期刊
NEUROLOGY
卷 80, 期 10, 页码 933-940出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3182840c4f
关键词
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资金
- National Institute of Neurological Disorders and Stroke Intramural Research Program
- Austrian Science Fund FWF (Erwin Schroedinger Fellowship) [J2783-B09]
- International Essential Tremor Foundation
- National Institute of Neurological Disorders and Stroke/NIH
- Neurotoxin Institute
- Ariston Pharmaceuticals
- NIH/National Institute of Neurological Disorders and Stroke
- US Department of Defense (Army)
- NIH (from Brainsway)
- NIH Intramural Program
- US Army via the Henry Jackson Foundation
- Ariston Pharmaceutical Company via a Cooperative Research and Development Agreement (CRADA) with the NIH
- Kinetics Foundation via a Clinical Trials Agreement with the NIH
Objective: To assess safety and efficacy of an oral, single, low dose of octanoic acid (OA) in subjects with alcohol-responsive essential tremor (ET). Methods: We conducted a double-blind, placebo-controlled, crossover, phase I/II clinical trial evaluating the effect of 4 mg/kg OA in 19 subjects with ET. The primary outcome was accelerometric postural tremor power of the dominant hand 80 minutes after administration. Secondary outcomes included digital spiral analysis, pharmacokinetic sampling, as well as safety measures. Results: OA was safe and well tolerated. Nonserious adverse events were mild (Common Terminology Criteria for Adverse Events grade 1) and equally present after OA and placebo. At the primary outcome, OA effects were not different from placebo. Secondary outcome analyses of digital spiral analysis, comparison across the entire time course in weighted and nonweighted accelerometry, as well as nondominant hand tremor power did not show a benefit of OA over placebo. The analysis of individual time points showed that OA improved tremor at 300 minutes (dominant hand, F-1,F-16 = 5.49, p = 0.032 vs placebo), with a maximum benefit at 180 minutes after OA (both hands, F-1,F-16 = 6.1, p = 0.025). Conclusions: Although the effects of OA and placebo at the primary outcome were not different, secondary outcome measures suggest superiority of OA in reducing tremor at later time points, warranting further trials at higher dose levels. Classification of evidence: This study provides Class I evidence that a single 4-mg/kg dose of OA is not effective in reducing postural tremor in patients with ET at a primary outcome of 80 minutes, but is effective for a secondary outcome after 180 minutes. Neurology (R) 2013;80:933-940
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