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Pioglitazone in Early Parkinson's Disease

15. září 2015 aktualizováno: University of Rochester

A Multi-Center, Double-Blind, Placebo-Controlled Phase II Study of Pioglitazone in Early Parkinson's Disease

This is a multi-center, double-blind, placebo controlled clinical trial of two dosages of oral pioglitazone (15 milligram(mg) and 45 milligram (mg)) for safety, tolerability, and futility.

Subjects who are on stable dose of rasagiline 1 mg/day or selegiline 10 mg/day for at least 8 weeks but no more than 8 months, will be randomized to one of two dosages of oral pioglitazone (15 mg and 45 mg) or matching placebo.

The study will measure disease progression by the change in total Unified Parkinson's Disease Rating Scale (UPDRS) score between the baseline visit and 44 weeks.

Přehled studie

Postavení

Dokončeno

Detailní popis

A Multi-Center, Double-Blind, Placebo-Controlled Phase II Study of Pioglitazone in Early Parkinson's Disease (PD). The patient population has early stage PD (< 5 years from diagnosis), must be treated with 1 mg/day of rasagiline or 10 mg/day of selegiline for at least 8 weeks but not more than 8 months prior to enrollment.

The primary objective of this clinical trial is to assess the futility of pioglitazone on PD disease progression as measured by the change in total UPDRS score between the baseline visit and 44 weeks. The secondary objectives of the study are to collect additional efficacy and safety/tolerability data to be used in planning a subsequent Phase III trial of pioglitazone in early, treated PD. Measures of cognition, mood and blood- and urine-based biomarkers will also be explored. Subjects in this trial are randomly assigned in a 1:1:1 ratio to one of three study arms: 15 mg, 45 mg or placebo.

Typ studie

Intervenční

Zápis (Aktuální)

210

Fáze

  • Fáze 2

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Alabama
      • Birmingham, Alabama, Spojené státy, 35294-0017
        • Univeristy of Alabama at Birmingham
    • Arizona
      • Phoenix, Arizona, Spojené státy, 85013
        • Barrow Neurological Institute
    • California
      • Fountain Valley, California, Spojené státy, 92708
        • The Parkinson's & Movement Disorder Institute
      • Los Angeles, California, Spojené státy, 90083
        • University of Southern California
      • San Fransisco, California, Spojené státy, 94143-0114
        • University of California San Fransisco
    • Colorado
      • Aurora, Colorado, Spojené státy, 80045
        • Univeristy of Colorado Denver
    • Florida
      • Gainsville, Florida, Spojené státy, 32610
        • University of Florida
      • Jacksonville, Florida, Spojené státy, 32209
        • University of Florida, Jacksonville
      • Miami, Florida, Spojené státy, 33136
        • University of Miami
      • Tampa, Florida, Spojené státy, 33606
        • University of South Florida
    • Georgia
      • Atlanta, Georgia, Spojené státy, 30329
        • Emory University School of Medicine
      • Augusta, Georgia, Spojené státy, 30912
        • Medical College of Georgia
    • Hawaii
      • Honolulu, Hawaii, Spojené státy, 96819
        • Pacific Health Research & Education Institute
    • Illinois
      • Chicago, Illinois, Spojené státy, 60611
        • Northwestern University
      • Chicago, Illinois, Spojené státy, 60612
        • Rush University Medical Center
    • Kansas
      • Kansas City, Kansas, Spojené státy, 66160
        • University of Kansas Medical Center
    • Kentucky
      • Lexington, Kentucky, Spojené státy, 40536
        • University Of Kentucky
    • Louisiana
      • New Orleans, Louisiana, Spojené státy, 70121
        • Ochsner Clinic Foundation
      • Shreveport, Louisiana, Spojené státy, 71103
        • LSU Health Science Center Shreveport
    • Maryland
      • Baltimore, Maryland, Spojené státy, 21287-0875
        • Johns Hopkins University
    • Massachusetts
      • Boston, Massachusetts, Spojené státy, 02215
        • Beth Israel Deaconess Medical Center
      • Boston, Massachusetts, Spojené státy, 02115
        • Brigham & Women's Hospital
    • Michigan
      • Ann Arbor, Michigan, Spojené státy, 48109-5316
        • University of Michigan
      • East Lansing, Michigan, Spojené státy, 48824
        • Michigan State University
    • Minnesota
      • Golden Valley, Minnesota, Spojené státy, 55427
        • Struthers Parkinson's Center
    • Missouri
      • St Louis, Missouri, Spojené státy, 63110
        • Washington University
    • New Hampshire
      • Lebanon, New Hampshire, Spojené státy, 03756
        • Dartmouth Hitchcock Medical Center
    • New York
      • Brooklyn, New York, Spojené státy, 11203-2098
        • SUNY downstate Medical Center
      • Manhasset, New York, Spojené státy, 11030
        • North Shore - LIJ Health System
    • North Carolina
      • Durham, North Carolina, Spojené státy, 27705
        • Duke University
    • Oregon
      • Portland, Oregon, Spojené státy, 97239-3098
        • Oregon Health & Science University
    • Pennsylvania
      • Philadelphia, Pennsylvania, Spojené státy, 19107
        • Thomas Jefferson University
      • Philadelphia, Pennsylvania, Spojené státy, 19107
        • University of Pennsylvania
    • South Carolina
      • Charleston, South Carolina, Spojené státy, 29401
        • Medical University of South Carolina
    • Tennessee
      • Nashville, Tennessee, Spojené státy, 37232
        • Vanderbilt University
    • Texas
      • Dallas, Texas, Spojené státy, 75390-9036
        • University of Texas Southwestern Medical Center
    • Vermont
      • Burlington, Vermont, Spojené státy, 05405
        • University of Vermont
    • Virginia
      • Charlottesville, Virginia, Spojené státy, 22903
        • University of Virginia

