A Safety, Tolerability and Levodopa Pharmacokinetics Study of Repeated ND0612 in Parkinson's Disease Patients (ND0612/003)
A Phase IIa Multicenter, Randomized, Double-blind, Placebo-controlled Study Followed by an Open-label Period, to Evaluate the Safety, Tolerability, and Levodopa Pharmacokinetics in Levodopa-treated Parkinson's Disease Patients With Motor Fluctuations, Administered With Repeated Subcutaneous ND0612
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Jerusalem, Israel
- Hadassah Medical Center
-
Petah Tikva, Israel
- Rabin Medical Center
-
Tel Aviv, Israel
- Tel Aviv Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men and women with idiopathic PD whose diagnosis was confirmed by presence of at least two of the cardinal signs (resting tremor, bradykinesia, rigidity) and lacking any other known or suspected cause of parkinsonism.
- Patients who experienced motor fluctuations averaging at least two hours daily in the "OFF" state during the waking hours (including morning akinesia), corresponding to the end-of-dose deterioration phenomenon ("wearing off") confirmed by the baseline home diaries.
- Modified Hoehn and Yahr stage < 5 in the "OFF" state.
- Patients who were taking optimized LD/decarboxylase inhibitor therapy (based on the investigator's judgment) that was stable for at least 14 days prior to baseline. Patients were to receive at least three daily doses of LD (which could include a bedtime dose) with at least three hours between doses.
- Patients treated with dopaminergic agonists and other anti-PD drugs were to be on stable doses for at least 30 days prior to baseline and those doses were to remain constant throughout the study period.
- Women who were postmenopausal, surgically sterilized, or using adequate birth control. Women of childbearing potential were to have a negative pregnancy test (beta human chorionic gonadotropin [hCG] serum) at screening.
- Patients between the ages of 30 and 80.
- Patients willing and able to give informed consent.
- Patients and/or caregivers able to understand and follow instructions for use of SC delivery pump.
- Patients who demonstrated the ability to keep accurate diaries of PD symptoms (ON-OFF diaries).
Exclusion Criteria:
- Patients treated with controlled release formulation of LD/CD. (Note: Patients treated with Entacapone, Tolcapone, or Stalevo were allowed to participate in Period 1 but were excluded from Period 2 participation)
- Patients with a clinically significant or unstable medical or surgical condition which would preclude safe and complete study participation. Such conditions may include gastrointestinal, cardiovascular, pulmonary, hepatic, renal, or metabolic diseases or malignancies as determined by medical history, physical exam, laboratory tests, or ECG.
- History of melanoma or significant skin disorders.
- Patients with significant cognitive impairment as defined by a MMSE score of < 25.
- Patients treated with dopaminergic agonists, anticholinergics, monoamine oxidase (MAO)-B inhibitors, or antipsychotics that need dose adjustment in the 30 days prior to Study Baseline.
- Patients with clinically significant psychiatric illness, including major depression (according to Diagnostic and Statistical Manual of Mental Disorders [DSM] IV criteria for major depressive episode) or other problems that might compromise their ability to provide consent or participate fully in the study.
- Patients with a history of alcohol or substance abuse within the past two years.
- Patients who have taken experimental medications within 60 days prior to baseline.
- Patients who have undergone a neurosurgical intervention for PD (e.g. pallidotomy, thalamotomy, transplantation, or deep brain stimulation procedures).
- Patients with severe disabling dyskinesias.
- Patients with hearing, visual or motor impairments that prevent them from using the pump or reacting effectively to errors.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Period 1. ND0612
A 24h SC infusion of levodopa/carbidopa 270/63 mg daily in addition to the current standard of care treatment for 14 days
|
Subcutaneous infusion via CRONO ND pump
Other Names:
|
|
Placebo Comparator: Period 1. Placebo
A 24h SC infusion of saline in addition to the current standard of care treatment for 14 days
|
Subcutaneous infusion via CRONO ND pump
Other Names:
|
|
Experimental: Period 2. ND0612
A 24h SC infusion of levodopa/carbidopa 270/63 mg daily in addition to the current standard of care treatment for 7 days
|
Subcutaneous infusion via CRONO ND pump
Other Names:
|
|
Experimental: Period 2. ND0612 + Entacapone
A 24h SC infusion of levodopa/carbidopa 270/63 mg daily in addition to the current standard of care treatment + Entacapone 200 mg 3 times/day (every 6 hours during waking hours) for 7 days
|
Subcutaneous infusion via CRONO ND pump
Other Names:
200 mg oral tablet
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Safety
Time Frame: 14 days
|
1. Incidence and frequency of adverse events, of dopaminergic adverse events 2. Adverse events reporting related to the ND0612 subcutaneous administration, Draize score 3. Vital signs, physical exam, Laboratory measurements
|
14 days
|
|
Levodopa pharmacokinetics (LD PK)
Time Frame: 1hr and 2hr predose, 0h, 0.5 hr, 1hr, 1.5hr, 2hr, 3hr, 4hr, 5hr, 6hr, 7hr, 8hr, 9hr and 10hr hours post oral LD dose
|
LD PK parameters: Cmax, Area under the Curve (AUC), T>1000ng/ml, through levels at baseline and during treatment at 14 days.
|
1hr and 2hr predose, 0h, 0.5 hr, 1hr, 1.5hr, 2hr, 3hr, 4hr, 5hr, 6hr, 7hr, 8hr, 9hr and 10hr hours post oral LD dose
|
|
Tolerability
Time Frame: 14 days
|
Withdrawal rates and discontinuations due to adverse events
|
14 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
LD dose adjustment
Time Frame: 14 days
|
Change in oral LD total daily dose, change in number of oral LD doses during the first 2 weeks, use of rescue therapy during the third week.
|
14 days
|
|
Pump Usability
Time Frame: 14 days
|
Simulated usability study, formative Pump usability evaluation.
Human factor study.
Training on the use of the pump will be performed and questionnaire will be filled to assess the ease of use of the pump and the efficiency of the training.
|
14 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Senior Medical Director, NeuroDerm Ltd.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Synucleinopathies
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neurodegenerative Diseases
- Movement Disorders
- Parkinsonian Disorders
- Basal Ganglia Diseases
- Parkinson Disease
- Amino Acids, Peptides, and Proteins
- Organic Chemicals
- Hydrocarbons
- Hydrocarbons, Cyclic
- Hydrocarbons, Aromatic
- Amines
- Inorganic Chemicals
- Chlorine Compounds
- Amino Acids
- Catechols
- Phenols
- Benzene Derivatives
- Phenylalanine
- Amino Acids, Aromatic
- Amino Acids, Cyclic
- Catecholamines
- Dihydroxyphenylalanine
- Sodium Compounds
- Chlorides
- Hydrochloric Acid
- Tyrosine
- Levodopa
- Sodium Chloride
- entacapone
Other Study ID Numbers
Other Study ID Numbers
- ND0612/003
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