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A Trial to Explore the Potential Benefit of Safinamide on Cognitive Impairment Associated With Parkinson's Disease

Primary Purpose

Parkinson's Disease With Cognitive Impairments

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
safinamide
placebo
Sponsored by
Newron Pharmaceuticals SPA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson's Disease With Cognitive Impairments focused on measuring Parkinson's Disease, Cognition, Safinamide, Phase 2, Non-demented patients, Levodopa, Dopamine agonist

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female outpatients (aged 45 to 80 years inclusive)
  • Diagnosis of idiopathic Parkinson's Disease (PD) according to the UK PDS Brain Bank Criteria and a Hoehn and Yahr Stage of I to III (mild to moderate motor severity) at Screening. The diagnosis will be based on medical history and neurological examination
  • Subjects and informants must report cognitive impairment in at least one cognitive domain on the PD Cognitive Questionnaire (PD-CQ).
  • Cognitive impairment confirmed by a total score equal to- or below 26 on the Montreal Cognitive Assessment (MoCA)
  • Be able to speak, read, and write in the language in which the tests are written and must be able to perform all the assessments in this language
  • Receiving treatment with dopaminergic therapy (dopamine agonist and/or levodopa at a stable dose for at least four weeks prior to Screening and for the duration of the study)
  • Understand and sign the appropriate approved Informed Consent Form(s), one for the study (mandatory) and one for the pharmacogenetic evaluation (optional)

Exclusion Criteria:

  • Any indication of forms of Parkinsonism other than idiopathic PD
  • Diagnosis of PD Dementia (probable, possible) according to the Clinical Diagnostic Criteria for Dementia Associated with PD
  • Diagnosis of Dementia with Lewy Bodies according to the McKeith criteria.
  • Subjects with any clinically significant DSM-IV-TR Axis I Disorders including major depression and severe anxiety; current diagnosis of substance abuse or history of alcohol or drug abuse for 3 months prior to Visit 1 (Screening)
  • Mental/physical/social condition which could preclude performing efficacy or safety assessments
  • Severe white matter disease, multiple lacunar infarcts, or signs of significant vascular changes on Magnetic Resonance Imaging (MRI)
  • Signs and symptoms suggestive of transmissible spongiform encephalopathy, or family members who suffer(ed) from such
  • Current history of severe dizziness or fainting on standing, due to postural hypotension
  • Second- or third-degree atrioventricular block or sick sinus syndrome, uncontrolled atrial fibrillation, severe or unstable angina, congestive heart failure, myocardial infarction in the three months prior to Visit 1 (Screening), or significant electrocardiogram (ECG) abnormality, including heart-rate corrected interval QT (QTC) > 450 milliseconds (males) or > 470 milliseconds (females), with QTC based on the Bazett's correction method
  • Known diagnosis of human immunodeficiency virus (HIV) infection, positive results on tests for hepatitis B or C antibodies, or on tests for hepatitis B surface antigen (unless vaccinated)
  • Neoplastic disease, either currently active or in remission for less than 1 year
  • Clinically significant or unstable gastrointestinal, renal, hepatic, endocrine, pulmonary, or cardiovascular disease, including not well controlled hypertension, asthma, chronic obstructive pulmonary disease, and Type 1 diabetes that would, in the opinion of the Investigator, preclude participation to the study
  • Any clinically relevant abnormality, either on medical history, physical and neurological examination, ECG, or by diagnostic laboratory tests that, in the opinion of the Investigator, could hinder participation to the study
  • Currently experiencing end-of-dose wearing-off or on-off phenomena, disabling peak dose- or biphasic dyskinesia, or unpredictable or widely swinging fluctuations
  • Any medical conditions and/or taking concomitant medications that could put them at risk, interfere with study evaluations, or prevent meeting the requirements of the study
  • Currently participating to another clinical trial or who participated in a previous clinical trial within 30 days prior to Visit 1 (Screening) or who received any investigational product within 30 days or five half-lives, whichever was longer, prior to Visit 1 (Screening)
  • Previously treated with safinamide
  • Clinically significant hypertension or contraindications or hypersensitivity to monoamine oxidase-Type B (MAO-B) inhibitors
  • Anticholinergic medication and/or amantadine within 4 weeks prior to the Screening visit
  • Opioids (e.g., tramadol and meperidine derivatives) or MAO inhibitors (e.g., selegiline) within 8 weeks prior to Visit 1 (Screening) Dextromethorphan will be allowed to treat cough. One tricyclic- or tetracyclic antidepressant or trazodone will be permitted if taken at bedtime at a low dose as a sleeping aid
  • Acetylcholinesterase inhibitors or memantine within 4 weeks before start of the study treatment or requiring these medications during the treatment period
  • Depot neuroleptic during the study or within 1 injection cycle or oral neuroleptics (stable dose of quetiapine less than 100 mg/day for 8 weeks prior to Visit 1 will be allowed) within 4 weeks prior to Visit 1 (Screening)
  • Drug that has hepatotoxic potential (e.g., tamoxifen) within 4 weeks prior to Visit 1 (Screening), or radiation therapy, or a drug with cytotoxic potential (e.g., chemotherapy) within 1 year prior to the Screening visit.
  • Subjects who, in the judgment of the Investigator, is likely to be non-compliant or uncooperative during the study
  • Women who are pregnant, lactating, or who are attempting to conceive
  • Women of childbearing potential not willing to use an adequate contraceptive method (unless surgically sterilized) for 4 weeks prior to, during, and 4 weeks after the last dose of trial medication
  • Clinically significant ophthalmologic abnormality such as patients with albinism, family history of hereditary retinal disease, progressive and/or severe diminution of corrected visual acuity, retinitis pigmentosa, any active retinopathy or ocular inflammation (uveitis), or progressive, severe diabetic retinopathy
  • Known hypersensitivity to the trial treatment(s), including placebo or other comparator drug(s)
  • Legal incapacity or limited legal capacity

