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Safety, Tolerability and Symptomatic Efficacy of the ROCK-Inhibitor Fasudil in Patients With Parkinson's Disease

Primary Purpose

Idiopathic Parkinson´s Disease

Status
Recruiting
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Fasudil hydrochloride
Placebo
Sponsored by
Technical University of Munich
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Parkinson´s Disease

Eligibility Criteria

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

Inclusion Criteria: Patients with a diagnosis of at least probable PD according to MDS criteria (Postuma et al. MovDis 2015) and Hoehn & Yahr stage 1 - 3 must be non-fluctuating (no wearing-off, no dyskinesia) and stable on symptomatic PD medication for at least 6 weeks age: 30 - 80 years Women of childbearing potential must be non-lactating and surgically sterile or using a highly effective method of birth control and have a negative pregnancy test. Acceptable methods of birth control with a low failure rate (i.e. less than 1% per year) when used consistently and correct are for example implants, injectables, combined oral contraceptives, hormonal intrauterine devices (IUDs), sexual abstinence or vasectomized partner Capable of thoroughly understanding all information given and giving full informed consent according to GCP Exclusion Criteria: Atypical, secondary Parkinsonian syndromes, PD mimics, or any other medical condition known to have an association with Parkinsonian syndromes, which might confound or obscure the diagnosis of PD Patients with a history of intracranial bleeding, known intracerebral aneurysms or Moyamoya disease, or positive family history for the above. If only family history positive, MR- or x-ray-based cranial imaging not older than 24 months must confirm absence of bleeding, aneurysms, or Moyamoya Presence of any concomitant life-threatening disease or impairment likely to interfere with functional assessment Patients with known arterial hypotension (resting blood pressure <90/60 mmHg) or previous hypotensive episodes or requiring treatment for increasing of blood pressure, such as fludrocortisone, midodrine, etilefrine, cafedrine, or theodrenaline Patients with an uncontrollable or unstable arterial hypertensive disease (resting blood pressure >180 mmHg systolic and/or >120 mmHg diastolic under current antihypertensive medication) Known pulmonary hypertension and any medication prescribed for treatment of pulmonary hypertension Confirmed hepatic insufficiency or abnormal liver function (stable ASAT and/or ALAT greater than 3 times the upper limit of the normal range) and determined to be non-transient through repeat testing Renal insufficiency with a glomerular filtration rate (GFR) <60 ml/min/1,73m² (calculated by MDRD equation or byCKD-EPI equation) and determined to be non-transient through repeat testing Major psychiatric disorder, significant cognitive impairment or clinically evident dementia precluding evaluation of symptoms Hypersensitivity to any component of the IMP Liable to be not cooperative or comply with the trial requirements (as assessed by the investigator), or unable to be reached in the case of emergency Pregnant or breast-feeding females or females with childbearing potential, if no adequate contraceptive measures are used Previous participation in another clinical study involving trial medication within the preceding 12 weeks or five terminal half times of the longest to be eliminated trial medications (whichever is longer) or previous participation in this trial

Sites / Locations

  • Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für NeurologieRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

intervention arm (low dose)

intervention arm (high dose)

Control intervention arm (placebo)

Arm Description

oral Fasudil solution 88 mg/day (2 x 44 mg)

oral Fasudil solution 44 mg/day (2 x 22 mg)

oral placebo solution 2x/day.

Outcomes

Primary Outcome Measures

Combined occurrence of intolerance and/or occurrence of self-reported and pre-defined treatment-related SAEs
Combined occurrence of intolerance (termination of treatment because of treatment-related AE) and/or occurrence of self-reported and pre-defined (laboratory, vital signs) treatment-related SAEs

