- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02365012
Treatment of Orthostatic Intolerance in Patients With Parkinson's Disease Using Midodrine
August 25, 2015 updated by: Stephanie Pawlowski Wood, Corporal Michael J. Crescenz VA Medical Center
This study will evaluate whether treatment with the α1-agonist, midodrine, reduces subjective orthostatic lightheadedness as measured by the Non-Motor Symptoms Scale for Parkinson's Disease (NMSS) questionnaire, in patients with (positive control group, OH) or without documented orthostatic hypotension(orthostatic intolerance, OI).
It will also demonstrate the effect of treatment with an α1-agonist, midodrine, on beat-to-beat blood pressure and heart rate response during Valsalva maneuver (measured by Continuous Non-invasive Arterial Pressure, CNAP) in patients with OI or OH and evaluate the relationship to symptom improvement.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
This will be a cross-over study where participants with OI will be randomized to initially receive midodrine or placebo then crossed over to the opposite treatment after three weeks (2 weeks on midodrine or placebo plus one week wash out period).
The control group will consist of participants with OH and PD being treated with midodrine.
Basic demographic data including will be collected from the medical record of each participant after consent.
At each study visit, each participant will undergo traditional measurement of blood pressure and heart rate as well as measurement of beat-to-beat blood pressure and heart rate using CNAP™ during valsalva maneuver and in response to standing for 5 minutes after sitting.
Symptoms of orthostatic intolerance will be measured during the study visit using Domain 1 of the Non-Motor Symptoms Scale for Parkinson's Disease (NMSS).
At the initial study visit, participants will also be administered first dose of midodrine or placebo.
Supine sitting, and standing systolic and diastolic blood pressure and pulse rates will be measured immediately before and 1 hour after the administration of drug or placebo.
This blood pressure monitoring process will take place at each of the four study visits.
Study Type
Interventional
Enrollment (Anticipated)
50
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: James Morley, MD/Ph.D.
- Phone Number: 215-823-5934
Study Contact Backup
- Name: Stephanie Wood
- Phone Number: 215-823-5934
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- PVAMC
-
Contact:
- James Morley, MD/Ph.D.
- Phone Number: 215-823-5934
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
22 years to 89 years (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients with a diagnosis of idiopathic Parkinson's Disease
- Those patients with measured orthostatic hypotension will be included in the positive control group
- Those patients without measurable orthostatic hypotension who have symptoms of lightheadedness on standing will be included in the study group
Exclusion Criteria:
- Diagnosis of degenerative parkinsonian syndromes other than idiopathic Parkinson's Disease
- Inability to stand independently and remain standing for 5 minutes
- Cognitive impairment that is significant enough to affect the ability of the patient to provide informed consent or to reliably report orthostatic symptoms
- Patients with a pacemaker will also be excluded because the study is measuring heart rate responses which could potentially be altered by a pacemaker
- Because this study will be using a drug that can affect blood pressure, those patients with a standing BP of > 139/90 and heart rate <60 will be excluded
- Because this study will be using a drug that can affect supine hypertension, those patients with a supine BP of >139/90 and heart rate <60 will be excluded
- Current treatment with other drugs for orthostatic hypotension such as fludrocortisone
- Patients on phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine, dihydroergotamine
- Patients with acute or chronic renal failure (GFR <60)
- Patients with a history of pheochromocytoma, urinary retention, severe cardiac disease, history of congestive heart failure, diabetes, narrow-angle glaucoma, arrhythmias, bradycardia, severe hyperthyroidism, severe difficult urination (due to urinary retention or enlarged prostate)
- Pregnant or breast-feeding women.
- Women of childbearing potential with no effective contraceptive method of birth control and/or who are unwilling or unable to be tested for pregnancy.
- Women of childbearing potential must have a confirmed negative pregnancy test at screening and randomization visits. They must use an effective contraceptive method throughout the study, and agree to repeat urine pregnancy test at designated visits. The applied methods of contraception have to meet the criteria for a highly effective method of birth control (condoms, FDA approved oral contraceptives, patches, injections, rings, IUD).
- Patients with known drug allergy or hypersensitive to midodrine.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
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 |
---|---|
Placebo Comparator: Placebo
Placebo given three times a day for 2 weeks
|
|
Active Comparator: Midodrine
Midodrine 2.5 mg given three times a day for one week followed by 5 mg given three times a day for one week
|
Crossover intervention comparing midodrine to placebo for subjects with orthostatic intolerance
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
NMSS Domain I (improvement in symptoms of lightheadedness when standing)
Time Frame: 7 weeks
|
improvement in symptoms of lightheadedness when standing
|
7 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Valsalva response (Beat-to-beat blood pressure and heart rate variation during Valsalva maneuver)
Time Frame: 7 weeks
|
Beat-to-beat blood pressure and heart rate variation during Valsalva maneuver
|
7 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: James Morley, DOMD/Ph.D., PVAMC
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
April 1, 2014
Primary Completion (Anticipated)
June 1, 2017
Study Registration Dates
First Submitted
February 10, 2015
First Submitted That Met QC Criteria
February 17, 2015
First Posted (Estimate)
February 18, 2015
Study Record Updates
Last Update Posted (Estimate)
August 26, 2015
Last Update Submitted That Met QC Criteria
August 25, 2015
Last Verified
August 1, 2015
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neurologic Manifestations
- Parkinsonian Disorders
- Basal Ganglia Diseases
- Movement Disorders
- Synucleinopathies
- Neurodegenerative Diseases
- Autonomic Nervous System Diseases
- Primary Dysautonomias
- Parkinson Disease
- Orthostatic Intolerance
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Sympathomimetics
- Vasoconstrictor Agents
- Adrenergic alpha-1 Receptor Agonists
- Midodrine
Other Study ID Numbers
- 01482
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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