(22423 NIRVANA) A randomized, parallel-group treatment, Phase 2, double-blind pilot study to investigate the efficacy and safety of elinzanetant compared with placebo for treatment of sleep disturbances associated with menopause - 22423

开始日期2024-03-26

申办/合作机构

Bayer Consumer Care AG

[+1]

NCT06219902 / Completed临床1期

A Randomized, Double-blind, Placebo- and Active-controlled, 4-period, Crossover Study to Investigate Effects of Elinzanetant on Simulated Driving Performance and Cognitive Function in Healthy Women

Researchers are looking for a better way to treat vasomotor symptoms (VMS), also known as hot flashes.
Hot flashes are intense and sudden feelings of heat along with sweating and reddening of the skin. These are common for women going through the menopause but can also occur in men. Such symptoms are called VMS and are caused by changes in sex hormone levels.
The study treatment, elinzanetant, is being tested for the treatment of VMS in both men and women. It works by blocking the activity of a substance called neurokinin, which is thought to play a role in starting hot flashes.
Elinzanetant may cause lasting effects like sleepiness and tiredness. Such effects may make driving unsafe.
The main purpose of this study is to learn how elinzanetant affects the ability to drive the next day in healthy women.
For this, researchers will study participants' ability to keep a stable position within their lane while driving on a straight road on a computer-based driving test (also known as a driving simulator).
In this study, participants will take 2 different doses of elinzanetant, another drug called zopiclone, and matching placebos to these drugs.
Zopiclone helps treat sleeping problems. A placebo looks like a study drug but does not have any medicine in it.
Participants will take elinzanetant, zopiclone, and their matching placebos by mouth.
This study will have 4 treatment periods with each period lasting 6 days. In each period, participants will receive one of the following treatments in an order assigned to them randomly (by chance):
dose A of elinzanetant and a zopiclone placebo
dose B of elinzanetant and a zopiclone placebo
zopiclone 7.5 milligrams (mg) and elinzanetant placebo
elinzanetant placebo and zopiclone placebo
Each participant will be in the study for around 15 weeks with up to 6 visits to the study site.
Participants will visit the study site:
once before the treatment starts, so the study doctors and their team can check on their health and confirm if the participant can join the study
once in each of the 4 treatment periods for a 6-day stay at the study site with a gap of 14 days between each period. During each stay, they will take the assigned treatment from Days 1 to 5 and the driving test on Days 2 and 6
once, 2 to 3 days after their last treatment so the study doctors and their team can check on their health
During the study, the doctors and their study team will:
check participants' health by performing tests such as blood and urine tests, and checking heart health using an electrocardiogram (ECG)
check the participants' ability to drive and their brain function and level of sleepiness using different tests including a driving simulator test
check the level of the study drugs in participants' blood
ask the participants questions about how they are feeling and what adverse events they are having.
An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events, irrespective of whether they think they are related to the study treatment or not.

开始日期2024-01-08

申办/合作机构

Bayer AG

NCT06112756 / Active, not recruiting临床2期

A Randomized, Parallel-group Treatment, Phase 2, Double-blind Pilot Study to Investigate the Efficacy and Safety of Elinzanetant Compared With Placebo for Treatment of Sleep Disturbances Associated With Menopause.

Researchers are looking for a better way to treat women who have sleep disturbances associated with menopause.
Menopause is part of a natural aging process and happens when women's menstrual cycles, also called periods, stop. Sleep disturbances, for example, frequent waking up at night, are a common and bothersome symptom associated with menopause that affects women's quality of life.
The study treatment Elinzanetant (also called BAY 3427080) is under development to treat symptoms like hot flashes which are caused by hormonal changes associated with menopause. It may block the activity of a protein that has been found to contribute to sleep disturbances.
The main purpose of this study is to learn how does elinzanetant affect sleep disturbances associated with menopause as measured on a sleep test called polysomnography (PSG) as compared with placebo.
For this, the researchers will analyze
* change in the total number of minutes a participant wakes up at night after going to sleep after 4 weeks of treatment compared to before treatment
* change in the total number of minutes a participant wakes up at night after going to sleep after 12 weeks of treatment compared to before treatment
* change in the participant's total time asleep while in bed after 4 and 12 weeks of treatment compared to before treatment.
The study participants will be randomly (by chance) assigned to one of two treatment groups. Dependent on the group, they will take elinzanetant or placebo for 12 weeks.
Each participant will be in the study for approximately 22 weeks (plus potential washout period), including a screening phase of up to 6 weeks, 12 weeks of treatment, and a follow up phase of 4 weeks after the end of treatment. 5 visits to the study site are planned.
During the study, the doctors and their study team will:
* take blood and urine samples
* do physical examinations
* check vital signs
* do sleep tests
* use an electronic hand-held device to record sleep quality and hot flashes at home
An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events, irrespective if they think it is related or not to the study treatments.