Secondary Outcome Measures

Occurrence of intolerance
Occurrence of intolerance (termination of treatment because of treatment-related AE)
Occurrence of self-reported and pre-defined treatment-related SAEs
Occurrence of self-reported and pre-defined (laboratory, vital signs) treatment-related SAEs
Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)
the change of MDS-Unified PD Rating Scale (MDS-UPDRS) each part I to IV, min-max: 0-260, 0 indicating no disability and 260 indicating total disability, Part I: Nonmotor experiences of daily living: 13 items. Score range: 0-52; Part II: Motor experiences of daily living: 13 items. Score range: 0-52; Part III: Motor examination: 18 items. Score range: 0-132; Part IV: Motor complications: 6 items. Score range: 0-24; Each item has 0-4 ratings: 0 (normal), 1 (slight), 2 (mild), 3 (moderate), and 4 (severe).
MDS-Unified PD Rating Scale (MDS-UPDRS) score
the change of MDS-Unified PD Rating Scale (MDS-UPDRS) score part I to IV, min-max: 0-260, 0 indicating no disability and 260 indicating total disability, Part I: Nonmotor experiences of daily living: 13 items. Score range: 0-52; Part II: Motor experiences of daily living: 13 items. Score range: 0-52; Part III: Motor examination: 18 items. Score range: 0-132; Part IV: Motor complications: 6 items. Score range: 0-24; Each item has 0-4 ratings: 0 (normal), 1 (slight), 2 (mild), 3 (moderate), and 4 (severe).
Parkinson's Disease Questionnaire (PDQ-8)
the change of 8-item PD Quality of Life Scale (PDQ-8), min-max: 0-32, 0 no and 32 max
Non-Motor Symptom Questionnaire (NMSQuest)
the change of PD Non-Motor Symptom Questionnaire (NMSQuest), min-max: 0-30, 0 no and 30 max
Montreal Cognitive Assessment (MoCA)
the change of Montreal Cognitive Assessment (MoCA), Montreal Cognitive Assessment MoCA: min-max: 0 (worse) -30 (better outcome)
Beck's Depression Inventory II (BDI-II)
the change of Becks depression inventory-II (BDI-II), min-max: 0-63, 0 no and 63 max
Clinician Global Impression of Improvement (CGI-I) and Patient Global Impression of Improvement (PGI-I)
CGI-I [clinician]: min-max: 1-7, min-max: 1 (better) -7 (worse outcome) PGI-I [patient]: min-max: 1-7, min-max: 1 (better) -7 (worse outcome)

Full Information

First Posted
June 12, 2023
Last Updated
September 22, 2023
Sponsor
Technical University of Munich
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1. Study Identification

Unique Protocol Identification Number
NCT05931575
Brief Title
Safety, Tolerability and Symptomatic Efficacy of the ROCK-Inhibitor Fasudil in Patients With Parkinson's Disease
Official Title
Safety, Tolerability and Symptomatic Efficacy of the ROCK-Inhibitor Fasudil in Patients With Parkinson's Disease (ROCK-PD)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 11, 2023 (Actual)
Primary Completion Date
September 30, 2024 (Anticipated)
Study Completion Date
September 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Technical University of Munich

