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Pioglitazone in Early Parkinson's Disease

2015년 9월 15일 업데이트: 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.

연구 개요

상태

완전한

정황

상세 설명

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.

연구 유형

중재적

등록 (실제)

210

단계

  • 2 단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

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

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

30년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

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.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 네 배로

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 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.

다른 이름들:
  • 피오글리타존 염산염
  • ACTOS (R)
실험적: 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.

다른 이름들:
  • 피오글리타존 염산염
  • ACTOS (R)
위약 비교기: 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.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change in Total Unified Parkinson's Disease Rating Scale (UPDRS) Score From Baseline to 44 Weeks
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
Change in Ambulatory Capacity From Baseline to 44 Weeks
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 연구 책임자: Tanya Simuni, MD, Northwestern University
  • 연구 책임자: Karl Kieburtz, MD MPH, University of Rochester

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2011년 3월 1일

기본 완료 (실제)

2014년 5월 1일

연구 완료 (실제)

2014년 5월 1일

연구 등록 날짜

최초 제출

2010년 12월 3일

QC 기준을 충족하는 최초 제출

2011년 1월 18일

처음 게시됨 (추정)

2011년 1월 20일

연구 기록 업데이트

마지막 업데이트 게시됨 (추정)

2015년 10월 14일

QC 기준을 충족하는 마지막 업데이트 제출

2015년 9월 15일

마지막으로 확인됨

2013년 9월 1일

추가 정보

이 연구와 관련된 용어

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

파킨슨 병에 대한 임상 시험

Pioglitazone에 대한 임상 시험

구독하다