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Assessing the Pharmacokinetics, Safety, Tolerability and Efficacy of Continuous Oral Levodopa Via the DopaFuse® Delivery System in Parkinson's Disease Patients (SCOL)

Primary Purpose

Parkinson's Disease

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
continuous oral delivery of levodopa/carbidopa
Sponsored by
SynAgile Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Parkinson's Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Diagnosis of Parkinson's Disease consistent with UK Brain Bank Criteria
  2. Age at least 30 years old at time of consent
  3. Male and Female participants (Women of child-bearing potential (WOCB) are eligible for participation if they are not pregnant or breastfeeding and agree to follow the contraceptive guidance in Appendix 3 during the treatment period and for at least 30 days after the last dose of study treatment)
  4. Suitable for oral retainer wear
  5. A good response to Levodopa, as assessed by the Investigator
  6. At least 2 hours of wearing OFF time per day, as reported by the participant
  7. Predictable early morning OFF periods, in the judgement of the participant and the Investigator
  8. Taking 400-1,200 mg of LD/CD per day in at least 4 doses, with stable dosing for the last 28 days prior to screening.
  9. A modified Hoehn and Yahr of ≤ 3 in the ON state at screening
  10. A stable regimen of anti-PD medications for the last 28 days prior to Screening
  11. A Mini-Mental State Examination (MMSE) Score ≥26
  12. Capable of giving signed informed consent
  13. Approved for entry into the study by the Enrollment Authorization Committee (EAC)

Exclusion Criteria:

  1. Atypical or secondary Parkinson's Disease
  2. Severe Dyskinesia that might interfere with study performance in the judgement of Investigator
  3. Clinically significant dysphagia or sialorrhea that might interfere with administration of study intervention in the judgement of the Investigator
  4. Use of extended release levodopa within 28 days prior to screening
  5. Any clinically significant medical, surgical, or psychiatric condition; laboratory value or ECG result which, in the opinion of the Investigator, makes the participant unsuitable for study entry or potentially unable to complete all aspects of the study.
  6. Presence of clinically significant orthostatic hypotension at screening, in the opinion of Investigator or the EAC
  7. Suicidal ideation within 1 year prior to the Screening Visit as evidenced by answering "yes" to Questions 4 or 5 on the suicidal ideation portion of the Columbia Suicide Severity Rating Scale (C-SSRS) or attempted suicide within the last 5 years.
  8. History of psychosis or hallucinations in the past six months
  9. Any malignancy in the past 5 years (excluding basal cell carcinoma of the skin or cervical carcinoma in situ that have been successfully treated.)
  10. Current or previous diagnosis of malignant melanoma or the presence of any suspicious skin lesion based on physical exam findings
  11. Unable to give blood required for the study
  12. History of allergic reaction to plastics
  13. LD infusion therapy (i.e. Duodopa); current or previous continuous apomorphine infusion treatment.
  14. Participation in any other clinical trial <30 days prior to screening visit.
  15. Presence of two third molars ("wisdom teeth") on the upper dentition
  16. Participants who, for any reason, are judged by the Investigator or the EAC to be inappropriate for this study, including participants who are unable to communicate or cooperate with the Investigator or who have/had a clinically significant illness or abnormal physical examination that may compromise safety of the participant during the trial or affect ability of the participant to adhere to study procedures.
  17. Participants taking non-selective monoamine oxidase (MAO) inhibitors
  18. Participants with known hypersensitivity to the active ingredients (levodopa, carbidopa) or excipients (Benzoic Acid, Disodium Edetate, Medium Chain Triglycerides, Poloxamer 188) of the drug paste
  19. Participants with narrow-angle glaucoma

Sites / Locations

  • San Raffaele Cassino
  • Centro Parkinson, Policlinico Tor Vergata
  • IRCCS San Raffaele Pisana
  • Centre Hospitalier de Luxembourg
  • Neuroscience Centre (CINAC)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DopaFuse Delivery System 50mg LD/hr or 68mg LD/hr flow rate

Arm Description

Either 50mg/13mg LD/CD per hour or 68mg/17mg LD/CD per hour flow rate based upon Subject's standard levodopa (LD) dose. Subjects will routinely wear each container for approximately 5 hours (3 containers per day).

Outcomes

Primary Outcome Measures

Variability in plasma concentration of levodopa as assessed with the Levodopa Fluctuation Index (Cmax-Cmin)/Caverage)
Comparing Day 2 to Day 1 in steady state (4-12 hours). Fluctuation index will also be calculated by the hour.
Treatment Emergent Adverse Events
Serious Adverse Events
Treatment Emergent Adverse Events leading to discontinuation
Percent of participants that complete study
Difference in OFF time between Days 1 and 15, based on in-person investigator ratings
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.

