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Trial of OnabotulinumtoxinA for Depression in Parkinson Disease

2. august 2019 oppdatert av: Johns Hopkins University

Randomized Controlled Trial of OnabotulinumtoxinA for Depression in Parkinson Disease

This study evaluates the efficacy of onabotulinumtoxinA (BOTOX®) in the treatment of depression associated with Idiopathic Parkinson Disease in adults. As a Randomized Controlled Trial, half of the participants will receive onabotulinumtoxinA injections and half will receive a placebo saline solution.

Studieoversikt

Status

Avsluttet

Detaljert beskrivelse

Depression is a common, but treatable, comorbid condition often seen in persons with Idiopathic Parkinson Disease (iPD). Depression in Parkinson Disease may be hard to treat as patients with iPD may be sensitive to side effect of medication. As a result, other treatments which have better side effects profiles than antidepressants may be equivalent (or better) options.

OnabotulinumtoxinA is a purified formulation of botulinum toxin serotype A which is widely utilized for neurological (and cosmetic) purposes in medicine. OnabotulinumtoxinA has preliminary studies showing it may be beneficial for the treatment of Major Depressive Disorder when given in isolated injections to facial muscles (corrugator and procerus). When given in low doses, onabotulinumtoxinA is thought to have minimal side effects.

The investigators propose that a single treatment onabotulinumtoxinA may improve symptoms of depression in persons with Parkinson Disease over three months compared to placebo. The investigators plan to use both subjective and objective evaluations of depression symptoms and regular physical exams to ensure physical (motor) symptoms of Parkinson Disease do not worsen.

Studietype

Intervensjonell

Registrering (Faktiske)

3

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Maryland
      • Baltimore, Maryland, Forente stater, 21287
        • Johns Hopkins University School Of Medicine

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 95 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Written informed consent is obtained in the English language;
  • They are a 18 to 95 years old;
  • They meet United Kingdom Brain Bank Criteria for probable idiopathic Parkinson disease;
  • They meet Diagnostic and Statistical Manual (DSM)-IV criteria for major depressive disorder (MDD) as diagnosed by the M.I.N.I. at screening;
  • They are judged by the investigator to have the capacity to understand the nature of the study;
  • They are willing to comply with all the requirements of the study;
  • They are considered by the investigator to be likely to adhere to the protocol.

Exclusion Criteria:

  • They have been treated with onabotulinumtoxinA injected into the facial muscles for any reason in the 3 months prior to screening;
  • They have Bipolar Disorder, Post-Traumatic Stress Disorder, a Psychotic Disorder or any other non-unipolar depressive disorder as a principal diagnosis in the 6 months prior to screening;
  • They endorse active suicidal ideation at enrollment or during any study visit, or have attempted suicide in the six months prior to screening;
  • They have a history of substance abuse or dependence in the 2 months prior to screening;
  • They test positive for illicit drugs on urine screen, and this has not been adequately explained to the satisfaction of the investigator
  • They are considered to be at significant risk of committing homicide;
  • They have an unstable medical condition;
  • Women of childbearing potential who are pregnant or are considering becoming pregnant during the length of the study;
  • There has been a change in their PD medication or psychotherapy treatment regimen in the 30 days preceding screening;
  • They are regarded, for any reason, by the principal investigator as being an unsuitable candidate for the protocol.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Intervention
One injection of onabotulinumtoxinA (29 units for women and 40 units for men) will be injected into two facial muscles - the corrugator and procerus.
OnabotulinumtoxinA (29 units for women; 40 units for men) diluted with 0.9% sodium chloride (saline) solution to 40 units per milliliter (mL) (0.725 mL for women, 1 mL for men)
Andre navn:
  • Botox
  • Botulinumtoksin type A
Placebo komparator: Control
One injection of saline solution will be injected into two facial muscles - the corrugator and procerus.
0.9% sodium chloride solution (saline) solution injections (0.725mL for women, 1mL for men)
Andre navn:
  • Vanlig saltvann

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Hamilton Rating Scale for Depression (HDRS)
Tidsramme: Baseline and two visits over three months (weeks 6 and 12)
Improvement on a clinician-rated objective scale for depression as assessed over two weeks (6 weeks and 12 weeks after treatment)
Baseline and two visits over three months (weeks 6 and 12)
Clinical Global Impression - Improvement (CGI-I)
Tidsramme: Baseline and two visits over three months (weeks 6 and 12)
Improvement on a measure of global change from screening to study discontinuation
Baseline and two visits over three months (weeks 6 and 12)
Clinical Global Impression - Severity (CGI-S)
Tidsramme: Baseline and two visits over three months (weeks 6 and 12)
Improvement on measure of global illness severity from screening to study discontinuation
Baseline and two visits over three months (weeks 6 and 12)
Beck Depression Inventory II
Tidsramme: Baseline and two visits over three months (weeks 6 and 12)
Improvement on a participant-rated subjective scale for depression as assessed over two visits
Baseline and two visits over three months (weeks 6 and 12)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Clinical Severity Score for Glabellar Frown Lines
Tidsramme: Baseline and two visits over three months (weeks 6 and 12)
Assessment of change in participant frowning before and after onabotulinumtoxinA injections and relationship with depressive symptoms
Baseline and two visits over three months (weeks 6 and 12)

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. november 2018

Primær fullføring (Faktiske)

30. mai 2019

Studiet fullført (Faktiske)

1. juni 2019

Datoer for studieregistrering

Først innsendt

28. februar 2017

Først innsendt som oppfylte QC-kriteriene

28. februar 2017

Først lagt ut (Faktiske)

3. mars 2017

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

6. august 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

2. august 2019

Sist bekreftet

1. august 2019

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Deidentified group data will be shared between the two study sites (Johns Hopkins and NIH)

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Ja

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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