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

30 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

  1. Willing and able to give informed consent.
  2. Men and women with idiopathic PD of less than 5 years duration from diagnosis with a Hoehn and Yahr Stage < 2.
  3. On stable dosage of rasagiline 1 mg/day or selegiline 10 mg/day for at least 8 weeks but not more than 8 months prior to baseline. Expected to remain on stable dose of rasagiline or selegiline as the only treatment for their PD for the duration of the study (44 weeks).
  4. Diagnosis must be confirmed by bradykinesia plus one of the other cardinal signs (resting tremor, rigidity) being present, without any other known or suspected cause of parkinsonism. The clinical signs must be asymmetric.
  5. Subjects may be taking stable doses (30 days) of anticholinergics or creatine (< 5gm/day) but must be expected to remain on the same dose.
  6. Age > 30 years.
  7. Women who are not postmenopausal or surgically sterile must use a medically accepted contraceptive regimen for at least 60 days before the baseline visit, and agree to continue such use throughout the duration of the study and for 30 days after the final dose of study drug.

Exclusion Criteria:

  1. Exposure to dopaminergic PD therapy or amantadine within 60 days prior to baseline visit or for 90 days or more at any point in the past
  2. Use of any of the following drugs within 180 days prior to baseline: neuroleptics, metoclopramide, alpha-methyldopa, clozapine, olanzapine and flunarizine.
  3. Use of any of the following drugs within 90 days prior to baseline: methylphenidate, cinnarizine, reserpine, tetrabenazine, amphetamine or monoamine oxidase (MAO)-A inhibitors (pargyline, phenelzine, and tranylcypromine).
  4. Presence of drug-induced parkinsonism (e.g., metoclopramide, flunarizine), metabolic identified neurogenetic disorders (e.g., Wilson's disease), encephalitis, or other atypical Parkinsonian syndromes (e.g., progressive supranuclear palsy, multiple system atrophy).
  5. Participation in other drug studies or receipt of other investigational drugs within 30 days prior to baseline or during the study.
  6. Presence of freezing.
  7. Any clinically significant psychiatric or medical condition or laboratory abnormality, which would in the judgment of the Investigator interfere with the subject's ability to participate.
  8. History of stereotaxic brain surgery for PD
  9. Clinically significant structural brain disease that the investigator believes would interfere with study evaluations.
  10. History of congestive heart failure.
  11. Use of pioglitazone or rosiglitazone within 90 days before randomization.
  12. Known intolerance to pioglitazone or rosiglitazone.
  13. Allergy to rasagiline or selegiline, or contraindication to rasagiline or selegiline use.
  14. Type I or Type II diabetes mellitus.
  15. HgbA1C greater than or equal to 6% at Screening.
  16. Known liver disease or elevation of AST or ALT greater than 2.5 times the upper limit of normal.
  17. Known history of osteoporosis. All women ≥ 65 years of age or men and woman at high risk of osteoporosis should have documented evidence of screening for osteoporosis. Factors associated with high risk of osteoporosis include: previous non traumatic fracture, chronic glucocorticoid use, body weight under 58 kg, family history of hip fracture, current cigarette smoking, and excessive alcohol intake.
  18. Drug or alcohol use or dependence that, in the opinion of the Investigator, would interfere with the safe conduct of the study.
  19. Significant peripheral edema (2+ or more) of the extremities of any etiology.
  20. Current or planned use of gemfibrozil or rifampin during the trial.
  21. History of bladder cancer.
  22. Evidence of hematuria which has not been evaluated for evidence of bladder cancer. (Documentation of work up or a repeat urine test that was negative for hematuria and the primary care physician or urologist does not feel that further work up is required.)
  23. History of macular edema.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Čtyřnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: 15 mg pioglitazone

Oral capsules of Pioglitazone (15 mg capsules) either 15 mg/qd or 45 mg/qd

Subjects will titrate in a blinded fashion to 30 mg/day after 2 weeks and to 45 mg per day) 2 weeks later as tolerated.