Secondary Outcome Measures

Coefficient of variation (CV) for plasma levodopa.
This will be calculated between 4 and 12 hours on Days 1 and 2 comparing DopaFuse and oral levodopa tablets.
Variability in plasma concentration of levodopa as assessed with the Levodopa Fluctuation Index (Cmax-Cmin)/Caverage).
Comparing Day 3 to Day 1, as well as Day 2 (0-12 hours) to Day 1. Fluctuation index will also be calculated by the hour.
Levodopa and Carbidopa peak plasma concentration (Cmax)
Variability in plasma levodopa comparing Dopafuse and oral levodopa tablets based on fluctuation index and CV in participants who are H. pylori negative/positive
Questionnaire for Impulse Control Disorders in Parkinson's Disease Rating Scale (QUIP-RS)
Columbia - Suicide Severity Rating Scale (C-SSRS)
Difference in OFF Time between Day 1 and Day 3
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Difference in ON Time without troublesome dyskinesia between Days 1, 3 and 15
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Difference in ON Time with troublesome (severe) dyskinesia between Days 1, 3 and 15
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Change in Unified Parkinson's Disease Rating Scale Part III at 6 hours after morning dose between Days 1, 3 and 15
Levodopa and Carbidopa time to maximum plasma concentration (Tmax)
Levodopa and Carbidopa area under the plasma concentration versus time curve (AUC)

Full Information

First Posted
February 22, 2021
Last Updated
August 9, 2022
Sponsor
SynAgile Corporation
Collaborators
Clintrex Research Corporation, TFS Trial Form Support, Clinical Data Science GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT04778176
Brief Title
Assessing the Pharmacokinetics, Safety, Tolerability and Efficacy of Continuous Oral Levodopa Via the DopaFuse® Delivery System in Parkinson's Disease Patients
Acronym
SCOL
Official Title
Assessing the Pharmacokinetics, Safety, Tolerability and Efficacy of Continuous Oral Levodopa Via the DopaFuse® Delivery System in Parkinson's Disease Patients
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
June 16, 2021 (Actual)
Primary Completion Date
July 21, 2022 (Actual)
Study Completion Date
August 2, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SynAgile Corporation
Collaborators
Clintrex Research Corporation, TFS Trial Form Support, Clinical Data Science GmbH

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate whether the DopaFuse System can reduce the fluctuation of plasma levodopa levels compared to participants' standard intermittent doses of oral LD/CD tablets (background treatment). It will also assess whether the system is safe, well tolerated, and can relieve motor symptoms.

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 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DopaFuse Delivery System 50mg LD/hr or 68mg LD/hr flow rate
Arm Type
Experimental
Arm Description
Either 50mg/13mg LD/CD per hour or 68mg/17mg LD/CD per hour flow rate based upon Subject's standard levodopa (LD) dose. Subjects will routinely wear each container for approximately 5 hours (3 containers per day).
Intervention Type
Combination Product
Intervention Name(s)
continuous oral delivery of levodopa/carbidopa
Intervention Description
The system consists of a reusable custom dental retainer, its case, and a pre-filled, single-use container which continuously releases levodopa/carbidopa into the back of the mouth.
Primary Outcome Measure Information:
Title
Variability in plasma concentration of levodopa as assessed with the Levodopa Fluctuation Index (Cmax-Cmin)/Caverage)
Description
Comparing Day 2 to Day 1 in steady state (4-12 hours). Fluctuation index will also be calculated by the hour.
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2.
Title
Treatment Emergent Adverse Events
Time Frame
Screening to Day 29
Title
Serious Adverse Events
Time Frame
Screening to Day 29
Title
Treatment Emergent Adverse Events leading to discontinuation
Time Frame
Screening to Day 29
Title
Percent of participants that complete study
Time Frame
Screening to Day 29
Title
Difference in OFF time between Days 1 and 15, based on in-person investigator ratings
Description
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Time Frame
Day 1 compared to Day 15
Secondary Outcome Measure Information:
Title
Coefficient of variation (CV) for plasma levodopa.
Description
This will be calculated between 4 and 12 hours on Days 1 and 2 comparing DopaFuse and oral levodopa tablets.
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2.
Title
Variability in plasma concentration of levodopa as assessed with the Levodopa Fluctuation Index (Cmax-Cmin)/Caverage).
Description
Comparing Day 3 to Day 1, as well as Day 2 (0-12 hours) to Day 1. Fluctuation index will also be calculated by the hour.
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2. Pre-dose and at 30 minute intervals for two hours, and at one-hour intervals for the remainder of the 12 hours on Day 3.
Title
Levodopa and Carbidopa peak plasma concentration (Cmax)
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2. Pre-dose and at 30 minute intervals for two hours, and at one-hour intervals for the remainder of the 12 hours on Day 3.
Title
Variability in plasma levodopa comparing Dopafuse and oral levodopa tablets based on fluctuation index and CV in participants who are H. pylori negative/positive
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2. Pre-dose and at 30 minute intervals for two hours, and at one-hour intervals for the remainder of the 12 hours on Day 3.
Title
Questionnaire for Impulse Control Disorders in Parkinson's Disease Rating Scale (QUIP-RS)
Time Frame
Screening to Day 29
Title
Columbia - Suicide Severity Rating Scale (C-SSRS)
Time Frame
Screening to Day 29
Title
Difference in OFF Time between Day 1 and Day 3
Description
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Time Frame
Day 1 and Day 3
Title
Difference in ON Time without troublesome dyskinesia between Days 1, 3 and 15
Description
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Time Frame
Days 1, 3, and 15
Title
Difference in ON Time with troublesome (severe) dyskinesia between Days 1, 3 and 15
Description
Investigator-rated assessment of motor state (ON or OFF) pre-dose and every 30 minutes for 12 hours.
Time Frame
Days 1, 3 and 15
Title
Change in Unified Parkinson's Disease Rating Scale Part III at 6 hours after morning dose between Days 1, 3 and 15
Time Frame
Days 1, 3 and 15
Title
Levodopa and Carbidopa time to maximum plasma concentration (Tmax)
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2. Pre-dose and at 30 minute intervals for two hours, and at one-hour intervals for the remainder of the 12 hours on Day 3.
Title
Levodopa and Carbidopa area under the plasma concentration versus time curve (AUC)
Time Frame
pre-dose and every 30 minutes for 12 hours on Days 1 and 2. Pre-dose and at 30 minute intervals for two hours, and at one-hour intervals for the remainder of the 12 hours on Day 3.
Other Pre-specified Outcome Measures:
Title
A comparison of the subgroups who are H. pylori positive and negative will be performed as an exploratory analysis.
Time Frame
Screening to Day 15

