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A Placebo- and Ropinirole-Controlled Study for SPM 962 in Advanced Parkinson's Disease Patients

Primary Purpose

Parkinson's Disease

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
SPM 962
Ropinirole
Placebo
Sponsored by
Otsuka Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson's Disease

Eligibility Criteria

30 Years - 79 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject diagnosed as having Parkinson's disease in accordance with "Diagnostic Criteria established by the Research Committee of MHLW-specified Intractable Neurodegenerative Diseases (1995)".
  • Subject is 30 and more and less than 80 years of age at the time of informed consent.
  • Hoehn & Yahr stage 2-4 (on time).
  • Total UPDRS Part 3 score is over 10 at screening test (on time).
  • Subject is on a stable dose of L-dopa with no change in daily dose or dosing regimen for at least 28 days prior to the initial treatment of SPM 962.
  • Subject has any of the following problematic symptoms; 1) Wearing off phenomenon (including frozen gait at off time and dystonia at off time) 2) On and off phenomenon 3) Delayed-on and/or No-on phenomenon 4) Dyskinesia 5) Not well controlled with L-dopa.

Exclusion Criteria:

  • Subject who has previously participated in a clinical trial of SPM962 and taken the investigational product (IP).
  • Subject has psychiatric symptoms, e.g. confusion, hallucination, delusion, excitation, delirium, abnormal behavior at screening test or baseline.
  • Subject whose SBP declines by at least 30 mmHg from supine to standing position based on the orthostatic hypotension assessment, or subject who develops orthostatic hypotension at baseline.
  • Subject has a history of epilepsy, convulsion and other.
  • Subject who has complications or a history of serious cardiac diseases or arrhythmia (eg, congestive heart failure of class 3 or 4 in the NYHA classification, second or third degree atrioventricular block, complete left bundle branch block, sick sinus syndrome, ventricular fibrillation, myocardial infarction within 12 months prior to the screening test, or a complication of angina pectoris).
  • Subjects has QTc-interval >450 msec twice at screening. Subject has a the average QTc-interval from two ECGs >450 msec in males and >470 msec in females at baseline.
  • Subject has congenital long QT syndrome.
  • Subject whose serum potassium level is < 3.5mEq/L at the screening test.
  • Subject has a total bilirubin >= 3.0 mg/dL or AST(GOT) or ALT(GPT) greater than 2.5 times of the upper limit of the reference range (or >= 100 IU/L) at screening test, or suffers complications of active phase of chronic hepatitis or liver cirrhosis.
  • Subject has BUN >= 30 mg/dL or serum creatinine >= 2.0 mg/dl at screening test.
  • Subject has a history of allergic reaction to topical agents such as transdermal patch.
  • Subject has a history of known intolerance/hypersensitivity to ropinirole and/or adverse drug reactions that prevent subject from receiving treatment.
  • Subject is pregnant or nursing or woman who plans pregnancy during the trial.
  • Subject is receiving therapy with prohibited drug specified in the study protocol.
  • Subject has a history of pallidotomy, thalamotomy, deep brain stimulation or fetal tissue transplant.
  • Subject has dementia, including DLB and PDD (MMSE score <= 24 at screening).
  • Subject who has a complication or history of malignant neoplastic disease, or received treatment for the disease within 12 months prior to the screening test.
  • Subject is unable to give consent.
  • Subject who is unable to properly record information in a diary.
  • Subject is participating in another trial of IPs or received other IPs within 12 weeks prior to commencement of study treatment.
  • Investigator judges that subject is inappropriate as a study subject with other reasons.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

SPM 962

Ropinirole

Placebo

Arm Description

SPM 962 transdermal patch

Ropinirole tablet

SPM962 placebo patch and Ropinirole placebo tab

Outcomes

Primary Outcome Measures

Unified Parkinson's Disease Rating Score (UPDRS) Part 3 Sum Score
Mean change (LOCF) from baseline in UPDRS Part 3 sum score (on state) at 16 weeks after dosing. UPDRS is a scale for monitoring Parkinson's Disease-related disability and impairment. The UPDRS consists of the following four sub-scales. Part 1: Mentation, Part 2: Activities of Daily Living, Part 3: Motor, Part 4: Complications. Part 3 assesses 14 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.

