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A Phase 2 Study to Evaluate the Safety and Efficacy of ABP-450 in the Treatment of Cervical Dystonia

Primary Purpose

Cervical Dystonia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ABP-450
Placebo
Sponsored by
AEON Biopharma, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Dystonia

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients between 18 and 75 years of age (inclusive)
  2. A clinical diagnosis of cervical dystonia (ie, spasmodic torticollis) defined by:

    • TWSTRS total score ≥20
    • TWSTRS severity score ≥10
    • TWSTRS disability score ≥3
    • TWSTRS pain score ≥1
  3. On a stable dose of medications (if any) used for focal dystonia treatment (eg, anticholinergics and benzodiazepines) for at least 3 months prior to and expected throughout the study duration
  4. For pre-treated patients only: Source documentation (eg, patient history) of the last 2 consecutive injection sessions with a botulinum toxin type A
  5. For pre-treated patients only: At least 16 weeks must have passed between the last injection with botulinum toxin for cervical dystonia and baseline treatment (patients can be screened at Week 15 but cannot be enrolled until 16 weeks [for Day 0 injection])
  6. Provided written informed consent to being treated for cervical dystonia with ABP-450
  7. Stated willingness to comply with all study procedures, including attendance at the study center for all study visits as scheduled and have technological capabilities to have televisits

Exclusion Criteria:

  1. Traumatic torticollis or tardive torticollis
  2. Predominant retrocollis or anterocollis
  3. Myotomy or denervation surgery in the affected muscles (eg, peripheral denervation and/or spinal cord stimulation)
  4. Hypersensitivity to human serum albumin, sucrose, or botulinum toxin type A
  5. Previous treatment for cervical dystonia with rimabotulinumtoxin B
  6. Diagnosis of myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis, or any other significant neuromuscular disease that might interfere with the trial
  7. Current swallowing disorder of any origin (dysphagia scale ≥3, ie, severe, with swallowing difficulties and requiring a change in diet)
  8. Marked limitation on passive range of motion that suggests contractures or other structural abnormality, eg, cervical contractures or cervical spine syndrome
  9. Treatment with botulinum toxins of any type for any indication other than cervical dystonia within 16 weeks prior to baseline and during the study
  10. Medical or psychiatric conditions that may increase the risk associated with study participation or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study
  11. Participation in another interventional study during participation in this study
  12. Pregnant or lactating females, or females of child-bearing potential not willing to use an acceptable method of contraception (ie, intrauterine device, barrier methods with spermicide, or abstinence)
  13. For pre-treated patients only: The patient's most recent injection with botulinum toxin exceeding the number of units specified as follows:

    • OnabotulinumtoxinA (BOTOX®): >300 units
    • IncobotulinumtoxinA (Xeomin®): >300 units
    • AbobotulinumtoxinA (Dysport®): >750 units

Sites / Locations

  • Arizona Neuroscience Research
  • Movement Disorder Center of Arizona
  • Parkinson's and Movement Disorder Institute
  • Neuro Pain Medical Center
  • Loma Linda University
  • New England Institute for Neurology and Headache
  • Infinity Clinical Research LLC
  • The Neurology Research Group
  • University of South Florida
  • Neurology One
  • Emory University
  • Rush University Medical Center
  • Michigan State University
  • Quest Research Institute - Hunt - PPDS
  • University of New Mexico
  • The Cleveland Clinic Foundation
  • Cleveland Clinic Lou Ruvo Center for Brain Health
  • The Orthopedic Foundation
  • Veracity Neuroscience LLC
  • Vanderbilt University Medical Center
  • Baylor College of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

ABP-450 - Low Dose

ABP-450 - Medium Dose

ABP-450 - High Dose

Placebo

Arm Description

ABP-450 Low Dose - Intramuscular injections into affected neck muscles.

ABP-450 Mid Dose - Intramuscular injections into affected neck muscles.

ABP-450 High Dose - Intramuscular injections into affected neck muscles.

Placebo (0.9% saline, sterile, unpreserved, USP/Ph.Eur.) - Intramuscular injections into affected neck muscles.

