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Efficacy, Tolerability and Safety of Azilect in Subjects With Progressive Supranuclear Palsy (PROSPERA)

Primary Purpose

Progressive Supranuclear Palsy

Status
Terminated
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Rasagiline
Sugar pill
Sponsored by
Prof. Dr. Stefan Lorenzl
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Progressive Supranuclear Palsy focused on measuring PSP, Progressive Supranuclear Palsy, Rasagiline, Azilect, PROSPERA

Eligibility Criteria

50 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Clinical signs of Progressive Supranuclear Palsy (PSP). Diagnosis will be made for patients with clinical probable PSP (Litvan et al., 1996). Patients will be included with PSP stage </= II (Golbe et al., 1997), at least with a PSPRS < 40 (Golbe et al., 2007) and according to the diagnostic criteria resumed after the Neuroprotection and Natural History in Parkinson Plus Syndromes (NNIPPS) trial (Bensimon et al., 2009)
  • Patients, male or female, aged 50 to 80 years
  • Subjects whose clinical condition at the time of enrolment does not or requires a low [</= 500 mg /day] stable dose of L-3,4-Dihydroxyphenylalanine (L-DOPA) for at least 2 weeks prior to study entry
  • Capability and willingness to give written signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study

Exclusion Criteria:

  • No clinically probable PSP
  • No written informed consent possible
  • Age > 80 or < 50 years
  • Dementia (Mini-Mental State Examination [MMSE] </= 24)
  • Subjects with clinically significant psychiatric illness, including major depression
  • Subjects who have taken any experimental drugs within 60 days prior to baseline
  • Subjects who have used sympathomimetics (including over-the-counter remedies - nasal or oral), dextromethorphan, pethidine or St. John's wort within 7 days prior to baseline.
  • Loss of postural reflexes (no independent walking possible, inability to stand unassisted, wheelchair-bound)
  • Feeding tube / recommendation for a feeding tube
  • Unintelligible speech
  • History of brain disease (e.g. repeated strokes, cerebral tumour, hydrocephalus)
  • 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) exposure
  • Oculogyric crisis
  • Early severe autonomic failure
  • Systemic disorder affecting the brain
  • Women who are not postmenopausal (e.g. one year without menstrual periods) or surgically sterilized.
  • Known history of hypersensitivity to the investigational drug or to drugs with a similar chemical structure
  • Subjects who have used antidepressants, including selective serotonin re-uptake inhibitors, tricyclic and tetracyclic antidepressants (except amitriptyline <= 50 mg/day, trazodone < = 100 mg/day, citalopram < = 20 mg/ day, sertraline < = 100 mg/day and paroxetine < = 30 mg/day, escitalopram < = 10 mg/day) within 42 days prior to baseline
  • Subjects who have used any drugs known to have been involved in a drug interaction via inhibition of hepatic Cytochrome P450 1A2 (CYP 1A2) within 30 days prior to baseline (cimetidine, ciprofloxacin, clarithromycin, enoxacin, erythromycin, fluvoxamine, isoniazide, nalidixic acid, norfloxacin, troleandomycin, zileuton)
  • Subjects who have used Monoamine oxidase (MAO) inhibitors including reserpine and methyldopa within three months prior to baseline
  • Anti-emetic or antipsychotic medication with central dopamine antagonist activity (except quetiapine fumarate) within six months prior to baseline
  • Participation in a clinical trial within the last 30 days prior to study start
  • Unstable antiparkinsonian medication within 30 days before baseline
  • Previous use of Rasagiline or Selegiline
  • Subjects who have a clinically significant or unstable medical or surgical condition that may preclude safe and complete study participation (based on the investigator's judgment). Such conditions might include cardiovascular, vascular diseases, pulmonary, hepatic impairment (Child-Pugh score > 5), renal, or metabolic dis-eases or malignancies as determined by medical history, physical examination, laboratory tests, or ECG

Sites / Locations

  • Department of Neurology and Palliative Care Klinikum der Universität München (Hospital of the University of Munich)

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Rasagiline

Sugar pill

Arm Description

Outcomes

Primary Outcome Measures

Assessment of the need for additional L-DOPA therapy or the need to increase the dose of L-DOPA during the trial
Since there is no established treatment regimen for Progressive Supranuclear Palsy (PSP) patients, the only well characterized medication is L-3,4-Dihydroxyphenylalanine (L-DOPA) therapy. Since this therapy may exert a small effect in PSP patients, begin with L-DOPA therapy or increase in L-DOPA therapy will be used in this trial as rescue medication.
Reduction of the reported deterioration using the PSP rating scale
To assess the efficacy of Rasagiline using the Progressive Supranuclear Palsy Rating Scale (PSPRS), aiming at a 33% reduction of the reported deterioration (Golbe et. al., 2007), i.e. a mean yearly increase of 6.5 instead of 9.7 points.