Secondary Outcome Measures

UPDRS Part 3 Sum Score
Mean change (LOCF) from baseline in UPDRS Part 3 sum score (on state) at 8 and 10 weeks after dosing. UPDRS Part 3 assesses 14 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.
UPDRS Part 2 Sum Score
Mean change (LOCF) from baseline in UPDRS Part 2 sum score (average scores of on state and off state) at 16 weeks after dosing. UPDRS 2 assesses 13 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.
Off Time
Mean change (LOCF) from baseline in off time at 16 weeks after dosing. Off-time is a state where L-Dopa becomes ineffective. Off-time was measured by patient diary in hours/day.
Parkinson's Disease Sleep Scale-2 (PDSS-2)
Mean change (LOCF) from baseline in PDSS-2 sum score at 16 weeks after dosing. PDSS-2 is a scale for assessing sleep disorders in Parkinson's disease. PDSS consists of 15 questions about sleep and nocturnal disturbances. The score of each question ranges from 0 (never) to 4 (very frequent). The sum of each question serves as the scale score. Thus a decrease in the scores means improvement.
On Time
Mean change (LOCF) from baseline in on time at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.
On Time Without Dyskinesia Disturbing Daily Activities
Mean change (LOCF) from baseline in on time without dyskinesia disturbing daily activities at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.
On Time With Dyskinesia Disturbing Daily Activities
Mean change (LOCF) from baseline in on time with dyskinesia disturbing daily activities at 16 weeks after dosing (rate against on time).
Effective Rate in UPDRS Part 3 Sum Score
Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in UPDRS Part 3 sum score (on state) at 16 weeks after dosing.
Effective Rate in UPDRS Part 2 Sum Score
Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in UPDRS Part 2 sum score (average scores of on state and off state) at 16 weeks after dosing.
Effective Rate in Off Time
Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in off time at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.
Clinical Global Impression (CGI)
Change (LOCF) from baseline in CGI score. CGI improvement is a clinician-reported scale for assessing how much the patient's illness has improved or worsened from baseline. The scale scoring criteria are 1: very much improved, 2: much improved, 3: minimally improved, 4: no change, 5: minimally worse, 6: much worse, 7: very much worse. A decrease in the scores means improvement.
Dystonia (at an Early Hour)
Change (LOCF) from baseline in occurrence of Dystonia (at an early hour).
Dystonia (in the Daytime)
Change (LOCF) from baseline in occurrence of Dystonia (in the daytime).

