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A Study to Evaluate ENT-01 for the Treatment of Parkinson's Disease Dementia

Primary Purpose

Parkinson Disease, Dementia

Status
Suspended
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Active Investigational Treatment ENT-01
Sponsored by
Enterin Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson Disease focused on measuring PDD, parkinson's disease-related dementia

Eligibility Criteria

30 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients aged 30-90 years, both genders
  • Patients or care-giver must provide informed consent and be willing and able to comply with study procedures.
  • Patients must be diagnosed with Parkinson's disease defined as the presence of at least three of the following cardinal features, in the absence of alternative explanations or atypical features: rest tremor, rigidity, bradykinesia and/or akinesia, postural and gait abnormalities.
  • Patients must have dementia as defined by (1) decline in cognitive function and (2) functional impairment, which together in, in the opinion of the investigator, has resulted in a clinical diagnosis of dementia.
  • MoCA < 24 in support of a dementia diagnosis
  • Have a reliable and actively involved caregiver who must be able to communicate in English and be willing to comply with protocol requirements.
  • If on anti-parkinsonian agents, participants must be on stable dosage for at least 4 weeks prior to baseline.
  • If on medications enhancing cognition (rivastigmine, galantamine, donepezil, memantine), participants must be on stable dosage for at least 8 weeks prior to baseline.
  • If on antidepressant medications, participants must be on stable dosage for at least 4 weeks prior to baseline.
  • If on clozapine, pimavanserin or quetiapine to address drug-induced or disease-related psychosis, participants must be on stable dosage for 4 weeks prior to baseline.
  • Female patients of childbearing potential must have negative serum or urine pregnancy tests and must not be lactating. For females able to bear children, a hormonal (i.e., oral, implantable, or injectable) and single-barrier method, or a double-barrier method of birth control must be used throughout the study. A vasectomized partner will be allowed as one in conjunction with another single-barrier method.
  • Female patients unable to bear children must have this documented in the case report form (CRF) (i.e., tubal ligation, hysterectomy, or postmenopausal [defined as a minimum of one year since the last menstrual period]). Post-menopausal status will be confirmed by follicle stimulating hormone (FSH) in women less than 60 years of age.

Exclusion Criteria:

  • Patient or caregiver unable or unwilling to provide informed consent or to comply with study procedures.
  • Unable to withdraw proton pump inhibitors at the end of run-in period.
  • Unable to withdraw from anti-cholinergics at the beginning of the run-in period
  • Any clinically significant abnormalities on screening laboratories or physical examination requiring further evaluation or treatment.
  • Neurological disorder other than Parkinson's disease that in the opinion of the investigator might interfere with the conduct of the study
  • Females who are pregnant or breastfeeding
  • History of excessive alcohol use or substance abuse
  • Psychotic disorder was present before the diagnosis of Parkinson's disease
  • Patient or caregiver unable to administer daily oral dosing of study drug
  • Caregiver unwilling or unable to unable to complete stool diary, dispense study medication and accompany the patient to all visits
  • Participation in an investigational drug trial within the month prior to dosing in the present study.
  • A compromised gastrointestinal system which includes: Structural, metabolic, or functional GI diseases or disorders; History of major GI surgery within 30 days (a history of cholecystectomy, polypectomy, hernia repair, appendicectomy, gastric surgery for peptic ulcer and gastric banding for obesity are not exclusionary as long as they were performed more than 30 days before the screening visit. Partial or complete colectomy is exclusionary).
  • Review of Screening period diaries indicates either of the following: Fewer than 11 days of diary completion; More than 5 complete spontaneous bowel movements per week based upon the average Complete Spontaneous Bowel Movement (CSBM) rate reported during the Screening Period.
  • Any other reason, which in the opinion of the investigator would confound proper interpretation of the study.

Sites / Locations

  • Neuro Pain Medical Center
  • Evolution Research Group - Neuroscience Research Institution
  • Elias Research - Neurology Diagnostics Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Active Treatment

Arm Description

ENT-01 tablet will be taken once daily by mouth.

