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A Fixed Dose, Dose Response Study for Ropinirole Prolonged Release in Patients With Early Stage Parkinson's Disease

A Fixed Dose, Dose Response Study for Ropinirole Prolonged Release (PR) in Patients With Early Stage Parkinson's Disease

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01485172
Acronym
TANDEM-662
Enrollment
186
Registered
2011-12-05
Start date
2012-01-31
Completion date
2014-04-30
Last updated
2018-06-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Parkinson Disease

Brief summary

This study is a fixed dose, dose response study to characterize the dose response for ropinirole PR in early stage PD patients (Hoehn & Yahr stages I-III). After screening and baseline assessments, subjects will be randomized to one of six final target treatment groups (placebo, 2, 4, 8, 12 or 24mg/day ropinirole PR). The study will consist of a screening period, an up-titration period, a maintenance period, a down titration period and a follow up period. This study utilizes change from baseline in the UPDRS motor score as the primary endpoint, in line with that used in the ropinirole PR monotherapy pivotal study (SK&F101468/168). Clinical review of the primary and secondary endpoints will be performed in order to establish the lowest maximally effective therapeutic dose.

Interventions

DRUGropinirole monotherapy

ropinirole as monotherapy in Parkinson's disease

placebo as monotherapy in Parkinson's disease

Sponsors

GlaxoSmithKline
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
30 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Diagnosis of idiopathic Parkinson's disease (according to modified Hoehn & Yahr criteria Stages I-III.) * Subjects aged 30 years or greater at screening. Women of child-bearing potential must be practicing a clinically accepted method of contraception during the study and for at least one month prior to randomization and one month following completion of the study. Acceptable contraceptive methods include abstinence, oral contraception, injectable progestogen, implants of levonorgestrel, estrogenic vaginal ring, percutaneous contraceptive patches, surgical sterilisation, male partner sterilization, intrauterine device \[IUD\], or double barrier method: condom or occlusive cap (diaphragm or cervical/vault caps) plus spermicidal agent (foam/gel/film/cream/suppository. * A baseline UPDRS motor score of at least 10. * Limited prior exposure to low or moderate doses of L-DOPA (up to 3 months in total) or dopamine agonists including ropinirole (up to 6 months in total) is allowed provided treatment is discontinued for a minimum of 4 weeks prior to screening. * Provide written informed consent for this study. * Be willing and able to comply with study procedures.

Exclusion criteria

* Subjects with Parkinson's disease in whom dopaminergic therapy is not warranted at the time of screening. * Subjects with severe, clinically significant condition(s) other than Parkinson's disease which, in the opinion of the investigator, render the subject unsuitable for the study (e.g., psychiatric, haematological, renal, hepatic, endocrinology, neurological \[other than Parkinson's disease\], cardiovascular, or active malignancy \[other than basal cell carcinoma\]). * Subjects with crippling degenerative arthritis or other physical or mental conditions precluding accurate assessment of efficacy or safety. * Subjects with prior or current major psychosis (e.g., schizophrenia or psychotic depression) e.g. scoring 3 or 4 on UPDRS item 2 \[thought disorder\] or item 3 \[depression\]. * Subjects with severe clinical dementia e.g. scoring 3 or 4 on UPDRS item 1 \[mentation\]. * Subjects with severe dizziness or fainting due to postural hypotension on standing. * Subjects with a personal history of melanoma. * Subjects with clinically significant abnormalities in laboratory or ECG tests at Screening. If findings are outside the normal range and the subject is included, it must be documented by the investigator that the findings are not of clinical significance. * Subjects diagnosed with an impulse control disorder. The modified MIDI will be conducted at screening. Subjects who score positive for this screen must be referred to a specialist for diagnostic evaluation prior to enrolling (screening) in the study. * Subjects with an active suicidal plan/intent or have had active suicidal thoughts in the past 6 months. Subjects with a history of suicide attempt in the last 2 years or more than 1 lifetime suicide attempt. * Current alcohol or drug dependence. * Definite or suspected personal or family history of clinically significant adverse reactions or hypersensitivity to ropinirole (or to drugs with a similar chemical structure) that would preclude long-term dosing with ropinirole. * Withdrawal, introduction, or change in dose of hormone replacement therapy and/or any drug known to substantially inhibit CYP1A2 (e.g. ciprofloxacine, fluvoxamine, cimetidine, ethinyloestradiol) or induce CYP1A2 (e.g. tobacco, omeprazole) within 7 days prior to baseline (randomization). * Subjects on chronic therapy with any of these agents may be enrolled but doses must have remained stable from 7 days prior to baseline (randomization) through the end of the treatment period. Smokers should maintain normal smoking habit. * Women who are pregnant or breast-feeding. * Use of an investigational drug from 30 days or 5 half-lives (which ever is longer) prior to baseline (randomization) to the end of the treatment period.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor ScoreBaseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS is a clinician based rating scale used to measure motor impairments and disability. The UPDRS assesses six features of PD impairment. These are evaluated using a combination of data collected by interview and examination of the participant. One of the six features include the Part III - Motor Examination where scores can range 0-108 where the maximum score indicates the worse condition. BL is defined as the last non-missing assessment measured on or before the first dose date. The change from BL was calculated by subtracting the BL values from the individual post-randomization values. The least squares(LS) means were estimated using the mixed model repeated measures(MMRM) adjusting for BL UPDRS motor score and race(white versus other) or by using the non-parametric rank analysis of covariance(ANCOVA).

