Masupiridine lowers aggression among elderly patients with Alzheimer's disease

Hyderabad, Telangana: A new study published in the International Journal of Geriatric Psychiatry shows that masupiridine, a selective 5-HT6 receptor antagonist, reduces agitation/aggression and psychotic episodes in individuals with intermediate Alzheimer's disease (AD).

Both neuropsychiatric symptoms and cognitive decline are common in AD patients, but the neuropsychiatric symptoms are more difficult for family members and caregivers and have a large cost impact. In order to investigate the effects of masupirdine on neuropsychiatric symptoms, Ramakrishna Nirogi and his colleagues undertook this investigation.

In individuals with moderate AD, the effects of masupirdine (SUVN-502) on cognition were examined. The predetermined primary endpoint did not distinguish between the medication and placebo. The 12-item neuropsychiatric inventory scale's post hoc domain analyses were done.

The key highlights of this study were:

1. A statistically significant reduction in agitation/aggression scores was seen in the masupirdine 50 mg and masupirdine 100 mg treated arms at Week 13 in comparison to the placebo, and the effect was sustained for the duration of the 26-week trial in the masupirdine 50 mg treatment arm.

2. This effect was seen in a subgroup of patients (placebo, n=57; masupirdine 50 mg, n=53; masupird Similar findings were obtained in the subset of individuals who had agitation/aggression symptoms at baseline ≥3.

3. A substantial decline in psychosis ratings was seen in the masupirdine 50 mg and 100 mg treatment arms compared to placebo in the subgroup of patients who had baseline psychosis symptoms and/or symptom development.

In conclusion, Currently, the first-line therapy for neuropsychiatric symptoms in AD patients is non-pharmacologic, psychosocial intervention. Pharmacologic treatments, most notably antipsychotics, have a negligible impact on neuropsychiatric symptoms in AD patients; nevertheless, the use of antipsychotics is constrained by adverse effects, including black box warnings.

Reference: 

Nirogi, R., Jayarajan, P., Benade, V., Shinde, A., Goyal, V. K., Jetta, S., Ravula, J., Abraham, R., Grandhi, V. R., Subramanian, R., Pandey, S. K., Badange, R. K., Mohammed, A. R., Jasti, V., Ballard, C., & Cummings, J. (2022). Potential Beneficial Effects of Masupirdine (SUVN‐502) on Agitation/Aggression and Psychosis in Patients with Moderate Alzheimer's disease: Exploratory Post Hoc Analyses. In International Journal of Geriatric Psychiatry. Wiley. https://doi.org/10.1002/gps.5813