Effects of cilomilast, a selective phosphodiesterase 4 inhibitor, on esophageal motility and ph, and orocecal and colonic transit: Two single-center, randomized, double-blind, placebo-controlled, two-part crossover studies in healthy volunteers
Phase IIb studies have reported that cilomilast, a selective phosphodiesterase 4 inhibitor being developed for the treatment of chronic obstructive pulmonary disease, is associated with gastrointestinal (GI) adverse effects (AEs) in a small proportion (≈5%) of individuals. The aims of these 2 studie...
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Veröffentlicht in: | Clinical therapeutics 2006-04, Vol.28 (4), p.569-581 |
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Zusammenfassung: | Phase IIb studies have reported that cilomilast, a selective phosphodiesterase 4 inhibitor being developed for the treatment of chronic obstructive pulmonary disease, is associated with gastrointestinal (GI) adverse effects (AEs) in a small proportion (≈5%) of individuals.
The aims of these 2 studies were to investigate the effects of cilomilast 15 mg BID on: (1) lower esophageal sphincter pressure (LESP) and esophageal body motility and pH (study 1); and (2) orocecal and whole-gut transit times (OCTT and WGTT, respectively) (study 2) in healthy volunteers.
These 2 randomized, double-blind, placebo-controlled, 2-part crossover studies were conducted at the Neurogastroenterology Unit, Wythenshawe Hospital, Manchester, United Kingdom (study 1) and GlaxoSmithKline, Harlow, United Kingdom (study 2). In study 1, subjects were randomly assigned to receive either cilomilast (15 mg BID) or matched placebo (control) for 7 days (13 doses; subjects were not given the evening dose on day 7), and in study 2, cilomilast (15 mg BID) or matched placebo (control) for 9 days (18 doses) in each of 2 treatment periods. After study drug administration, combined esophageal motility and pH were recorded for 2 hours before and 4 hours after the administration of a standardized meal (2400 kJ [573 kcal]). Sequences of 6 consecutive 5-mL water swallows (separated by 20 seconds) were carried out 60 and 90 minutes (fasting) and 150, 180, 210, 240, 300, and 360 minutes (fed) after study drug administration. OCTT was determined from the increase in breath hydrogen after the meal. WGTT was determined from the time taken to excrete at least 16 of 20 ingested radiopaque markers, ingested as 2 capsules, each containing 10 radiopaque markers, with 240 mL of water. AEs were elicited at specified times throughout each session using nonleading questions, spontaneously reported AEs, and diary cards.
Study 1 enrolled 20 subjects (11 men, 9 women; age range, 20–52 years). Study 2 enrolled 16 subjects (10 men, 6 women; age range, 19–48 years). No clinically significant differences in the amplitude (mean difference in postprandial-preprandial AUC
0-t/t, 6.09 mm Hg; 95% CI, −10.66 to 22.84), duration (difference, −0.08 second; 95% CI, −0.54 to 0.37), or velocity of propagation (difference, 0.90 cm/s; 95% CI, −0.66 to 2.46) of esophageal contractions, LESP (difference, −0.39 mm Hg; 95% CI, −5.23 to 4.45), or preprandial or postprandial percentage time pH |
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ISSN: | 0149-2918 1879-114X |
DOI: | 10.1016/j.clinthera.2006.04.003 |