Sites / Locations

  • The Parkinson's Institute
  • Mayo Clinic Florida
  • Emory University
  • Northwestern University
  • Rush University Medical Center
  • Johns Hopkins University
  • US Medical Information Located in
  • Cleveland Clinic
  • Baylor College of Medicine Parkinson's Disease Center and Movement Disorders Clinic
  • Hospital Clinic de Barcelona
  • Hospital De La Santa Creui Sant Pau
  • Hospital General de Catalunya
  • USP Institut Universitari Dexeus
  • Hosptial General Univ Gregorio Maranon
  • Hospital Mutual de Terrassa

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

100mg safinamide

Placebo

Arm Description

Two 50mg tablets of safinamide once per day for 12 weeks (weeks 1-12) Open Label part: Two 50mg tablets of safinamide once per day for 12 weeks (week 13-24)

Two 50mg tablets of placebo once per day for 12 weeks (weeks 1-12) Open Label part: Two 50mg tablets of safinamide once per day for 12 weeks (week 13-24)

Outcomes

Primary Outcome Measures

Parkinson's Disease Cognitive Rating Scale (PD-CRS)
Total score reduction in the PD-CRS at 12 weeks compared to the Baseline. The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.

Secondary Outcome Measures

PD-CRS subscale scores
The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
PD-CRS subscale scores
The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
PD-CRS total score
The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
Dementia Rating Scale - 2 (DRS-2) total score
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
DRS-2 total score
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
DRS-2 subscale scores
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
DRS-2 subscale scores
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
Clinical Global Impression (CGI) Change in Cognitive Dysfunction (CGI-C Cognition)
CGI is a clinician-rated instrument assessing the severity (CGI-S) and the improvement/change (CGI-C) of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-C Cognition will be administered at 6 weeks, 12 weeks, and 24 weeks.
CGI-C Cognition
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-C Cognition will be administered at 6 weeks, 12 weeks, and 24 weeks.
CGI-Severity in Cognitive Dysfunction (CGI-S Cognition)
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-S Cognition will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
CGI-S Cognition
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-S Cognition will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Patient's Clinical Global Impression of Change in Cognitive (PCGI-C Cognition)
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. Subjects will be asked to rate their own change in cognition using the CGI-C. This rating will be the PCGI-C Cognition. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scales is 7. The Patient's Change in Cognitive Dysfunction (PCGI-C) will be administered at 6 weeks, 12 weeks, and 24 weeks.
PCGI-C Cognition
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. Subjects will be asked to rate their own change in cognition using the CGI-C. This rating will be the PCGI-C Cognition. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scales is 7. The Patient's Change in Cognitive Dysfunction (PCGI-C) will be administered at 6 weeks, 12 weeks, and 24 weeks.
Grid-Hamilton Depression Rating Scale (Grid-HAMD)
Grid-HAMD uses a grid-like structure to separates the frequency from the intensity of a symptom. The 17 items of the scale are rated on a 5-point (0-4) or 3-point (0-2) scale. Items using the 5-point scale are rated as 0 (absent), 1 (doubtful to mild), 2 (mild to moderate), 3 (moderate to severe), or 4 (very severe). Items using the 3-point scale are rated as 0 (absent), 1 (probable), or 2 (definite). The higher the score, the greater the depression. The scale will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Grid-HAMD