开始日期2023-11-08

申办/合作机构

Bayer AG

100 项与 Elinzanetant 相关的临床结果

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100 项与 Elinzanetant 相关的转化医学

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100 项与 Elinzanetant 相关的专利（医药）

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项与 Elinzanetant 相关的文献（医药）

2024-09-18·CPT-Pharmacometrics & Systems Pharmacology

Population pharmacokinetic-pharmacodynamic model of elinzanetant based on integrated clinical phase I and II data.

Article

作者: Joseph, Shiju ; Willmann, Stefan ; Frechen, Sebastian ; Schultze-Mosgau, Marcus-Hillert ; Zhang, Yang ; Austin, Rupert ; Lloyd, Adam ; Schneider, Annika R P ; Solms, Alexander

Elinzanetant is a potent and selective dual neurokin-1 (NK-1) and -3 (NK-3) receptor antagonist that is currently developed for the treatment of women with moderate-to-severe vasomotor symptoms (VMS) associated with menopause. Here, we report the development of a population pharmacokinetic (popPK) model for elinzanetant and its principal metabolites based on an integrated dataset from 366 subjects (including 197 women with VMS) collected in 10 phase I or II studies. The pharmacokinetics of elinzanetant and its metabolites could be well described by the popPK model. Within the investigated dose range of 40-160 mg, the oral bioavailability of elinzanetant was dose independent and estimated to be 36.7%. The clearance of elinzanetant was estimated to be 7.26 L/h and the central and peripheral distribution volume were 23.7 and 168 L. No intrinsic or extrinsic influencing factors have been identified in the investigated population other than the effect of a high-fat breakfast on the oral absorption of elinzanetant. The popPK model was then coupled to a pharmacodynamic model to predict occupancies of the NK-1 and NK-3 receptors. After repeated once-daily administration of the anticipated therapeutic dose of 120 mg elinzanetant, the model-predicted median receptor occupancies are >99% for NK-1 and >94.8% for NK-3 during day and night-time, indicating sustained and near-complete inhibition of both target receptors during the dosing interval.

2024-06-01·Menopause (New York, N.Y.)

Design of OASIS 1 and 2: phase 3 clinical trials assessing the efficacy and safety of elinzanetant for the treatment of vasomotor symptoms associated with menopause

Article

作者: Mao, Guangping ; Atanackovic, Gordana ; Mellinger, Uwe ; Morrison, Marina ; Pinkerton, JoAnn V. ; Caetano, Cecilia ; Holz, Cornelia ; Haberland, Claudia ; Schaefers, Matthias ; Parke, Susanne ; Seitz, Christian ; Nisius, Sven ; Haseli Mashhadi, Nazanin ; Panay, Nick ; Simon, James ; Zuurman, Lineke

Abstract:

Objective:

Elinzanetant is a selective neurokinin-1,3 receptor antagonist in development for the treatment of vasomotor symptoms (VMS) associated with menopause. The pivotal, double-blind, randomized, placebo-controlled phase 3 studies Overall Assessment of efficacy and Safety of elinzanetant In patients with vasomotor Symptoms (OASIS) 1 and 2 will assess the efficacy and safety of elinzanetant in women with VMS.

Methods:

The OASIS 1 and 2 pivotal studies are designed in accordance with regulatory guidance. Postmenopausal women with moderate/severe VMS are randomized to receive 120 mg elinzanetant or placebo once daily for 12 weeks, followed by a 14-week active treatment extension. Primary endpoints are the mean change in frequency and severity of moderate/severe VMS from baseline to weeks 4 and 12. Key secondary endpoints will assess the onset of action and effects on sleep disturbance and menopause-related quality of life. Primary and key secondary endpoints will be analyzed using a mixed model with repeated measures. Feedback from postmenopausal women with VMS was used during protocol development.

Results:

Women confirmed the relevance of endpoints that assess the impact of VMS, sleep disturbance, and mood changes, and the need for new nonhormone treatments. Educational materials around study design, conduct and expected assessments and procedures were developed based on questions and concerns raised by women.

Conclusions:

The OASIS 1 and 2 pivotal phase 3 studies will enable assessment of the efficacy and safety of elinzanetant as a treatment for VMS, together with its effect on sleep disturbances, depressive symptoms, and menopause-related quality of life. Feedback from postmenopausal women with VMS was used to maximize patient centricity in the trials.

2024-05-02·EXPERT OPINION ON PHARMACOTHERAPY

Elinzanetant, a new combined neurokinin-1/-3 receptor antagonist for the treatment of postmenopausal vasomotor symptoms

Review

作者: Hager, Marlene ; Ott, Johannes ; Fitz, Victoria ; Goldstein, Tal

INTRODUCTION:

In many postmenopausal women, quality of life is decreased due to vasomotor symptoms. Efficient and well-tolerated non-hormonal treatment options are needed.