Outcomes

Primary Outcome Measures

Cognition Improvement by Dementia Severity Rating Scale (DSRS) - Primary Outcome
To determine the safety and efficacy of repeated oral doses of ENT-01 in improving cognition in patients with Parkinson's disease dementia, measured by the Dementia Severity Rating Scale (DSRS). The DSRS Test is used to track changes in cognitive status over time. Its five subscales provide additional information on specific abilities: Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory. The score ranges from 0 to 54, with 0-18 being mild, 19-36 being moderate and 37-54 being severe. Improvements would be indicated by lower scores from baseline to end of fixed dose period.

Secondary Outcome Measures

Change from Baseline in Montreal Cognitive Assessment (MOCA) - Secondary Outcomes
To determine the effect of repeated oral doses of ENT-01 in improving cognition in patients with Parkinson's disease Dementia, measured by an improvement in the Montreal Cognitive Assessment (MOCA) from baseline.
Change from Baseline to the End of the Fixed Dose Period in Symptoms Adapted for Parkinson's Disease (SAPS-PD) - Secondary Outcomes
To determine the effect of repeated oral doses of ENT-01 in improving the frequency and/or severity of hallucinations/delusions during the Fixed Dose period over baseline in patients with Parkinson's disease Dementia. Improvement is defined as 2.33 points or greater reduction in score from baseline on the SAPS-PD.
Change from Baseline to the End of the Fixed Dose Period in Neuropsychiatric Inventory (NPI) and Caregiver Distress (NPI-D) - Secondary Outcomes
To determine the effect of repeated oral doses of ENT-01 in patients with Parkinson's disease Dementia, measured by an improvement in total score for behavioral impairment from baseline to the end of fixed dose for the NPI and NPI-D. The NPI total score is calculated by adding the scores of the domains (each domain scores ranges from 0 to 144, with higher scores indicating greater behavioral impairment. The caregiver distress scores in each of the domains are not included in the NPI total score. The caregiver distress (NPI-D) total score is calculated by adding scores of caregiver distress in each of the domains (score ranges from 0 to 5 in each domain). The NPID total score ranges from 0 to 60 with higher scores indicating greater distress.
Change from Baseline to the End of the Fixed Dose Period in Parkinson's Disease Questionnaire-39 (PDQ-39) - Secondary Outcomes
To determine the effect of repeated oral doses of ENT-01 in patients with Parkinson's disease Dementia, measured by an improvement in behavioral impairment, cognition, and social function by having lower scores for the PDQ-39 from baseline to the end of fixed dose. The PDQ-39 assesses how often people affected by Parkinson's experience difficulties across 8 dimensions of daily living including relationships, social situations and communication. Lower scores indicate better quality of life. There is a 5-point ordinal system for scoring - 0 is never, and 4 is always.

Full Information

First Posted
April 18, 2019
Last Updated
June 8, 2023
Sponsor
Enterin Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03938922
Brief Title
A Study to Evaluate ENT-01 for the Treatment of Parkinson's Disease Dementia
Official Title
A Multicenter, Open Label Study to Evaluate Tolerability and Efficacy of Orally Administered ENT-01 for the Treatment of Parkinson's Disease Dementia.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Suspended
Why Stopped
Potentially resume in 2024
Study Start Date
January 15, 2024 (Anticipated)
Primary Completion Date
June 15, 2025 (Anticipated)
Study Completion Date
December 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Enterin Inc.

