Study to Assess Droxidopa in the Treatment of Freezing Of Gait Symptoms in Patients With Parkinson's Disease
Primary Purpose
Gait Disorders, Neurologic
Status
Withdrawn
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
droxidopa
Sponsored by
About this trial
This is an interventional treatment trial for Gait Disorders, Neurologic
Eligibility Criteria
Inclusion Criteria:
- Male or female patients, aged at least 30 years;
- Diagnosed with probable levodopa-responsive idiopathic Parkinson's Disease , and receiving levodopa. Other Parkinson's Disease medications can also be used.
- At least 3 months incidence of typical freezing of gait (FOG) symptoms, occurring while levodopa is otherwise providing an "on" mobility state (including at least one of the following FOG patterns: start hesitancy, freezing at making turns or when passing through a doorway, spontaneous freezing during continued walking, or freezing of gait related to a simultaneous mental or physical activity).
- Provide written informed consent to participate in the study and understand that they may withdraw their consent at any time without prejudice to their future medical care
- On a stable dose of carbidopa, alone or with other Parkinson's medication, providing a range of carbidopa between 100mg and 400mg daily
Exclusion Criteria:
- Taking direct acting vasoconstricting agent (i.e. ephedrine or midodrine). Patients taking vasoconstrictor agents such as ephedrine or midodrine must stop taking these drugs at least 2 days or 5 half-lives (whichever is longer) prior to their baseline visit;
- Taking more than one anti-hypertensive medication for the treatment of high blood pressure. Short acting anti-hypertensive medication taken at night to prevent supine hypertension will be allowed.
- Have changed dose or frequency of Parkinson's medication within 2 weeks of baseline
- Known or suspected alcohol or substance abuse within 1 year
- Sustained hypertension (BP greater than 140/90 mmHg in the sitting position)
- Symptomatic coronary artery disease, severe congestive heart failure
- Women who are pregnant, lactating, or plan to become pregnant during the course of this study;
- Women of child bearing potential (WOCP) who are not using two methods of contraception (at least one barrier: i.e. condom) with their partner.
- Male patients who are sexually active with a woman of child bearing potential (WOCP) and not using two methods of contraception (at least one barrier: i.e. condom)
- Untreated closed angle glaucoma, or treated closed angle glaucoma that in the opinion of an ophthalmologist would cause increased risk to the patient;
- Active (last 6 months) atrial fibrillation or, in the investigator's opinion, any other significant cardiac arrhythmia that should preclude the patient from this trial;
- History of myocardial infarction or unstable angina
- Diabetes insipidus, insulin dependent diabetes mellitus, or diabetic neuropathy;
- In the investigator's opinion, any other significant systemic illness;
- Known or suspected malignancy (other than basal cell carcinoma);
- Known gastrointestinal illness or other gastrointestinal disorder that may, in the investigator's opinion, affect the absorption of study drug;
- Any major surgical procedure within 30 days of the baseline visit;
- Currently receiving any investigational drug or have received an investigational drug within 30 days of the baseline visit;
- In the investigator's opinion, clinically significant abnormalities on clinical examination or laboratory testing that should preclude the patient from this trial;
- Patient has only lower body Parkinson's Disease
- In the investigators opinion, freezing of gait is attributable to previous stroke
Sites / Locations
- Henry Ford West Bloomfield Hospital
- University of Alberta, Movement Disorders Clinic Glenrose Rehabilitation Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
droxidopa
placebo
Arm Description
Northera (2R,3S)-2-amino-3-(3,4-dihydroxyphenyl)-3-hydroxypropanoic acid L-DOPS L-threo-dihydroxyphenylserine Droxidopa SM-5688
placebo
Outcomes
Primary Outcome Measures
Evaluate the safety of droxidopa as measured by the incidence, relatedness, and severity of adverse events.
Secondary Outcome Measures
Evaluate the effect of droxidopa on freezing of gait symptoms using the Freezing of Gait Questionnaire
Evaluate the efficacy of droxidopa in the treatment of freezing of gait by using the Observed Freezing of Gait Rating (OFGR) scale
Evaluate the effect of droxidopa on signs and symptoms associated with Parkinson's Disease utilizing the composite scores of the Unified Parkinson's Disease Rating Scale
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01331122
Brief Title
Study to Assess Droxidopa in the Treatment of Freezing Of Gait Symptoms in Patients With Parkinson's Disease
Official Title
A Phase II, Double-Blind, Placebo-Controlled Randomized Crossover Study to Assess the Clinical Benefit and Safety of Droxidopa in the Treatment of Freezing of Gait Symptoms in Patients With Parkinson's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
March 2013
Overall Recruitment Status
Withdrawn
Why Stopped
Never initiated. Withdrawn by sponsor.
Study Start Date
April 2012 (undefined)
Primary Completion Date
December 2012 (Anticipated)
Study Completion Date
December 2012 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chelsea Therapeutics
4. Oversight
5. Study Description
Brief Summary
Freezing of Gait (FoG) is a class of symptoms that occur in Parkinson's patients. Also called motor blocks, FoG is characterized by a sudden inability to move the lower extremities which usually lasts less than 10 seconds. The exact pathophysiology of FoG is poorly understood, but treatment with levodopa appears to improve FoG observed in the off-state. As Parkinson's patients progress in severity, FoG in the on-state can increase in frequency and appears to be resistant to dopaminergic therapies. There is additional evidence that norepinephrine as well as dopaminergic systems may be involved in FoG.
