A Study Comparing Efficacy of Levodopa-Carbidopa Intestinal Gel/Carbidopa-Levodopa Enteral Suspension and Optimized Medical Treatment on Dyskinesia in Subjects With Advanced Parkinson's Disease (DYSCOVER) (DYSCOVER)
Parkinson's Disease (PD)
About this trial
This is an interventional treatment trial for Parkinson's Disease (PD) focused on measuring Carbidopa, Levodopa, Efficacy, Levodopa-carbidopa intestinal gel, Advanced Parkinson's Disease
Eligibility Criteria
Inclusion Criteria:
- Participants must have a diagnosis of idiopathic Parkinson's disease (PD) according to the United Kingdom Parkinson's Disease Society (UKPDS) Brain Bank Criteria
- Participants with advanced levodopa-responsive PD and persistent motor fluctuations who have not been controlled with optimized medical treatment (OMT: the maximum therapeutic effect obtained with pharmacological antiparkinsonian therapies when no further improvement is expected with regard to any additional manipulations of levodopa and/or other antiparkinsonian medication based on the Investigator's clinical judgment)
- Unified Dyskinesia Rating Scale (UDysRs) Total score ≥ 30 at Visit 3
Exclusion Criteria:
- Participant(s) treated with levodopa-carbidopa intestinal gel (LCIG) previously
- Participant's PD diagnosis is unclear or there is a suspicion that the subject has a parkinsonian syndrome such as secondary parkinsonism (e.g. caused by drugs, toxins, infectious agents, vascular disease, trauma, brain neoplasm), parkinson-plus syndrome (e.g. Multiple System Atrophy, Progressive supranuclear Palsy, Diffuse Lewy Body disease) or other neurodegenerative disease that might mimic the symptoms of PD
- Participant(s) has undergone neurosurgery for the treatment of Parkinson's disease.
- Participant(s) has contraindications to levodopa (e.g. narrow angle glaucoma, malignant melanoma)
- Participant(s) experiencing clinically significant sleep attacks or clinically significant impulsive behavior (e.g. pathological gambling, hypersexuality) at any point during the three months prior to the Screening evaluation as judged by the Principal Investigator
Sites / Locations
- Parkinson's Disease Treatment Center of Southwest Florida /ID# 150095
- Central Texas Neurology Consul /ID# 150088
- Helsinki Univ Central Hospital /ID# 151214
- Oulun yliopistollinen sairaala /ID# 150947
- Mediterraneo Hospital /ID# 150955
- University General Hospital of Heraklion "PA.G.N.I" /ID# 150956
- University Hospital of Ioannin /ID# 150954
- Pecsi Tudomanyegyetem Klinikai Kozpont I. sz. Belgyogyaszati Klinika /ID# 170116
- Semmelweis Egyetem /ID# 170117
- Szegedi Tudomanyegyetem /ID# 170115
- Policlinico Universitario Campus Bio-Medico /ID# 150846
- A.O. Univ. Ospedali Riuniti /ID# 150853
- Azienda USL Toscana Centro /ID# 150770
- Seconda Universita' di Napoli /ID# 150851
- Policlinico Tor Vergata /ID# 151167
- Univerzitna nemocnica L. Pasteura /ID# 150146
- Univerzitna nemocnica Martin /ID# 150145
- Univerzitna Nemocnica Bratislava /ID# 150144
- Univerzitna Nemocnica Bratislava /ID# 150171
- Hospital Regional Universitari /ID# 171485
- Hospital Universitario Cruces /ID# 203807
- Hospital General Univ de Elche /ID# 150154
- Hospital Univ de la Princesa /ID# 150157
- Hospital General Universitario Gregorio Maranon /ID# 150155
- Hospital Univ Ramon y Cajal /ID# 150152
- Hospital Universitario Infanta /ID# 159696
- Hospital Universitario Virgen Macarena /ID# 158861
- Hospital Virgen de la Salud /ID# 166297
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Optimized Medical Treatment (OMT)
Levodopa-Carbidopa Intestinal Gel (LCIG)
Participants randomized to OMT continued their current anti Parkinson's disease (anti-PD) medication regimen for the duration of the study. All anti-PD medications and medications to treat dyskinesia must have remained stable for the duration of the study unless adjustments were medically indicated. The Investigator provided the prescription for continued OMT.
The total daily dose of infusion LCIG was composed of three components: (i) the morning dose, (ii) continuous maintenance infusion dose and (iii) extra doses. A temporary nasojejunal (NJ) tube may have been used initially with the infusion pump to determine a participant's response to this method of treatment and to optimize the dose of LCIG before treatment with a permanent percutaneous endoscopic gastrostomy - with jejunal extension (PEG-J) tube was started. Following optional NJ and/or PEG-J placement and, at the investigator's discretion, the participant may have begun initiation and titration of LCIG infusion on Day 1 once tube placement was confirmed. The dose of LCIG was adjusted to obtain the optimal clinical response. The rate of LCIG infusion is typically within the range of 1 to 10 mL/hour (20 to 200 mg of levodopa/hour) in most instances and runs over a period of 16 consecutive hours each day.