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of this phase Ila trial is to provide evidence on safety, tolerability and symptomatic efficacy of the ROCK-inhibitor Fasudil in patients with early Parkinson's disease (PD). Fasudil has shown neuroprotective and pro-regenerative effects, modulated microglial activity and attenuated alpha-synuclein aggregation in PD models in vitro and in vivo. It has been licensed in Japan since 1995 for the treatment of vasospasms and has a beneficial safety profile arguing for its repurposing. Up to 15 trial centers in Germany will recruit patients. Blinded trial medication will be prepared and shipped by the University Pharmacy Leipzig. Fasudil in two dosages or placebo will be administered orally twice daily to 75 early PD patients for a total of 3 weeks. Safety, tolerability and symptomatic efficacy endpoints will be assessed up to 4 weeks after end of treatment. Its well-known safety profile and the lack of disease-modifying treatments for PD justifies its use in patients with early Parkinson's disease. ROCK-PD is a prerequisite for subsequent long-term clinical trials assessing disease-modification in PD in addition to symptomatic efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Parkinson´s Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
intervention arm (low dose)
Arm Type
Experimental
Arm Description
oral Fasudil solution 88 mg/day (2 x 44 mg)
Arm Title
intervention arm (high dose)
Arm Type
Experimental
Arm Description
oral Fasudil solution 44 mg/day (2 x 22 mg)
Arm Title
Control intervention arm (placebo)
Arm Type
Placebo Comparator
Arm Description
oral placebo solution 2x/day.
Intervention Type
Drug
Intervention Name(s)
Fasudil hydrochloride
Other Intervention Name(s)
Fasudil hydrochloride (Fasudil)
Intervention Description
Duration of intervention per patient: 22 days; Application scheme: one dose on day 1, two doses on days 2 - 21, one dose on day 22.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Quinine dihydrochloride solution
Intervention Description
0.05 ml Quinine dihydrochloride solution (from Quinina Labesfal) in screw flask supplemented with 30 ml Glucose 40% solution from miniplasco directly before use
Primary Outcome Measure Information:
Title
Combined occurrence of intolerance and/or occurrence of self-reported and pre-defined treatment-related SAEs
Description
Combined occurrence of intolerance (termination of treatment because of treatment-related AE) and/or occurrence of self-reported and pre-defined (laboratory, vital signs) treatment-related SAEs
Time Frame
from day 1 to day 22
Secondary Outcome Measure Information:
Title
Occurrence of intolerance
Description
Occurrence of intolerance (termination of treatment because of treatment-related AE)
Time Frame
from day 1 to day 22
Title
Occurrence of self-reported and pre-defined treatment-related SAEs
Description
Occurrence of self-reported and pre-defined (laboratory, vital signs) treatment-related SAEs
Time Frame
from day 1 to day 22, and day 1 to day 50
Title
Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)
Description
the change of MDS-Unified PD Rating Scale (MDS-UPDRS) each part I to IV, min-max: 0-260, 0 indicating no disability and 260 indicating total disability, Part I: Nonmotor experiences of daily living: 13 items. Score range: 0-52; Part II: Motor experiences of daily living: 13 items. Score range: 0-52; Part III: Motor examination: 18 items. Score range: 0-132; Part IV: Motor complications: 6 items. Score range: 0-24; Each item has 0-4 ratings: 0 (normal), 1 (slight), 2 (mild), 3 (moderate), and 4 (severe).
Time Frame
part I and II from day 1 to day 22, and day 1 to day 50; time frame: part III and IV from day 1 to day 10, day 1 to day 22, and day 1 to day 50
Title
MDS-Unified PD Rating Scale (MDS-UPDRS) score
Description
the change of MDS-Unified PD Rating Scale (MDS-UPDRS) score part I to IV, min-max: 0-260, 0 indicating no disability and 260 indicating total disability, Part I: Nonmotor experiences of daily living: 13 items. Score range: 0-52; Part II: Motor experiences of daily living: 13 items. Score range: 0-52; Part III: Motor examination: 18 items. Score range: 0-132; Part IV: Motor complications: 6 items. Score range: 0-24; Each item has 0-4 ratings: 0 (normal), 1 (slight), 2 (mild), 3 (moderate), and 4 (severe).
Time Frame
from day 1 to day 22, and day 1 to day 50
Title
Parkinson's Disease Questionnaire (PDQ-8)
Description
the change of 8-item PD Quality of Life Scale (PDQ-8), min-max: 0-32, 0 no and 32 max
Time Frame
from day 1 to day 22, and day 1 to day 50
Title
Non-Motor Symptom Questionnaire (NMSQuest)
Description
the change of PD Non-Motor Symptom Questionnaire (NMSQuest), min-max: 0-30, 0 no and 30 max
Time Frame
from day 1 to day 10, day 1 to day 22, and day 1 to day 50
Title
Montreal Cognitive Assessment (MoCA)
Description
the change of Montreal Cognitive Assessment (MoCA), Montreal Cognitive Assessment MoCA: min-max: 0 (worse) -30 (better outcome)
Time Frame
from day 1 to day 22, and day 1 to day 50
Title
Beck's Depression Inventory II (BDI-II)
Description
the change of Becks depression inventory-II (BDI-II), min-max: 0-63, 0 no and 63 max
Time Frame
from day 1 to day 22, and day 1 to day 50
Title
Clinician Global Impression of Improvement (CGI-I) and Patient Global Impression of Improvement (PGI-I)
Description
CGI-I [clinician]: min-max: 1-7, min-max: 1 (better) -7 (worse outcome) PGI-I [patient]: min-max: 1-7, min-max: 1 (better) -7 (worse outcome)
Time Frame
at day 10, 22 and day 50

