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Evaluation of the Efficacy and Safety of Modified Release AFQ056 in Parkinson's Patients With L-dopa Induced Dyskinesias

2020년 12월 15일 업데이트: Novartis Pharmaceuticals

13-week, Double-blind, Placebo-controlled, Fixed-dose, Multicenter Study to Evaluate the Efficacy and Safety of Modified Release AFQ056 in Reducing Moderate to Severe L-dopa Induced Dyskinesias in Patients With Parkinson's Disease

This study will assess the efficacy and safety of modified release AFQ056 in patients that have Parkinson's Disease L-dopa Induced Dyskinesias (PD-LID)

연구 개요

연구 유형

중재적

등록 (실제)

154

단계

  • 2 단계

연락처 및 위치

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

연구 장소

      • Beelitz-Heilstaetten, 독일, 14547
        • Novartis Investigative Site
      • Berlin, 독일, 12163
        • Novartis Investigative Site
      • Bochum, 독일, 44791
        • Novartis Investigative Site
      • Duesseldorf, 독일, 40225
        • Novartis Investigative Site
      • Kassel, 독일, 34128
        • Novartis Investigative Site
      • Leipzig, 독일, 04103
        • Novartis Investigative Site
      • Muenchen, 독일, 80804
        • Novartis Investigative Site
      • München, 독일, 81675
        • Novartis Investigative Site
      • Stadtroda, 독일, 07646
        • Novartis Investigative Site
    • California
      • Sunnyvale, California, 미국, 94089
        • Novartis Investigative Site
    • Colorado
      • Englewood, Colorado, 미국, 80113
        • Novartis Investigative Site
    • Florida
      • Tampa, Florida, 미국, 33612
        • Novartis Investigative Site
    • Kansas
      • Kansas City, Kansas, 미국, 66160
        • Novartis Investigative Site
    • Wisconsin
      • Milwaukee, Wisconsin, 미국, 53233
        • Novartis Investigative Site
      • Bern, 스위스, 3010
        • Novartis Investigative Site
      • Lausanne, 스위스, 1011
        • Novartis Investigative Site
      • Madrid, 스페인, 28006
        • Novartis Investigative Site
    • Cataluña
      • Barcelona, Cataluña, 스페인, 08025
        • Novartis Investigative Site
      • Barcelona, Cataluña, 스페인, 08036
        • Novartis Investigative Site
      • Sant Cugat, Cataluña, 스페인, 08190
        • Novartis Investigative Site
    • Pais Vasco
      • San Sebastian, Pais Vasco, 스페인, 20014
        • Novartis Investigative Site
      • Bratislava, 슬로바키아, 82606
        • Novartis Investigative Site
      • Bratislava, 슬로바키아, 83305
        • Novartis Investigative Site
      • Innsbruck, 오스트리아, A-6020
        • Novartis Investigative Site
      • Linz, 오스트리아, A-4020
        • Novartis Investigative Site
      • Vienna, 오스트리아, A-1220
        • Novartis Investigative Site
    • BS
      • Brescia, BS, 이탈리아, 25123
        • Novartis Investigative Site
    • BZ
      • Bolzano, BZ, 이탈리아, 39100
        • Novartis Investigative Site
    • PI
      • Pisa, PI, 이탈리아, 56126
        • Novartis Investigative Site
    • RM
      • Roma, RM, 이탈리아, 00163
        • Novartis Investigative Site
      • Roma, RM, 이탈리아, 00179
        • Novartis Investigative Site
    • Ontario
      • London, Ontario, 캐나다, N6A 5A5
        • Novartis Investigative Site
      • Clermont-Ferrand Cedex 1, 프랑스, 63003
        • Novartis Investigative Site
      • Lille Cedex, 프랑스, 59037
        • Novartis Investigative Site
      • Pessac, 프랑스, 33604
        • Novartis Investigative Site
      • Poitiers, 프랑스, 86021
        • Novartis Investigative Site
      • Budapest, 헝가리, 1085
        • Novartis Investigative Site
      • Kaposvár, 헝가리, 7400
        • Novartis Investigative Site
      • Szeged, 헝가리, H-6725
        • Novartis Investigative Site