Outcomes

Primary Outcome Measures

Incidence of Treatment-related Serious Adverse Events
The primary safety endpoint will be the incidence of treatment-related serious adverse events since the start of treatment by Treatment Group when dosed with placebo, ABP-450 (low dose), ABP-450 (mid dose), or ABP-450 (high dose).

Secondary Outcome Measures

Mean Change in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) Total Score
The mean change in the total score of the TWSTRS since the start of treatment will be assessed by treatment group. The TWSTRS total score is a summation of the following subscales: Severity scale, Disability scale and Pain scale with a higher score representing a worse outcome.
Mean Change in the subscale score of severity of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)
The mean change in the subscale score of severity of the TWSTRS since the start of treatment will be assessed by Treatment Group. The higher score represents the greater severity.
Mean Change in the subscale score of disability of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) Spasmodic Torticollis Rating Scale (TWSTRS)
The mean change in the subscale score of disability of the TWSTRS since the start of treatment will be assessed by Treatment Group. The higher score represents the greater disability.
Mean Change in the subscale score of pain of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)
The mean change in the subscale score of pain of the TWSTRS since the start of treatment will be assessed by Treatment Group. The higher score represents the greater pain.
Mean Change in Patient Global Impression of Change (PGI-C)
The mean change in the subject's assessment of the change in clinical status since the start of treatment measured by the Patients' Global Impression of Change (PGI-C) Scale will be assessed by Treatment Group.
Mean Change in Patient Global Impression of Severity (PGI-S)
The mean change in the subject's assessment of the severity of their condition since the start of treatment measured by the Patients' Global Impression of Severity (PGI-S) Scale will be assessed by Treatment Group.
Mean Change in Clinical Global Impression of Change (CGI-C)
The mean change from Baseline in the Clinical Global Impression of Change (CGI-C) Score will be assessed by Treatment Group. CGI-C is a clinical assessment with a 7-point scale ranging from "very much improved" to "very much worse".
Mean Change in Clinical Global Impression of Severity (CGI-S)
The mean change from Baseline in the Clinical Global Impression of Severity (CGI-S) Score will be assessed by Treatment Group. CGI-S is a clinical assessment of the patient's illness severity on a 7-point scale ranging from "normal" to "among the most extremely ill patients".

Full Information

First Posted
April 14, 2021
Last Updated
March 6, 2023
Sponsor
AEON Biopharma, Inc.
Collaborators
PPD
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1. Study Identification

Unique Protocol Identification Number
NCT04849988
Brief Title
A Phase 2 Study to Evaluate the Safety and Efficacy of ABP-450 in the Treatment of Cervical Dystonia
Official Title
A Phase 2, Randomized, Double-Blind, Multicenter, Placebo Controlled Study to Evaluate the Safety and Efficacy of Intramuscular ABP-450 (prabotulinumtoxinA) Injection for the Treatment of Cervical Dystonia
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
March 29, 2021 (Actual)
Primary Completion Date
July 11, 2022 (Actual)
Study Completion Date
July 11, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AEON Biopharma, Inc.
Collaborators
PPD

