Long-term tolerability and maintenance of therapeutic response to sodium oxybate in an open-label extension study in patients with fibromyalgia
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- 作者：Michael Spaeth (1) (6)
Cayetano Alegre (2)
Serge Perrot (3)
Youyu Grace Wang (4)
Diane R Guinta (4)
Sarah Alvarez-Horine (4)
Irwin Jon Russell (5) - 刊名：Arthritis Research & Therapy
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：15
- 期：6
- 全文大小：
- 作者单位：Michael Spaeth (1) (6)
Cayetano Alegre (2)
Serge Perrot (3)
Youyu Grace Wang (4)
Diane R Guinta (4)
Sarah Alvarez-Horine (4)
Irwin Jon Russell (5)
1. Rheumatologische Schwerpunktpraxis, Bahnhofstrasse 95, 82166, Graefelfing, Munich, Germany
6. Leitender Arzt Rheumatologie, Spital Linth, 8730, Uznach, Switzerland
2. Institut Universitari Dexeus, Carrer Sabino de Arana 5, 08028, Barcelona, Spain
3. Service de Mecine Interne et Consultation de la Douleur, Hpital Dieu, UniversitParis, Descartes, INSERM U 987, 1 Place du Parvis Notre Dame, 75004, Paris, France
4. Jazz Pharmaceuticals, Inc, 3180 Porter Drive, Palo Alto, CA, 94304, USA
5. Department of Medicine, University of Texas Health Science Center at San Antonio, 7434 Floyd Curl Drive, San Antonio, TX, 78229, USA - ISSN：1478-6354
文摘
Introduction The long-term safety and therapeutic response of sodium oxybate (SXB) in fibromyalgia syndrome (FM) patients were assessed for a combined period of up to 1 year in a prospective, multicenter, open-label, extension study in patients completing 1 of 2 phase 3 randomized, double-blind, controlled, 14-week trials that examined the efficacy and safety of SXB 4.5 g, SXB 6 g, and placebo for treatment of FM. Methods This extension study comprised an additional 38 weeks of treatment and was carried out at 130 clinical sites in 7 countries. Initial entry criteria for the previous 2 double-blind clinical trials required that patients aged 18 years met the American College of Rheumatology 1990 criteria for FM, had a body mass index (BMI) < 40 kg/m2, and had a score 50 on a 100-mm pain visual analog scale (VAS) at baseline. All patients began treatment in the extension study with SXB 4.5 g/night (administered in 2 equally divided doses) for at least 1 week, followed by possible serial 1.5 g/night dose increases to 9 g/night (maximum) or reductions to 4.5 g/night (minimum). Results Of the 560 FM patients enrolled in this extension study, 319 (57.0%) completed the study. The main reason for early discontinuation was adverse events (AEs; 23.0% of patients). Patients were primarily middle-aged (mean 46.910.8 years), female (91.1%), white (91.4%), with a mean duration of FM symptoms of 9.98.7 years. Serious AEs were experienced by 3.6% of patients. The most frequently reported AEs (incidence 5% at any dose or overall) were nausea, headache, dizziness, nasopharyngitis, vomiting, sinusitis, diarrhea, anxiety, insomnia, influenza, somnolence, upper respiratory tract infection, muscle spasms, urinary tract infection, and gastroenteritis viral. Maintenance of SXB therapeutic response was demonstrated with continued improvement from controlled-study baseline in pain VAS, Fibromyalgia Impact Questionnaire (FIQ) total scores, and other measures. Responder analyses showed that 68.8% of patients achieved 30% reduction in pain VAS and 69.7% achieved 30% reduction in FIQ total score at study endpoint. Conclusions The long-term safety profile of SXB in FM patients was similar to that in the previously reported controlled clinical trials. Improvement in pain and other FM clinical domains was maintained during long-term use. Trial registration ClinicalTrials.gov NCT00423605.