- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04251585
Intranasal Insulin in Parkinson's Disease (INI-PD)
Single Center Safety and Tolerability Trial of Intranasal Insulin in Parkinson's Disease
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's dementia and was originally described as a motor disease. The diagnosis of PD is still based on the core motor features of bradykinesia, resting tremor, and rigidity, primarily as a result of degeneration of nigrostriatal dopaminergic neurons. In addition to the classic motor symptoms, however, PD is increasingly recognized as a multisystem disorder. A variety of non-motor symptoms, including cognitive deficits and dementia, are commonly observed in patients with PD.
In this study, we aim to investigate which intranasal insulin dose out of three doses and placebo, administered at three different doses or placebo over a 21-day period, is the optimum dosage based on safety and tolerability in Parkinson's disease. A similar design was used in a trial investigating intranasal oxytocin in frontotemporal dementia. Dosing for the first two groups of this study is based on previously conducted intranasal insulin studies in Alzheimer's disease (AD) and mild cognitive impairment (MCI), using daily doses on 20 and 40 IU of intranasal insulin. Higher dose have been found to be safe in healthy adults. Prior studies performed have demonstrated favorable effects of this regimen in the MCI/AD population without peripheral hypoglycemia.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Sharon Hwee
- Phone Number: 651-495-6363
- Email: Sharon.x.Hwee@HealthPartners.com
Study Contact Backup
- Name: Maria Pyle
- Phone Number: 651-495-6363
- Email: Maria.X.Pyle@HealthPartners.com
Study Locations
-
-
Minnesota
-
Saint Paul, Minnesota, United States, 55130
- Recruiting
- HealthPartners Neuroscience Center
-
Contact:
- Sharon Hwee
- Phone Number: 651-495-6363
- Email: Sharon.x.Hwee@HealthPartners.com
-
Contact:
- Maria Pyle
- Phone Number: 651-495-6363
- Email: Maria.X.Pyle@HealthPartners.com
-
Principal Investigator:
- Julia C Johnson, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subject has Idiopathic PD defined by the cardinal sign, bradykinesia, plus the presence of at least 1 of the following: resting tremor or rigidity and without any other known or suspected cause of Parkinsonism (according to Movement disorder society (MDS) clinical diagnostic criteria for Parkinson's disease confirmed by a fellowship trained movements disorder specialist
- Subject is Hoehn & Yahr stage less than or equal to 3
- Subject has a MOCA score ≥10.
- Subject is > 40 and <90 years of age.
- Female subjects are post-menopausal or have a negative pregnancy test
- The subject must be proficient in speaking, reading and understanding English in order to comply with procedural testing of cognitive function, memory and physiology.
- Subject has provided informed written consent prior to participation. In the event that subject is legally unable to provide informed written consent due to deterioration in cognitive abilities, fully informed written consent must be provided by a legally authorized representative.
- Subject is on a stable dose (at least 1 month prior to baseline visit) of antiparkinsonian agents and is willing to remain on this dose for the duration of the study. If the subject is on a cholinesterase inhibitor, a stable dose without changes for 1 month is also required.
- Subject has undergone a brain CT or MRI prior to the study as part of their previous diagnostic workup for PD to rule out underlying structural lesions, as determined clinically significant by the investigator
Exclusion Criteria:
- Subject has atypical Parkinson's syndrome(s) due to drugs (e.g., metoclopramide, neuroleptics), metabolic neurogenetic disorders (e.g., Wilson's Disease), encephalitis, cerebrovascular disease, or degenerative disease (e.g., Progressive Supranuclear Palsy, Multiple System Atrophy, Corticobasal Degeneration, Lewy Body dementia)
- Subject has medical history and/or clinically determined disorders: chronic sinusitis, untreated thyroid disease, or significant head trauma.
- Subject has history of any of the following: moderate to severe pulmonary disease, poorly controlled congestive heart failure, significant cardiovascular and/or cerebrovascular events within previous 6 months, condition known to affect absorption, distribution, metabolism, or excretion of drugs such as any hepatic, renal or gastrointestinal disease or any other clinically relevant abnormality that inclusion would pose a safety risk to the subject as determined by investigator.
- Subject has had previous nasal and/or oto-pharyngeal surgery and severe deviated septum and/or other anomalies.
