Parkinson's Disease With Motor Response Fluctuations (OFF Phenomena) MedDRA version: 18.1 Level: LLT Classification code 10034007 Term: Parkinson's disease NOS System Organ Class: 100000004852
Conditions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Has signed and dated an IRB/IEC-approved informed consent form before any protocol-specific screening procedures are performed. 2. Is a male or female aged 30 to 85 years, inclusive.Women of child-bearing potential must use protocol-defined contraceptive measures (see Section 11.1.5) and must have a negative serum human chorionic gonadotropin (hCG) test at screening. These patients must be willing to remain on their current form of contraception for the duration of the study. 3. Patients who have idiopathic PD (i.e., not induced by drugs or other diseases) as defined by fulfilling Steps 1 and 2 of the United Kingdom (UK) Brain Bank criteria, diagnosed after the age of 30 years. 4. Patients who are classified as Stage 1 to 3 (in the ON state) on the modified Hoehn and Yahr scale for staging of PD severity. 5. Patients who have experienced motor fluctuations for a minimum of 2 hours of average daily OFF time per waking day (excluding early morning OFF time) by self-report and confirmed by the PD Diary (on 3 consecutive days) during the screening period. 6a. Patients who are on a LD-containing therapy, not including Rytary (or equivalent), must be stable on oral LD-containing therapy for at least 2 weeks prior to SV1 with a LD/DDI-containing regimen 6b. Patients who are on a LD-containing therapy, when including Rytary (or equivalent), should be on a stable dose for at least 6 weeks prior to SV1. 6c. The frequency of L-dopa administrations must be at least 3 times during the waking day and a total daily LD dose of = 1600 mg. 7. Patients should be stable on other PD medications for at least 4 weeks prior to SV1. 8. Patients must have a = 25% difference between UPDRS Part 3 scores recorded in their ON and OFF states at screening. 9. Patients must understand (with or without caregiver assistance) their daily medication regimen and must agree that they will not change their daily medication doses during the study. 10. Patients must have normal cognition as confirmed by a score of = 25 on the Mini Mental State Examination (MMSE), performed in the ON state. 11. Patients must be able to perform a spirometry maneuver in the ON and OFF states and must have a screening FEV1 = 50% of predicted, and an FEV1/FVC ratio >60% in the ON state at screening. 12. (A pulmonologist will review the spirometry tracings/morphology of any patients with an FEV1 that is = 50% to 60% to 60% to =65 years) yes F.1.3.1 Number of subjects for this age range 97
Exclusion criteria
Exclusion criteria: 1. Patients who have dyskinesia of a severity that would significantly interfere with their ability to participate or perform study procedures. 2. Pregnant or lactating females or females wishing to become pregnant. 3. Patients who have any known contraindication to the use of LD, including a history of malignant melanoma or a history of narrow-angle glaucoma. 4. Patients who have had previous surgery for PD (including but not limited to deep brain stimulation or cell transplantation) or plan to have stereotactic surgery during the study period. 5. Patients with a history of psychotic symptoms requiring treatment, or suicidal ideation or attempt within the prior 12 months (stable regimens [for at least 4 weeks prior to SV1] of anti-depressant medications and certain low-dose atypical antipsychotic medications are permitted in case they are indicated to treat symptoms other than psychotic symptoms). 6. Patients who have cancer with the exception of the following: basal cell carcinoma or successfully treated squamous cell carcinoma of the skin; cervical carcinoma in situ; prostatic carcinoma in situ; or other malignancies curatively treated and with no evidence of disease recurrence for at least 3 years. 7. Patients taking certain prohibited medications (see Section 9.4.2). 8. Patients with a history of drug or alcohol abuse within the prior 12 months. 9. Patients with chronic obstructive pulmonary disease (COPD), asthma, or other chronic respiratory disease within the last 5 years. 10. Patients with any contraindication to performing routine spirometry or who are unable to perform a spirometry maneuver (see Appendix 14 for a list of contraindications). 11. Patients with a current history of symptomatic orthostatic hypotension despite adequate treatment. 12. Patients with any condition that in the investigator’s opinion would make patients unable to comply with study procedures or make them unsuitable for participation in the study. 13. Patients who have any clinically significant abnormality or finding from examination, tests, or history that may compromise patient safety. Potential issues of concern should be raised to the medical monitor during eligibility review. 14. Patients who have participated in any prior CVT-301 study, regardless of treatment group assignment. 15. Patients who have been treated with an investigational drug within 4 weeks or 5 half-lives (whichever is longer) prior to the beginning of the screening period (this includes investigational formulations of marketed products).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To compare the effects of CVT-301 versus placebo on the change from pre-dose in Unified Parkinson’s Disease Rating Scale (UPDRS) Part 3 motor score at 30 minutes following treatment of patients experiencing an OFF episode at Treatment Visit 4 (TV4) (Week 12).;Secondary Objective: 1. Proportion of patients achieving resolution of an OFF to an ON state within 60 minutes after study drug is administered in the clinic, maintaining the ON state at 60 minutes after study drug administration (per the examiner’s subjective assessment). 2. Change from pre-dose in UPDRS Part 3 motor score at 20 minutes following treatment of patients experiencing an OFF episode. 3. Proportion of patients who improved based on the Patient Global Impression of Change (PGI-C) rating scale measured pre-dose. 4. Change from pre-dose in total daily OFF time assessed by the patient and recorded in the PD Diary for 3 consecutive days prior to TV4. 5. Change from pre-dose in UPDRS Part 3 motor score at 10 minutes following treatment of patients experiencing an OFF episode.;Primary end point(s): The change from pre-dose in the UPDRS Part 3 score at 30 minutes post-dose.;Timepoint(s) of evaluation of this end point: Treatment Visit 4 (week 12). | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): The following endpoints related to the key secondary objectives will be calculated. • Endpoint related to secondary objective #1: Proportion of patients achieving resolution of an OFF to an ON state within 60 minutes after study drug is administered in the clinic and maintaining the ON at 60 minutes after study drug administration (per the examiner’s subjective assessment). This endpoint will be based on the examiner’s subjective assessment at TV4. In case the assessment of turning on within 60 minutes is missing but the assessment of maintaining the ON at 60 minutes has been done, the patient will be classified based on the available assessment. In case the assessment of maintenance of ON at 60 minutes is missing, the patient will be classified as having missing data. • Endpoint related to secondary objective #2: Change from pre-dose in UPDRS Part 3 motor score at 20 minutes following treatment of patients experiencing an OFF episode in the clinic at TV4. The missing assessment will be managed similarly as for the primary endpoint. • Endpoint related to secondary objective #3: The PGI-C rating scale measured pre-dose at TV4. The non-missing values will be categorized as improvements (much improved, improved, a little improved) or non-improvements (no change, a little worse, worse, much worse). • Endpoint related to secondary objective #4: Change from baseline (3 consecutive days prior to TV1, or in case of missing data, the last 3 recorded days before TV1) in patient-recorded total daily OFF time, assessed by the patient and recorded in the PD Diary for 3 consecutive days prior to TV4 (or in case of missing data, the last 3 recorded days before TV4). The validity of the PD diary entries will be checked prior to including a diary day in the summary calculations. Only valid diary days will be included in the diary summarizations. o A day will be considered as being valid if at least 80% of the entries during the day have bee | — |
Countries
Canada, Czech Republic, Poland, Spain, United States
Contacts
INC Research