Secondary

MeasureTime frameDescription
Number of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor ScoreBaseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS motor scores can range from 0-108 where the maximum score indicates the worse condition. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.
Number of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III CombinedBaseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52 as determined by the physician. The UPDRS Part III is the Motor Examination (Total Motor Score \[TMS\]) and is defined as the total score, ranging from 0-108 as determined by the physician, of the tests given in the motor examination section. The combined scores of Parts II and III can range from 0-160 with the higher score indicating the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date.
Responder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor ScoreBaseline and Week 4 of the Maintenance Period (Study Week 17)The responder rate is defined as the percentage of participants with a greater than or equal to (\>=)30% reduction in their individual Baseline UPDRS motor score at Week 4 of the Maintenance Period (Study Week 17). Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.
Change From Baseline in UPDRS Parts II and III CombinedBaseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52 as determined by the physician. The UPDRS Part III is the Motor Examination (Total Motor Score \[TMS\]) and is defined as the total score, ranging from 0-108 as determined by the physician, of the tests given in the motor examination section. The combined scores of Parts II and III can range from 0-160 with the higher score indicating the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.
Number of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor ScoreBaseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS motor scores can range from 0-108 where the maximum score indicates the worse condition. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.
Change From Baseline in the Total UPDRS Score (Parts I-III)Baseline and Week 4 of the Maintenance Period (Study Week 17)The total UPDRS score was calculated by the sum of the values for each component (Part I + Part II + Part III) as determined by the physician. The UPDRS Part I scores mentation, behavior and mood and scores can range from 0-16. The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52. The UPDRS Part III is the Motor Examination (Total Motor Score \[TMS\]) and scores range from 0-108. The total UPDRS (Part I + II + III) scores can range from 0-176 with the higher score indicating the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.
Change From Baseline in the UPDRS Part I (Mentation)Baseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS Part I scores mentation, behavior and mood as determined by a physician and participants were tested during the on phase of Parkinson's. This component of the UPDRS is the total score for 4 items (the items 1- 4 include intellectual impairment, thought disorder, motivation/initiative, and depression) and may have a value ranging from 0 to 16 as determined by a physician where 16 indicates the maximum score and the worse condition. All 4 items have to be present for a total score to be calculated. If one or more items are missing, the total score for the component will also be missing. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.
Responder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) ScaleWeek 4 of the Maintenance Period (Study Week 17)The CGI-I scale allows the investigator to rate the participant's total improvement since the beginning of treatment (Baseline). Baseline is defined as the last non-missing assessment measured on or before the first dose date. The scale is rated from 1-7 where 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse. The responder rate is defined as the percentage of participants with a score of 1 or 2.
Percentage of Participants Withdrawn From the Study Due to Lack of EfficacyUp to Week 4 of the Maintenance Period (Study Week 17)The percentage of participants who withdrew from the study due to lack of efficacy as defined by either the participant or the investigator is presented here.
Change From Baseline in UPDRS Activities of Daily LivingBaseline and Week 4 of the Maintenance Period (Study Week 17)The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52 as determined by the physician. The higher score indicates the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Countries

Estonia, Russia, Slovakia, South Korea, United States

Participant flow

Recruitment details

Eligible participants (par.) were diagnosed with early stage Parkinson's disease (according to modified Hoehn and Yahr criteria Stages I-III) and randomized at Screening into one of six treatment arms to receive placebo or ropinirole Prolonged Release (PR) tablets.

