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Evaluation of the Safety, Tolerability, and Efficacy of Orally Administered PTL201 in MS Patients With Spasticity-related Symptoms

Primary Purpose

Multiple Sclerosis

Status
Unknown status
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
PTL201
Placebo Oral Capsule
Sponsored by
PhytoTech Therapeutics, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Sclerosis

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient (male or female), age 18-65 years
  2. Definite diagnosis of MS, according to McDonald 2010 criteria, at least six months prior to enrollment, with MS associated spasticity for at least 3 months prior to enrollment

    1. Patients suffer from moderate to-severe MS-associated spasticity (≥4 sNRS), with no adequate response to traditional antispastic medications
    2. EDSS score: 4 ≤ EDSS ≤ 6; functional motor score ≥3.0 Safety, tolerability and efficacy of PTL201 in reducing multiple sclerosis-associated spasticity-related symptoms
    3. Moderate to severe spasticity in at least two districts of upper and/or lower limbs
  3. Anti-spasticity agent(s) and/or disease-modifying medications maintained at a stable dose for 30 days prior to and throughout the study
  4. Patients able to self-score spasticity
  5. Absence of clinical or neuroradiological relapses from at least three months prior to study entry
  6. Willingness and ability to provide written informed consent
  7. Willingness and ability to comply with all study requirements
  8. Inclusion criteria for placebo-controlled treatment phase:

No major protocol violations were recorded for the patient in the responder phase and at least 20% improvement in sNRS

Exclusion Criteria:

  1. Concomitant disease or disorder with spasticity-like symptoms or that may influence the subject's level of spasticity, or medical history suggesting that relapse/remission is likely to recur during the study or expected to influence spasticity
  2. Currently using or used cannabis or cannabinoid-based medications within 30 days of study entry and is unwilling to abstain from using them for the duration of the study.
  3. Concurrent significant psychiatric, renal, hepatic,cardiovascular or convulsive disorders
  4. History or immediate family history of schizophrenia, other psychotic illness, severe personality disorder, or other significant psychiatric disorder other than depression related to MS/MS-associated spasticity.
  5. Any known or suspected history of substance abuse/dependence disorder (including opiate abuse),current heavy alcohol consumption, current use of illicit drug, or current non-prescribed use of any prescription drug.
  6. Poorly controlled epilepsy or recurrent seizures (i.e., one or more seizures in the past year).
  7. Known or suspected hypersensitivity to cannabinoids or to any of the excipients of the study drugs.
  8. Myocardial infarction or clinically significant cardiac dysfunction within 12 months of study entry or a cardiac disorder that, in the opinion of the investigator, would put the patient at risk of a clinically significant arrhythmia or myocardial infarction
  9. Female patients of child-bearing potential and male patients whose partner is of childbearing potential, unless willing to ensure that they or their partner use effective contraception throughout the study and for three months thereafter
  10. Female patient who is pregnant, lactating, or planning pregnancy during the course of the study or within the 3 months thereafter.
  11. Any other significant diseases or disorder, which, in the opinion of the investigator, participation in the study may either put the patient at risk or may influence the result of the study, or the patient's ability to participate in the study.
  12. Travel outside the country planned during the study.
  13. Unwilling to abstain from donating blood during the study.
  14. Patients previously randomized into a cannabinoid-based clinical trial for MS pain and spasticity within 6 months of study entry.

Sites / Locations

  • Sheba medical center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

PTL201

Placebo

Arm Description

Up to 30 mg/day (30 mg THC, 10 mg CBD), recommended to be administered after meals and if required before bed time. Patients will be instructed not to take more than 10 mg (two capsules) at a single dosing session.