- Subject has history of any psychiatric illness that would pose a safety risk to the subject as determined by investigator.
- Subject is currently taking sedative medications that are clinically contraindicated as determined by investigator.
- Subject has undergone a recent change (<1 month) in their anti-parkinsonian medication, cholinesterase inhibitor or anti-depressant medication.
- Subject has current or recent drug or alcohol abuse or dependence as defined by Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR).
- Screening laboratory results that are medically relevant, in which inclusion would pose a safety risk to the subject as determined by investigator.
- Subject has participated in a clinical trial investigation within 3 months of this study.
- Subject has an insulin allergy.
- Subject has Insulin-dependent diabetes
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Low Insulin
Regular insulin (Novolin-R) 20 international units (10 units) in one nostril twice daily for 21 days, 100 µl volume.
|
Intranasal insulin
|
Experimental: Medium Insulin
Regular insulin (Novolin-R) 40 international units (10 units) in each nostril twice daily for 21 days, 100 µl volume.
|
Intranasal insulin
|
Experimental: High Insulin
Regular insulin (Novolin-R) 80 international units (10 units) in each nostril twice daily for 21 days, 200 µl volume.
|
Intranasal insulin
|
Placebo Comparator: Placebo
0.9% sodium chloride in each nostril twice daily for 21 days, 100 µl volume.
|
Intranasal placebo (0.9% saline)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety measured by count of safety events
Time Frame: 3 weeks
|
Composite safety event - this is a count of either a reduction of fasting glucose to <70 mg/dL or an unintended reduction of weight >5%.
A larger composite event count indicates a less safe treatment.
|
3 weeks
|
Safety measured by fasting glucose
Time Frame: 3 weeks
|
Pre-post change in fasting glucose (mg/dL).
A larger decrease in fasting glucose indicates a less safe treatment.
|
3 weeks
|
Safety measured by body weight
Time Frame: 3 weeks
|
Pre-post change in body weight (lbs).
An unintended decrease in body weight indicates a less safe treatment.
|
3 weeks
|
Safety measured by the number of serious adverse events (SAE) and adverse events (AE)
Time Frame: 3 weeks
|
Total number of AEs/SAEs during the course of treatment.
More AEs/SAEs indicates a less safe treatment.
|
3 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cognitive function measured by the Montreal cognitive assessment (MoCA)
Time Frame: 5 weeks
|
Pre-post difference.
Total sum of scores.
Range: 0-30.
Higher score indicates less memory loss
|
5 weeks
|
Cognitive function measured by the Weschler Adult Intelligence Scale - Fourth Edition (WAIS-IV) Digit Span
Time Frame: 3 weeks
|
Pre-post difference.
Scaled score.
Range: 1-19.
Forward and backward.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Trailmaking Test Part A Time
Time Frame: 3 weeks
|
Pre-post difference.
T-score.
Range: 0-25.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Trailmaking Test Part B Time
Time Frame: 3 weeks
|
Pre-post difference.
T-score.
Range: 0-26.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Trailmaking Test Parts A & B Errors
Time Frame: 3 weeks
|
Pre-post difference.
Total number of errors.
No range.
More errors indicate more impairment.
|
3 weeks
|
Cognitive function measured by the Judgement of Line Orientation
Time Frame: 3 weeks
|
Pre-post difference.
Z-score.
Range: 0-29.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Logical Memory Scaled Scores
Time Frame: 3 weeks
|
Pre-post difference.
Scaled score.
Range: 1-19.
Logical memory immediate, delayed and recognition.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Logical Memory Recognition
Time Frame: 3 weeks
|
Pre-post difference.
No range.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Hopkins Verbal Learning Test - Revised (HVLT)
Time Frame: 3 weeks
|
Pre-post difference.
T-score.
Range: 0-12.
Immediate recall, delayed recall, and recognition.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Visuospatial Memory Test - Revised (BVMT)
Time Frame: 3 weeks
|
Pre-post difference.
T-score.
Range: 0-6.
Immediate recall, delayed recall, and recognition.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by the Stroop Color Word Test (CWT)
Time Frame: 3 weeks
|
Pre-post difference.
T-score.
Range: 0-25.
Word reading, color naming, color-word, and interference.