Pre-assignment details

After Screening, par. underwent a 13 Week Up-Titration Period until reaching their target dose then continued on their target dose during a 4 Week Maintenance Period up to Week 17. All par. underwent a 1 Week Down-Titration Period and then a Follow-Up Visit 1-2 Weeks after receiving the last dose of treatment.

Participants by arm

ArmCount
Treatment Group A: Placebo
Participants (par.) were administered a matching Prolonged Release (PR) placebo tablet Once Daily (OD) for up to 17 weeks. Par. completed a Follow-up visit 2 weeks after receiving the last dose of study medication.
40
Treatment Group B: 2 mg/Day
Par. were administered a ropinirole PR tablet totalling 2 milligrams per day (mg/day), OD up to Study Week 17. Par. reaching their target dose and completing the maintenance period or withdrawing prematurely were switched to placebo for down-titration for 1 week before completing a Follow-up visit 2 weeks after receiving the last dose of study medication.
13
Treatment Group C: 4 mg/Day
Par. were administered a ropinirole PR tablet totalling 2 mg/day, OD for one week. Par. were up-titrated to 4 mg/day at Week 2 and continued this dose up to Study Week 17. Par. reaching their target dose and completing the maintenance period or withdrawing prematurely were down-titrated to 2 mg for 4 days and then switched to placebo for 3 days for down-titration before completing a Follow-up visit 2 weeks after receiving the last dose of study medication.
41
Treatment Group D: 8 mg/Day
Par. were administered a ropinirole PR tablet totalling 2 mg/day, OD for one week. Par. were up-titrated to 4 mg/day at Week 2, 6 mg/day at Week 3, and 8 mg/day at Week 4. Par. continued this dose up to Study Week 17. Par. reaching their target dose and completing the maintenance period or withdrawing prematurely were down-titrated for 1 week before completing a Follow-up visit 2 weeks after receiving the last dose of study medication.
40
Treatment Group E: 12 mg/Day
Par. were administered a ropinirole PR tablet totalling 2 mg/day, OD for one week. Par. were up-titrated to 4 mg/day at Week 2, 6 mg/day at Week 3, 8 mg/day at Week 4, and 12 mg/day at Week 6. Par. continued this dose up to Study Week 17. Par. reaching their target dose and completing the maintenance period or withdrawing prematurely were down-titrated for 1 week before completing a Follow-up visit 2 weeks after receiving the last dose of study medication.
39
Treatment Group F: 24 mg/Day
Par. were administered a ropinirole PR tablet totalling 2 mg/day, OD for one week. Par. were up-titrated to 4 mg/day at Week 2, 6 mg/day at Week 3, 8 mg/day at Week 4, 12 mg/day at Week 6, 16 mg/day at Week 8, 20 mg/day at Week 10, and 24 mg/day at Week 12. Par. continued this dose up to Study Week 17. Par. reaching their target dose and completing the maintenance or withdrawing prematurely were down-titrated for 1 week before completing a Follow-up visit 2 weeks after receiving the last dose of study medication.
13
Total186

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Overall StudyAdverse Event212212
Overall StudyLack of Efficacy200000
Overall StudyLost to Follow-up001001
Overall StudyPhysician Decision000010
Overall StudyProtocol defined stopping criteria100010
Overall StudyProtocol Violation004510
Overall StudyWithdrawal by Subject200111

