A Placebo- and Ropinirole-Controlled Study for SPM 962 in Advanced Parkinson's Disease Patients

A Double-Blind, 3-Arm, Parallel Group, Placebo- and Ropinirole-Controlled Study for SPM 962 in Advanced Parkinson's Disease Patients With Concomitant Treatment of L-dopa

• To demonstrate the non-inferiority of SPM 962 to ropinirole in terms of efficacy in order to confirm clinical value of SPM 962.
• To demonstrate the superiority of SPM 962 to placebo in terms of efficacy.
• To investigate the tolerability and safety of SPM 962 up to 36.0 mg/day.

Study Overview

• Status: Completed
• Conditions: Parkinson's Disease
• Intervention / Treatment: Drug: SPM 962; Drug: Ropinirole; Drug: Placebo

• Study Type: Interventional
• Enrollment (Actual): 420
• Phase: Phase 3

Contacts and Locations

Study Locations

• Japan
  • Chubu Region, Japan
  • Chugoku Region, Japan
  • Hokkaido Region, Japan
  • Kanto Region, Japan
  • Kinki Region, Japan
  • Kyushu Region, Japan
  • Shikoku Region, Japan
  • Tohoku Region, Japan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 30 years to 79 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subject diagnosed as having Parkinson's disease in accordance with "Diagnostic Criteria established by the Research Committee of MHLW-specified Intractable Neurodegenerative Diseases (1995)".
• Subject is 30 and more and less than 80 years of age at the time of informed consent.
• Hoehn & Yahr stage 2-4 (on time).
• Total UPDRS Part 3 score is over 10 at screening test (on time).
• Subject is on a stable dose of L-dopa with no change in daily dose or dosing regimen for at least 28 days prior to the initial treatment of SPM 962.
• Subject has any of the following problematic symptoms; 1) Wearing off phenomenon (including frozen gait at off time and dystonia at off time) 2) On and off phenomenon 3) Delayed-on and/or No-on phenomenon 4) Dyskinesia 5) Not well controlled with L-dopa.

Exclusion Criteria:

• Subject who has previously participated in a clinical trial of SPM962 and taken the investigational product (IP).
• Subject has psychiatric symptoms, e.g. confusion, hallucination, delusion, excitation, delirium, abnormal behavior at screening test or baseline.
• Subject whose SBP declines by at least 30 mmHg from supine to standing position based on the orthostatic hypotension assessment, or subject who develops orthostatic hypotension at baseline.
• Subject has a history of epilepsy, convulsion and other.
• Subject who has complications or a history of serious cardiac diseases or arrhythmia (eg, congestive heart failure of class 3 or 4 in the NYHA classification, second or third degree atrioventricular block, complete left bundle branch block, sick sinus syndrome, ventricular fibrillation, myocardial infarction within 12 months prior to the screening test, or a complication of angina pectoris).
• Subjects has QTc-interval >450 msec twice at screening. Subject has a the average QTc-interval from two ECGs >450 msec in males and >470 msec in females at baseline.
• Subject has congenital long QT syndrome.
• Subject whose serum potassium level is < 3.5mEq/L at the screening test.
• Subject has a total bilirubin >= 3.0 mg/dL or AST(GOT) or ALT(GPT) greater than 2.5 times of the upper limit of the reference range (or >= 100 IU/L) at screening test, or suffers complications of active phase of chronic hepatitis or liver cirrhosis.
• Subject has BUN >= 30 mg/dL or serum creatinine >= 2.0 mg/dl at screening test.
• Subject has a history of allergic reaction to topical agents such as transdermal patch.
• Subject has a history of known intolerance/hypersensitivity to ropinirole and/or adverse drug reactions that prevent subject from receiving treatment.
• Subject is pregnant or nursing or woman who plans pregnancy during the trial.
• Subject is receiving therapy with prohibited drug specified in the study protocol.
• Subject has a history of pallidotomy, thalamotomy, deep brain stimulation or fetal tissue transplant.
• Subject has dementia, including DLB and PDD (MMSE score <= 24 at screening).
• Subject who has a complication or history of malignant neoplastic disease, or received treatment for the disease within 12 months prior to the screening test.
• Subject is unable to give consent.
• Subject who is unable to properly record information in a diary.
• Subject is participating in another trial of IPs or received other IPs within 12 weeks prior to commencement of study treatment.
• Investigator judges that subject is inappropriate as a study subject with other reasons.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SPM 962; SPM 962 transdermal patch	Drug: SPM 962; SPM 962 transdermal patch once a daily up to 36.0 mg/day
Active Comparator: Ropinirole; Ropinirole tablet	Drug: Ropinirole; Ropinirole oral administration TID up to 15.0 mg/day
Placebo Comparator: Placebo; SPM962 placebo patch and Ropinirole placebo tab	Drug: Placebo; SPM962-placebo patch and Ropinirole-placebo tab