Grid-HAMD uses a grid-like structure to separates the frequency from the intensity of a symptom. The 17 items of the scale are rated on a 5-point (0-4) or 3-point (0-2) scale. Items using the 5-point scale are rated as 0 (absent), 1 (doubtful to mild), 2 (mild to moderate), 3 (moderate to severe), or 4 (very severe). Items using the 3-point scale are rated as 0 (absent), 1 (probable), or 2 (definite). The higher the score, the greater the depression. The scale will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Parkinson's Disease Sleep Scale (PDSS)
PDSS addresses commonly reported symptoms associated with sleep disturbance: Overall quality of night's sleep (item 1); Sleep onset and maintenance insomnia (items 2&3); Nocturnal restlessness (items 4&5); Nocturnal psychosis (items 6&7); Nocturia (items 8&9); Nocturnal motor symptoms (items 10-13); Sleep refreshment (item 14); Daytime dozing (item 15). Scores for each item range from 0 (symptom severe & always experienced) to 10 (symptom-free). The maximum cumulative score is 150 (subject is free of all symptoms). The PDSS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
PDSS
PDSS addresses commonly reported symptoms associated with sleep disturbance: Overall quality of night's sleep (item 1); Sleep onset and maintenance insomnia (items 2&3); Nocturnal restlessness (items 4&5); Nocturnal psychosis (items 6&7); Nocturia (items 8&9); Nocturnal motor symptoms (items 10-13); Sleep refreshment (item 14); Daytime dozing (item 15). Scores for each item range from 0 (symptom severe & always experienced) to 10 (symptom-free). The maximum cumulative score is 150 (subject is free of all symptoms). The PDSS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Apathy Scale (AS)
AS is a tool to measure severity of apathy in PD subjects. It consists of 14 questions that are to be answered on a four-point Likert scale. The maximum score is 42 with a low and high apathy cut-off score of 14. The AS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
AS
AS is a tool to measure severity of apathy in PD subjects. It consists of 14 questions that are to be answered on a four-point Likert scale. The maximum score is 42 with a low and high apathy cut-off score of 14. The AS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
CGI-C Cognition
CGI is a clinician-rated instrument assessing the severity (CGI-S) and the improvement/change (CGI-C) of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-C Cognition will be administered at 6 weeks, 12 weeks, and 24 weeks.
CGI-S Cognition
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-S Cognition will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
PCGI-C Cognition
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. Subjects will be asked to rate their own change in cognition using the CGI-C. This rating will be the PCGI-C Cognition. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scales is 7. The Patient's Change in Cognitive Dysfunction (PCGI-C) will be administered at 6 weeks, 12 weeks, and 24 weeks.
Grid-HAMD
Grid-HAMD uses a grid-like structure to separates the frequency from the intensity of a symptom. The 17 items of the scale are rated on a 5-point (0-4) or 3-point (0-2) scale. Items using the 5-point scale are rated as 0 (absent), 1 (doubtful to mild), 2 (mild to moderate), 3 (moderate to severe), or 4 (very severe). Items using the 3-point scale are rated as 0 (absent), 1 (probable), or 2 (definite). The higher the score, the greater the depression. The scale will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
PDSS
PDSS addresses commonly reported symptoms associated with sleep disturbance: Overall quality of night's sleep (item 1); Sleep onset and maintenance insomnia (items 2&3); Nocturnal restlessness (items 4&5); Nocturnal psychosis (items 6&7); Nocturia (items 8&9); Nocturnal motor symptoms (items 10-13); Sleep refreshment (item 14); Daytime dozing (item 15). Scores for each item range from 0 (symptom severe & always experienced) to 10 (symptom-free). The maximum cumulative score is 150 (subject is free of all symptoms). The PDSS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
AS
AS is a tool to measure severity of apathy in PD subjects. It consists of 14 questions that are to be answered on a four-point Likert scale. The maximum score is 42 with a low and high apathy cut-off score of 14. The AS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.