Baseline characteristics

CharacteristicTreatment Group A: PlaceboTotalTreatment Group F: 24 mg/DayTreatment Group E: 12 mg/DayTreatment Group D: 8 mg/DayTreatment Group C: 4 mg/DayTreatment Group B: 2 mg/Day
Age, Continuous63.1 Years
STANDARD_DEVIATION 8.82
61.6 Years
STANDARD_DEVIATION 10.85
62.5 Years
STANDARD_DEVIATION 12.88
61.7 Years
STANDARD_DEVIATION 10.78
60.3 Years
STANDARD_DEVIATION 11.72
62.1 Years
STANDARD_DEVIATION 11.38
58.2 Years
STANDARD_DEVIATION 11.12
Race/Ethnicity, Customized
African American/African Heritage
2 Participants2 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian - East Asian
2 Participants11 Participants1 Participants2 Participants5 Participants1 Participants0 Participants
Race/Ethnicity, Customized
Asian - Japanese
0 Participants1 Participants0 Participants0 Participants0 Participants1 Participants0 Participants
Race/Ethnicity, Customized
Asian - South East Asian Heritage
0 Participants1 Participants0 Participants0 Participants1 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Missing
0 Participants1 Participants0 Participants1 Participants0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
White - White/Caucasian
36 Participants170 Participants12 Participants36 Participants34 Participants39 Participants13 Participants
Sex: Female, Male
Female
17 Participants91 Participants6 Participants19 Participants28 Participants16 Participants5 Participants
Sex: Female, Male
Male
23 Participants95 Participants7 Participants20 Participants12 Participants25 Participants8 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —— / —
other
Total, other adverse events
17 / 405 / 1318 / 4124 / 4018 / 397 / 13
serious
Total, serious adverse events
0 / 400 / 131 / 410 / 402 / 390 / 13

Outcome results

Primary

Change From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score

The UPDRS is a clinician based rating scale used to measure motor impairments and disability. The UPDRS assesses six features of PD impairment. These are evaluated using a combination of data collected by interview and examination of the participant. One of the six features include the Part III - Motor Examination where scores can range 0-108 where the maximum score indicates the worse condition. BL is defined as the last non-missing assessment measured on or before the first dose date. The change from BL was calculated by subtracting the BL values from the individual post-randomization values. The least squares(LS) means were estimated using the mixed model repeated measures(MMRM) adjusting for BL UPDRS motor score and race(white versus other) or by using the non-parametric rank analysis of covariance(ANCOVA).

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: Intent to Treat (ITT) Population: all randomized subjects who received at least one dose of study medication, had a Baseline efficacy assessment for the specific outcome, and had at least one respective efficacy outcome assessment collected after randomization (Baseline) visit, i.e. had at least one respective Post-Baseline efficacy assessment.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Treatment Group A: PlaceboChange From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score-1.91 Score on a scale
Treatment Group B: 2 mg/DayChange From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score-1.58 Score on a scale
Treatment Group C: 4 mg/DayChange From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score-2.76 Score on a scale
Treatment Group D: 8 mg/DayChange From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score-4.31 Score on a scale
Treatment Group E: 12 mg/DayChange From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score-4.07 Score on a scale
Treatment Group F: 24 mg/DayChange From Baseline (BL) in Unified Parkinson Disease (PD) Rating Scale (UPDRS) Motor Score-2.83 Score on a scale
p-value: 0.86495% CI: [-3.41, 4.05]Mixed Models Analysis
p-value: 0.53995% CI: [-3.61, 1.9]Mixed Models Analysis
p-value: 0.09195% CI: [-5.21, 0.39]Mixed Models Analysis
p-value: 0.12495% CI: [-4.93, 0.6]Mixed Models Analysis
p-value: 0.65895% CI: [-5.04, 3.19]Mixed Models Analysis
p-value: 0.439ANCOVA
p-value: 0.177ANCOVA
p-value: 0.06ANCOVA
p-value: 0.047ANCOVA
p-value: 0.407ANCOVA
Secondary

Change From Baseline in the Total UPDRS Score (Parts I-III)