PTL201 and placebo capsules will be identical in appearance

Outcomes

Primary Outcome Measures

Incidence of study treatment-related adverse events (AE)
Change in sNRS scores from randomization to end of placebo-controlled treatment phase

Secondary Outcome Measures

Incidence of all AEs
Percent change in walking velocity
Clinical Global Impression Improvement (CGI-I) assessment using a 7-point scale condition
Cadence (steps/min) assessment
Stride length (cm) assessment
pNRS assessment
Spasm frequency assessment
Sleep disturbance assessment
Assessment of clinical gait measures
Timed (sec) 25 foot walk test (T25FW)
Assessment of clinical gait measures
Timed (sec) up and go test (TUG)

Full Information

First Posted
December 25, 2016
Last Updated
September 26, 2017
Sponsor
PhytoTech Therapeutics, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03005119
Brief Title
Evaluation of the Safety, Tolerability, and Efficacy of Orally Administered PTL201 in MS Patients With Spasticity-related Symptoms
Official Title
A Phase II, Double-blind, Randomized, Placebocontrolled, Parallel-group, Single-center Study to Evaluate the Safety, Tolerability, and Efficacy of Orally Administered PTL201 in Multiple Sclerosis (MS) Patients With Spasticity-related Symptoms
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Unknown status
Study Start Date
March 1, 2018 (Anticipated)
Primary Completion Date
December 2018 (Anticipated)
Study Completion Date
December 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PhytoTech Therapeutics, Ltd.