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 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • Males and Females 30-80 years old
  • Use of highly effective methods of contraception during study in women of childbearing potential
  • Outpatients
  • Clinical diagnosis of Parkinson's Disease according to UK Parkinson's Disease Society Brain Bank Clinical Diagnosis criteria
  • Score of >/= 2 on UPDRS items 32 and 33
  • Dyskinesias for at least 3 months before baseline
  • On stable treatment regimen with L-dopa and other anti-parkinsonian treatment for 4 weeks prior to baseline
  • Demonstrate capacity to complete accurate diary ratings
  • Patients who have a primary caregiver willing to assess the condition of the patient throughout the study in accordance with protocol requirements
  • Group 2 only: Patients must be on a stable and well tolerated dose of amantadine for at least 4 weeks prior to BL1 and must maintain the stable dose of amantadine during the remainder of the study

Exclusion Criteria:

  • Atypical/secondary form of Parkinson's disease
  • History of surgical treatment of PD, including deep brain stimulation
  • A score of 5 in the "ON"- state on the Modified Hoehn and Yahr scale
  • Advanced, severe, or unstable disease other than PD
  • Evidence of dementia
  • Treatment with certain prohibited medications
  • Amantadine within 2 weeks prior to BL1 visit (applies to Group 1 only)

Other protocol-defined inclusion/exclusion criteria may apply.

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: AFQ056 150 mg
Patients randomized to the AFQ056 150 mg arm will receive AFQ056 oral tablets to be titrated until reaching the target dose of 150 mg twice daily.

AFQ056 will be supplied as oral modified release tablets in 25 mg, 50 mg, 100 mg, 150 mg, and 200 mg.

Patients will be randomized in two groups by amantadine status.

  • Group 1: Patients are not permitted to take amantadine within 2 weeks prior to the BL1 visit.
  • Group 2: Patients must be on a stable and well tolerated dose of amantadine for at least 4 weeks prior to BL1 and must maintain the stable dose of amantadine during the remainder of the study.)
실험적: AFQ056 200 mg

Patients randomized to the AFQ056 200 mg arm will receive AFQ056 oral tablets to be titrated until reaching the target dose of 200 mg twice daily.

Patients will be randomized in two groups by amantadine status.

  • Group 1: Patients are not permitted to take amantadine within 2 weeks prior to the BL1 visit.
  • Group 2: Patients must be on a stable and well tolerated dose of amantadine for at least 4 weeks prior to BL1 and must maintain the stable dose of amantadine during the remainder of the study.)

AFQ056 will be supplied as oral modified release tablets in 25 mg, 50 mg, 100 mg, 150 mg, and 200 mg.

Patients will be randomized in two groups by amantadine status.

  • Group 1: Patients are not permitted to take amantadine within 2 weeks prior to the BL1 visit.
  • Group 2: Patients must be on a stable and well tolerated dose of amantadine for at least 4 weeks prior to BL1 and must maintain the stable dose of amantadine during the remainder of the study.)
위약 비교기: Placebo
Patients randomized to the Placebo arm will receive oral AFQ056 Placebo twice daily
Placebo for AFQ056 will be supplied as oral tablets.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change in modified AIMS (Abnormal Involuntary Movement Scale) total score from baseline to Week 12
기간: 12 weeks

The modified AIMS is a scale used to assess dyskinesia. It focuses on six different parts of the body and rates abnormal movements from 0 (absence of dyskinesia to 4 (severe) (maximal score, 24).

Change from baseline to Week 12 will be analyzed using the mixed effect repeated measures model (MMRM) including treatment, pooled center, week, treatment by week interaction as fixed effects and baseline total score as covariate with an unstructured covariance structure.

12 weeks
The incidence rate of adverse events
기간: Monitored for the duration of the study which is 13 weeks

The occurrence of adverse events would be sought by non-directive questioning of the patient. Adverse events may also be detected when they are volunteered by the patient or through physical examination, laboratory test, or other assessments.

