer is measured to be approximately 250 nm, with a nanosheet size of 120 nm ± 40 nm and a number of layers between 6 and 9 layers. Moreover, the electrical characteristics clearly showed that the MoS2 thin film exhibits good conductivity and a linear I-V curve response, indicating good ohmic contact between the MoS2 film and the electrodes. As an example of applicability, we fabricated chemiresistive sensor devices with a MoS2 film as a sensing layer. The performance of the MoS2-chemiresistive sensor for NO2 was assessed by being exposed to different concentrations of NO2 (1 ppm to 10 ppm). This sensor shows a sensibility to low concentrations of 1 ppm, with a response time of 114 s and a recovery time of 420 s. The effect of thin-film thickness and operating temperatures on sensor response was studied. The results show that thinner film exhibits a higher response to NO2; the response decreases as the working temperature increases.

8.
Autism ; 25(1): 125-136, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32854512

RESUMO

LAY ABSTRACT: When answering how the same object might appear to others in different locations, people can provide answers by mentally putting themselves into another person's location using the embodied self-rotation strategy or by rotating the target object toward themselves using the object-based mental rotation strategy. In this study, after learning the embodied self-rotation or object-based mental rotation strategies, autistic children improved their visual perspective-taking performance, which is believed to be impaired or delayed in autistic individuals. We recruited 34 autistic children and an equal number of ability-matched typical children and examined their visual perspective-taking performance at baseline and after learning the embodied self-rotation and object-based mental rotation strategies. As previous visual perspective-taking and other social cognition interventions for autistic individuals have primarily focused on the embodied self-rotation strategy, showing moderate effectiveness and limited generalizability, we explored the effects of both embodied self-rotation and object-based mental rotation strategies for improving perspective-taking performance and discussed their implications in this study. The results showed that autistic children had a lower performance at baseline compared with typical children; however, they were still sensitive to both embodied self-rotation and object-based mental rotation strategies. Unlike typical children, who gained more from the embodied self-rotation strategy, autistic children benefited similarly from the two strategies. This suggests that there are multiple ways to helping autistic children overcome their difficulty in perspective-taking tasks. Future interventions for autistic children could consider combining various strategies that better suit their autistic traits.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Transtorno do Espectro Autista/terapia , Transtorno Autístico/terapia , Criança , Desenvolvimento Infantil , Humanos , Aprendizagem
9.
Int J Ment Health Nurs ; 30(4): 939-954, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33893718

RESUMO

The outbreak of coronavirus disease 2019 (COVID-19) is having a dramatic effect on the mental health of healthcare workers (HCWs). Upon the emergence of the COVID-19 pandemic, the Chinese government dispatched about 42 000 HCWs to Wuhan City and Hubei Province to fight this pandemic. This study briefly examines front-line nurses who experienced burnout, with the main objective of investigating the mediating roles of positive and negative affect in the relationship between resilience and burnout in Wuhan hospitals at the peak of the COVID-19 pandemic. A total of 180 front-line nurses voluntarily participated via a social media group. They completed the online questionnaires, including the Maslach Burnout Inventory-General Survey (MBI-GS), the Positive and Negative Affect Schedule (PANAS), the Connor-Davidson Resilience Scale (CD-RISC), demographics, and work-related characteristics. Structural equation modelling (SEM) analysis was used to examine the mediating effect of positive and negative affect on the relationship between resilience and burnout. The total prevalence of burnout was 51.7%, of which 15.0% were severe burnout. These preliminary results revealed that positive and negative affect fully mediated the effects of resilience on burnout, emotional exhaustion, depersonalization, and reduced personal accomplishment of front-line nurses. It is necessary to know the impact of resilience on HCWs with burnout through the positive and negative affect of individual backgrounds and situations, and how policymakers can deploy resilience interventions to support front-line HCWs.