Secondary Outcome Measures

Reduction of gait disturbances and postural stability
Adverse Event (AE) incidence
Safety laboratory values (blood cell count, aspartate aminotransferase [AST], alanine aminotransferase [ALT], creatinine, Vitamin B12, folic acid, homocysteine and methylmalonic acid)
Vital signs
Number of subjects (%) who discontinue the study
Number of subjects (%) who discontinue the study due to AEs

Full Information

First Posted
August 20, 2010
Last Updated
April 23, 2013
Sponsor
Prof. Dr. Stefan Lorenzl
Collaborators
Teva Branded Pharmaceutical Products R&D, Inc., Ludwig-Maximilians - University of Munich
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1. Study Identification

Unique Protocol Identification Number
NCT01187888
Brief Title
Efficacy, Tolerability and Safety of Azilect in Subjects With Progressive Supranuclear Palsy
Acronym
PROSPERA
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy, Safety and Tolerability of Rasagiline in Subjects With Progressive Supranuclear Palsy (Phase III)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2013
Overall Recruitment Status
Terminated
Why Stopped
IMP used off label by phys. in pat. with PSP. Thus no more eligible patients were available for the study(pre-treatm.with Rasagiline=exclusion criterion
Study Start Date
January 2010 (undefined)
Primary Completion Date
June 2012 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Prof. Dr. Stefan Lorenzl
Collaborators
Teva Branded Pharmaceutical Products R&D, Inc., Ludwig-Maximilians - University of Munich

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether rasagiline is effective in the treatment of Progressive Supranuclear Palsy (PSP), a rapidly progressing disease with a symptomatology similar to Parkinson's Disease. The major aim of this study is the limitation or halting of the process of neurodegeneration and influence postural instability.
Detailed Description
Progressive Supranuclear Palsy (PSP) is a rapidly progressing disease with a median survival after onset of symptoms of 5.8 years.PSP is characterized by early falls, vertical ophthalmoparesis, akinetic-rigid features, prominent bulbar dysfunction and fronto-subcortical dementia. So far there is no treatment for the disease as the negative outcomes of the vast majority of studies make it impossible to set standards. As the majority of patients experience severe falls and vertigo already in the early phase of the disease, the drug of desire would be able to slow disease progression with a special focus on postural instability and exert neuroprotective effects. The monoamino oxidase inhibitor Rasagiline might be able to influence progression of PSP.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Progressive Supranuclear Palsy
Keywords
PSP, Progressive Supranuclear Palsy, Rasagiline, Azilect, PROSPERA