AREAS COVERED:

The present review summarizes what is known about the etiology of postmenopausal vasomotor symptoms as a rationale for the mechanism of action of Elinzanetant, a new neurokinin (NK)-1/-3 receptor antagonist, as well as its efficacy and side effect profile.

EXPERT OPINION:

Elinzanetant likely exerts an antagonistic effect on the NK-3 receptor in the preoptic thermoregulatory zone, but also an additional antagonistic effect on the NK-1 receptor possibly leading to a reduction in vasodilatation and heat-sensing neuro-activity. Elinzanetant's reported peak drug concentrations are reached within one hour and the terminal elimination half-life is approximately 15 hours. Two phase IIb clinical trials evaluated the safety profile and efficacy of several doses. There were no serious adverse events, which also included a lack of evidence of drug-related hepatotoxicity. Overall, Elinzanetant seems to be well-tolerated. In the SWITCH-1 study, the 120 mg/day and 160 mg/day regimen showed good efficacy for the treatment of vasomotor symptoms and led to significant improvements in quality of life. Thus, 120 mg oral Elinzanetant/day was used in phase III trials, whose results have not yet been published.

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项与 Elinzanetant 相关的新闻（医药）

2024-10-19

·药渡Daily

【药渡药闻报告-创新药篇】-2024年第40期/总第161期

全球药物批准/研发动态 01 全球新药批准情况根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）全球（不含中国）共有4个新药获批上市。其中，NDA批准2个，BLA批准1个，新适应症批准1个。与上个统计周期相比，本次减少1个批准新药。 10月3日，FDA批准纳武利尤单抗（Opdivo）联合铂类双药化疗作为新辅助治疗，随后在手术后使用纳武利尤单抗单药作为辅助治疗，用于可切除（肿瘤≥4cm和/或淋巴结阳性）非小细胞肺癌（NSCLC）且无已知EGFR突变或ALK重排的成人。纳武利尤单抗组未达到中位无事件生存期，化疗组未达到18.4个月，不良反应与Nivolumab联合化疗的其他临床试验中发生的不良反应相似。推荐的纳武利尤单抗剂量为每3周360毫克（新辅助治疗）和每4周480毫克（辅助治疗）。 10月8日，卫材宣布“URECE片剂”（Dotinurad）已在泰国获得批准，用于治疗痛风和高尿酸血症者。URECE通过选择性抑制与肾脏尿酸重吸收相关的尿酸盐转运蛋白来抑制尿酸重吸收并降低血尿酸水平。已知高尿酸血症与多种疾病有关，包括泌尿系统、内分泌系统、代谢系统和心脑血管系统的疾病，以及痛风，由于生活方式和饮食偏好的变化，患者人数将进一步增加。全球（不含中国）新药批准情况（部分） 02 全球新药申报进展根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）全球（不含中国）共有6个新药申报上市。其中，NDA申报4个，BLA申报1个，细胞疗法1个。与上次统计周期相比，本次减少2个NDA/BLA申报。 10月9日，拜耳宣布FDA已受理Elinzanetant的新药申请，用于治疗与更年期相关的中度至重度血管舒缩症状，其新药申请基于三项III期研究的积极数据OASIS 1、2和3。Elinzanetant是第一个双重神经激肽-1和3受体拮抗剂，处于后期临床开发阶段，每天口服一次。 NDA/BLA申报（部分）根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）全球（不含中国）共有6个药物获监管机构特殊资格认定。其中，化学药4个，生物药2个。与上次统计周期相比，本次增加1个获监管机构特殊资格认定的药物。 10月9日，索元生物宣布DB104（Liafensine）用于难治性抑郁症（TRD）获FDA授予快速通道资格。Liafensine是三重再摄取抑制剂，可同时抑制在抑郁症中起重要作用的5-羟色胺、去甲肾上腺素和多巴胺的再摄取。今年4月，索元生物宣布ENLIGHTEN研究顺利完成并达到了主要终点及所有次要终点。DGM4阳性TRD受试者的蒙哥马利-阿斯伯格抑郁量表评分相比对照组改善了近4.4分，其安全性及耐受性表现特别优异。 10月10日，FDA授予Coherent Biopharma的注射用CBP-1008快速通道资格，用于治疗铂类耐药卵巢透明细胞癌（OCCC）。超过315名恶性实体瘤患者已被纳入CBP-1008试验，CBP-1008耐受性良好，不良事件多为轻度至中度，ORR达到31.3%，mDOR达到7.2个月。此外，CBP-1008在RP3D为0.15 mg/kg的先前1-3L治疗中显示出优异的PROC疗效。在高级别浆液性卵巢癌（HGSOC）目标人群中，ORR和DCR分别达到50.0%和85.7%。特殊资格认定情况（部分） 03 全球新药研发进展根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）全球（不含中国）新药临床研发状态更新共计33条，涉及肿瘤、血液和淋巴疾病、遗传代谢病、神经疾病以及免疫系统疾病等共计10个领域。其中，肿瘤领域临床进展更新居各领域之首，为12条：涉及化学药5条，生物药5条，细胞疗法2条。 10月8日，Boehringer宣布FDA已授予胰高血糖素/GLP-1受体双重激动剂Survodutide突破性疗法认定，用于治疗患有非肝硬化代谢功能障碍相关脂肪性肝炎和中度或晚期纤维化（2期或3期）的成人。