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with a diagnosis of at least probable PD according to MDS criteria (Postuma et al. MovDis 2015) and Hoehn & Yahr stage 1 - 3 must be non-fluctuating (no wearing-off, no dyskinesia) and stable on symptomatic PD medication for at least 6 weeks age: 30 - 80 years Women of childbearing potential must be non-lactating and surgically sterile or using a highly effective method of birth control and have a negative pregnancy test. Acceptable methods of birth control with a low failure rate (i.e. less than 1% per year) when used consistently and correct are for example implants, injectables, combined oral contraceptives, hormonal intrauterine devices (IUDs), sexual abstinence or vasectomized partner Capable of thoroughly understanding all information given and giving full informed consent according to GCP Exclusion Criteria: Atypical, secondary Parkinsonian syndromes, PD mimics, or any other medical condition known to have an association with Parkinsonian syndromes, which might confound or obscure the diagnosis of PD Patients with a history of intracranial bleeding, known intracerebral aneurysms or Moyamoya disease, or positive family history for the above. If only family history positive, MR- or x-ray-based cranial imaging not older than 24 months must confirm absence of bleeding, aneurysms, or Moyamoya Presence of any concomitant life-threatening disease or impairment likely to interfere with functional assessment Patients with known arterial hypotension (resting blood pressure <90/60 mmHg) or previous hypotensive episodes or requiring treatment for increasing of blood pressure, such as fludrocortisone, midodrine, etilefrine, cafedrine, or theodrenaline Patients with an uncontrollable or unstable arterial hypertensive disease (resting blood pressure >180 mmHg systolic and/or >120 mmHg diastolic under current antihypertensive medication) Known pulmonary hypertension and any medication prescribed for treatment of pulmonary hypertension Confirmed hepatic insufficiency or abnormal liver function (stable ASAT and/or ALAT greater than 3 times the upper limit of the normal range) and determined to be non-transient through repeat testing Renal insufficiency with a glomerular filtration rate (GFR) <60 ml/min/1,73m² (calculated by MDRD equation or byCKD-EPI equation) and determined to be non-transient through repeat testing Major psychiatric disorder, significant cognitive impairment or clinically evident dementia precluding evaluation of symptoms Hypersensitivity to any component of the IMP Liable to be not cooperative or comply with the trial requirements (as assessed by the investigator), or unable to be reached in the case of emergency Pregnant or breast-feeding females or females with childbearing potential, if no adequate contraceptive measures are used Previous participation in another clinical study involving trial medication within the preceding 12 weeks or five terminal half times of the longest to be eliminated trial medications (whichever is longer) or previous participation in this trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Paul Lingor, MD
Phone
+49 89 4140 8257
Email
paul.lingor@tum.de
First Name & Middle Initial & Last Name or Official Title & Degree
Andreas Wolff, MD
Phone
+49 89 4140 8237
Email
andreas.wolff@tum.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Lingor, MD
Organizational Affiliation
Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für Neurologie
Official's Role
Principal Investigator
Facility Information:
Facility Name
Technische Universität München, Klinikum rechts der Isar, Klinik und Poliklinik für Neurologie
City
Munich
ZIP/Postal Code
81675
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Lingor, MD
Email
paul.lingor@tum.de

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety, Tolerability and Symptomatic Efficacy of the ROCK-Inhibitor Fasudil in Patients With Parkinson's Disease

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