Full Information

First Posted
September 28, 2010
Last Updated
March 28, 2013
Sponsor
Newron Pharmaceuticals SPA
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1. Study Identification

Unique Protocol Identification Number
NCT01211587
Brief Title
A Trial to Explore the Potential Benefit of Safinamide on Cognitive Impairment Associated With Parkinson's Disease
Official Title
A Double-blind, Randomized, Placebo-controlled, Parallel-group Phase II Study to Explore the Potential Beneficial Effects of Safinamide on Cognition in Non-demented Patients With Idiopathic Parkinson's Disease (PD) and Cognitive Impairment
Study Type
Interventional

2. Study Status

Record Verification Date
June 2012
Overall Recruitment Status
Completed
Study Start Date
September 2010 (undefined)
Primary Completion Date
April 2012 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Newron Pharmaceuticals SPA

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research trial is to determine if safinamide (experimental drug) can improve cognition in cognitively impaired but non-demented Parkinson's disease patients. The word "experimental" means the trial drug is not approved by Health Authorities (government authorities) and is still being tested for safety and effectiveness. Approximately one hundred (100) patients will participate in this research trial. The research trial will be conducted in approximately thirty (30) medical centers in the following countries: Argentina, Canada, Italy, Peru, South Africa, Spain and USA. The research trial will last until June 2012.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Parkinson's Disease With Cognitive Impairments
Keywords
Parkinson's Disease, Cognition, Safinamide, Phase 2, Non-demented patients, Levodopa, Dopamine agonist

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
103 (Actual)