The total UPDRS score was calculated by the sum of the values for each component (Part I + Part II + Part III) as determined by the physician. The UPDRS Part I scores mentation, behavior and mood and scores can range from 0-16. The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52. The UPDRS Part III is the Motor Examination (Total Motor Score \[TMS\]) and scores range from 0-108. The total UPDRS (Part I + II + III) scores can range from 0-176 with the higher score indicating the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (LEAST_SQUARES_MEAN)
Treatment Group A: PlaceboChange From Baseline in the Total UPDRS Score (Parts I-III)-2.74 Score on a scale
Treatment Group B: 2 mg/DayChange From Baseline in the Total UPDRS Score (Parts I-III)-2.18 Score on a scale
Treatment Group C: 4 mg/DayChange From Baseline in the Total UPDRS Score (Parts I-III)-3.83 Score on a scale
Treatment Group D: 8 mg/DayChange From Baseline in the Total UPDRS Score (Parts I-III)-5.93 Score on a scale
Treatment Group E: 12 mg/DayChange From Baseline in the Total UPDRS Score (Parts I-III)-6.68 Score on a scale
Treatment Group F: 24 mg/DayChange From Baseline in the Total UPDRS Score (Parts I-III)-3.40 Score on a scale
p-value: 0.82395% CI: [-4.38, 5.5]Mixed Models Analysis
p-value: 0.56895% CI: [-4.86, 2.68]Mixed Models Analysis
p-value: 0.10195% CI: [-7.01, 0.63]Mixed Models Analysis
p-value: 0.0495% CI: [-7.7, -0.18]Mixed Models Analysis
p-value: 0.81195% CI: [-6.08, 4.77]Mixed Models Analysis
Secondary

Change From Baseline in the UPDRS Part I (Mentation)

The UPDRS Part I scores mentation, behavior and mood as determined by a physician and participants were tested during the on phase of Parkinson's. This component of the UPDRS is the total score for 4 items (the items 1- 4 include intellectual impairment, thought disorder, motivation/initiative, and depression) and may have a value ranging from 0 to 16 as determined by a physician where 16 indicates the maximum score and the worse condition. All 4 items have to be present for a total score to be calculated. If one or more items are missing, the total score for the component will also be missing. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (LEAST_SQUARES_MEAN)
Treatment Group A: PlaceboChange From Baseline in the UPDRS Part I (Mentation)0.05 Score on a scale
Treatment Group B: 2 mg/DayChange From Baseline in the UPDRS Part I (Mentation)-0.34 Score on a scale
Treatment Group C: 4 mg/DayChange From Baseline in the UPDRS Part I (Mentation)-0.01 Score on a scale
Treatment Group D: 8 mg/DayChange From Baseline in the UPDRS Part I (Mentation)-0.26 Score on a scale
Treatment Group E: 12 mg/DayChange From Baseline in the UPDRS Part I (Mentation)-0.02 Score on a scale
Treatment Group F: 24 mg/DayChange From Baseline in the UPDRS Part I (Mentation)0.50 Score on a scale
p-value: 0.10295% CI: [-0.86, 0.08]Mixed Models Analysis
p-value: 0.72395% CI: [-0.41, 0.29]Mixed Models Analysis
p-value: 0.08495% CI: [-0.66, 0.04]Mixed Models Analysis
p-value: 0.69795% CI: [-0.42, 0.28]Mixed Models Analysis
p-value: 0.08695% CI: [-0.06, 0.97]Mixed Models Analysis
Secondary

Change From Baseline in UPDRS Activities of Daily Living

The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52 as determined by the physician. The higher score indicates the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (LEAST_SQUARES_MEAN)
Treatment Group A: PlaceboChange From Baseline in UPDRS Activities of Daily Living-0.26 Score on a scale
Treatment Group B: 2 mg/DayChange From Baseline in UPDRS Activities of Daily Living0.91 Score on a scale
Treatment Group C: 4 mg/DayChange From Baseline in UPDRS Activities of Daily Living-0.73 Score on a scale
Treatment Group D: 8 mg/DayChange From Baseline in UPDRS Activities of Daily Living-1.13 Score on a scale
Treatment Group E: 12 mg/DayChange From Baseline in UPDRS Activities of Daily Living-1.27 Score on a scale
Treatment Group F: 24 mg/DayChange From Baseline in UPDRS Activities of Daily Living-0.99 Score on a scale
p-value: 0.15895% CI: [-0.46, 2.81]Mixed Models Analysis
p-value: 0.44695% CI: [-1.71, 0.76]Mixed Models Analysis
p-value: 0.16395% CI: [-2.1, 0.36]Mixed Models Analysis
p-value: 0.11795% CI: [-2.27, 0.25]Mixed Models Analysis
p-value: 0.45695% CI: [-2.67, 1.2]Mixed Models Analysis
Secondary

