Parkinson's Disease (PD)
Conditions
Keywords
Parkinson's disease (PD), BIA 9-1067, Opicapone
Brief summary
To investigate the effect of three single oral doses of BIA 9-1067 (25 mg, 50 mg and 100 mg) on the levodopa pharmacokinetics when administered in combination with a single-dose of controlled-release levodopa/carbidopa 100/25 mg (Sinemet® CR 100/25)
Detailed description
Single centre, double-blind, randomized, placebo-controlled, crossover study with four consecutive single-dose treatment periods. The washout period between doses was to be at least 14 days. On each treatment period, after completion of pre-dose assessments, BIA 9-1067/Placebo was to be administered concomitantly with the dose of Sinemet® CR 100/25; post-dose assessments were to be completed and subjects were to be discharged 72 h post-dose. Subjects were to attend four treatment periods and were to receive a different dose of BIA 9-1067 (25 mg, 50 mg and 100 mg) or placebo during each of these treatment periods.
Interventions
OPC, Opicapone
PLC, Placebo
Controlled-release levodopa/carbidopa 100/25 mg
Sponsors
Study design
Eligibility
Inclusion criteria
* Availability for the entire study period and willingness to adhere to the protocol requirements as evidenced by the informed consent form (ICF) duly read, signed and dated by the volunteer prior to participation in the study. * Male volunteers. * Volunteers of at least 18 years of age but not older than 45 years. * Volunteers with body mass index (BMI) greater than or equal to 19 and below 30 kg/m2. * Volunteers who were non- or ex-smokers. An ex-smoker is defined as someone who completely stopped smoking for at least 12 months before day 1 of this study. * Volunteers who were healthy as determined by pre-study (at screening) medical history, physical examination, vital signs, complete neurological examination and 12-lead ECG. * Volunteers who had clinical laboratory test results judged clinically acceptable (within the laboratory's stated normal range; if not within this range, they must had been without any clinical significance) at screening and admission to first treatment period. * Volunteers who had negative tests for hepatitis B surface antigen (HBsAg), anti-hepatitis C antibodies (HCV Ab), and Human immunodeficiency viruses -1 and -2 antibodies (HIV-1 and HIV-2 Ab) at screening. * Volunteers who had negative screen of ethyl alcohol and drugs of abuse at screening. * Due to unknown risks and potential harm to the unborn fetus, sexually active men must have agreed to use a medically acceptable form of contraception throughout the study.
Exclusion criteria
* Volunteers who did not conform to the above inclusion criteria, or in case of * Volunteers who had a clinically relevant surgical history. * Volunteers who had a clinically relevant family history. * Volunteers who had a history of relevant atopy. * Volunteers who had a significant infection or known inflammatory process at screening or first admission. * Volunteers who had acute gastrointestinal symptoms at the time of screening or first admission (e.g., nausea, vomiting, diarrhoea, heartburn). * Volunteers who were vegetarians, vegans or have medical dietary restrictions. * Volunteers who could not communicate reliably with the investigator. * Volunteers who were unlikely to co-operate with the requirements of the study. * Significant history of hypersensitivity to BIA 9-1067, tolcapone, entacapone, levodopa, carbidopa or any related products (including excipients of the formulations) as well as severe hypersensitivity reactions (like angioedema) to any drugs. * Presence of significant gastrointestinal, liver or kidney disease, or any other conditions known to interfere with the absorption, distribution, metabolism or excretion of drugs or known to potentiate or predispose to undesired effects. * History of significant gastrointestinal, liver or kidney disease that may affect drug bioavailability. * Presence or history of significant cardiovascular, pulmonary, hematologic, neurologic, psychiatric, lymphatic, musculoskeletal, genitourinary, endocrine, immunologic, dermatologic or connective tissue disease. * Suicidal tendency, history of or disposition to seizures, state of confusion, clinically relevant psychiatric diseases. * Presence of significant heart disease or disorder according to ECG. * Presence of suspicious undiagnosed skin lesions or a history of melanoma. * Previous history of Neuroleptic Malignant Syndrome (NMS) and/or nontraumatic rhabdomyolysis. * Presence or history of significant