AEs will be summarized by presenting, for each treatment group the number and percentage of patients having any adverse event, having an adverse event in each system organ class and having each individual adverse event by system organ class and preferred term.

Monitored for the duration of the study which is 13 weeks
Time to onset of adverse events
기간: Monitored for the duration of the study which is 13 weeks

The occurrence of adverse events (AEs) would be sought by non-directive questioning of the patient. Adverse events may also be detected when they are volunteered by the patient or through physical examination, laboratory test, or other assessments.

AEs will be summarized by presenting, for each treatment group the number and percentage of patients having any adverse event, having an adverse event in each system organ class and having each individual adverse event by system organ class and preferred term.

Monitored for the duration of the study which is 13 weeks
The percentage of patients reaching and maintaining the target dose during the fixed dose treatment period
기간: Assessed during the fixed dose treatment period of 6 weeks

Randomized patients will be up titrated to the target dose and remain on the target dose for the duration of the fixed dose treatment period.

AEs will be summarized by presenting, for each treatment group the number and percentage of patients having any adverse event, having an adverse event in each system organ class and having each individual adverse event by system organ class and preferred term.

Assessed during the fixed dose treatment period of 6 weeks
The percentage of patients discontinued during the up titration period due to AE
기간: Assessed during the up titration period of 6 weeks

Patients randomized will be up titrated to the target doses at regular intervals during the up titration period.

AEs will be summarized by presenting, for each treatment group the number and percentage of patients having any adverse event, having an adverse event in each system organ class and having each individual adverse event by system organ class and preferred term.

Assessed during the up titration period of 6 weeks

2차 결과 측정

결과 측정
측정값 설명
기간
The change in total score and sub-score of UDysRS Parts I, II, III, and IV from baseline to Week 12
기간: 12 weeks

The UDysRS captures dyskinesia and has 4 parts: I: Historical Disability of On-Dyskinesia impact (max 44 pts); II: Historical Disability of Off-Dystonia impact (max 16 pts); III: Objective Impairment dyskinesia (max 28 pts); IV: Objective Disability based on Part III activities (max 16 pts). Higher scores mean greater severity.

Change from baseline to Week 12 will be analyzed using mixed-effect repeated measure model (MMRM) including treatment, pooled center, week, treatment by week interaction as fixed effects and baseline total score as covariate with an unstructured covariance structure.

12 weeks
Change in Lang-Fahn Activities of Daily Living Dyskinesia Scale (LFADLDS) total score from baseline to Week 12
기간: 12 weeks

The LFADLDS assesses the degree of dyskinesia interfering with activities of daily living. Specific definitions for severity rating codes (range, 0-4 for each task) will be provided for reproducibility of results. A higher score indicates more severe impairment. A patient and caregiver version of the revised LFADLDS will be used in this study.

Change from baseline to Week 12 will be analyzed using MMRM including treatment, pooled center, week, treatment by week interaction as fixed effects and baseline total score as covariate with an unstructured covariance structure.

12 weeks
Change in clinician-rated global impression of change (CGIC) score from baseline to Week 12
기간: 12 weeks

The CGIC provides investigator-rated assessment of change from baseline to assess disability due to dyskinesia. Change from baseline will be rated on a 7-point, Likert-type scale where 1 = markedly improved, 2 = moderately improved, 3 = minimally improved, 4 = unchanged, 5 = minimally worse, 6 = moderately worse, and 7 = markedly worse.

The CGIC score at week 12 last observation carried forward (LOCF) will be analyzed using analysis of covariance (ANCOVA) model with treatment group, pooled center, and baseline CGIS (Clinical Global Impression of Severity) score as factors.

12 weeks
Change from baseline Total ON- and OFF-times and ON-time with dyskinesia and with troublesome dyskinesias (patient diary) to Week 12
기간: 12 weeks

A patient home diary developed and validated for use in PD patients will be used to record whether the patient is asleep, OFF, ON without dyskinesia, ON with troublesome dyskinesias, and ON with non-troublesome dyskinesia.

