- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01653132
Incobotulinum Toxin A (Xeomin®) for Troublesome Sialorrhea in Parkinson's Disease (PD)/Parkinsonism
Randomized Double Blind Placebo Controlled Cross-Over Study of Incobotulinum Toxin A (Xeomin®) for Troublesome Sialorrhea in Parkinson's Disease (PD)/Parkinsonism
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Participants will be recruited if they have Parkinson's disease, Parkinsonism. Inclusion and exclusion criteria are summarized below. Participants will be screened at the first visit to make sure they are eligible for the trial. They will then undergo baseline testing including neurologic evaluation, questions to assess their memory and cognitive status and evaluation of their disease status using parts of the Unified Parkinsons's Disease Ratings Scale (UPDRS) that are routinely used to follow disease progression. They will be given a questionnaire to evaluate the severity of their drooling. Their saliva production will be measured by having them spit into a cup for 5 minutes, twice.
At the first visit, after making sure they are eligible for the study and performing the baseline testing and procedures, they will be given either Xeomin or placebo (saline injections without medication) injections in the 4 glands that produce saliva. They will not know which injection they received. This visit will take about 2 hours. They will be followed up every month and asked about side effects, have neurologic evaluation and UPDRS testing and fill-in the questionnaire for drooling severity. Saliva volume will be measured as done at the first visit. At either Month 4 or 5, participants will receive the second injection. This will be a "cross-over" injection, i.e., if they received Xeomin at the first injection they will receive saline at the second and vice versa. Thus, all participants will receive the study medication Xeomin, either as the first injection or the second injection at 4 months or 5 months. The follow up after the second injection will be one monthly visit for 3 months, with similar evaluations as described above. The follow-up visit will take about 1 hour each.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
For PD/ Parkinsonism: 1. PD, Multiple Systems Atrophy (MSA), or Progressive Supranuclear Palsy (PSP) diagnosed by clinical criteria, ages 20-80 with troublesome sialorrhea as defined below**.
Sialorrhea that patients or their families or treating physicians think is troublesome
- Swallowing function: Functional Oral Intake Scale (FOIS)* of 5 or greater
- If patients have been treated with other medications for sialorrhea earlier, they should be off the medications at least 4 weeks prior to the baseline evaluation.
- If they are on other medications for sialorrhea at the time of the baseline evaluation, the doses will be held stable throughout the period of the study.
- Women of child bearing age will need to be on a reliable method of birth control for the duration of the study.
Exclusion Criteria:
For PD:
- Current use of Coumadin
- Concurrent significant medical illness
- History of myasthenia gravis or Lambert-Eaton Syndrome
- Ongoing substance abuse
- History of unreliable follow-up
- Past use of Xeomin® or other botulinum toxin preparations
- Cognitive impairment, defined as a score ≤ 23/30 on the Mini Mental Status Exam
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Incobotulinum Toxin A
Twenty units (0.2 ml) of incobotulinum toxin A injected into each parotid gland and 30 units (0.3 ml) to each submandibular gland for a total dose of 100 units using anatomical landmarks
|
Twenty units (0.2 ml) of incobotulinum toxin A were injected into each parotid gland and 30 units (0.3 ml) to each submandibular gland for a total dose of 100 units using anatomical landmarks
Other Names:
|
Placebo Comparator: Placebo
Sterile, preservative free 0.9% saline, 1 ml, was used as placebo, and injected into the parotid (0.2 ml each) and submandibular (0.3ml each) glands .
|
Sterile, preservative free 0.9% saline, 1 ml, was used as placebo, and injected into the parotid (0.2 ml each) and submandibular (0.3ml each) glands .
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objectively Measured Salivary Weight
Time Frame: baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Change in saliva weight between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period.
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baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Objectively Measured Percentage Salivary Weight
Time Frame: baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Percentage change in saliva weight between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period.
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baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Drooling Frequency and Severity Scale (DFSS) Scores
Time Frame: baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
measured between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period.Drooling Frequency and Severity Score. The Drooling Score equals the sum of the Severity and Frequency sub-scores. The range is 2-9, higher numbers represent worse drooling Drooling Severity Scale
1. = No drooling 2. = Occasionally drools 3. = Frequently drools 4. = Constant drooling |
baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Number of Participants With Response, Defined as Subjects With ≥ 2 Point Improvement in the DFSS Scores.
Time Frame: baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
measured between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period.
|
baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Number of Participants With Response, Defined as Subjects With ≥ 20% Reduction in Saliva Volume.
Time Frame: between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
measured between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
between baseline and one month post-injection in the Incobotulinum toxin A period compared to the placebo period
|
Collaborators and Investigators
Investigators
- Principal Investigator: Pushpa Narayanaswami, MD, Beth Israel Deaconess Medical Center
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2011P00304
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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