Assuntos
Esgotamento Profissional , COVID-19 , Enfermeiras e Enfermeiros , Esgotamento Profissional/epidemiologia , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
10.
Menopause ; 14(3 Pt 1): 408-14, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17224857

RESUMO

OBJECTIVE: Drospirenone (DRSP), a spironolactone analog with aldosterone antagonist activity, is a novel progestogen developed for use as hormone therapy in postmenopausal women in combination with 17beta-estradiol (E2). DRSP/E2 lowers blood pressure when used alone in hypertensive postmenopausal women or when administered concomitantly with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. DRSP/E2 has not been studied in combination with the widely prescribed hydrochlorothiazide (HCTZ). We investigated the effects of 3 mg DRSP/1 mg E2 versus placebo on blood pressure and potassium balance when added to existing therapy with 25 mg HCTZ in postmenopausal women with established stage I hypertension. DESIGN: This was a single-center, double-blind, randomized, placebo-controlled, two-treatment, two 4-week treatment period crossover study in 36 postmenopausal women with stage I hypertension maintained on 25 mg HCTZ. The endpoint was a change from baseline in systolic and diastolic blood pressures by 24-hour ambulatory blood pressure monitoring. Safety monitoring included serum potassium (mEq/L) and adverse events. RESULTS: Mean systolic and diastolic blood pressures by 24-hour ambulatory blood pressure monitoring were reduced significantly, by -7.2 and -4.5 mm Hg, respectively, with DRSP/E2 as compared with placebo. The decrease in potassium with HCTZ was 0.2 mEq/L less with DRSP/E2 than placebo, suggesting a potassium-sparing effect. The most frequently observed adverse events with DRSP/E2 were vaginal bleeding and breast tenderness, which were attributable to the hormone therapy. CONCLUSIONS: DRSP/E2 substantially lowers systolic and diastolic blood pressure when added to existing antihypertensive therapy with HCTZ in hypertensive postmenopausal women. In addition, DRSP/E2 has a potassium-sparing effect that counteracts HCTZ-induced potassium loss.


Assuntos
Androstenos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Hidroclorotiazida/uso terapêutico , Hipertensão/tratamento farmacológico , Antagonistas de Receptores de Mineralocorticoides/uso terapêutico , Idoso , Pressão Sanguínea/efeitos dos fármacos , Determinação da Pressão Arterial/métodos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Combinação de Medicamentos , Terapia de Reposição de Estrogênios , Feminino , Humanos , Hipertensão/prevenção & controle , Pessoa de Meia-Idade , Pós-Menopausa/efeitos dos fármacos , Potássio/sangue , Resultado do Tratamento
11.
J Clin Pharmacol ; 47(10): 1292-302, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17906162

RESUMO

The effects of combination hormone therapy of drospirenone (DRSP), a novel progestin with antialdosterone properties, and 17beta-estradiol (E2) on hydrochlorothiazide (HCTZ) pharmacokinetics/pharmacodynamics versus placebo were investigated in a double-blind, placebo-controlled, crossover study. Thirty-six postmenopausal women with stage 1 hypertension maintained on 25 mg of HCTZ once daily were randomized to receive either 3 mg of DRSP/1 mg of E2 or placebo once daily for 4 weeks. Plasma HCTZ, serum DRSP, E2, potassium, aldosterone, and plasma renin activity were determined at baseline and after 4 weeks. Results showed that the combination of DRSP/E2 plus 25 mg of HCTZ is safe and well tolerated in hypertensive postmenopausal women. The pharmacokinetics of HCTZ were not affected by coadministration of DRSP/E2. The geometric mean ratios and 90% confidence intervals ([HCTZ + DRSP/E2]/[HCTZ + placebo]) for HCTZ (a) area under the serum/plasma concentration-time curve from 0 to 24 hours and (b) maximum plasma concentration were 101 (90.7, 112) and 103 (92.8, 115), respectively. In the HCTZ + DRSP/E2 group, serum potassium, aldosterone, and plasma renin activity all increased in a manner marginally consistent with a beneficial antialdosterone effect, counteracting the HCTZ-induced potassium loss and lowering both systolic and diastolic blood pressure. No dose adjustment is required when DRSP/E2 is added to antihypertensive therapy with HCTZ in hypertensive postmenopausal women.