4. Oversight

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

5. Study Description

Brief Summary
This study will be conducted as a multi-center, open label study in the US. There will be 40 patient to receive the active investigational product.
Detailed Description
The study will be conducted on an out-patient basis. Each patient will have 5 visits to the clinic: a screening visit, a randomization visit, 1 followup visit, 1 end of treatment visit, and 1 end of study visit. Patients will be allowed to adjust their dosing, based upon protocol specifications. Rescue medications will be provided to all patients to ensure they move their bowels on a regular basis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson Disease, Dementia
Keywords
PDD, parkinson's disease-related dementia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active Treatment
Arm Type
Experimental
Arm Description
ENT-01 tablet will be taken once daily by mouth.
Intervention Type
Drug
Intervention Name(s)
Active Investigational Treatment ENT-01
Intervention Description
ENT-01 will be administered in tablet form, once daily. Other Names: ENT-01
Primary Outcome Measure Information:
Title
Cognition Improvement by Dementia Severity Rating Scale (DSRS) - Primary Outcome
Description
To determine the safety and efficacy of repeated oral doses of ENT-01 in improving cognition in patients with Parkinson's disease dementia, measured by the Dementia Severity Rating Scale (DSRS). The DSRS Test is used to track changes in cognitive status over time. Its five subscales provide additional information on specific abilities: Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory. The score ranges from 0 to 54, with 0-18 being mild, 19-36 being moderate and 37-54 being severe. Improvements would be indicated by lower scores from baseline to end of fixed dose period.
Time Frame
10 weeks
Secondary Outcome Measure Information:
Title
Change from Baseline in Montreal Cognitive Assessment (MOCA) - Secondary Outcomes
Description
To determine the effect of repeated oral doses of ENT-01 in improving cognition in patients with Parkinson's disease Dementia, measured by an improvement in the Montreal Cognitive Assessment (MOCA) from baseline.
Time Frame
10 weeks
Title
Change from Baseline to the End of the Fixed Dose Period in Symptoms Adapted for Parkinson's Disease (SAPS-PD) - Secondary Outcomes
Description
To determine the effect of repeated oral doses of ENT-01 in improving the frequency and/or severity of hallucinations/delusions during the Fixed Dose period over baseline in patients with Parkinson's disease Dementia. Improvement is defined as 2.33 points or greater reduction in score from baseline on the SAPS-PD.
Time Frame
10 weeks
Title
Change from Baseline to the End of the Fixed Dose Period in Neuropsychiatric Inventory (NPI) and Caregiver Distress (NPI-D) - Secondary Outcomes
Description
To determine the effect of repeated oral doses of ENT-01 in patients with Parkinson's disease Dementia, measured by an improvement in total score for behavioral impairment from baseline to the end of fixed dose for the NPI and NPI-D. The NPI total score is calculated by adding the scores of the domains (each domain scores ranges from 0 to 144, with higher scores indicating greater behavioral impairment. The caregiver distress scores in each of the domains are not included in the NPI total score. The caregiver distress (NPI-D) total score is calculated by adding scores of caregiver distress in each of the domains (score ranges from 0 to 5 in each domain). The NPID total score ranges from 0 to 60 with higher scores indicating greater distress.
Time Frame
10 weeks
Title
Change from Baseline to the End of the Fixed Dose Period in Parkinson's Disease Questionnaire-39 (PDQ-39) - Secondary Outcomes
Description
To determine the effect of repeated oral doses of ENT-01 in patients with Parkinson's disease Dementia, measured by an improvement in behavioral impairment, cognition, and social function by having lower scores for the PDQ-39 from baseline to the end of fixed dose. The PDQ-39 assesses how often people affected by Parkinson's experience difficulties across 8 dimensions of daily living including relationships, social situations and communication. Lower scores indicate better quality of life. There is a 5-point ordinal system for scoring - 0 is never, and 4 is always.
Time Frame
10 weeks
Other Pre-specified Outcome Measures:
Title
To compare the effect of ENT-01 on motor and non-motor symptoms of Parkinson's disease including Movement Disorder Society - Unified Parkinsons' Disease Rating Scale (MDS-UPDRS).
Description
The additional efficacy endpoints of the study are the change from baseline in each of the following tests during the Fixed Dose Period (FDP). Baseline is defined as the end of the screening period (Visit 2). Improvement is indicated by lower total scores for the MDS-UPDRS. The standard four-part MDS-UPDRS will be administered to determine whether there is any improvement in scores during the treatment period. Motor deterioration will be assessed from Part 3 of the MDS-UPDRS, but total score will also be reported (sum of Parts 1, 2, and 3).
Time Frame
10 weeks
Title
To compare the effect of ENT-01 on non-motor symptoms of Parkinson's disease for skin-temperature determined Circadian rhythm and weight.