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rasagiline
Arm Type
Active Comparator
Arm Title
Sugar pill
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Rasagiline
Other Intervention Name(s)
Azilect
Intervention Description
tablet once daily 1 mg 1 year
Intervention Type
Drug
Intervention Name(s)
Sugar pill
Other Intervention Name(s)
Placebo
Intervention Description
tablet once daily one year
Primary Outcome Measure Information:
Title
Assessment of the need for additional L-DOPA therapy or the need to increase the dose of L-DOPA during the trial
Description
Since there is no established treatment regimen for Progressive Supranuclear Palsy (PSP) patients, the only well characterized medication is L-3,4-Dihydroxyphenylalanine (L-DOPA) therapy. Since this therapy may exert a small effect in PSP patients, begin with L-DOPA therapy or increase in L-DOPA therapy will be used in this trial as rescue medication.
Time Frame
1 year
Title
Reduction of the reported deterioration using the PSP rating scale
Description
To assess the efficacy of Rasagiline using the Progressive Supranuclear Palsy Rating Scale (PSPRS), aiming at a 33% reduction of the reported deterioration (Golbe et. al., 2007), i.e. a mean yearly increase of 6.5 instead of 9.7 points.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Reduction of gait disturbances and postural stability
Time Frame
1 year
Title
Adverse Event (AE) incidence
Time Frame
1 year
Title
Safety laboratory values (blood cell count, aspartate aminotransferase [AST], alanine aminotransferase [ALT], creatinine, Vitamin B12, folic acid, homocysteine and methylmalonic acid)
Time Frame
1 year
Title
Vital signs
Time Frame
1 year
Title
Number of subjects (%) who discontinue the study
Time Frame
1 year
Title
Number of subjects (%) who discontinue the study due to AEs
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Clinical signs of Progressive Supranuclear Palsy (PSP). Diagnosis will be made for patients with clinical probable PSP (Litvan et al., 1996). Patients will be included with PSP stage </= II (Golbe et al., 1997), at least with a PSPRS < 40 (Golbe et al., 2007) and according to the diagnostic criteria resumed after the Neuroprotection and Natural History in Parkinson Plus Syndromes (NNIPPS) trial (Bensimon et al., 2009) Patients, male or female, aged 50 to 80 years Subjects whose clinical condition at the time of enrolment does not or requires a low [</= 500 mg /day] stable dose of L-3,4-Dihydroxyphenylalanine (L-DOPA) for at least 2 weeks prior to study entry Capability and willingness to give written signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study Exclusion Criteria: No clinically probable PSP No written informed consent possible Age > 80 or < 50 years Dementia (Mini-Mental State Examination [MMSE] </= 24) Subjects with clinically significant psychiatric illness, including major depression Subjects who have taken any experimental drugs within 60 days prior to baseline Subjects who have used sympathomimetics (including over-the-counter remedies - nasal or oral), dextromethorphan, pethidine or St. John's wort within 7 days prior to baseline. Loss of postural reflexes (no independent walking possible, inability to stand unassisted, wheelchair-bound) Feeding tube / recommendation for a feeding tube Unintelligible speech History of brain disease (e.g. repeated strokes, cerebral tumour, hydrocephalus) 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) exposure Oculogyric crisis Early severe autonomic failure Systemic disorder affecting the brain Women who are not postmenopausal (e.g. one year without menstrual periods) or surgically sterilized. Known history of hypersensitivity to the investigational drug or to drugs with a similar chemical structure Subjects who have used antidepressants, including selective serotonin re-uptake inhibitors, tricyclic and tetracyclic antidepressants (except amitriptyline <= 50 mg/day, trazodone < = 100 mg/day, citalopram < = 20 mg/ day, sertraline < = 100 mg/day and paroxetine < = 30 mg/day, escitalopram < = 10 mg/day) within 42 days prior to baseline Subjects who have used any drugs known to have been involved in a drug interaction via inhibition of hepatic Cytochrome P450 1A2 (CYP 1A2) within 30 days prior to baseline (cimetidine, ciprofloxacin, clarithromycin, enoxacin, erythromycin, fluvoxamine, isoniazide, nalidixic acid, norfloxacin, troleandomycin, zileuton) Subjects who have used Monoamine oxidase (MAO) inhibitors including reserpine and methyldopa within three months prior to baseline Anti-emetic or antipsychotic medication with central dopamine antagonist activity (except quetiapine fumarate) within six months prior to baseline Participation in a clinical trial within the last 30 days prior to study start Unstable antiparkinsonian medication within 30 days before baseline Previous use of Rasagiline or Selegiline Subjects who have a clinically significant or unstable medical or surgical condition that may preclude safe and complete study participation (based on the investigator's judgment). Such conditions might include cardiovascular, vascular diseases, pulmonary, hepatic impairment (Child-Pugh score > 5), renal, or metabolic dis-eases or malignancies as determined by medical history, physical examination, laboratory tests, or ECG
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stefan Lorenzl, PD Dr.
Organizational Affiliation
Klinikum der Universität München (Hospital of the University of Munich)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Neurology and Palliative Care Klinikum der Universität München (Hospital of the University of Munich)
City
München
ZIP/Postal Code
81377
Country
Germany

12. IPD Sharing Statement

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Efficacy, Tolerability and Safety of Azilect in Subjects With Progressive Supranuclear Palsy

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