Boehringer启动了两项关于Survodutide的III期研究，分别是LIVERAGE治疗MASH和中度或晚期纤维化患者的LIVERAGE-Cirrhosis。 10月9日，多域宣布其FLT3/IRAK4双靶点抑制剂HPB-092的临床研究申请获FDA批准，即将开展用于治疗急性髓性白血病（AML）的I期临床研究。在临床前研究中，其FLT3/IRAK4双靶点抑制剂HPB-092活性指标与安全性显著优于目前已获批的同靶点药物。已有数据证明抑制IRAK4活性可以治疗RNA剪切体突变的AML和骨髓增生异常综合征。全球新药研发进展详情（部分） 04 全球医药交易事件本次统计周期（2024.10.05-10.11）全球（含中国）医药交易时间共计37起，涉及药物权益转让、公司并购等多起交易事件。全球医药交易时间汇总表（部分）国内药物批准/研发动态 01 国内新药批准情况根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）国内共有8个新药获NMPA批准上市。其中，NDA批准1个，BLA批准3个，新适应症批准4个。与上次统计周期相比，本次增加5个NMPA批准新药。 10月8日，NMPA官网显示，丽珠医药注射用醋酸曲普瑞林微球的新适应症上市申请已获得批准。该产品是每月一次肌肉注射的一种促性腺激素释放激素（GnRH）激动剂，本次获批的适应症为治疗子宫内膜异位症。GnRH可显著降低血雌激素水平，强效减轻内异症相关疼痛症状，一定程度缩小内异症病灶。此款曲普瑞林微球具有起效时间长、减少用药次数等特点，可减轻患者痛苦和用药负担，提高用药耐受性和可及性。 10月11日，君实生物宣布昂戈瑞西单抗注射液（重组人源化抗PCSK9单克隆抗体注射液）的上市许可申请获得NMPA批准，用于治疗原发性高胆固醇血症（非家族性）和混合型血脂异常的成人患者。此次获批包括2种规格，分别为150mg（1ml）/支（预充式注射器）、150mg（1ml）/支（预充式自动注射器）。JS002-003研究结果显示，昂戈瑞西单抗150mg Q2W或300mg Q4W皮下注射，可显著降低LDL-C水平达60%以上，且在52周的治疗期间始终维持稳定的降幅。国内新药批准情况（部分） 02 国内新药临床默示许可进展根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）国内共有24个新药获临床默示许可，涉及34个受理号。其中，化学药6个，治疗用生物制品17个，预防用生物制品1个。与上次统计周期相比，本次增加14个临床默示许可获批受理号。本周国内新药临床默示许可进展（部分） 03 国内新药申报进展根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）国内共有9个新药申报上市，涉及17个受理号。其中，化药4个，治疗用生物制品5个。与上个统计周期相比，本次增加9个新药申报上市受理号。国内新药申报上市情况（部分）根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）国内共有23个新药申报临床，涉及31个受理号。其中，化学药13个，治疗用生物制品8个，预防用生物制品2个。与上次统计周期相比，本次增加6个临床申报受理号。国内新药临床申报情况（部分）根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）国内共有1个药物获NMPA特殊资格认定。其中，化学药1个。与上次统计周期相比，本次减少1个获监管机构特殊资格认定的药物。 10月13日，恒瑞医药收到国家药品监督管理局下发的《受理通知书》，公司1类创新药、EZH2抑制剂SHR2554片的药品上市许可申请获国家药监局受理，且被纳入拟优先审评品种公示，拟定适应症为：用于既往接受过至少1线系统性治疗的复发或难治外周T细胞淋巴瘤（PTCL）。SHR2554-I-101研究前期数据显示：每天2次350mg给药SHR2554安全性良好，对包括复发或难治PTCL和滤泡性淋巴瘤（FL）在内的多种淋巴瘤中显示出良好的抗肿瘤活性；II期推荐剂量下，61%的复发或难治PTCL获得缓解，预估中位PFS为11.1个月。国内监管机构特殊资格认定药物 04 国内新药研发进展根据药渡数据统计分析，本次统计周期（2024.10.05-10.11）国内新药临床研发状态更新共计6条，涉及肿瘤、遗传和代谢疾病以及皮肤病共计3个领域。其中，化学药4条，生物药2条。与上次统计周期相比，本次增加1条国内新药临床研发状态更新。 10月9日，诺诚健华宣布其新型酪氨酸激酶2（Tyrosine Kinase 2, TYK2）抑制剂ICP-488治疗中重度斑块状银屑病II期临床研究达到主要终点。在接受治疗12周的患者中，ICP-488展示了卓越的有效性和安全性，在每日一次6毫克和9毫克两个剂量组中，PASI 75的应答率分别达到77.3%和78.6%，PASI 90的应答率分别达到36.4%和50.0%，PASI 100的应答率分别达到11.4%和11.9%，sPGA 0/1的应答率分别达到70.5%和71.4%。 10月10日，中国药物临床试验登记与信息公示平台官网近日公示，辉瑞已经启动了一项国际多中心（含中国）III期临床研究，该研究旨在评价PF-06821497联合恩扎卢胺对比恩扎卢胺或多西他赛对既往接受过醋酸阿比特龙治疗的转移性去势抵抗性前列腺癌患者的疗效和安全性。研究表明，EZH2的过表达可通过多种作用机制来促进癌症的发生和进展，包括沉默肿瘤抑制基因的表达、促进参与细胞增殖和存活的基因表达等。国内新药研发进展（部分） 05 国内新药研发领域政策法规动态国家药监局药审中心关于发布《抗肿瘤药物临床试验中SUSAR分析与处理技术指导原则》的通告（2024年第42号）为加强临床试验可疑且非预期严重不良反应（SUSAR）信息的风险评估，提升SUSAR信息的发现、识别和风险处理，药审中心组织制定了《抗肿瘤药物临床试验中SUSAR分析与处理技术指导原则》（见附件）。根据《国家药监局综合司关于印发药品技术指导原则发布程序的通知》（药监综药管〔2020〕9号）要求，经国家药品监督管理局审查同意，现予发布，自发布之日起施行。特此通告。 06 国内新药研发领域热点新闻站在十字路口上的“ADC一哥“ 如果要问中国创新药最拿得出手的是什么，ADC药物绝对拥有一战之力。2022年科伦博泰与默沙东的百亿美元合作，以及2023年百利天恒与BMS的84亿美元交易打破了中国创新药单个项目出海记录，让外界意识到中国已经成为全球ADC药物研发的中心。然而，在国产ADC大放异彩的同时，曾经的国产“ADC一哥”荣昌生物正在面临“生死抉择”，核心产品商业化加速的同时，机会与挑战共存。更多资讯，请阅读原文罗氏，挺进CVRM领域近期，罗氏在2024年医药日活动中阐述了最新药物研发进展以及未来研发的战略方向。值得注意的是，除了肿瘤、自身免疫、神经系统、眼科等传统优势业务，心血管、肾脏及代谢领域（CVRM）成为罗氏新押注的疾病领域，罗氏认为，在下一个增长周期中，CVRM将成为业绩增长的重要引擎。更多资讯，请阅读原文咨询、合作请联系作者小D有话说为方便读者阅读及保存，我们将周报原文整理成了PDF版本，如需获取全文，可点击最上方蓝字，在药渡Daily公众号后台回复“1018创新药周报”，即可下载。