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of Parkinson's Disease consistent with UK Brain Bank Criteria Age at least 30 years old at time of consent Male and Female participants (Women of child-bearing potential (WOCB) are eligible for participation if they are not pregnant or breastfeeding and agree to follow the contraceptive guidance in Appendix 3 during the treatment period and for at least 30 days after the last dose of study treatment) Suitable for oral retainer wear A good response to Levodopa, as assessed by the Investigator At least 2 hours of wearing OFF time per day, as reported by the participant Predictable early morning OFF periods, in the judgement of the participant and the Investigator Taking 400-1,200 mg of LD/CD per day in at least 4 doses, with stable dosing for the last 28 days prior to screening. A modified Hoehn and Yahr of ≤ 3 in the ON state at screening A stable regimen of anti-PD medications for the last 28 days prior to Screening A Mini-Mental State Examination (MMSE) Score ≥26 Capable of giving signed informed consent Approved for entry into the study by the Enrollment Authorization Committee (EAC) Exclusion Criteria: Atypical or secondary Parkinson's Disease Severe Dyskinesia that might interfere with study performance in the judgement of Investigator Clinically significant dysphagia or sialorrhea that might interfere with administration of study intervention in the judgement of the Investigator Use of extended release levodopa within 28 days prior to screening Any clinically significant medical, surgical, or psychiatric condition; laboratory value or ECG result which, in the opinion of the Investigator, makes the participant unsuitable for study entry or potentially unable to complete all aspects of the study. Presence of clinically significant orthostatic hypotension at screening, in the opinion of Investigator or the EAC Suicidal ideation within 1 year prior to the Screening Visit as evidenced by answering "yes" to Questions 4 or 5 on the suicidal ideation portion of the Columbia Suicide Severity Rating Scale (C-SSRS) or attempted suicide within the last 5 years. History of psychosis or hallucinations in the past six months Any malignancy in the past 5 years (excluding basal cell carcinoma of the skin or cervical carcinoma in situ that have been successfully treated.) Current or previous diagnosis of malignant melanoma or the presence of any suspicious skin lesion based on physical exam findings Unable to give blood required for the study History of allergic reaction to plastics LD infusion therapy (i.e. Duodopa); current or previous continuous apomorphine infusion treatment. Participation in any other clinical trial <30 days prior to screening visit. Presence of two third molars ("wisdom teeth") on the upper dentition Participants who, for any reason, are judged by the Investigator or the EAC to be inappropriate for this study, including participants who are unable to communicate or cooperate with the Investigator or who have/had a clinically significant illness or abnormal physical examination that may compromise safety of the participant during the trial or affect ability of the participant to adhere to study procedures. Participants taking non-selective monoamine oxidase (MAO) inhibitors Participants with known hypersensitivity to the active ingredients (levodopa, carbidopa) or excipients (Benzoic Acid, Disodium Edetate, Medium Chain Triglycerides, Poloxamer 188) of the drug paste Participants with narrow-angle glaucoma
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ephraim Heller, MBA
Organizational Affiliation
SynAgile Corporation
Official's Role
Study Chair
Facility Information:
Facility Name
San Raffaele Cassino
City
Cassino
ZIP/Postal Code
03043
Country
Italy
Facility Name
Centro Parkinson, Policlinico Tor Vergata
City
Rome
ZIP/Postal Code
00133
Country
Italy
Facility Name
IRCCS San Raffaele Pisana
City
Rome
ZIP/Postal Code
00163
Country
Italy
Facility Name
Centre Hospitalier de Luxembourg
City
Luxembourg
Country
Luxembourg
Facility Name
Neuroscience Centre (CINAC)
City
Móstoles
ZIP/Postal Code
28938
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Assessing the Pharmacokinetics, Safety, Tolerability and Efficacy of Continuous Oral Levodopa Via the DopaFuse® Delivery System in Parkinson's Disease Patients

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