Change From Baseline in UPDRS Parts II and III Combined

The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52 as determined by the physician. The UPDRS Part III is the Motor Examination (Total Motor Score \[TMS\]) and is defined as the total score, ranging from 0-108 as determined by the physician, of the tests given in the motor examination section. The combined scores of Parts II and III can range from 0-160 with the higher score indicating the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (LEAST_SQUARES_MEAN)
Treatment Group A: PlaceboChange From Baseline in UPDRS Parts II and III Combined-2.88 Scores on a scale
Treatment Group B: 2 mg/DayChange From Baseline in UPDRS Parts II and III Combined-1.81 Scores on a scale
Treatment Group C: 4 mg/DayChange From Baseline in UPDRS Parts II and III Combined-3.81 Scores on a scale
Treatment Group D: 8 mg/DayChange From Baseline in UPDRS Parts II and III Combined-5.63 Scores on a scale
Treatment Group E: 12 mg/DayChange From Baseline in UPDRS Parts II and III Combined-6.62 Scores on a scale
Treatment Group F: 24 mg/DayChange From Baseline in UPDRS Parts II and III Combined-3.87 Scores on a scale
p-value: 0.66295% CI: [-3.78, 5.93]Mixed Models Analysis
p-value: 0.62195% CI: [-4.63, 2.77]Mixed Models Analysis
p-value: 0.1595% CI: [-6.5, 1.01]Mixed Models Analysis
p-value: 0.04895% CI: [-7.43, -0.04]Mixed Models Analysis
p-value: 0.71595% CI: [-6.32, 4.35]Mixed Models Analysis
Secondary

Number of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score

The UPDRS motor scores can range from 0-108 where the maximum score indicates the worse condition. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (NUMBER)
Treatment Group A: PlaceboNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score5 Participants
Treatment Group B: 2 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score3 Participants
Treatment Group C: 4 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score7 Participants
Treatment Group D: 8 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score7 Participants
Treatment Group E: 12 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score9 Participants
Treatment Group F: 24 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Motor Score2 Participants
p-value: 0.66295% CI: [0.22, 10.84]Generalized Estimating Equations model
p-value: 0.55795% CI: [0.4, 5.55]Generalized Estimating Equations model
p-value: 0.34795% CI: [0.51, 6.72]Generalized Estimating Equations model
p-value: 0.37995% CI: [0.49, 6.38]Generalized Estimating Equations model
p-value: 0.85195% CI: [0.19, 7.63]Generalized Estimating Equations model
Secondary

Number of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined

The UPDRS Part II is the Activities of Daily Living (ADL) score and can range from 0-52 as determined by the physician. The UPDRS Part III is the Motor Examination (Total Motor Score \[TMS\]) and is defined as the total score, ranging from 0-108 as determined by the physician, of the tests given in the motor examination section. The combined scores of Parts II and III can range from 0-160 with the higher score indicating the worse condition. Tests were performed when the participant is in the on state of Parkinson's. Baseline is defined as the last non-missing assessment measured on or before the first dose date.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (NUMBER)
Treatment Group A: PlaceboNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined6 Participants
Treatment Group B: 2 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined3 Participants
Treatment Group C: 4 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined7 Participants
Treatment Group D: 8 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined10 Participants
Treatment Group E: 12 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined12 Participants
Treatment Group F: 24 mg/DayNumber of Participants With a >=10 Points Reduction From Baseline in UPDRS Parts II and III Combined5 Participants
Secondary

Number of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score

The UPDRS motor scores can range from 0-108 where the maximum score indicates the worse condition. Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (NUMBER)
Treatment Group A: PlaceboNumber of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score9 Participants
Treatment Group B: 2 mg/DayNumber of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score6 Participants
Treatment Group C: 4 mg/DayNumber of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score14 Participants
Treatment Group D: 8 mg/DayNumber of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score16 Participants
Treatment Group E: 12 mg/DayNumber of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score19 Participants
Treatment Group F: 24 mg/DayNumber of Participants With a >=5 Points Reduction From Baseline in UPDRS Motor Score5 Participants
p-value: 0.39795% CI: [0.4, 9.98]Generalized Estimating Equations model
p-value: 0.13195% CI: [0.79, 6.4]Generalized Estimating Equations model
p-value: 0.01895% CI: [1.25, 9.92]Generalized Estimating Equations model
p-value: 0.0295% CI: [1.22, 10.64]Generalized Estimating Equations model
p-value: 0.20295% CI: [0.59, 12.16]Generalized Estimating Equations model
Secondary

Percentage of Participants Withdrawn From the Study Due to Lack of Efficacy

The percentage of participants who withdrew from the study due to lack of efficacy as defined by either the participant or the investigator is presented here.