上市批准申请上市临床3期临床结果

2024-10-18

·药智网

更年期新疗法的「双雄大战」

根据联合国世界卫生组织估计，到2030年，全球更年期女性人口预计将增加到12亿，我国的更年期女性超过2.1亿。高达80%的更年期女性会经历VMS（Vasomotor symptoms，潮热），在末次月经后平均持续7至10年，其中三分之一的女性报告会出现非常频繁或严重的症状。 HRT（hormone replacement therapy，激素替代疗法）是目前批准用于治疗VMS的标准疗法。但是，有许多女性由于医疗禁忌症（如激素相关癌症）或疗法风险，不适合或拒绝接受激素治疗。新的创新疗法亟待出世。 01 激素敏感患者的标准疗法缺位 VMS症状会对睡眠、情绪、认知功能、社交互动、人际关系和工作表现产生极大的负面影响，导致疲劳、焦虑、抑郁等。从全球市场来看，根据Gandview的报告，2022年全球更年期市场规模为169亿美元，预计2023年至2030年的复合年增长率(CAGR)将达到5.33%，总额突破250亿美元。从国内市场来看，2020年我国更年期用药行业市场规模为107.7亿元，同比增长10.8%。2021年市场规模达到119.27亿元，同比增长12.5%。经机构预测，至2030年，市场规模预计突破300亿元。随着人口老龄化加剧，更年期药物市场规模将持续上涨。目前VMS治疗药物按时间线与作用机制主要可以分为3种，HRT药物、HRT替代药物、神经激肽受体拮抗剂。表1 VMS治疗药物分类数据来源：公开资料整理截至目前，HRT仍然是治疗VMS的金标准，但是HRT并非适合所有人。有些人可能有对HRT成分的过敏反应，或者存在患乳腺癌、子宫内膜癌、血栓形成等重大健康风险的情况下，不适合接受HRT。此外，HRT也存在一些风险，如卒中和血栓形成的风险增加。文献显示，HRT不适用于激素敏感的癌症，雌激素在理论上对表达雌激素受体(ER)和/或使用抗雌激素治疗的肿瘤构成危险。并且，一项研究显示更年期症状和疼痛会降低乳腺癌辅助内分泌治疗的依从性，从而导致多达50%的妇女死亡率可能上升20%。虽然出现一些替代HRT治疗的办法，包括SSRIS、加巴喷丁/普瑞巴林等。但由于药物设计之初并非用于VMS，这些通过拓展适应症而来的药物疗法通常不如HRT有效，而且往往受到副作用的限制。因此，目前还没有治疗激素敏感患者（如乳腺癌患者）的VMS标准疗法。 02 新疗法的「双雄大战」众所周知，哺乳动物的生殖功能主要受到下丘脑-垂体-性腺轴（HPG）的调控，性腺接收到来自上游的信号刺激后分泌相应性激素，且可以通过正负反馈对下丘脑与垂体进行调控。与HRT疗法的“缺啥补啥”不同，神经激肽受体拮抗剂着眼于从生殖控制途径的上游来治疗VMS。根据遗传证据表明，kisspeptin以及NKB（neurokininB，神经激肽B）及其受体NK3R对人类青春期和成年两性的生殖功能起着重要作用。这两种神经肽被证明在一组下丘脑神经元中部分共定位，且与Dy(opioid neuropeptide dynorphin，阿片类神经肽强啡肽)共定位，因此，这些神经元被称为“KNDy”神经元。大量研究探索它们在控制促性腺激素释放激素(GnRH)中的作用，因此成为哺乳动物生殖的主要调节器。研究发现NKB在绝经后女性的下丘脑中过度表达，且介导与更年期雌激素缺乏相关的VMS。因此，NKB/NK3成了治疗VMS的潜力靶点。图1 NKB/NK3的作用机制图片来源：参考来源4 截至目前，商业化进度最快的是安斯泰来的Fezolinetant（非唑奈坦）与拜耳的Elinzanetant（依林奈坦）。安斯泰来的Fezolinetant是全球首款非激素类NK3R拮抗剂，分别在2023年5月和12月在美国和欧洲获批，商品名为Veozah®和Veoza®。此外，其在中国进行的III期MOONLIGHT3研究也取得了积极的关键结果。据Evaluate Pharma公司预测，到2028年，Fezolinetant的销售额将达到19亿美元，将成为安斯泰来的又一重磅炸弹药物。至此，安斯泰来开启了VMS治疗的新时代。 Elinzanetant紧跟其后，2024年10月9日，拜耳宣布美国食品药品监督管理局（FDA）接受了Elinzanetant的新药申请。随后在2024年10月15日，拜耳已向欧洲药品管理局（EMA）提交了Elinzanetant的上市许可申请（MAA）。 