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the safety and tolerability of oral administration of PTL201 for relief of spasticity-related symptoms in 70 MS patients and to evaluate the efficacy of oral administration of PTL201 in relief of spasticity-related symptoms in MS patients. The pharmacokinetics of PTL201 in comparison to buccally administered Sativex will be evaluated in sub-study prior to the efficacy study.
Detailed Description
The study will be comprised of the following parts: Pharmacokinetics (PK) sub-study: A 7-day baseline observation period. Randomized cross-over treatments (Sativex, PTL201), performed at minimum 7-day washout. Follow up - one week after the last dosing session. Efficacy study: A 7-day baseline observation period. Single-blind responder phase - 4 weeks. Randomized, double-blind, placebo-controlled treatment phase - 4 weeks Follow up - two weeks. Subjects participating in the pharmacokinetic sub-study will be allowed to participate in the efficacy study and will not be required to repeat the 7-day observation period of the efficacy study. Doses will be titrated over a one-week period until reaching maximum tolerated dose (MTD) for each participant The MTD will be self administered for three weeks thereafter. Participants demonstrating response to treatment will continue self administering daily PTL201 treatment or placebo, for an additional four weeks. Participants will keep a daily diary.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
70 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PTL201
Arm Type
Experimental
Arm Description
Up to 30 mg/day (30 mg THC, 10 mg CBD), recommended to be administered after meals and if required before bed time. Patients will be instructed not to take more than 10 mg (two capsules) at a single dosing session.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
PTL201 and placebo capsules will be identical in appearance
Intervention Type
Drug
Intervention Name(s)
PTL201
Intervention Description
Two piece acid resistance hard capsule filled with seamless gelatin matrix green beads containing tetrahydrocannabinol (THC) and cannabidiol (CBD). Each capsule contain 5 mg THC and 5 mg CBD
Intervention Type
Drug
Intervention Name(s)
Placebo Oral Capsule
Intervention Description
Placebo seamless gelatin matrix green beads containing excipients only
Primary Outcome Measure Information:
Title
Incidence of study treatment-related adverse events (AE)
Time Frame
10 weeks (70 days) from beginning of treatment to end of follow-up
Title
Change in sNRS scores from randomization to end of placebo-controlled treatment phase
Time Frame
during the 4 weeks (28 days) placebo-controlled treatment period
Secondary Outcome Measure Information:
Title
Incidence of all AEs
Time Frame
during 10 week treatment plus follow up period
Title
Percent change in walking velocity
Time Frame
during 4 weeks placebo-controlled treatment period
Title
Clinical Global Impression Improvement (CGI-I) assessment using a 7-point scale condition
Time Frame
at randomization (day 29) and the end of placebo-controlled treatment phase (day 57)
Title
Cadence (steps/min) assessment
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Title
Stride length (cm) assessment
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Title
pNRS assessment
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Title
Spasm frequency assessment
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Title
Sleep disturbance assessment
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Title
Assessment of clinical gait measures
Description
Timed (sec) 25 foot walk test (T25FW)
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Title
Assessment of clinical gait measures
Description
Timed (sec) up and go test (TUG)
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Other Pre-specified Outcome Measures:
Title
Combined modified Ashworth score (cMAS) and MS walking scale 12 (MSWS-12) assessments, posturography measure, Selected spatio-temporal parameters of gait
Time Frame
at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient (male or female), age 18-65 years Definite diagnosis of MS, according to McDonald 2010 criteria, at least six months prior to enrollment, with MS associated spasticity for at least 3 months prior to enrollment Patients suffer from moderate to-severe MS-associated spasticity (≥4 sNRS), with no adequate response to traditional antispastic medications EDSS score: 4 ≤ EDSS ≤ 6; functional motor score ≥3.0 Safety, tolerability and efficacy of PTL201 in reducing multiple sclerosis-associated spasticity-related symptoms Moderate to severe spasticity in at least two districts of upper and/or lower limbs Anti-spasticity agent(s) and/or disease-modifying medications maintained at a stable dose for 30 days prior to and throughout the study Patients able to self-score spasticity Absence of clinical or neuroradiological relapses from at least three months prior to study entry Willingness and ability to provide written informed consent Willingness and ability to comply with all study requirements Inclusion criteria for placebo-controlled treatment phase: No major protocol violations were recorded for the patient in the responder phase and at least 20% improvement in sNRS Exclusion Criteria: Concomitant disease or disorder with spasticity-like symptoms or that may influence the subject's level of spasticity, or medical history suggesting that relapse/remission is likely to recur during the study or expected to influence spasticity Currently using or used cannabis or cannabinoid-based medications within 30 days of study entry and is unwilling to abstain from using them for the duration of the study. Concurrent significant psychiatric, renal, hepatic,cardiovascular or convulsive disorders History or immediate family history of schizophrenia, other psychotic illness, severe personality disorder, or other significant psychiatric disorder other than depression related to MS/MS-associated spasticity. Any known or suspected history of substance abuse/dependence disorder (including opiate abuse),current heavy alcohol consumption, current use of illicit drug, or current non-prescribed use of any prescription drug. Poorly controlled epilepsy or recurrent seizures (i.e., one or more seizures in the past year). Known or suspected hypersensitivity to cannabinoids or to any of the excipients of the study drugs. Myocardial infarction or clinically significant cardiac dysfunction within 12 months of study entry or a cardiac disorder that, in the opinion of the investigator, would put the patient at risk of a clinically significant arrhythmia or myocardial infarction Female patients of child-bearing potential and male patients whose partner is of childbearing potential, unless willing to ensure that they or their partner use effective contraception throughout the study and for three months thereafter Female patient who is pregnant, lactating, or planning pregnancy during the course of the study or within the 3 months thereafter. Any other significant diseases or disorder, which, in the opinion of the investigator, participation in the study may either put the patient at risk or may influence the result of the study, or the patient's ability to participate in the study. Travel outside the country planned during the study. Unwilling to abstain from donating blood during the study. Patients previously randomized into a cannabinoid-based clinical trial for MS pain and spasticity within 6 months of study entry.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hagit Sacks
Phone
+972 3 6449599
Email
hsacks@mmjphytotech.com.au
Facility Information:
Facility Name
Sheba medical center
City
Tel Hashomer, Ramat gan
Country
Israel
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anat Achiron, Prof.
Email
Anat.Achiron@sheba.health.gov.il

12. IPD Sharing Statement

Learn more about this trial

Evaluation of the Safety, Tolerability, and Efficacy of Orally Administered PTL201 in MS Patients With Spasticity-related Symptoms

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