Full Information

First Posted
June 24, 2012
Last Updated
April 23, 2014
Sponsor
Otsuka Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01628926
Brief Title
A Placebo- and Ropinirole-Controlled Study for SPM 962 in Advanced Parkinson's Disease Patients
Official Title
A Double-Blind, 3-Arm, Parallel Group, Placebo- and Ropinirole-Controlled Study for SPM 962 in Advanced Parkinson's Disease Patients With Concomitant Treatment of L-dopa
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
June 2009 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
May 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Otsuka Pharmaceutical Co., Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To demonstrate the non-inferiority of SPM 962 to ropinirole in terms of efficacy in order to confirm clinical value of SPM 962. To demonstrate the superiority of SPM 962 to placebo in terms of efficacy. To investigate the tolerability and safety of SPM 962 up to 36.0 mg/day.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SPM 962
Arm Type
Experimental
Arm Description
SPM 962 transdermal patch
Arm Title
Ropinirole
Arm Type
Active Comparator
Arm Description
Ropinirole tablet
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
SPM962 placebo patch and Ropinirole placebo tab
Intervention Type
Drug
Intervention Name(s)
SPM 962
Intervention Description
SPM 962 transdermal patch once a daily up to 36.0 mg/day
Intervention Type
Drug
Intervention Name(s)
Ropinirole
Intervention Description
Ropinirole oral administration TID up to 15.0 mg/day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
SPM962-placebo patch and Ropinirole-placebo tab
Primary Outcome Measure Information:
Title
Unified Parkinson's Disease Rating Score (UPDRS) Part 3 Sum Score
Description
Mean change (LOCF) from baseline in UPDRS Part 3 sum score (on state) at 16 weeks after dosing. UPDRS is a scale for monitoring Parkinson's Disease-related disability and impairment. The UPDRS consists of the following four sub-scales. Part 1: Mentation, Part 2: Activities of Daily Living, Part 3: Motor, Part 4: Complications. Part 3 assesses 14 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.
Time Frame
baseline, 16 weeks after dosing
Secondary Outcome Measure Information:
Title
UPDRS Part 3 Sum Score
Description
Mean change (LOCF) from baseline in UPDRS Part 3 sum score (on state) at 8 and 10 weeks after dosing. UPDRS Part 3 assesses 14 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.
Time Frame
baseline, 8 and 10 weeks after dosing
Title
UPDRS Part 2 Sum Score
Description
Mean change (LOCF) from baseline in UPDRS Part 2 sum score (average scores of on state and off state) at 16 weeks after dosing. UPDRS 2 assesses 13 items. Each item is scored from 0 (normal) to 4 (severe). The sum score serves as the sub-scale score. A higher score indicates a greater severity of symptoms. Thus a decrease in the scores means improvement.
Time Frame
Baseline, 16 weeks after dosing
Title
Off Time
Description
Mean change (LOCF) from baseline in off time at 16 weeks after dosing. Off-time is a state where L-Dopa becomes ineffective. Off-time was measured by patient diary in hours/day.
Time Frame
Baseline, 16 weeks after dosing
Title
Parkinson's Disease Sleep Scale-2 (PDSS-2)
Description
Mean change (LOCF) from baseline in PDSS-2 sum score at 16 weeks after dosing. PDSS-2 is a scale for assessing sleep disorders in Parkinson's disease. PDSS consists of 15 questions about sleep and nocturnal disturbances. The score of each question ranges from 0 (never) to 4 (very frequent). The sum of each question serves as the scale score. Thus a decrease in the scores means improvement.
Time Frame
Baseline, 16 weeks after dosing
Title
On Time
Description
Mean change (LOCF) from baseline in on time at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.
Time Frame
Baseline, 16 weeks after dosing
Title
On Time Without Dyskinesia Disturbing Daily Activities
Description
Mean change (LOCF) from baseline in on time without dyskinesia disturbing daily activities at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.
Time Frame
Baseline, 16 weeks after dosing
Title
On Time With Dyskinesia Disturbing Daily Activities
Description
Mean change (LOCF) from baseline in on time with dyskinesia disturbing daily activities at 16 weeks after dosing (rate against on time).
Time Frame
Baseline, 16 weeks after dosing
Title
Effective Rate in UPDRS Part 3 Sum Score
Description
Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in UPDRS Part 3 sum score (on state) at 16 weeks after dosing.
Time Frame
Baseline, 16 weeks after dosing
Title
Effective Rate in UPDRS Part 2 Sum Score
Description
Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in UPDRS Part 2 sum score (average scores of on state and off state) at 16 weeks after dosing.
Time Frame
Baseline, 16 weeks after dosing
Title
Effective Rate in Off Time
Description
Effective rate (percentage of subjects with 20% or 30% decrease) (LOCF) in off time at 16 weeks after dosing. On-time is a state where L-Dopa is effective. On-time was measured by patient diary in hours/day.
Time Frame
Baseline, 16 weeks after dosing
Title
Clinical Global Impression (CGI)
Description
Change (LOCF) from baseline in CGI score. CGI improvement is a clinician-reported scale for assessing how much the patient's illness has improved or worsened from baseline. The scale scoring criteria are 1: very much improved, 2: much improved, 3: minimally improved, 4: no change, 5: minimally worse, 6: much worse, 7: very much worse. A decrease in the scores means improvement.
Time Frame
Baseline, 16 weeks after dosing
Title
Dystonia (at an Early Hour)
Description
Change (LOCF) from baseline in occurrence of Dystonia (at an early hour).
Time Frame
Baseline, 16 weeks after dosing
Title
Dystonia (in the Daytime)
Description
Change (LOCF) from baseline in occurrence of Dystonia (in the daytime).
Time Frame
Baseline, 16 weeks after dosing