glaucoma. * Used of prescription medications including monoamine oxidase (MAO) inhibitors within 28 days before day 1 of the study. * Used of over-the-counter (OTC) products within 7 days before day 1 of the study. * Maintenance therapy with any drug, or significant history of drug dependency (drug abuse) or alcohol abuse (\> 3 units of alcohol per day, intake of excessive alcohol, acute or chronic). * Any clinically significant illness in the previous 28 days before day 1 of this study. * Used of any enzyme-modifying drugs, including strong inhibitors of cytochrome P450 (CYP) enzymes (such as cimetidine, fluoxetine, quinidine, erythromycin, ciprofloxacin, fluconazole, ketoconazole, diltiazem and HIV antivirals) and strong inducers of CYP enzymes (such as barbiturates, carbamazepine, glucocorticoids, phenytoin and rifampicin), in the previous 28 days before day 1 of this study. * Volunteers who took an Investigational Product (in another clinical trial) or donated 50 mL or more of blood in the previous 28 days before day 1 of this study. * Poor motivation, intellectual problems likely to limit the validity of consent to participate in the study or limit the ability to comply with the protocol requirements or inability to cooperate adequately, inability to understand and to observe the instructions of the physician. * Donation of 500 mL or more of blood (Canadian Blood Services, Hema-Quebec, clinical studies, etc.) in the previous 56 days before day 1 of this study. * Positive urine screening of ethyl alcohol or drugs of abuse at admission to any treatment period. * Any history of tuberculosis and/or prophylaxis for tuberculosis. * Positive results to HIV, HBsAg or anti-HCV tests. * Participation in any previous clinical study with BIA 9-1067 within 84 days before day 1 of the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| AUC0-t - Area Under the Plasma Concentration-time Curve to Last Measurable Time Point | pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose | AUC0-t - Area under the plasma concentration-time curve to last measurable time point for levodopa |
| AUC0-∞ - Area Under the Plasma Concentration-time Curve Extrapolated to Infinity | pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose | AUC0-∞ - Area under the plasma concentration-time curve extrapolated to infinity for levodopa |
| Cmax - Maximum Observed Plasma Concentration | pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose | Cmax - Maximum observed plasma concentration of levodopa |
| Emax - Maximum Inhibition of COMT Activity | pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose | Emax - Maximum inhibition of Catechol-O-Methyltransferase (COMT) activity |
| tEmax - Time of Occurrence of Emax | pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose | — |
| AUEC0-24 - Area Under the Effect-time Curve From t=0h to t=24h | pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose | — |
Countries
Canada
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Group 1 Period 1: BIA 9-1067 25 mg Period 2: BIA 9-1067 50 mg Period 3: BIA 9-1067 100 mg Period 4: Placebo
BIA 9-1067/Placebo was to be administered concomitantly with the dose of Sinemet® CR 100/25 (Single-dose of controlled-release levodopa/carbidopa 100/25 mg: 1 tablet of Sinemet® CR 100/25.)
BIA 9-1067: OPC, Opicapone
Placebo: PLC, Placebo
Sinemet® CR 100/25: Controlled-release levodopa/carbidopa 100/25 mg | 3 |
| Group 2 Period 1: BIA 9-1067 50 mg Period 2: BIA 9-1067 100 mg Period 3: Placebo Period 4: BIA 9-1067 25 mg
BIA 9-1067/Placebo was to be administered concomitantly with the dose of Sinemet® CR 100/25 (Single-dose of controlled-release levodopa/carbidopa 100/25 mg: 1 tablet of Sinemet® CR 100/25.)
BIA 9-1067: OPC, Opicapone
Placebo: PLC, Placebo
Sinemet® CR 100/25: Controlled-release levodopa/carbidopa 100/25 mg | 3 |
| Group 3 Period 1: BIA 9-1067 100 mg Period 2: Placebo Period 3: BIA 9-1067 25 mg Period 4: BIA 9-1067 50 mg
BIA 9-1067/Placebo was to be administered concomitantly with the dose of Sinemet® CR 100/25 (Single-dose of controlled-release levodopa/carbidopa 100/25 mg: 1 tablet of Sinemet® CR 100/25.)
BIA 9-1067: OPC, Opicapone
Placebo: PLC, Placebo
Sinemet® CR 100/25: Controlled-release levodopa/carbidopa 100/25 mg | 3 |
| Group 4 Period 1: Placebo Period 2: BIA 9-1067 25 mg Period 3: BIA 9-1067 50 mg Period 4: BIA 9-1067 100 mg
Subjects were to attend four treatment periods and were to receive a different dose of BIA 9-1067 (25 mg, 50 mg and 100 mg) or placebo during each of these treatment periods.