Assuntos
Androstenos/farmacologia , Anti-Hipertensivos/farmacocinética , Estradiol/farmacologia , Estrogênios/farmacologia , Hidroclorotiazida/farmacocinética , Antagonistas de Receptores de Mineralocorticoides/farmacologia , Idoso , Aldosterona/sangue , Androstenos/efeitos adversos , Androstenos/sangue , Anti-Hipertensivos/sangue , Anti-Hipertensivos/farmacologia , Área Sob a Curva , Disponibilidade Biológica , Estudos Cross-Over , Método Duplo-Cego , Combinação de Medicamentos , Interações Medicamentosas , Quimioterapia Combinada , Estradiol/efeitos adversos , Estradiol/sangue , Terapia de Reposição de Estrogênios , Estrogênios/efeitos adversos , Estrogênios/sangue , Feminino , Humanos , Hidroclorotiazida/sangue , Hidroclorotiazida/farmacologia , Hipertensão/tratamento farmacológico , Pessoa de Meia-Idade , Antagonistas de Receptores de Mineralocorticoides/efeitos adversos , Antagonistas de Receptores de Mineralocorticoides/sangue , Pós-Menopausa , Potássio/sangue
12.
Br J Pharmacol ; 174(1): 15-27, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27714763

RESUMO

BACKGROUND AND PURPOSE: We conducted preclinical and clinical studies to examine the pharmacological, particularly cardiac, effects of amiselimod (MT-1303), a second-generation sphingosine 1-phosphate (S1P) receptor modulator, designed to reduce the bradycardia associated with fingolimod and other S1P receptor modulators. EXPERIMENTAL APPROACH: The selectivity of the active metabolite amiselimod phosphate (amiselimod-P) for human S1P receptors and activation of G-protein-coupled inwardly rectifying K+ (GIRK) channels in human atrial myocytes were assessed. Its cardiac distribution was determined in rats, and cardiovascular telemetry was assessed in monkeys. We also examined the pharmacokinetics, pharmacodynamics and safety of amiselimod in healthy humans. KEY RESULTS: Amiselimod-P showed potent selectivity for S1P1 and high selectivity for S1P5 receptors, with minimal agonist activity for S1P4 and no distinct agonist activity for S1P2 or S1P3 receptors and approximately five-fold weaker GIRK activation than fingolimod-P. After oral administration of amiselimod or fingolimod at 1 mg·kg-1 , the concentration of amiselimod-P in rat heart tissue was lower than that of fingolimod-P, potentially contributing to the minimal cardiac effects of amiselimod. A telemetry study in monkeys confirmed that amiselimod did not affect heart rate or ECG parameters. In healthy human subjects, peripheral blood lymphocyte counts gradually reduced over the 21 day dosing period, with similar lymphocyte count profiles with the highest doses by day 21, and no clinically significant bradycardia observed on day 1 or during the study. CONCLUSIONS AND IMPLICATIONS: Amiselimod exhibited potent therapeutic efficacy with minimal cardiac effects at the anticipated clinical dose and is unlikely to require dose titration.


Assuntos
Doenças Autoimunes/tratamento farmacológico , Bradicardia/tratamento farmacológico , Organofosfatos/farmacologia , Propanolaminas/farmacologia , Receptores de Lisoesfingolipídeo/agonistas , Animais , Doenças Autoimunes/metabolismo , Bradicardia/metabolismo , Linhagem Celular , Relação Dose-Resposta a Droga , Humanos , Macaca fascicularis , Masculino , Estrutura Molecular , Organofosfatos/administração & dosagem , Organofosfatos/química , Propanolaminas/administração & dosagem , Propanolaminas/química , Ratos , Ratos Sprague-Dawley , Receptores de Lisoesfingolipídeo/metabolismo , Receptores de Esfingosina-1-Fosfato , Relação Estrutura-Atividade
13.
Lancet Neurol ; 15(11): 1148-59, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27543447