Droxidopa has has been approved for use in Japan since 1989 for treatment of frozen gait or dizziness associated with Parkinson's Disease. This study is to further explore the safety and efficacy of droxidopa in this indication.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gait Disorders, Neurologic
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
droxidopa
Arm Type
Experimental
Arm Description
Northera (2R,3S)-2-amino-3-(3,4-dihydroxyphenyl)-3-hydroxypropanoic acid L-DOPS L-threo-dihydroxyphenylserine Droxidopa SM-5688
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
placebo
Intervention Type
Drug
Intervention Name(s)
droxidopa
Other Intervention Name(s)
Northera, SM-5688, L-DOPS, L-threo-dihydroxyphenylserine
Intervention Description
Oral, 100, 200, 300, 400, 500, or 600 mg TID, duration includes two crossover periods of up to a 2 week titration period followed by a 4 week treatment period,with a washout between crossover periods.
Primary Outcome Measure Information:
Title
Evaluate the safety of droxidopa as measured by the incidence, relatedness, and severity of adverse events.
Time Frame
18 Weeks
Secondary Outcome Measure Information:
Title
Evaluate the effect of droxidopa on freezing of gait symptoms using the Freezing of Gait Questionnaire
Time Frame
18 Weeks
Title
Evaluate the efficacy of droxidopa in the treatment of freezing of gait by using the Observed Freezing of Gait Rating (OFGR) scale
Time Frame
18 Weeks
Title
Evaluate the effect of droxidopa on signs and symptoms associated with Parkinson's Disease utilizing the composite scores of the Unified Parkinson's Disease Rating Scale
Time Frame
18 Weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female patients, aged at least 30 years;
Diagnosed with probable levodopa-responsive idiopathic Parkinson's Disease , and receiving levodopa. Other Parkinson's Disease medications can also be used.
At least 3 months incidence of typical freezing of gait (FOG) symptoms, occurring while levodopa is otherwise providing an "on" mobility state (including at least one of the following FOG patterns: start hesitancy, freezing at making turns or when passing through a doorway, spontaneous freezing during continued walking, or freezing of gait related to a simultaneous mental or physical activity).
Provide written informed consent to participate in the study and understand that they may withdraw their consent at any time without prejudice to their future medical care
On a stable dose of carbidopa, alone or with other Parkinson's medication, providing a range of carbidopa between 100mg and 400mg daily
Exclusion Criteria:
Taking direct acting vasoconstricting agent (i.e. ephedrine or midodrine). Patients taking vasoconstrictor agents such as ephedrine or midodrine must stop taking these drugs at least 2 days or 5 half-lives (whichever is longer) prior to their baseline visit;
Taking more than one anti-hypertensive medication for the treatment of high blood pressure. Short acting anti-hypertensive medication taken at night to prevent supine hypertension will be allowed.
Have changed dose or frequency of Parkinson's medication within 2 weeks of baseline
Known or suspected alcohol or substance abuse within 1 year
Sustained hypertension (BP greater than 140/90 mmHg in the sitting position)
Symptomatic coronary artery disease, severe congestive heart failure
Women who are pregnant, lactating, or plan to become pregnant during the course of this study;
Women of child bearing potential (WOCP) who are not using two methods of contraception (at least one barrier: i.e. condom) with their partner.
Male patients who are sexually active with a woman of child bearing potential (WOCP) and not using two methods of contraception (at least one barrier: i.e. condom)
Untreated closed angle glaucoma, or treated closed angle glaucoma that in the opinion of an ophthalmologist would cause increased risk to the patient;
Active (last 6 months) atrial fibrillation or, in the investigator's opinion, any other significant cardiac arrhythmia that should preclude the patient from this trial;
History of myocardial infarction or unstable angina
Diabetes insipidus, insulin dependent diabetes mellitus, or diabetic neuropathy;
In the investigator's opinion, any other significant systemic illness;
Known or suspected malignancy (other than basal cell carcinoma);
Known gastrointestinal illness or other gastrointestinal disorder that may, in the investigator's opinion, affect the absorption of study drug;
Any major surgical procedure within 30 days of the baseline visit;
Currently receiving any investigational drug or have received an investigational drug within 30 days of the baseline visit;
In the investigator's opinion, clinically significant abnormalities on clinical examination or laboratory testing that should preclude the patient from this trial;
Patient has only lower body Parkinson's Disease
In the investigators opinion, freezing of gait is attributable to previous stroke
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter A LeWitt, MD
Organizational Affiliation
Henry Ford Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Henry Ford West Bloomfield Hospital
City
West Bloomfield
State/Province
Michigan
ZIP/Postal Code
48322
Country
United States
Facility Name
University of Alberta, Movement Disorders Clinic Glenrose Rehabilitation Hospital
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T5G 0B7
Country
Canada
12. IPD Sharing Statement
Learn more about this trial
Study to Assess Droxidopa in the Treatment of Freezing Of Gait Symptoms in Patients With Parkinson's Disease
We'll reach out to this number within 24 hrs