4. Oversight

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

5. Study Description

Brief Summary
This Phase 2 trial will evaluate the safety and efficacy of ABP-450 for the treatment of cervical dystonia in adults. The study will enroll 60 patients across approximately 30 sites in the United States. Study subjects will be divided evenly across a low dose group, a medium dose group, a high dose group, and a placebo group for one treatment cycle.
Detailed Description
This Phase 2 trial will evaluate the safety and efficacy of ABP-450 for the treatment of cervical dystonia in adults. The study will enroll 60 patients across approximately 30 sites in the United States. Study subjects will be divided evenly across a low dose, a medium dose group, a high dose and placebo group for one treatment cycle.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cervical Dystonia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Approximately 60 patients will be randomized in a 1:1:1:1 ratio and receive one of the four treatments: ABP-450 low dose, ABP-450 mid dose, ABP-450 high dose, or placebo via intramuscular injection into affected neck muscles.
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
The investigator, study nurse/other study personnel, and patients will be blinded to the treatment group. An appropriately trained person will reconstitute investigational product, fill masked syringes and provide them to the blinded investigator, but will not perform any assessments with the patient.
Allocation
Randomized
Enrollment
59 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ABP-450 - Low Dose
Arm Type
Experimental
Arm Description
ABP-450 Low Dose - Intramuscular injections into affected neck muscles.
Arm Title
ABP-450 - Medium Dose
Arm Type
Experimental
Arm Description
ABP-450 Mid Dose - Intramuscular injections into affected neck muscles.
Arm Title
ABP-450 - High Dose
Arm Type
Experimental
Arm Description
ABP-450 High Dose - Intramuscular injections into affected neck muscles.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo (0.9% saline, sterile, unpreserved, USP/Ph.Eur.) - Intramuscular injections into affected neck muscles.
Intervention Type
Drug
Intervention Name(s)
ABP-450
Other Intervention Name(s)
prabotulinumtoxinA
Intervention Description
ABP-450 (prabotulinumtoxinA) contains a 900kDA botulinum toxin type-A complex produced by the bacterium Clostridium botulinum.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
0.9% sodium chloride, saline
Intervention Description
0.9% sodium chloride, sterile, unpreserved, USP/Ph.Eur.
Primary Outcome Measure Information:
Title
Incidence of Treatment-related Serious Adverse Events
Description
The primary safety endpoint will be the incidence of treatment-related serious adverse events since the start of treatment by Treatment Group when dosed with placebo, ABP-450 (low dose), ABP-450 (mid dose), or ABP-450 (high dose).
Time Frame
Baseline up to 20 Weeks
Secondary Outcome Measure Information:
Title
Mean Change in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) Total Score
Description
The mean change in the total score of the TWSTRS since the start of treatment will be assessed by treatment group. The TWSTRS total score is a summation of the following subscales: Severity scale, Disability scale and Pain scale with a higher score representing a worse outcome.
Time Frame
Baseline up to 20 weeks
Title
Mean Change in the subscale score of severity of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)
Description
The mean change in the subscale score of severity of the TWSTRS since the start of treatment will be assessed by Treatment Group. The higher score represents the greater severity.
Time Frame
Baseline up to 20 weeks
Title
Mean Change in the subscale score of disability of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) Spasmodic Torticollis Rating Scale (TWSTRS)
Description
The mean change in the subscale score of disability of the TWSTRS since the start of treatment will be assessed by Treatment Group. The higher score represents the greater disability.
Time Frame
Baseline up to 20 weeks
Title
Mean Change in the subscale score of pain of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)
Description
The mean change in the subscale score of pain of the TWSTRS since the start of treatment will be assessed by Treatment Group. The higher score represents the greater pain.
Time Frame
Baseline up to 20 weeks
Title
Mean Change in Patient Global Impression of Change (PGI-C)
Description
The mean change in the subject's assessment of the change in clinical status since the start of treatment measured by the Patients' Global Impression of Change (PGI-C) Scale will be assessed by Treatment Group.
Time Frame
Baseline up to 20 weeks
Title
Mean Change in Patient Global Impression of Severity (PGI-S)
Description
The mean change in the subject's assessment of the severity of their condition since the start of treatment measured by the Patients' Global Impression of Severity (PGI-S) Scale will be assessed by Treatment Group.
Time Frame
Baseline up to 20 weeks
Title
Mean Change in Clinical Global Impression of Change (CGI-C)
Description
The mean change from Baseline in the Clinical Global Impression of Change (CGI-C) Score will be assessed by Treatment Group. CGI-C is a clinical assessment with a 7-point scale ranging from "very much improved" to "very much worse".
Time Frame
Baseline up to 20 weeks
Title
Mean Change in Clinical Global Impression of Severity (CGI-S)
Description
The mean change from Baseline in the Clinical Global Impression of Severity (CGI-S) Score will be assessed by Treatment Group. CGI-S is a clinical assessment of the patient's illness severity on a 7-point scale ranging from "normal" to "among the most extremely ill patients".