8. Arms, Groups, and Interventions

Arm Title
100mg safinamide
Arm Type
Experimental
Arm Description
Two 50mg tablets of safinamide once per day for 12 weeks (weeks 1-12) Open Label part: Two 50mg tablets of safinamide once per day for 12 weeks (week 13-24)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Two 50mg tablets of placebo once per day for 12 weeks (weeks 1-12) Open Label part: Two 50mg tablets of safinamide once per day for 12 weeks (week 13-24)
Intervention Type
Drug
Intervention Name(s)
safinamide
Intervention Description
Safinamide will be provided in tablets equivalent to 50 mg in blisters. After randomization, patients receiving safinamide will take two 50 mg tablets once per day for 12 weeks (weeks 1-12). During the open label phase, patients will receive 100mg of safinamide once per day (two 50 mg tablets) for 12 weeks (weeks 13-24).
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Identical placebo tablets will be provided in blisters. After randomization, patients receiving placebo will take two tablets once per day for 12 weeks (weeks 1-12). During the open label phase, patients will receive 100mg of safinamide once per day (two 50 mg tablets) for 12 weeks (weeks 13-24).
Primary Outcome Measure Information:
Title
Parkinson's Disease Cognitive Rating Scale (PD-CRS)
Description
Total score reduction in the PD-CRS at 12 weeks compared to the Baseline. The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
PD-CRS subscale scores
Description
The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
Time Frame
6 weeks
Title
PD-CRS subscale scores
Description
The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
Time Frame
24 weeks
Title
PD-CRS total score
Description
The PD-CRS detects early cognitive impairment in Parkinson's disease. It is composed of 2 scales, the subcortical scale (items 1, 3, 4, 5, 7, 8, 9) and the cortical scale (items 2, 6). The total score of the subcortical scale is from 0 to 114. The total score of the cortical scale is from 0 to 20. The PD-CRS Total score represents the sum of scores on the cortical and subcortical scales. It ranges from 0 to 134. The more points, the less the impairment.
Time Frame
24 weeks
Title
Dementia Rating Scale - 2 (DRS-2) total score
Description
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
Time Frame
12 weeks
Title
DRS-2 total score
Description
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
Time Frame
24 weeks
Title
DRS-2 subscale scores
Description
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
Time Frame
12 weeks
Title
DRS-2 subscale scores
Description
DRS-2 will provide a general measure of cognitive ability in PD subjects. It has thus been chosen as a tool to compare cognitive performance in PD across different trials. Administered at Baseline, Week 12 and Week 24. The DRS-2 consists of 36 tasks divided into 5 subscales (Attention, Initiation/Perseveration, Construction, Conceptualization, and Memory). The maximum score on each subscale is as follows: Attention = 37; Initiation/Perseveration = 37; Construction = 6; Conceptualization = 39, Memory = 25. The DRS-2 total score = 144 (the more points, the less the impairment).
Time Frame
24 weeks
Title
Clinical Global Impression (CGI) Change in Cognitive Dysfunction (CGI-C Cognition)
Description
CGI is a clinician-rated instrument assessing the severity (CGI-S) and the improvement/change (CGI-C) of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-C Cognition will be administered at 6 weeks, 12 weeks, and 24 weeks.
Time Frame
6 weeks
Title
CGI-C Cognition
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-C Cognition will be administered at 6 weeks, 12 weeks, and 24 weeks.
Time Frame
24 weeks
Title
CGI-Severity in Cognitive Dysfunction (CGI-S Cognition)
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-S Cognition will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
6 weeks
Title
CGI-S Cognition
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-S Cognition will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
24 weeks
Title
Patient's Clinical Global Impression of Change in Cognitive (PCGI-C Cognition)
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. Subjects will be asked to rate their own change in cognition using the CGI-C. This rating will be the PCGI-C Cognition. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scales is 7. The Patient's Change in Cognitive Dysfunction (PCGI-C) will be administered at 6 weeks, 12 weeks, and 24 weeks.
