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Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of PF-06649751 in Parkinson's Disease

3 de febrero de 2017 actualizado por: Pfizer

A Phase 1b, 2-period, Open Label, Multicenter, Dose Escalation Study To Evaluate The Safety, Tolerability, Pharmacokinetics And Pharmacodynamics Of Pf-06649751 In Subjects With Parkinson's Disease And Motor Fluctuations

This study will be an open label, dose escalation study to investigate the safety, tolerability, pharmacokinetics and pharmacodynamics of repeated daily quaque die (QD) doses given over 21 days (Day 3 to Day 23) to sequential cohorts of subjects with Parkinson's disease. Each cohort will have 2 study periods. For each cohort, subjects will enter Period 1 and if they meet criteria, approximately 12 subjects will be enrolled into Period 2 and dosed with PF 06649751. Based on results observed in a previous study, Cohorts 1 and 2 will not be conducted. Cohorts 3 - 6 will test doses uptitrated to 5 mg, 15 mg and 25 mg QD. Doses may be modified based on emerging safety, tolerability and PK data, but the maximum daily dose that will be given in any cohort will have PK predictions at steady state that are anticipated to be below toxicokinetic limits. An option for down titration to the previous dose level is available should the investigator consider that an AE is intolerable. Following down titration, a single up titration to the next dose level may be attempted if the subject remains symptom free for at least 48 hrs. Safety, tolerability and PK data of Cohort 3 will be reviewed prior to initiating the dosing in Cohorts 4 and 5. Available safety, tolerability and PK data up to Day 24 of at least 5 subjects from Cohorts 4 will be reviewed prior to initiating the dosing in Cohort 6.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Actual)

50

Fase

  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Bélgica
      • Brussels, Bélgica, B-1070
        • Pfizer Clinical Research Unit
  • Estados Unidos
    • California
      • Fountain Valley, California, Estados Unidos, 92708
        • The Parkinson's and Movement Disorder Institute
      • Fountain Valley, California, Estados Unidos, 92708
        • Orange Coast Memorial Medical Center
      • Long Beach, California, Estados Unidos, 90806
        • Collaborative Neuroscience Network, LLC
    • Colorado
      • Englewood, Colorado, Estados Unidos, 80113
        • Rocky Mountain Movement Disorders Center
      • Lakewood, Colorado, Estados Unidos, 80228
        • Davita Clinical Research Center
    • Florida
      • Hallandale Beach, Florida, Estados Unidos, 33009
        • MD Clinical
      • Orlando, Florida, Estados Unidos, 32806
        • Compass Research, LLC
    • Georgia
      • Atlanta, Georgia, Estados Unidos, 30331
        • Atlanta Center for Medical Research
    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02114
        • Massachusetts General Hospital
      • Boston, Massachusetts, Estados Unidos, 02114
        • Massachusetts General Hospital -- FOR DRUG SHIPMENT ONLY
    • Michigan
      • Farmington Hills, Michigan, Estados Unidos, 48334
        • Quest Research Institute
    • New Jersey
      • Marlton, New Jersey, Estados Unidos, 08053
        • PRA International
    • North Carolina
      • Raleigh, North Carolina, Estados Unidos, 27612
        • Carolina Phase I Research, LLC
    • Oklahoma
      • Oklahoma City, Oklahoma, Estados Unidos, 73112
        • Lynn Health Science Institute
    • Texas
      • Dallas, Texas, Estados Unidos, 75231
        • Neurology Consultants of Dallas, PA
      • Dallas, Texas, Estados Unidos, 75231
        • Walnut Hill Medical Center

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

30 años a 80 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Clinical diagnosis of idiopathic Parkinson's Disease with at least 2 out of 3 cardinal characteristics (tremor, rigidity, bradykinesia)
  • Mini-Mental State Examination (MMSE) ≥ 25
  • Hoehn & Yahr Stage I-III inclusive
  • Documented history of end of L-Dopa wearing OFF
  • Cohort 5 only: History of dyskinesia following L-Dopa dosing and Score of at least 2 on Part IV, item 4.2 (functional impact of dyskinesia) of the MDS-UPDRS

Exclusion Criteria:

  • Atypical/secondary parkinsonism
  • History of surgical intervention for Parkinson's Disease
  • Dementia/cognitive impairment that can interfere with study assessments

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Ciencia básica
  • Asignación: No aleatorizado
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Cohort 3
Titration of PF-06649751 up to 5 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 5mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD (slow titration with option to down titrate)
Droga: PF-06649751
Oral daily doses titrated up to 25 mg QD
Experimental: Cohort 4
Titration of PF-06649751 up to 15 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 5mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD (slow titration with option to down titrate)
Droga: PF-06649751
Oral daily doses titrated up to 25 mg QD
Experimental: Cohort 5
Titration of PF-06649751 up to 15 mg QDi n subjects with Levodopa-induced dyskinesias (LID)
Droga: PF-06649751
Oral daily doses titrated up to 5mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD (slow titration with option to down titrate)
Droga: PF-06649751
Oral daily doses titrated up to 25 mg QD
Experimental: Cohort 6
Titration of PF-0649751 up to 25 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 5mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD
Droga: PF-06649751
Oral daily doses titrated up to 15 mg QD (slow titration with option to down titrate)
Droga: PF-06649751
Oral daily doses titrated up to 25 mg QD