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject diagnosed as having Parkinson's disease in accordance with "Diagnostic Criteria established by the Research Committee of MHLW-specified Intractable Neurodegenerative Diseases (1995)". Subject is 30 and more and less than 80 years of age at the time of informed consent. Hoehn & Yahr stage 2-4 (on time). Total UPDRS Part 3 score is over 10 at screening test (on time). Subject is on a stable dose of L-dopa with no change in daily dose or dosing regimen for at least 28 days prior to the initial treatment of SPM 962. Subject has any of the following problematic symptoms; 1) Wearing off phenomenon (including frozen gait at off time and dystonia at off time) 2) On and off phenomenon 3) Delayed-on and/or No-on phenomenon 4) Dyskinesia 5) Not well controlled with L-dopa. Exclusion Criteria: Subject who has previously participated in a clinical trial of SPM962 and taken the investigational product (IP). Subject has psychiatric symptoms, e.g. confusion, hallucination, delusion, excitation, delirium, abnormal behavior at screening test or baseline. Subject whose SBP declines by at least 30 mmHg from supine to standing position based on the orthostatic hypotension assessment, or subject who develops orthostatic hypotension at baseline. Subject has a history of epilepsy, convulsion and other. Subject who has complications or a history of serious cardiac diseases or arrhythmia (eg, congestive heart failure of class 3 or 4 in the NYHA classification, second or third degree atrioventricular block, complete left bundle branch block, sick sinus syndrome, ventricular fibrillation, myocardial infarction within 12 months prior to the screening test, or a complication of angina pectoris). Subjects has QTc-interval >450 msec twice at screening. Subject has a the average QTc-interval from two ECGs >450 msec in males and >470 msec in females at baseline. Subject has congenital long QT syndrome. Subject whose serum potassium level is < 3.5mEq/L at the screening test. Subject has a total bilirubin >= 3.0 mg/dL or AST(GOT) or ALT(GPT) greater than 2.5 times of the upper limit of the reference range (or >= 100 IU/L) at screening test, or suffers complications of active phase of chronic hepatitis or liver cirrhosis. Subject has BUN >= 30 mg/dL or serum creatinine >= 2.0 mg/dl at screening test. Subject has a history of allergic reaction to topical agents such as transdermal patch. Subject has a history of known intolerance/hypersensitivity to ropinirole and/or adverse drug reactions that prevent subject from receiving treatment. Subject is pregnant or nursing or woman who plans pregnancy during the trial. Subject is receiving therapy with prohibited drug specified in the study protocol. Subject has a history of pallidotomy, thalamotomy, deep brain stimulation or fetal tissue transplant. Subject has dementia, including DLB and PDD (MMSE score <= 24 at screening). Subject who has a complication or history of malignant neoplastic disease, or received treatment for the disease within 12 months prior to the screening test. Subject is unable to give consent. Subject who is unable to properly record information in a diary. Subject is participating in another trial of IPs or received other IPs within 12 weeks prior to commencement of study treatment. Investigator judges that subject is inappropriate as a study subject with other reasons.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kyoji Imaoka, Mr
Organizational Affiliation
Otsuka Pharmaceutical Co., Ltd.
Official's Role
Study Director
Facility Information:
City
Chubu Region
Country
Japan
City
Chugoku Region
Country
Japan
City
Hokkaido Region
Country
Japan
City
Kanto Region
Country
Japan
City
Kinki Region
Country
Japan
City
Kyushu Region
Country
Japan
City
Shikoku Region
Country
Japan
City
Tohoku Region
Country
Japan

12. IPD Sharing Statement

Learn more about this trial

A Placebo- and Ropinirole-Controlled Study for SPM 962 in Advanced Parkinson's Disease Patients

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