Time Frame
6 weeks
Title
PCGI-C Cognition
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. Subjects will be asked to rate their own change in cognition using the CGI-C. This rating will be the PCGI-C Cognition. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scales is 7. The Patient's Change in Cognitive Dysfunction (PCGI-C) will be administered at 6 weeks, 12 weeks, and 24 weeks.
Time Frame
24 weeks
Title
Grid-Hamilton Depression Rating Scale (Grid-HAMD)
Description
Grid-HAMD uses a grid-like structure to separates the frequency from the intensity of a symptom. The 17 items of the scale are rated on a 5-point (0-4) or 3-point (0-2) scale. Items using the 5-point scale are rated as 0 (absent), 1 (doubtful to mild), 2 (mild to moderate), 3 (moderate to severe), or 4 (very severe). Items using the 3-point scale are rated as 0 (absent), 1 (probable), or 2 (definite). The higher the score, the greater the depression. The scale will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
6 weeks
Title
Grid-HAMD
Description
Grid-HAMD uses a grid-like structure to separates the frequency from the intensity of a symptom. The 17 items of the scale are rated on a 5-point (0-4) or 3-point (0-2) scale. Items using the 5-point scale are rated as 0 (absent), 1 (doubtful to mild), 2 (mild to moderate), 3 (moderate to severe), or 4 (very severe). Items using the 3-point scale are rated as 0 (absent), 1 (probable), or 2 (definite). The higher the score, the greater the depression. The scale will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
24 weeks
Title
Parkinson's Disease Sleep Scale (PDSS)
Description
PDSS addresses commonly reported symptoms associated with sleep disturbance: Overall quality of night's sleep (item 1); Sleep onset and maintenance insomnia (items 2&3); Nocturnal restlessness (items 4&5); Nocturnal psychosis (items 6&7); Nocturia (items 8&9); Nocturnal motor symptoms (items 10-13); Sleep refreshment (item 14); Daytime dozing (item 15). Scores for each item range from 0 (symptom severe & always experienced) to 10 (symptom-free). The maximum cumulative score is 150 (subject is free of all symptoms). The PDSS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
6 weeks
Title
PDSS
Description
PDSS addresses commonly reported symptoms associated with sleep disturbance: Overall quality of night's sleep (item 1); Sleep onset and maintenance insomnia (items 2&3); Nocturnal restlessness (items 4&5); Nocturnal psychosis (items 6&7); Nocturia (items 8&9); Nocturnal motor symptoms (items 10-13); Sleep refreshment (item 14); Daytime dozing (item 15). Scores for each item range from 0 (symptom severe & always experienced) to 10 (symptom-free). The maximum cumulative score is 150 (subject is free of all symptoms). The PDSS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
24 weeks
Title
Apathy Scale (AS)
Description
AS is a tool to measure severity of apathy in PD subjects. It consists of 14 questions that are to be answered on a four-point Likert scale. The maximum score is 42 with a low and high apathy cut-off score of 14. The AS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
6 weeks
Title
AS
Description
AS is a tool to measure severity of apathy in PD subjects. It consists of 14 questions that are to be answered on a four-point Likert scale. The maximum score is 42 with a low and high apathy cut-off score of 14. The AS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
24 weeks
Title
CGI-C Cognition
Description
CGI is a clinician-rated instrument assessing the severity (CGI-S) and the improvement/change (CGI-C) of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-C Cognition will be administered at 6 weeks, 12 weeks, and 24 weeks.
Time Frame
12 weeks
Title
CGI-S Cognition
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. The original scale has been adapted to assess the severity of cognitive dysfunctions and the change/improvement in cognitive dysfunctions over time. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scale is 7. The CGI-S Cognition will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
12 weeks
Title
PCGI-C Cognition
Description
CGI is a clinician-rated instrument assessing the severity and the improvement/change of PD over time scale. Subjects will be asked to rate their own change in cognition using the CGI-C. This rating will be the PCGI-C Cognition. Rating will be based on a Likert-type scale (0 = Not assessed, 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse). The maximum score on the scales is 7. The Patient's Change in Cognitive Dysfunction (PCGI-C) will be administered at 6 weeks, 12 weeks, and 24 weeks.