Lower score indicates more impairment.
|
3 weeks
|
Cognitive function measured by Fluency
Time Frame: 3 weeks
|
Pre-post difference.
T-score.
No range.
Letter fluency and category fluency.
Lower score indicates more impairment.
|
3 weeks
|
Mood measured by the Beck Depression Inventory - Second Edition
Time Frame: 3 weeks
|
Pre-post difference.
Raw score.
Range: 0-63.
Higher score indicates more symptomatic.
|
3 weeks
|
Apathy measured by the Apathy scale
Time Frame: 3 weeks
|
Pre-post difference.
Raw score.
Range: 0-42.
Higher score indicates more symptomatic.
|
3 weeks
|
Mood measured by the Columbia Suicide Severity Rating (C-SSRS)
Time Frame: 3 weeks
|
Pre-post difference.
Raw score.
Range:1 or 0. 1 score - more symptomatic, 0 score - no symptoms.
|
3 weeks
|
Motor function as measured by the United Parkinson's Disease Rating Scale (UPDRS)
Time Frame: 3 weeks
|
Pre-post difference.
Raw score.
Range: 0-72.
Higher score indicates more symptomatic.
|
3 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Julia C Johnson, MD, HealthPartners Neurology
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- A19-214
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Parkinson Disease
-
National Heart, Lung, and Blood Institute (NHLBI)CompletedParkinson Disease 6, Early-Onset | Parkinson Disease (Autosomal Recessive, Early Onset) 7, Human | Parkinson Disease Autosomal Recessive, Early Onset | Parkinson Disease, Autosomal Recessive Early-Onset, Digenic, Pink1/Dj1United States
-
ProgenaBiomeRecruitingParkinson Disease | Parkinsons Disease With Dementia | Parkinson-Dementia Syndrome | Parkinson Disease 2 | Parkinson Disease 3 | Parkinson Disease 4United States
-
King's College LondonGlaxoSmithKlineCompletedParkinson Disease | Idiopathic Parkinson Disease | Parkinson Disease, PARK8United Kingdom
-
Ohio State UniversityCompletedParkinson's Disease | Parkinson Disease | Idiopathic Parkinson Disease | Idiopathic Parkinson's Disease | Parkinson Disease, Idiopathic | Parkinson's Disease, IdiopathicUnited States
-
National Yang Ming UniversityUnknownEarly Onset Parkinson Disease | Early Stage Parkinson Disease
-
Michele Tagliati, MDRecruitingREM Sleep Behavior Disorder | Symptomatic Parkinson Disease | Pre-motor Parkinson DiseaseUnited States
-
Cedars-Sinai Medical CenterEnrolling by invitationREM Sleep Behavior Disorder | Symptomatic Parkinson Disease | Pre-motor Parkinson DiseaseUnited States
-
Mahatma Gandhi Institute of Medical SciencesCompletedStroke, Parkinson' s Disease, Neurological Impairments, Tele-rehabilitationIndia
-
Merck Sharp & Dohme LLCCompletedParkinson Disease | Idiopathic Parkinson Disease | Idiopathic Parkinson's Disease
-
University of DeustoCompletedPARKINSON DISEASE (Disorder)Spain
Clinical Trials on Regular Novolin R
-
HealthPartners InstituteRecruiting
-
University of North Carolina, Chapel HillWakeMed Health and HospitalsCompletedPregnancy | Non Insulin Dependent DiabetesUnited States
-
Universidade PositivoEmory UniversitySuspendedAcute Coronary SyndromeUnited States, Brazil
-
HealthPartners InstituteTerminatedFrontotemporal Dementia, Behavioral VariantUnited States
-
Beth Israel Deaconess Medical CenterNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Novo... and other collaboratorsCompletedType 2 Diabetes MellitusUnited States
-
Pennington Biomedical Research CenterNutrition Obesity Research CenterCompletedInsulinUnited States
-
Boston Children's HospitalNational Heart, Lung, and Blood Institute (NHLBI)CompletedHyperglycemia | Heart Defects, CongenitalUnited States
-
WockhardtTerminatedType I DiabetesUnited States, India
-
First Affiliated Hospital, Sun Yat-Sen UniversityUnknown
-
WockhardtCompletedDiabetes MellitusUnited States