BIA 9-1067: OPC, Opicapone
Placebo: PLC, Placebo
Sinemet® CR 100/25: Controlled-release levodopa/carbidopa 100/25 mg | 3 |
| Total | 12 |
Baseline characteristics
| Characteristic | Group 1 | Group 2 | Group 3 | Group 4 | Total |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 3 Participants | 3 Participants | 3 Participants | 3 Participants | 12 Participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 3 Participants | 3 Participants | 3 Participants | 3 Participants | 12 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 6 / 12 | 4 / 11 | 4 / 12 | 5 / 12 |
| serious Total, serious adverse events | 0 / 12 | 0 / 11 | 0 / 12 | 0 / 12 |
Outcome results
AUC0-∞ - Area Under the Plasma Concentration-time Curve Extrapolated to Infinity
AUC0-∞ - Area under the plasma concentration-time curve extrapolated to infinity for levodopa
Time frame: pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BIA 9-1067 25 mg | AUC0-∞ - Area Under the Plasma Concentration-time Curve Extrapolated to Infinity | 1986 ng.h/mL | Standard Deviation 395.2 |
| BIA 9-1067 50 mg | AUC0-∞ - Area Under the Plasma Concentration-time Curve Extrapolated to Infinity | 2144 ng.h/mL | Standard Deviation 437.4 |
| BIA 9-1067 100 mg | AUC0-∞ - Area Under the Plasma Concentration-time Curve Extrapolated to Infinity | 2215 ng.h/mL | Standard Deviation 381 |
| Placebo | AUC0-∞ - Area Under the Plasma Concentration-time Curve Extrapolated to Infinity | 1677 ng.h/mL | Standard Deviation 541.7 |
AUC0-t - Area Under the Plasma Concentration-time Curve to Last Measurable Time Point
AUC0-t - Area under the plasma concentration-time curve to last measurable time point for levodopa
Time frame: pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BIA 9-1067 25 mg | AUC0-t - Area Under the Plasma Concentration-time Curve to Last Measurable Time Point | 1886 ng.h/mL | Standard Deviation 396.1 |
| BIA 9-1067 50 mg | AUC0-t - Area Under the Plasma Concentration-time Curve to Last Measurable Time Point | 1997 ng.h/mL | Standard Deviation 389.4 |
| BIA 9-1067 100 mg | AUC0-t - Area Under the Plasma Concentration-time Curve to Last Measurable Time Point | 2059 ng.h/mL | Standard Deviation 372.7 |
| Placebo | AUC0-t - Area Under the Plasma Concentration-time Curve to Last Measurable Time Point | 1575 ng.h/mL | Standard Deviation 521.3 |
AUEC0-24 - Area Under the Effect-time Curve From t=0h to t=24h
Time frame: pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BIA 9-1067 25 mg | AUEC0-24 - Area Under the Effect-time Curve From t=0h to t=24h | 621 pmol/mg Hb/h.h | Standard Deviation 300 |
| BIA 9-1067 50 mg | AUEC0-24 - Area Under the Effect-time Curve From t=0h to t=24h | 427 pmol/mg Hb/h.h | Standard Deviation 214 |
| BIA 9-1067 100 mg | AUEC0-24 - Area Under the Effect-time Curve From t=0h to t=24h | 363 pmol/mg Hb/h.h | Standard Deviation 201 |
| Placebo | AUEC0-24 - Area Under the Effect-time Curve From t=0h to t=24h | 1144 pmol/mg Hb/h.h | Standard Deviation 445 |
Cmax - Maximum Observed Plasma Concentration
Cmax - Maximum observed plasma concentration of levodopa
Time frame: pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BIA 9-1067 25 mg | Cmax - Maximum Observed Plasma Concentration | 716 ng/mL | Standard Deviation 201.9 |
| BIA 9-1067 50 mg | Cmax - Maximum Observed Plasma Concentration | 673 ng/mL | Standard Deviation 269.9 |
| BIA 9-1067 100 mg | Cmax - Maximum Observed Plasma Concentration | 570 ng/mL | Standard Deviation 136.2 |
| Placebo | Cmax - Maximum Observed Plasma Concentration | 554 ng/mL | Standard Deviation 220.5 |
Emax - Maximum Inhibition of COMT Activity
Emax - Maximum inhibition of Catechol-O-Methyltransferase (COMT) activity
Time frame: pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BIA 9-1067 25 mg | Emax - Maximum Inhibition of COMT Activity | 16.5 pmol/mg Hb/h | Standard Deviation 10.8 |
| BIA 9-1067 50 mg | Emax - Maximum Inhibition of COMT Activity | 7.44 pmol/mg Hb/h | Standard Deviation 7.42 |
| BIA 9-1067 100 mg | Emax - Maximum Inhibition of COMT Activity | 3.16 pmol/mg Hb/h | Standard Deviation 4.97 |
| Placebo | Emax - Maximum Inhibition of COMT Activity | 39.3 pmol/mg Hb/h | Standard Deviation 16 |
tEmax - Time of Occurrence of Emax
Time frame: pre-dose, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 48 and 72 h post-dose
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BIA 9-1067 25 mg | tEmax - Time of Occurrence of Emax | 4.92 hours | Standard Deviation 2.71 |
| BIA 9-1067 50 mg | tEmax - Time of Occurrence of Emax | 3.59 hours | Standard Deviation 1.95 |
| BIA 9-1067 100 mg | tEmax - Time of Occurrence of Emax | 2.33 hours | Standard Deviation 0.985 |
| Placebo | tEmax - Time of Occurrence of Emax | 7.17 hours | Standard Deviation 8.95 |