Change from baseline to Week 12 will be analyzed using MMRM including treatment, pooled center, week, treatment by week interaction as fixed effects and baseline total score as covariate with an unstructured covariance structure.

12 weeks
Change in score for items 32, 33 and 34 of Part IV of the Unified Parkinson's Disease Rating Scale (UPDRS ) from baseline to Week 12
기간: 12 weeks

UPDRS assesses the disease state of PD. Question 32 assesses length of dyskinesias in percentage of the day. Question 33 assesses disability during the previous week (not disabling, mildly disabling, moderately disabling, severely disabling, completely disabling). Question 34 assesses painfulness of dyskinesias from 0 (no painful dyskinesias) to 4 (marked).

The change will be analyzed using MMRM including treatment, pooled center, week, treatment by week interaction as fixed effects and baseline total score as covariate with an unstructured covariance structure.

12 weeks
Changes in vital signs from baseline to each post-baseline visit
기간: Monitored at regular visits throughout duration of the study which is 13 weeks
Pulse and blood pressures are taken at each visit. Vital sign data will be summarized by presenting summary statistics for change from baseline values. The incidence rates of clinically notable vital sign abnormalities will be summarized.
Monitored at regular visits throughout duration of the study which is 13 weeks
Changes in hematology/blood chemistry and urinalysis laboratory evaluations from baseline to each post-baseline visit where hematology/blood chemistry and urinalysis are collected
기간: Monitored at regular visits throughout duration of the study which is 13 weeks
Standard hematology with differential; measures of coagulability: aPTT, PT/INR; standard clinical chemistry; FSH, LH, oxytocin, prolactin, TBG, TSH, and T4; urinalysis (specific gravity, protein, glucose and blood) Laboratory data will be summarized by presenting shift tables, by presenting summary statistics, change from baseline values, and incidence rates of clinically notable abnormalities summarized.
Monitored at regular visits throughout duration of the study which is 13 weeks
Changes in electrocardiogram (ECG) from baseline to each post-baseline visit where ECGs are performed
기간: Monitored at regular visits throughout duration of the study which is 13 weeks

A standard 12-lead ECG will be performed. A central facility will be used for interpretation and analysis of the ECGs.

ECG intervals will be summarized by summary statistics for change from baseline values and incidence rates of clinically notable abnormalities summarized.

Monitored at regular visits throughout duration of the study which is 13 weeks
Percentage of adverse events including treatment emergent adverse events and serious adverse events
기간: Monitored for the duration of the study which is 13 weeks

The occurrence of adverse events would be sought by non-directive questioning of the patient. Adverse events may be detected when they are volunteered by the patient or through physical examination, laboratory test, or other assessments.

Treatment-emergent adverse events (TEAEs) will be summarized by presenting, for each treatment group, the number and percentage of patients having an AE, having an AE in each system organ class and having each AE by system organ class and preferred term.

Monitored for the duration of the study which is 13 weeks
Change in Unified Parkinson's Disease Rating Scale (UPDRS) Part III (Motor Examination) scores from baseline to Week 12
기간: 12 weeks

Part III of the UPDRS (items 18-31; score 0-56), measures speech, facial expression, tremor, action or postural tremor, rigidity, finger taps, hand movement, alternating movement, leg agility, arising from a chair, posture, gait, postural stability, and bradykinesia. A higher score means worsening of symptoms.

Changes from baseline to Week 12 will be analyzed using MMRM including treatment, pooled center, week, treatment by week interaction as fixed effects and baseline total score as covariate with an unstructured covariance structure.

12 weeks
Change in Mini Mental State Exam (MMSE) total scores from baseline to Week 12
기간: 12 weeks

The MMSE is a test of cognitive dysfunction consisting of orientation, registration, attention-calculation, recall, and language administered by a health care professional. The MMSE results in total possible score of 30, with higher scores meaning better function.

The change from baseline to endpoint at Week 12 in MMSE total score will be analyzed using LOCF ANCOVA with treatment group and pooled center as factors and the baseline score as a covariate. Treatment differences in the change from baseline for scores with 90% CI will be reported as descriptive statistics.