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Periodo de tiempo: Baseline (Day 1) up to Day 30
An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; Initial or prolonged in-patient hospitalization; life threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug to the end of study (up to Day 30) that were absent before treatment or that worsened relative to pre-treatment state. AEs included both serious and non-serious adverse events.
Baseline (Day 1) up to Day 30
Number of Participants With Laboratory Test Abnormalities
Periodo de tiempo: Baseline up to Day 30
Criteria for laboratory abnormalities: Hemoglobin (Hgb),hematocrit, red blood cell(RBC) count: less than(<)0.8*lower limit of normal(LLN),mean corpuscular Hgb, mean corpuscular volume, mean corpuscular Hgb concentration:<0.9*LLN, greater than (>)1.1*upper limit of normal(ULN),platelet:<0.5*LLN,>1.75*ULN,lymphocyte,neutrophil:<0.8*LLN, >1.2*ULN, basophil, eosinophil, monocyte:>1.2*ULN, WBC:<0.6*LLN, >1.5*ULN;total bilirubin>1.5*ULN, aspartate aminotransferase,alanine aminotransferase,alkaline phosphatase:>3.0*ULN,total protein,albumin:<0.8*LLN,>1.2*ULN;blood urea nitrogen,creatinine:>1.3*ULN, uric acid>1.2*ULN;sodium<0.95*LLN,>1.05*ULN,potassium,chloride,calcium,bicarbonate:<0.9*LLN,>1.1*ULN;glucose<0.6*LLN,>1.5*ULN,urine pH:<4.5, >8; urine: WBC, RBC greater than or equal to (>=)20/high performance field, bacteria: >20; urobilinogen, urine: glucose, ketone, protein, Hgb, nitrite, leukocyte esterase, bilirubin: >=1.
Baseline up to Day 30
Number of Participants With Vital Sign Abnormalities
Periodo de tiempo: Baseline up to Day 30
Criteria for vital sign abnormality included supine pulse rate of <40 beats per minute (bpm) or >120 bpm, standing pulse rate of <40 bpm or >140 bpm, supine and standing systolic blood pressure (SBP) <90 millimeter of mercury (mmHg), supine and standing diastolic blood pressure (DBP) <50 mmHg, supine and standing SBP of >=30 mmHg maximum (max.) increase from baseline (IFB) and and decrease from baseline (DFB) in same posture, supine and Standing DBP of >=20 mmHg max. increase and decrease from baseline in same posture. Categories in which there was atleast 1 abnormality are reported in this outcome measure.
Baseline up to Day 30
Number of Participants With Electrocardiogram (ECG) Abnormalities
Periodo de tiempo: Baseline up to Day 30
Criteria for ECG abnormalities: maximum PR interval >=300 milliseconds (msec) and maximum increase PR interval increase from baseline (IFB): percent change (Pctchg) >=25 percent (%) for baseline value of >200 msec and Pctchg>=50% for baseline value of <=200 msec for PR interval, maximum QRS interval >=140 msec and a maximum IFB: Pctchg>=50%, maximum QTCF interval (Fridericia's Correction) of 450 msec to <480 msec, 480 msec to <500 msec or >=500 msec and a maximum change of <=30change<60 or >=60 msec from baseline.
Baseline up to Day 30
Number of Participants With Clinically Significant Change From Baseline in Physical Examination Findings
Periodo de tiempo: Baseline up to Day 30
Physical examination included examination of the head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. The examination assessed the participants for any potential changes in general appearance, the respiratory and cardiovascular systems, as well as towards participant reported symptoms. Findings were considered to be clinically significant based on investigator's decision.
Baseline up to Day 30
Number of Participants With Clinically Significant Neurological Examination Abnormality
Periodo de tiempo: Baseline up to Day 30
The complete or full neurological examination included assessment of the cranial nerves; muscle strength, tone, cortical drift, abnormal movements; deep tendon reflexes; sensory exam, coordination, gait and station. Higher cortical and motor function was considered part of the complete neurological exam. Findings were considered abnormal as confirmed by a certified neurologist.
Baseline up to Day 30
Number of Participants With Categorical Scores on The Columbia Suicide Severity Rating Scale (C-SSRS)
Periodo de tiempo: Baseline up to Day 30
The C-SSRS was an interview-based rating scale to systematically assess suicidal ideation and suicidal behavior. C-SSRS assessed whether participant experienced any of the following 1: completed suicide, 2: suicide attempt (response of "yes" on "actual attempt"), 3: preparatory acts toward imminent suicidal behavior ("yes" on "aborted attempt", "interrupted attempt", "preparatory acts or behavior"), 4: any suicidal behavior or ideation, suicidal ideation ("yes" on "wish to be dead", "non-specific active suicidal thoughts", "active suicidal ideation with methods without intent to act or some intent to act, without specific plan or with specific plan and intent"), 7: self-injurious behavior, no suicidal intent ("yes" on "has participant engaged in non-suicidal self-injurious behavior").
Baseline up to Day 30
Change From Baseline in Parkinson's Disease Diary For Participants With Motor Fluctuations at Day 13
Periodo de tiempo: Baseline, Day 13
According to Parkinson's disease diaries of participants "OFF" time was a time period when the medication no longer providing benefit with regard to mobility, slowness, and stiffness and participants experienced relatively poor overall function with worsening of tremor, rigidity, balance, or bradykinesia. "ON" time was a time period when medication was providing benefit with regard to mobility, slowness, and stiffness. "ON" time was classified as associated with or without troublesome dyskinesia (TD) that interfere with activities of daily living and with or without dyskinesia. "OFF" time and "ON" time with TD were generally considered to be "bad time" with regard to motor function, whereas "ON" time without dyskinesia (WD) and with non- troublesome dyskinesia (NTD) were generally considered to be "good time".
Baseline, Day 13
Change From Baseline in Parkinson's Disease Diary For Participants With Motor Fluctuations at Day 20
Periodo de tiempo: Baseline, Day 20
According to Parkinson's disease diaries of participants "OFF" time was a time period when the medication no longer providing benefit with regard to mobility, slowness, and stiffness and participants experienced relatively poor overall function with worsening of tremor, rigidity, balance, or bradykinesia. "ON" time was a time period when medication was providing benefit with regard to mobility, slowness, and stiffness. "ON" time was classified as associated with or without troublesome dyskinesia (TD) that interfere with activities of daily living and with or without dyskinesia. "OFF" time and "ON" time with TD were generally considered to be "bad time" with regard to motor function, whereas "ON" time without dyskinesia (WD) and with non- troublesome dyskinesia (NTD) were generally considered to be "good time".
Baseline, Day 20