Elinzanetant是首个双重神经激肽-1和3（NK-1和3）受体拮抗剂，与其他类似药物在发展中的不同之处在于它同时靶向NK1和NK3受体。目前，有证据支持NK3R和NK1R共同参与热调节的中枢调控。从三期临床结果做个简单对比，首先，无论是Fezolinetant还是Elinzanetant相较于安慰剂，都能显著降低VMS的发作频率。表2 Fezolinetant与Elinzanetant药效对比数据来源：参考来源4、6 但从降低数值上来看，似乎Elinzanetant略有提升，原因可能在于其同时靶向NK1和NK3受体，从而提升了其药效。因此，相信Elinzanetant上市之后将为拜耳带来惊喜，并对Fezolinetant造成冲击。对Fezolinetant而言，如何利用自己“first in class”的先发优势，快速“跑马圈地”才是正途。目前Fezolinetant已经涵盖了血管疾病、潮热、平滑肌瘤、多囊卵巢综合征、肾脏疾病等多种适应症。在VMS的开发方面，目前除了在美国、欧洲获得批准外，Fezolinetant还已经进入英国、加拿大和西班牙、中国的临床3期试验阶段。此外，2024年10月10日，安斯泰来宣布月底将在世界更年期大会期间对Fezolinetant进行四次口头报告和两次海报展示。竞速赛的枪声已经打响。除了进展最快的Fezolinetant、Elinzanetant外，数据统计，目前全球共有25款靶向NK3的药物，但大多数研究已终止或无进展，剩下处于正常开发状态的包括Sojournix的SJX-653、赛诺菲的奥沙奈坦、Biorbyt的SCH-206272，但进度缓慢。短期内，神经激肽受体拮抗剂这一创新疗法市场都将是Fezolinetant、Elinzanetant的双人舞台，之后谁将拿下“神经激肽受体拮抗剂药王”之称，我们拭目以待。参考来源： 1、Efficacy and safety of elinzanetant,a selective neurokinin-1,3 receptor antagonist for vasomotor symptoms:a dose-finding clinical trial(SWITCH-1).DOI:10.1097/GME.0000000000002138 2、Non-hormonal pharmacological interventions for managing vasomotor symptoms-how can we help:2024 landscape.https://doi-org.libproxy1.nus.edu.sg/10.1016/j.ejogrb.2024.09.013 3、《中国更年期用药行业市场前瞻与投资战略规划分析报告》，智研瞻产业研究院 4、Elinzanetant:a phase III therapy for postmenopausal patients with vasomotor symptoms.https://doi-org.libproxy1.nus.edu.sg/10.1080/13543784.2024.2305122 5、Efficacy and Safety of Fezolinetant in Moderate to Severe Vasomotor Symptoms Associated With Menopause:A Phase 3 RCT.https://doi-org.libproxy1.nus.edu.sg/10.1210/clinem/dgad058 6、Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause OASIS 1 and 2 Randomized Clinical Trials.AMA.Published online August 22,2024.doi:10.1001/jama.2024.14618 声明：本内容仅用作医药行业信息传播，为作者独立观点，不代表药智网立场。如需转载，请务必注明文章作者和来源。对本文有异议或投诉，请联系maxuelian@yaozh.com。责任编辑 | 史蒂文转载开白 | 马老师 18996384680（同微信）商务合作 | 王存星 19922864877（同微信）阅读原文，是受欢迎的文章哦