Time Frame
Baseline up to 20 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patients between 18 and 75 years of age (inclusive) A clinical diagnosis of cervical dystonia (ie, spasmodic torticollis) defined by: TWSTRS total score ≥20 TWSTRS severity score ≥10 TWSTRS disability score ≥3 TWSTRS pain score ≥1 On a stable dose of medications (if any) used for focal dystonia treatment (eg, anticholinergics and benzodiazepines) for at least 3 months prior to and expected throughout the study duration For pre-treated patients only: Source documentation (eg, patient history) of the last 2 consecutive injection sessions with a botulinum toxin type A For pre-treated patients only: At least 16 weeks must have passed between the last injection with botulinum toxin for cervical dystonia and baseline treatment (patients can be screened at Week 15 but cannot be enrolled until 16 weeks [for Day 0 injection]) Provided written informed consent to being treated for cervical dystonia with ABP-450 Stated willingness to comply with all study procedures, including attendance at the study center for all study visits as scheduled and have technological capabilities to have televisits Exclusion Criteria: Traumatic torticollis or tardive torticollis Predominant retrocollis or anterocollis Myotomy or denervation surgery in the affected muscles (eg, peripheral denervation and/or spinal cord stimulation) Hypersensitivity to human serum albumin, sucrose, or botulinum toxin type A Previous treatment for cervical dystonia with rimabotulinumtoxin B Diagnosis of myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis, or any other significant neuromuscular disease that might interfere with the trial Current swallowing disorder of any origin (dysphagia scale ≥3, ie, severe, with swallowing difficulties and requiring a change in diet) Marked limitation on passive range of motion that suggests contractures or other structural abnormality, eg, cervical contractures or cervical spine syndrome Treatment with botulinum toxins of any type for any indication other than cervical dystonia within 16 weeks prior to baseline and during the study Medical or psychiatric conditions that may increase the risk associated with study participation or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the patient inappropriate for entry into this study Participation in another interventional study during participation in this study Pregnant or lactating females, or females of child-bearing potential not willing to use an acceptable method of contraception (ie, intrauterine device, barrier methods with spermicide, or abstinence) For pre-treated patients only: The patient's most recent injection with botulinum toxin exceeding the number of units specified as follows: OnabotulinumtoxinA (BOTOX®): >300 units IncobotulinumtoxinA (Xeomin®): >300 units AbobotulinumtoxinA (Dysport®): >750 units
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cynthia Comella, MD
Organizational Affiliation
Rush University Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Joseph Jankovic
Organizational Affiliation
Baylor St. Luke's Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Arizona Neuroscience Research
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85032
Country
United States
Facility Name
Movement Disorder Center of Arizona
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Facility Name
Parkinson's and Movement Disorder Institute
City
Fountain Valley
State/Province
California
ZIP/Postal Code
92708
Country
United States
Facility Name
Neuro Pain Medical Center
City
Fresno
State/Province
California
ZIP/Postal Code
93710
Country
United States
Facility Name
Loma Linda University
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Facility Name
New England Institute for Neurology and Headache
City
Stamford
State/Province
Connecticut
ZIP/Postal Code
06905
Country
United States
Facility Name
Infinity Clinical Research LLC
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33024
Country
United States
Facility Name
The Neurology Research Group
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33613
Country
United States
Facility Name
Neurology One
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32792
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Michigan State University
City
East Lansing
State/Province
Michigan
ZIP/Postal Code
48824
Country
United States
Facility Name
Quest Research Institute - Hunt - PPDS
City
Farmington Hills
State/Province
Michigan
ZIP/Postal Code
48334
Country
United States
Facility Name
University of New Mexico
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87106
Country
United States
Facility Name
The Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Cleveland Clinic Lou Ruvo Center for Brain Health
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
89106
Country
United States
Facility Name
The Orthopedic Foundation
City
New Albany
State/Province
Ohio
ZIP/Postal Code
43054
Country
United States
Facility Name
Veracity Neuroscience LLC
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38157
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Individual Participant Data collected during the trial, after deidentification may be shared following review of the clinical study report by the FDA review division and if a decision is made to publish the results in a publication outside posting the results in clinicaltrials.gov.

Learn more about this trial

A Phase 2 Study to Evaluate the Safety and Efficacy of ABP-450 in the Treatment of Cervical Dystonia

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