Time Frame
12 weeks
Title
Grid-HAMD
Description
Grid-HAMD uses a grid-like structure to separates the frequency from the intensity of a symptom. The 17 items of the scale are rated on a 5-point (0-4) or 3-point (0-2) scale. Items using the 5-point scale are rated as 0 (absent), 1 (doubtful to mild), 2 (mild to moderate), 3 (moderate to severe), or 4 (very severe). Items using the 3-point scale are rated as 0 (absent), 1 (probable), or 2 (definite). The higher the score, the greater the depression. The scale will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
12 weeks
Title
PDSS
Description
PDSS addresses commonly reported symptoms associated with sleep disturbance: Overall quality of night's sleep (item 1); Sleep onset and maintenance insomnia (items 2&3); Nocturnal restlessness (items 4&5); Nocturnal psychosis (items 6&7); Nocturia (items 8&9); Nocturnal motor symptoms (items 10-13); Sleep refreshment (item 14); Daytime dozing (item 15). Scores for each item range from 0 (symptom severe & always experienced) to 10 (symptom-free). The maximum cumulative score is 150 (subject is free of all symptoms). The PDSS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
12 weeks
Title
AS
Description
AS is a tool to measure severity of apathy in PD subjects. It consists of 14 questions that are to be answered on a four-point Likert scale. The maximum score is 42 with a low and high apathy cut-off score of 14. The AS will be administered at Baseline, 6 weeks, 12 weeks, and 24 weeks.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female outpatients (aged 45 to 80 years inclusive) Diagnosis of idiopathic Parkinson's Disease (PD) according to the UK PDS Brain Bank Criteria and a Hoehn and Yahr Stage of I to III (mild to moderate motor severity) at Screening. The diagnosis will be based on medical history and neurological examination Subjects and informants must report cognitive impairment in at least one cognitive domain on the PD Cognitive Questionnaire (PD-CQ). Cognitive impairment confirmed by a total score equal to- or below 26 on the Montreal Cognitive Assessment (MoCA) Be able to speak, read, and write in the language in which the tests are written and must be able to perform all the assessments in this language Receiving treatment with dopaminergic therapy (dopamine agonist and/or levodopa at a stable dose for at least four weeks prior to Screening and for the duration of the study) Understand and sign the appropriate approved Informed Consent Form(s), one for the study (mandatory) and one for the pharmacogenetic evaluation (optional) Exclusion Criteria: Any indication of forms of Parkinsonism other than idiopathic PD Diagnosis of PD Dementia (probable, possible) according to the Clinical Diagnostic Criteria for Dementia Associated with PD Diagnosis of Dementia with Lewy Bodies according to the McKeith criteria. Subjects with any clinically significant DSM-IV-TR Axis I Disorders including major depression and severe anxiety; current diagnosis of substance abuse or history of alcohol or drug abuse for 3 months prior to Visit 1 (Screening) Mental/physical/social condition which could preclude performing efficacy or safety assessments Severe white matter disease, multiple lacunar infarcts, or signs of significant vascular changes on Magnetic Resonance Imaging (MRI) Signs and symptoms suggestive of transmissible spongiform encephalopathy, or family members who suffer(ed) from such Current history of severe dizziness or fainting on standing, due to postural hypotension Second- or third-degree atrioventricular block or sick sinus syndrome, uncontrolled atrial fibrillation, severe or unstable angina, congestive heart failure, myocardial infarction in the three months prior to Visit 1 (Screening), or significant electrocardiogram (ECG) abnormality, including heart-rate corrected interval QT (QTC) > 450 milliseconds (males) or > 470 milliseconds (females), with QTC based on the Bazett's correction method Known diagnosis of human immunodeficiency virus (HIV) infection, positive results on tests for hepatitis B or C antibodies, or on tests for hepatitis B surface antigen (unless vaccinated) Neoplastic disease, either currently active or in remission for less than 1 year Clinically significant or unstable gastrointestinal, renal, hepatic, endocrine, pulmonary, or