Ostatní jména:
  • Pioglitazon hydrochlorid
  • ACTOS (R)
Experimentální: 45 mg pioglitazone

Oral capsules of Pioglitazone (15 mg capsules) either 15 mg/qd or 45 mg/qd

Subjects will titrate in a blinded fashion to 30 mg/day after 2 weeks and to 45 mg per day) 2 weeks later as tolerated.

Ostatní jména:
  • Pioglitazon hydrochlorid
  • ACTOS (R)
Komparátor placeba: Matching Placebo
Placebo
Placebo will contain microcrystalline cellulose. An over-encapsulation process will be conducted in accordance with Clinical Good Manufacturing Procedures (cGMP) regulations to create a dosage form for the active study drug that will be indistinguishable from the comparator (Placebo) capsule.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change in Total Unified Parkinson's Disease Rating Scale (UPDRS) Score From Baseline to 44 Weeks
Časové okno: 44 weeks

Change in total UPDRS score from baseline to 44 weeks (in subjects treated with rasagiline 1 mg/day or selegiline 10 mg/day).

The Total UPDRS is the sum of parts I, II, and III. The possible range of the total UPDRS is from 0-176. Higher values indicate worse outcomes.

The change is 44 weeks - baseline.

44 weeks

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change in Ambulatory Capacity From Baseline to 44 Weeks
Časové okno: 44 weeks

This is the sum of the 5 UPDRS questions regarding ambulatory capacity: falling, freezing, walking, gait, postural stability.

Ambulatory Capacity is calculated as the sum of items 13-15, 29, 30 of the Unified Parkinson's Disease Rating Scale (UPDRS). It ranges from 0-20. Higher scores are worse. Change is 44 weeks - baseline.

44 weeks
Change in Schwab and England Scale From Baseline to 44 Weeks
Časové okno: 44 weeks
The modified Schwab and England Activities of Daily Living is a single question ranging from 0-100% with anchors for each 10% interval. Higher scores are better (100% completely independent- 0% vegetative).
44 weeks
Change in Parkinson's Disease Questionnaire (PDQ-39) From Baseline to 44 Weeks
Časové okno: 44 weeks

The Parkinson's Disease Questionnaire (PDQ-39) is a short, 39 item measure of quality of life in subjects with Parkinson's disease. The questionnaire covers 8 aspects of quality of life: mobility, activities of daily living, emotional well-being, stigma, social support, cognitions, communication and bodily discomfort.

The total score ranges from 0 (never have difficulty) to 100 (always have difficulty). Lower scores reflect better quality of life.

44 weeks
Change in the Mattis Dementia Rating Scale (DRS-2)From Baseline to 44 Weeks
Časové okno: 44 weeks
The Mattis dementia rating scale is a psychometric instrument designed to assess the extent and nature of dementia. Mattis Dementia Rating scale (DRS-2) raw score is the sum of 5 raw sub-scores (attention has possible 37 points, initiation/perseveration has possible 37 points, construction has possible 6 points, conceptualization has possible 39 points, memory has possible 25 points). Total range is 0-144. Higher scores are better.
44 weeks
Change in the 15-item Geriatric Depression Scale (GDS-15)From Baseline to 44 Weeks
Časové okno: 44 weeks
The Geriatric Depression Scale - 15 is a short 15 yes or no question instrument for assessing depression in the elderly. It has been found to be particularly useful in assessing depression in Parkinson's Disease. A score of 0 to 5 is normal. A score greater than 5 suggests depression.
44 weeks

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Ředitel studie: Tanya Simuni, MD, Northwestern University
  • Ředitel studie: Karl Kieburtz, MD MPH, University of Rochester

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia

1. března 2011

Primární dokončení (Aktuální)

1. května 2014

Dokončení studie (Aktuální)

1. května 2014

Termíny zápisu do studia

První předloženo

3. prosince 2010

První předloženo, které splnilo kritéria kontroly kvality

18. ledna 2011

První zveřejněno (Odhad)

20. ledna 2011

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Odhad)

14. října 2015

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

15. září 2015

Naposledy ověřeno

1. září 2013

Více informací

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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