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Maximum Observed Plasma Concentration (Cmax) of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Time to Reach Maximum Observed Plasma Concentration (Tmax) of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Apparent Clearance (CL/F) of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Terminal Half-Life (t1/2) of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Terminal half-life is the time measured for the plasma concentration of drug to decrease by one half. It was calculated as dividing the natural logarithm to the base e (Log e)*2/k el, where k el is the terminal phase rate constant calculated by a linear regression of the log-linear concentration-time curve.
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Area Under the Curve From Time Zero Extrapolated to Infinite Time of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
AUC (0 - inf)= Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0 - inf). It is obtained from AUC (0 - t) plus AUC (t - inf).
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Area Under the Curve From Time Zero to Last Quantifiable Concentration of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Area under the plasma concentration-time profile from time zero to the time of the last quantifiable concentration (C last).
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Apparent Volume of Distribution (Vz/F) of L-Dopa
Periodo de tiempo: Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Apparent volume of distribution after oral dose (Vz/F) is influenced by the fraction absorbed.
Pre-dose, 0.5, 1, 2, 4 and 8 hours post-dose on Day 1
Maximum Observed Plasma Concentration (Cmax) of PF-06649751
Periodo de tiempo: Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Time to Reach Maximum Observed Plasma Concentration (Tmax) of PF-06649751
Periodo de tiempo: Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Apparent Clearance (CL/F) of PF-06649751
Periodo de tiempo: Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 22
Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.
Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 22
Area Under the Curve From Time Zero to End of Dosing Interval of PF-06649751
Periodo de tiempo: Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Area under the concentration curve from time zero to end of dosing interval (AUCtau), where dosing interval was 12 hours.
Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Minimum Observed Plasma Trough Concentration (Cmin) of PF-06649751
Periodo de tiempo: Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Ratio of Accumulation for Area Under the Curve From Time Zero to End of Dosing Interval of PF-06649751
Periodo de tiempo: Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22
Rac was obtained from AUCtau after last dose divided by AUCtau after first dose, where AUC(tau) = Area under the concentration curve from time zero to end of dosing interval (AUCtau), where dosing interval was 12 hours.
Pre-dose on Day 3, 4, 8, 11, 14, 17, 20, Pre-dose, 0.5, 1, 1.5, 2, 4, 8 and 12 hour post-dose on Day 7, 13, 22

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Pfizer

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Enlaces Útiles

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de octubre de 2014

Finalización primaria (Actual)

1 de marzo de 2016

Finalización del estudio (Actual)

1 de marzo de 2016

Fechas de registro del estudio

Enviado por primera vez

15 de agosto de 2014

Primero enviado que cumplió con los criterios de control de calidad

21 de agosto de 2014

Publicado por primera vez (Estimar)

25 de agosto de 2014

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

27 de marzo de 2017

Última actualización enviada que cumplió con los criterios de control de calidad

3 de febrero de 2017

Última verificación

1 de diciembre de 2016

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • B7601005
  • 2014-003472-22 (Número EudraCT)

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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