RESUMO

BACKGROUND: Patients with multiple sclerosis, a chronic inflammatory demyelinating disease of the central nervous system with autoimmune pathogenesis, have shown partial response to a number of immunomodulating treatments, but the search for more effective, safe, and convenient therapeutic options continues. Amiselimod is an oral selective modulator of sphingosine 1-phosphate 1 (S1P1) receptor, which is being developed for the treatment of various autoimmune-mediated diseases. We assessed the safety and efficacy of amiselimod in patients with relapsing- remitting multiple sclerosis. METHODS: In this double-blind phase 2 trial, patients aged 18-60 years with active relapsing-remitting multiple sclerosis from 84 centres in Europe and Canada were randomly assigned (1:1:1:1) with an interactive web-response system to receive once daily oral amiselimod 0·1 mg, 0·2 mg, 0·4 mg, or placebo for 24 weeks. All study personnel, site personnel, investigators, and patients were masked to the treatment assignment during the study. The primary endpoint was the total number of gadolinium-enhanced T1-weighted lesions on monthly brain MRI scans from weeks 8 to 24. Analysis was done on the predefined evaluable population (all randomised patients who did not have any major protocol deviations, completed 24 weeks of treatment as planned, and had at least three valid post-dose MRI scans). This trial is registered with ClinicalTrials.gov, number NCT01742052. FINDINGS: Between Jan 31, 2013, and Dec 24, 2013, 536 patients were screened and 415 patients randomly assigned to amiselimod 0·1 mg (n=105), 0·2 mg (n=103), 0·4 mg (n=104), or placebo (n=103). The median total number of gadolinium-enhanced T1-weighted lesions from weeks 8 to 24 did not differ between the amiselimod 0·1 mg and placebo groups (median 1·6 lesions [range 0-132] in the placebo group vs 2·0 [0-105] in the 0·1 mg group [median difference 0·0, 95% CI -1·0 to 0·0, p=0·7517]), but was significantly lower in the two higher amiselimod dose groups than in the placebo group (0·0 lesions [range 0-35] in the 0·2 mg group [median difference vs placebo -1·0, 95% CI -1·0 to 0·0, p=0·0021] and 0·0 [range 0-30] in the 0·4 mg group [-1·0, -1·2 to 0·0, p=0·0003]). The estimated incident rate ratio compared with placebo was dose-dependently decreased with amiselimod (0·1 mg 0·53 [95% CI 0·33-0·85; p=0·0079], 0·2 mg 0·39 [95% CI 0·24-0·63; p=0·0001], and 0·4 mg 0·23 [95% CI 0·14-0·38; p<0·0001]). The incidence of treatment-emergent adverse events, including infections and cardiac disorders, were similar in the amiselimod treatment groups (59 [56%] of 105 patients in the 0·1 mg group, 69 [67%] of 103 in the 0·2 mg group, and 58 [56%] of 104 in the 0·4 mg group) to the incidence in the placebo group (66 [64%] of 103 patients); the most common treatment-emergent adverse events were headache (ten [10%], ten [10%], and ten [10%] vs four [4%]) and nasopharyngitis (nine [9%], seven [7%], ten [10%] vs eight [8%]). No serious treatment-emergent adverse event was reported for more than one patient in any group and no clinically significant heart rate reduction was observed at any amiselimod dose. INTERPRETATION: Amiselimod 0·2 mg and 0·4 mg significantly reduced the total number of gadolinium-enhanced T1-weighted lesions. The safety and efficacy profiles of amiselimod suggest that this S1P1 receptor modulator is a new potential treatment in multiple sclerosis and potentially other immune-mediated inflammatory diseases and deserves further investigation. FUNDING: Mitsubishi Tanabe Pharma Corporation.


Assuntos
Fatores Imunológicos/farmacologia , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Avaliação de Resultados em Cuidados de Saúde , Receptores de Lisoesfingolipídeo/efeitos dos fármacos , Adulto , Método Duplo-Cego , Feminino , Humanos , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Receptores de Esfingosina-1-Fosfato
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