Time frame: Up to Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (NUMBER)
Treatment Group A: PlaceboPercentage of Participants Withdrawn From the Study Due to Lack of Efficacy5 Percentage of participants
Treatment Group B: 2 mg/DayPercentage of Participants Withdrawn From the Study Due to Lack of Efficacy0 Percentage of participants
Treatment Group C: 4 mg/DayPercentage of Participants Withdrawn From the Study Due to Lack of Efficacy0 Percentage of participants
Treatment Group D: 8 mg/DayPercentage of Participants Withdrawn From the Study Due to Lack of Efficacy0 Percentage of participants
Treatment Group E: 12 mg/DayPercentage of Participants Withdrawn From the Study Due to Lack of Efficacy0 Percentage of participants
Treatment Group F: 24 mg/DayPercentage of Participants Withdrawn From the Study Due to Lack of Efficacy0 Percentage of participants
Secondary

Responder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale

The CGI-I scale allows the investigator to rate the participant's total improvement since the beginning of treatment (Baseline). Baseline is defined as the last non-missing assessment measured on or before the first dose date. The scale is rated from 1-7 where 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse. The responder rate is defined as the percentage of participants with a score of 1 or 2.

Time frame: Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (NUMBER)
Treatment Group A: PlaceboResponder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale20 Percentage of participants
Treatment Group B: 2 mg/DayResponder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale15 Percentage of participants
Treatment Group C: 4 mg/DayResponder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale28 Percentage of participants
Treatment Group D: 8 mg/DayResponder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale45 Percentage of participants
Treatment Group E: 12 mg/DayResponder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale56 Percentage of participants
Treatment Group F: 24 mg/DayResponder Rate According to the Clinical Global Impression - Global Improvement (CGI-I) Scale23 Percentage of participants
p-value: 0.73395% CI: [0.17, 3.49]Generalized Estimating Equations model
p-value: 0.51995% CI: [0.5, 4.02]Generalized Estimating Equations model
p-value: 0.00895% CI: [1.46, 12.07]Generalized Estimating Equations model
p-value: 0.00195% CI: [1.93, 15.46]Generalized Estimating Equations model
p-value: 0.75295% CI: [0.27, 5.98]Generalized Estimating Equations model
Secondary

Responder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score

The responder rate is defined as the percentage of participants with a greater than or equal to (\>=)30% reduction in their individual Baseline UPDRS motor score at Week 4 of the Maintenance Period (Study Week 17). Baseline is defined as the last non-missing assessment measured on or before the first dose date. The change from Baseline will be calculated by subtracting the Baseline values from the individual post-randomization values.

Time frame: Baseline and Week 4 of the Maintenance Period (Study Week 17)

Population: ITT Population. All participants with a non-missing efficacy observation at Baseline and during the maintenance period were analyzed

ArmMeasureValue (NUMBER)
Treatment Group A: PlaceboResponder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score18 Percentage of Participants
Treatment Group B: 2 mg/DayResponder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score31 Percentage of Participants
Treatment Group C: 4 mg/DayResponder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score23 Percentage of Participants
Treatment Group D: 8 mg/DayResponder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score30 Percentage of Participants
Treatment Group E: 12 mg/DayResponder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score38 Percentage of Participants
Treatment Group F: 24 mg/DayResponder Rate Defined as Participants With a >=30% Reduction in Baseline UPDRS Motor Score31 Percentage of Participants
p-value: 0.5495% CI: [0.36, 7.03]Generalized Estimating Equations model
p-value: 0.49495% CI: [0.49, 4.47]Generalized Estimating Equations model
p-value: 0.11595% CI: [0.81, 7.06]Generalized Estimating Equations model
p-value: 0.04595% CI: [1.02, 8.55]Generalized Estimating Equations model
p-value: 0.22195% CI: [0.58, 10.9]Generalized Estimating Equations model

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026