Description
The additional efficacy endpoints of the study are the changes in skin temperature using an I-button attached to a wrist band. The I-button will be worn throughout the study, from Visit 1 to Visit 5.
Time Frame
10 weeks
Title
To compare the effect of ENT-01 on non-motor symptoms of Parkinson's disease for weight.
Description
Body weight will be measured from Visit 1 to Visit 5.
Time Frame
10 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients aged 30-90 years, both genders Patients or care-giver must provide informed consent and be willing and able to comply with study procedures. Patients must be diagnosed with Parkinson's disease defined as the presence of at least three of the following cardinal features, in the absence of alternative explanations or atypical features: rest tremor, rigidity, bradykinesia and/or akinesia, postural and gait abnormalities. Patients must have dementia as defined by (1) decline in cognitive function and (2) functional impairment, which together in, in the opinion of the investigator, has resulted in a clinical diagnosis of dementia. MoCA < 24 in support of a dementia diagnosis Have a reliable and actively involved caregiver who must be able to communicate in English and be willing to comply with protocol requirements. If on anti-parkinsonian agents, participants must be on stable dosage for at least 4 weeks prior to baseline. If on medications enhancing cognition (rivastigmine, galantamine, donepezil, memantine), participants must be on stable dosage for at least 8 weeks prior to baseline. If on antidepressant medications, participants must be on stable dosage for at least 4 weeks prior to baseline. If on clozapine, pimavanserin or quetiapine to address drug-induced or disease-related psychosis, participants must be on stable dosage for 4 weeks prior to baseline. Female patients of childbearing potential must have negative serum or urine pregnancy tests and must not be lactating. For females able to bear children, a hormonal (i.e., oral, implantable, or injectable) and single-barrier method, or a double-barrier method of birth control must be used throughout the study. A vasectomized partner will be allowed as one in conjunction with another single-barrier method. Female patients unable to bear children must have this documented in the case report form (CRF) (i.e., tubal ligation, hysterectomy, or postmenopausal [defined as a minimum of one year since the last menstrual period]). Post-menopausal status will be confirmed by follicle stimulating hormone (FSH) in women less than 60 years of age. Exclusion Criteria: Patient or caregiver unable or unwilling to provide informed consent or to comply with study procedures. Unable to withdraw proton pump inhibitors at the end of run-in period. Unable to withdraw from anti-cholinergics at the beginning of the run-in period Any clinically significant abnormalities on screening laboratories or physical examination requiring further evaluation or treatment. Neurological disorder other than Parkinson's disease that in the opinion of the investigator might interfere with the conduct of the study Females who are pregnant or breastfeeding History of excessive alcohol use or substance abuse Psychotic disorder was present before the diagnosis of Parkinson's disease Patient or caregiver unable to administer daily oral dosing of study drug Caregiver unwilling or unable to unable to complete stool diary, dispense study medication and accompany the patient to all visits Participation in an investigational drug trial within the month prior to dosing in the present study. A compromised gastrointestinal system which includes: Structural, metabolic, or functional GI diseases or disorders; History of major GI surgery within 30 days (a history of cholecystectomy, polypectomy, hernia repair, appendicectomy, gastric surgery for peptic ulcer and gastric banding for obesity are not exclusionary as long as they were performed more than 30 days before the screening visit. Partial or complete colectomy is exclusionary). Review of Screening period diaries indicates either of the following: Fewer than 11 days of diary completion; More than 5 complete spontaneous bowel movements per week based upon the average Complete Spontaneous Bowel Movement (CSBM) rate reported during the Screening Period. Any other reason, which in the opinion of the investigator would confound proper interpretation of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Zasloff, MD, Ph.D
Organizational Affiliation
Enterin Inc.
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Denise Barbut, MD, FRCP
Organizational Affiliation
Enterin Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
Neuro Pain Medical Center
City
Fresno
State/Province
California
ZIP/Postal Code
93710
Country
United States
Facility Name
Evolution Research Group - Neuroscience Research Institution
City
Toms River
State/Province
New Jersey
ZIP/Postal Code
08755
Country
United States
Facility Name
Elias Research - Neurology Diagnostics Research
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45459
Country
United States

12. IPD Sharing Statement

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A Study to Evaluate ENT-01 for the Treatment of Parkinson's Disease Dementia

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