cardiovascular disease, including not well controlled hypertension, asthma, chronic obstructive pulmonary disease, and Type 1 diabetes that would, in the opinion of the Investigator, preclude participation to the study Any clinically relevant abnormality, either on medical history, physical and neurological examination, ECG, or by diagnostic laboratory tests that, in the opinion of the Investigator, could hinder participation to the study Currently experiencing end-of-dose wearing-off or on-off phenomena, disabling peak dose- or biphasic dyskinesia, or unpredictable or widely swinging fluctuations Any medical conditions and/or taking concomitant medications that could put them at risk, interfere with study evaluations, or prevent meeting the requirements of the study Currently participating to another clinical trial or who participated in a previous clinical trial within 30 days prior to Visit 1 (Screening) or who received any investigational product within 30 days or five half-lives, whichever was longer, prior to Visit 1 (Screening) Previously treated with safinamide Clinically significant hypertension or contraindications or hypersensitivity to monoamine oxidase-Type B (MAO-B) inhibitors Anticholinergic medication and/or amantadine within 4 weeks prior to the Screening visit Opioids (e.g., tramadol and meperidine derivatives) or MAO inhibitors (e.g., selegiline) within 8 weeks prior to Visit 1 (Screening) Dextromethorphan will be allowed to treat cough. One tricyclic- or tetracyclic antidepressant or trazodone will be permitted if taken at bedtime at a low dose as a sleeping aid Acetylcholinesterase inhibitors or memantine within 4 weeks before start of the study treatment or requiring these medications during the treatment period Depot neuroleptic during the study or within 1 injection cycle or oral neuroleptics (stable dose of quetiapine less than 100 mg/day for 8 weeks prior to Visit 1 will be allowed) within 4 weeks prior to Visit 1 (Screening) Drug that has hepatotoxic potential (e.g., tamoxifen) within 4 weeks prior to Visit 1 (Screening), or radiation therapy, or a drug with cytotoxic potential (e.g., chemotherapy) within 1 year prior to the Screening visit. Subjects who, in the judgment of the Investigator, is likely to be non-compliant or uncooperative during the study Women who are pregnant, lactating, or who are attempting to conceive Women of childbearing potential not willing to use an adequate contraceptive method (unless surgically sterilized) for 4 weeks prior to, during, and 4 weeks after the last dose of trial medication Clinically significant ophthalmologic abnormality such as patients with albinism, family history of hereditary retinal disease, progressive and/or severe diminution of corrected visual acuity, retinitis pigmentosa, any active retinopathy or ocular inflammation (uveitis), or progressive, severe diabetic retinopathy Known hypersensitivity to the trial treatment(s), including placebo or other comparator drug(s) Legal incapacity or limited legal capacity
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jonathan Willmer, MD, FRCPC
Organizational Affiliation
Merck Serono S.A., Geneva
Official's Role
Study Director
Facility Information:
Facility Name
The Parkinson's Institute
City
Sunnyvale
State/Province
California
Country
United States
Facility Name
Mayo Clinic Florida
City
Jacksonville
State/Province
Florida
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
Country
United States
Facility Name
US Medical Information Located in
City
Rockland
State/Province
Massachusetts
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
Country
United States
Facility Name
Baylor College of Medicine Parkinson's Disease Center and Movement Disorders Clinic
City
Houston
State/Province
Texas
Country
United States
Facility Name
Hospital Clinic de Barcelona
City
Barcelona
Country
Spain
Facility Name
Hospital De La Santa Creui Sant Pau
City
Barcelona
Country
Spain
Facility Name
Hospital General de Catalunya
City
Barcelona
Country
Spain
Facility Name
USP Institut Universitari Dexeus
City
Barcelona
Country
Spain
Facility Name
Hosptial General Univ Gregorio Maranon
City
Madrid
Country
Spain
Facility Name
Hospital Mutual de Terrassa
City
Terrassa - Barcelona
Country
Spain

12. IPD Sharing Statement

Learn more about this trial

A Trial to Explore the Potential Benefit of Safinamide on Cognitive Impairment Associated With Parkinson's Disease

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