Fibromyalgia Drug Meets Goal in Late-Stage Trial
A recent late-stage phase 3 trial of milnacipran, a dual-reuptake inhibitor
that preferentially blocks the reuptake of norepinephrine with higher
potency than serotonin and is currently under review by the FDA as a
treatment for fibromyalgia, showed positive results and confirmed findings
from 2 previous phase 3 trials that show the drug improved pain
symptoms in patients.
The results from the 1025-patient, multicenter, double-blind, placebo-controlled
trial showed that milnacipran demonstrated a highly statistically
significant difference to placebo in responder analyses based on a
concurrent and clinically meaningful improvement in pain, patient global
impression of change, and physical functioning.
Patients were enrolled at 75 centers across North America and were
randomized to receive a daily dose of 100 mg of milnacipran (n = 516)
or placebo (n = 509)?patients followed a 4- to 6-week dose-escalation
phase, a 12-week stable-dose treatment phase, and a 2-week discontinuation
phase. Preliminary results showed that a greater proportion of
patients treated with milnacipran (100 mg/day) experienced at least a
30% reduction in pain from baseline and also rated themselves as "very
much improved" or "much improved" based on the patient global assessment
(P <.001).
HIV/AIDS Drug Shows Increased Efficacy
The efficacy rate for a novel HIV/AIDS treatment
has recently shown improvement.
Patients taking maraviroc (Selzentry), in
combination with zidovudine/lamivudine
(Combivir) and selected by an enhanced
sensitivity tropism test to screen patients,
experienced a 68% rate of virologic suppression
to undetectable levels. These results
were found through a reanalysis of MERIT
ES (reanalysis of the MERIT [Maraviroc versus
Efavirenz Regimens as Initial Therapy]
Study with the Enhanced Trofile Assay)
and were presented at the 48th Annual
Interscience Conference on Antimicrobial
Agents and Chemotherapy/46th Annual
Meeting of the Infectious Diseases Society
of America in Washington, DC. In the MERIT
ES reanalysis, 68% of patients in the maraviroc
arm achieved suppression of the virus
to undetectable levels (<50 copies/mL).
Increased Immunity Shown with Probiotic
A recent study tested the efficacy of the probiotic
GanedenBC (Sustenex) in boosting the immune system
when exposed to adenovirus and influenza. The results
showed that the use of GanedenBC significantly increased
T-cell production of TNF-α in response to adenovirus exposure
(P = .027) and influenza A (H3N2 Texas strain) exposure
(P = .004), but it did not have a significant effect on the
response to other strains of influenza. The controlled study,
conducted by Mira Baron, MD, of Rapid Medical Research,
Inc, included 9 participants between the ages of 18 and 75
who completed the trial. Subjects were given capsules
containing 2 billion CFU of GanedenBC. Blood was drawn at baseline
and after 30 days to measure immune response. A 250%
increase was seen in the TNF-α response to adenovirus, and
a 1709% increase was observed in the TNF-α response to
influenza A (H3N2 Texas strain) after 30 days of treatment.
Rasagiline Slows Progression of Parkinson's Disease
The results of the phase 3 ADAGIO trial
were recently presented at the 12th
Congress of European Federation of
Neurological Societies in Madrid, Spain.
The study demonstrated that patients
with Parkinson's disease who began taking
rasagiline (Azilect) 1-mg tablets once
daily at the start of the trial showed
significant improvement, compared with
those who began the drug 9 months
later. The 1-mg dose met all 3 primary
end points and the secondary end point
with statistical significance.
The 3 hierarchical end points of the primary
analysis were based on total Unified
Parkinson's Disease Rating Scale scores:
(1) superiority of slopes in weeks 12 to 36;
(2) change from baseline to week 72; and
(3) noninferiority of slopes in weeks 48 to
72. The ADAGIO study?a randomized,
multicenter, double-blind, placebo-controlled,
parallel-group study?examined
rasagiline's potential disease-modifying
effects on 1176 patients with very early
Parkinson?s disease in 14 countries and
129 medical centers who were randomized
to receive rasagiline 1 or 2 mg/day
for 72 weeks or placebo for 36 weeks
followed by rasagiline 1 or 2 mg/day for
36 weeks.