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Unified Parkinson's Disease Rating Score (UPDRS) Part 3 Sum Score	Mean change (LOCF) from baseline in UPDRS Part 3 sum score (on state) at 16 weeks after dosing. UPDRS is a scale for monitoring Parkinson's Disease-related disability and impairment. The UPDRS consists of the following four sub-scales. Part 1: Mentation, Part 2: Activities of Daily Living, Part 3: Motor, Part 4: Complications. Part 3 assesses 14 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.	baseline, 16 weeks after dosing

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
UPDRS Part 3 Sum Score	Mean change (LOCF) from baseline in UPDRS Part 3 sum score (on state) at 8 and 10 weeks after dosing. UPDRS Part 3 assesses 14 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.	baseline, 8 and 10 weeks after dosing
UPDRS Part 2 Sum Score	Mean change (LOCF) from baseline in UPDRS Part 2 sum score (average scores of on state and off state) at 16 weeks after dosing. UPDRS 2 assesses 13 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.	Baseline, 16 weeks after dosing
Off Time	Mean change (LOCF) from baseline in off time at 16 weeks after dosing. Off-time is a state where L-Dopa becomes ineffective. Off-time was measured by patient diary in hours/day.	Baseline, 16 weeks after dosing
Parkinson's Disease Sleep Scale-2 (PDSS-2)	Mean change (LOCF) from baseline in PDSS-2 sum score at 16 weeks after dosing. PDSS-2 is a scale for assessing sleep disorders in Parkinson's disease. PDSS consists of 15 questions about sleep and nocturnal disturbances. The score of each question ranges from 0 (never) to 4 (very frequent). The sum of each question serves as the scale score. Thus a decrease in the scores means improvement.	Baseline, 16 weeks after dosing
On Time	Mean change (LOCF) from baseline in on time at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.	Baseline, 16 weeks after dosing
On Time Without Dyskinesia Disturbing Daily Activities	Mean change (LOCF) from baseline in on time without dyskinesia disturbing daily activities at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.	Baseline, 16 weeks after dosing
On Time With Dyskinesia Disturbing Daily Activities	Mean change (LOCF) from baseline in on time with dyskinesia disturbing daily activities at 16 weeks after dosing (rate against on time).	Baseline, 16 weeks after dosing
Effective Rate in UPDRS Part 3 Sum Score	Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in UPDRS Part 3 sum score (on state) at 16 weeks after dosing.	Baseline, 16 weeks after dosing
Effective Rate in UPDRS Part 2 Sum Score	Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in UPDRS Part 2 sum score (average scores of on state and off state) at 16 weeks after dosing.	Baseline, 16 weeks after dosing
Effective Rate in Off Time	Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in off time at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.	Baseline, 16 weeks after dosing
Clinical Global Impression (CGI)	Change (LOCF) from baseline in CGI score. CGI improvement is a clinician-reported scale for assessing how much the patient's illness has improved or worsened from baseline. The scale scoring criteria are 1: very much improved, 2: much improved, 3: minimally improved, 4: no change, 5: minimally worse, 6: much worse, 7: very much worse. A decrease in the scores means improvement.	Baseline, 16 weeks after dosing
Dystonia (at an Early Hour)	Change (LOCF) from baseline in occurrence of Dystonia (at an early hour).	Baseline, 16 weeks after dosing
Dystonia (in the Daytime)	Change (LOCF) from baseline in occurrence of Dystonia (in the daytime).	Baseline, 16 weeks after dosing

Collaborators and Investigators

• Sponsor: Otsuka Pharmaceutical Co., Ltd.

Study record dates

Study Major Dates

• Study Start: June 1, 2009
• Primary Completion (Actual): May 1, 2011
• Study Completion (Actual): May 1, 2011

Study Registration Dates

• First Submitted: June 24, 2012
• First Submitted That Met QC Criteria: June 24, 2012
• First Posted (Estimate): June 27, 2012

Study Record Updates

• Last Update Posted (Estimate): May 23, 2014
• Last Update Submitted That Met QC Criteria: April 23, 2014
• Last Verified: April 1, 2014

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Movement Disorders; Synucleinopathies; Neurodegenerative Diseases; Parkinson Disease; Physiological Effects of Drugs; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Dopamine Agonists; Dopamine Agents; Antiparkinson Agents; Anti-Dyskinesia Agents; Ropinirole
• Other Study ID Numbers: 243-08-001; JapicCTI-090888 (Other Identifier: JAPIC)