A Randomized Trial Assessing the Safety, Pharmacokinetics, and Efficacy During Morning Off of AZ-009.

BACKGROUND: Inhalation of apomorphine could be a faster-acting and more user-friendly alternative to subcutaneous injection for treating off periods in Parkinson's disease (PD). OBJECTIVE: The aim of this study was to compare the safety and pharmacokinetics of inhaled apomorphine (AZ-009) with subcutaneous apomorphine (APO-go PEN) in healthy volunteers (HVs) and to examine the safety, pharmacokinetics, and efficacy of AZ-009 in patients with PD. METHODS: In part A of this study, eight HVs received 1 mg AZ-009 and 2 mg subcutaneous apomorphine in a randomized crossover manner. In the subsequent single ascending dose parts in HVs (part B, n = 16) and patients with PD (part C, n = 25), participants were randomized to placebo or AZ-009 up to 4 mg. In patients, after medication withdrawal, Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III and on/off states were assessed predose and postdose. RESULTS: AZ-009 was rapidly absorbed with peak plasma concentrations at 2 minutes, as compared to 30 minutes for subcutaneous apomorphine. Adverse events for AZ-009 were comparable to subcutaneous apomorphine, except for mild and transient throat irritation. Adverse events limited AZ-009 dose escalation in HVs to 3 mg. Patients tolerated up to 4 mg. In patients with PD, 2, 3, and 4 mg AZ-009 reduced mean Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III score (standard deviation) by 10.7 (13.6), 12.8 (7.9), and 10.3 (3.7) points, respectively, compared to 4.8 (4.9) after placebo at 10 minutes postdose. The percentage of patients achieving full on within 45 minutes postdose increased dose dependently: 0% (placebo), 17% (2 mg), 50% (3 mg), and 83% (4 mg). CONCLUSIONS: AZ-009 appears to be a rapid-acting and reasonably well-tolerated formulation for treating off periods. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Multivariate analysis of infrared spectra for monitoring and understanding the kinetics and mechanisms of adsorption processes.

Water adsorption onto thin zeolite 3A wafers has been investigated as a function of time, water vapor concentration, and zeolite sample mass using mid-infrared spectroscopy coupled with multivariate data analysis. Principal component analysis (PCA) of the spectral region of the water combination band was used for quantitative characterization of water adsorption onto the zeolite. The kinetics of the adsorption of water are found to be very reproducible and nearly linear with time. The kinetics of water adsorption based on data from different masses of zeolite are consistent with a diffusion/immobilization model for which the interparticle diffusion rate is comparable to the rate of adsorption. The infrared zeolite bands (1340-1550 cm(-1)) change during the adsorption process and yield more detail about the adsorption sites of the material. PCA applied to the zeolite bands was not directly interpretable. However, multivariate curve resolution applied to the spectral region containing the zeolite bands readily demonstrates that zeolite 3A has three water adsorption sites or environments that are sequentially occupied. Potential explanations for the observations of the multivariate curve resolution (MCR) analysis of these infrared (IR) kinetic adsorption experiments are presented. The explanation most consistent with our data suggests that water adsorbs sequentially on the zeolite to form single, double, and triple water adsorption on single zeolite adsorption sites. The combination of infrared spectroscopy and multivariate analysis is therefore demonstrated to be a powerful method to study detailed adsorption kinetics and mechanisms of the adsorption of molecules onto surfaces.