临床结果临床研究

2024-10-16

·Pharmaceutical Technology

Synedgen partners with BARDA for MIIST305 development

GI-ARS is a significant radiation toxicity that can result in sepsis and lead to death. Credit: Jo Panuwat D/Shutterstock. Synedgen has announced a partnership with the Biomedical Advanced Research and Development Authority (BARDA) to develop its lead therapeutic, MIIST305, targeting gastrointestinal acute radiation syndrome (GI-ARS). GI-ARS is a significant radiation toxicity that can result in sepsis and lead to death, especially when patients are exposed to high levels of radiation from accidental or malicious sources. The deal, valued at up to $119m over six years, aims to fill a crucial gap in medical countermeasures for radiation exposure. Synedgen’s collaboration with BARDA begins with $17m dedicated to proof-of-concept studies in two animal models. The successful completion of these studies could lead to further development of MIIST305 through US Food and Drug Administration (FDA) approval. See Also: Bayer applies for EU approval of menopause drug elinzanetant ENHERTU gains conditional approval in China to treat NSCLC This partnership not only furthers the drug’s development but also contributes to the optimisation of a new nonclinical model for GI-ARS that could gain FDA acceptance. Synedgen president and CEO Shenda Baker stated: “We are delighted to be partnering with BARDA to develop MIIST305 as a therapeutic to address GIARS. “No currently available FDA-approved therapeutic exists to protect major gastrointestinal organs against acute exposure to ionising radiation. Importantly, this programme leverages Synedgen’s MIIST305 programme to address gastrointestinal inflammation and damage from radiation, chemical or physiological sources, thus potentially meeting this unmet need.” Currently, there are four FDA-approved products to treat haematopoietic acute radiation syndrome (H-ARS), but no approved treatments for GI-ARS. The partnership between Synedgen and BARDA addresses this gap, enhancing national defence readiness against radiation-related injuries. Synedgen’s drug design platform, known as multivalent innate immune signalling target (MIIST), has been instrumental in the development of MIIST305. This non-systemic therapeutic works by modulating immune responses and targeting the gastrointestinal cell surface to repair and restore the gut mucosal barrier, mitigating the effects of radiation exposure. Synedgen has also established a Phase I-ready programme for MIIST305 for ulcerative colitis treatment.