12 weeks
Change in cognitive test battery (CogState) scores form baseline to Week 12
기간: 12 weeks

This test consists of: Detection Task, Identification Task, One Card Learning Task, One Back Task, and International Shopping List Task. Speed times and working memory will be measured by the number of correct responses.

The change from baseline to endpoint at Week 12 for cognitive function will be analyzed using LOCF ANCOVA with treatment group and pooled center as factors and the baseline score as a covariate. Treatment differences in the change from baseline for cognitive function with 90% CI will be reported as descriptive statistics

12 weeks
Total scores of the Scales for Outcomes in Parkinson's disease - Psychiatric Complications (SCOPA-PC)
기간: Assessed for 12 weeks

The SCOPA-PC is an easily administered semi-structured, questionnaire developed for the assessment of psychiatric symptoms in Parkinson's disease patients administered by a clinician with input provided by patient and caregiver. The total SCOPA score ranges from 0-21, with higher scores reflecting more psychiatric complications.

The SCOPA-PC total score and each of the item scores will be summarized.

Assessed for 12 weeks
Proportion of patients who have suicidal ideation and behavior as mapped to Columbia Classification Algorithm for Suicide assessment (C-CASA) using data from Columbia-Suicide Severity Rating Scale (C-SSRS)
기간: This will be assessed for the duration of the study which is 13 weeks

The C-SSRS assesses suicidal ideation/behavior using a patient interview. The data is mapped to Columbia Classification Algorithm for Suicide assessment. The code and categories are: completed suicide, suicide attempt, preparatory actions toward imminent suicide behavior, suicidal ideation, self-injurious behavior without suicidal intent.

The proportion of patients who are coded in the categories above, the proportion of patients with any suicidal behavior engaged in during the study, and the proportion of patients with suicidality will be summarized.

This will be assessed for the duration of the study which is 13 weeks
Plasma Pharmacokinetics of AFQ056 in patients with Parkinson's disease with moderate to severe dyskinesias
기간: At Week 12 or earlier if the patient discontinues the study before Week 12

Blood samples will be taken by either direct venipuncture or an indwelling cannula inserted in a forearm vein. The first blood sample will be collected 1-3 hours after morning study medication dose. The second sample will be collected 3-5 hours after the morning study medication dose. The third blood sample will be collected 5-7 hours after the morning study medication dose.

Summary statistics for concentrations per sampling window will be provided and average plasma levels will be calculated.

At Week 12 or earlier if the patient discontinues the study before Week 12
Pharmacokinetics of AFQ056 in patients with Parkinson's disease with moderate to severe dyskinesias
기간: Monitored at regular visits throughout duration of the study which is 13 weeks

Blood samples will be taken by either direct venipuncture or an indwelling cannula inserted in a forearm vein. An alternative sampling method will also be explored. At all visits, the sample will be collected 1-3 hours after morning study medication dose. At Week 12, the second sample will be collected 3-5 hours after the morning study medication dose and the third sample will be collected 5-7 hours after the morning study medication dose.

Summary statistics for concentrations per sampling window will be provided and average plasma levels will be calculated.

Monitored at regular visits throughout duration of the study which is 13 weeks
Investigate the safety of concomitant administration of AFQ056 with amantadine
기간: 12 weeks
Investigation of the safety of AFQ056 with concomitant amantadine is being studied to gather drug-drug interaction data of amantadine and AFQ056 in this patient population.
12 weeks

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여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

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

2012년 4월 1일

기본 완료 (실제)

2013년 4월 1일

연구 완료 (실제)

2013년 4월 1일

연구 등록 날짜

최초 제출

2011년 12월 12일

QC 기준을 충족하는 최초 제출

2011년 12월 12일

처음 게시됨 (추정)

2011년 12월 14일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2020년 12월 23일

QC 기준을 충족하는 마지막 업데이트 제출

2020년 12월 15일

마지막으로 확인됨

2016년 3월 1일

추가 정보

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. .

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