放射疗法临床1期临床申请

100 项与 Elinzanetant 相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
-	Elinzanetant	-	-

研发状态

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适应症	最高研发状态	国家/地区	公司	日期
潮热	申请上市	美国	Bayer AG	2024-08-02
HR阳性乳腺癌	临床3期	奥地利	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	比利时	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	加拿大	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	芬兰	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	法国	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	德国	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	匈牙利	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	爱尔兰	Bayer AG	2022-10-14
HR阳性乳腺癌	临床3期	以色列	Bayer AG	2022-10-14

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临床结果

适应症

分期

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT05030584 (OASIS 3, NEWS) 人工标引	临床3期	血管舒缩症 \| 潮热	-	Elinzanetant	製積築鹽積醖艱淵壓網(憲夢齋餘壓憲願築夢鹽) = 鹹齋窪獵鑰膚醖鏇願淵鏇鹹膚廠憲遞膚蓋鬱醖 (遞糧選壓齋艱蓋繭築鏇 ) 达到	积极	2024-09-10
				Placebo	製積築鹽積醖艱淵壓網(憲夢齋餘壓憲願築夢鹽) = 醖築窪遞鏇顧醖醖鏇憲鏇鹹膚廠憲遞膚蓋鬱醖 (遞糧選壓齋艱蓋繭築鏇 ) 达到
NCT05042362 (OASIS-1, Biospace) 人工标引	临床3期	潮热	396	Elinzanetant	積鬱衊蓋遞選鹽窪憲獵(鹽願範糧淵憲襯繭齋範) = The safety profile of elinzanetant was favorable in both studies with headache and fatigue being the most frequent treatment emergent adverse events (TEAEs) within the elinzanetant groups. 範顧衊艱夢網鹹壓觸艱 (餘選壓淵鹹製構選觸觸 )	积极	2024-05-16
NCT05099159 (OASIS-2, Biospace) 人工标引	临床3期	潮热	400	Elinzanetant	簾繭鬱獵觸簾範願廠鬱(繭願鏇夢鏇鏇蓋餘齋憲) = The safety profile of elinzanetant was favorable in both studies with headache and fatigue being the most frequent treatment emergent adverse events (TEAEs) within the elinzanetant groups. 網網鑰願鹹夢糧構積艱 (顧廠夢糧餘構鏇網廠選 )	积极	2024-05-16
NCT05099159 \| NCT05042362 (OASIS 2, PipelineReview) 人工标引	临床3期	血管舒缩症	400	elinzanetant	繭艱齋醖淵淵壓顧築壓(壓鑰鏇窪淵夢廠獵衊網) = demonstrating statistically significant reductions 顧齋窪簾簾範範齋衊憲 (齋鏇網鬱範餘構繭築襯 ) 达到更多	积极	2024-01-08
				Placebo
NCT03596762 (SWITCH-1, CTgov)	临床2期	血管舒缩症 \| 潮热 \| 睡眠异常	199	Placebo (Placebo)	鹽窪衊獵繭憲餘鏇築淵(膚夢顧衊繭膚顧憲餘遞) = 鹽鬱簾夢積鹹醖襯顧鑰範願遞觸構鑰艱齋製網 (鹽築憲選網廠艱餘獵窪, 遞願壓觸壓遞糧淵鹽憲 ~ 願遞築鬱鏇獵鑰構醖觸) 更多	-	2023-03-10
				Elinzanetant (BAY3427080) (40 mg Elinzanetant (BAY3427080))	鹽窪衊獵繭憲餘鏇築淵(膚夢顧衊繭膚顧憲餘遞) = 憲繭鑰鹹積襯憲觸憲網範願遞觸構鑰艱齋製網 (鹽築憲選網廠艱餘獵窪, 淵齋繭顧膚膚選衊壓積 ~ 觸夢鏇構淵鹹窪顧淵築) 更多
Pubmed \| J Clin Endocrinol Metab	N/A	-	-	Elinzanetant 120 mg	餘廠夢構艱選構構觸範(顧鏇獵網製繭簾選鏇蓋) = 選鹽簾獵鏇鹽憲壓鏇網醖網窪鬱鹽鹽製艱觸窪 (憲襯顧鑰範齋窪觸遞願 ) 更多	-	2021-02-24
NCT02865538 (RELENT-1, CTgov)	临床1/2期	血管舒缩症	76	placebo+BAY3427080 (Placebo)	廠鏇繭獵鬱膚構鏇醖衊(簾糧憲簾繭廠鑰積壓糧) = 廠願鏇鬱繭膚鑰淵選憲餘夢願膚積壓壓鏇糧夢 (糧鑰鹹網壓網製齋獵壓, 遞顧憲獵願鏇餘衊選網 ~ 夢糧糧鏇壓選鹹構選願) 更多	-	2021-02-16
				BAY3427080 (50 mg BAY3427080)	憲蓋壓顧築艱製遞醖鏇(構獵齋顧鹽觸襯願夢艱) = 獵壓鬱網壓齋壓鹽遞觸鹽繭簾選鬱糧齋願顧鬱 (鹽壓網壓襯鹹顧選願願, 窪構製範糧膚鏇壓鬱憲 ~ 獵顧艱鹽糧夢簾獵鹹網) 更多