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SR-Exenatide (PT320) to Eveluate Efficacy and Safety in Patients With Early Parkinson's Disease

Primary Purpose

Early Parkinson's Disease

Status
Unknown status
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
PT320 2.0mg Placebo
PT320 2.0 mg
PT320 2.5 mg
Sponsored by
Peptron, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Early Parkinson's Disease

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient who is male or female aged 40-75 and is diagnosed with Parkinson's Disease (using Queen Square Brain Bank criteria)
  2. Patient who is diagnosed of Parkinson's Disease less than 24 months prior to the screening
  3. Patient who has a modified Hoehn and Yahr stage ≤ 2. 5
  4. Patient who has been taking L-dopa stable-dose less than 600 mg/day or who has not previously taken any medication for the treatment of Parkinson's Disease from 4 weeks prior to the screening.
  5. Patient who is able to inject an Investigational Product by himself/herself or a his/her guardian.
  6. Patient or legally acceptable representative who signs the informed consent form voluntarily and is able to comply with all study procedures

Exclusion Criteria:

  1. Patient who is diagnosed or suspected to have Parkinson-plus syndromes (e.g., Multiple System Atrophy, Progressive Supranuclear Palsy, Corticobasal Degeneration, Diffuse Lewy Body Disease, and etc.)
  2. Patient who has a BMI < 18.5 at the screening
  3. Patient who has known abnormalities on CT or MRI brain imaging that may have an impact on the protocol compliance and/or PET scan
  4. Patient who has dementia with MoCA-K ≤ 22
  5. Patient who has a history of severe heart failure (NYHA class III to IV), stroke, cerebral ischemic attack, or seizure within 1 year prior to screening; or a history myocardial infarction or unstable angina within 6 months prior to screening.
  6. Patient who has severe liver disease or has AST or ALT level 3 times more than ULN at the screening
  7. Patient who has clinically significant depression [> 18 of Korean Beck Depression Inventory II score (K-BDI-II)]
  8. Patient who has a history of brain surgery for any treatment of Parkinson's disease
  9. Patient who has participated in any clinical trials for the treatment of Parkinson's Disease within 3 months prior to screening
  10. Patient who took exenatide within 90 days prior to randomization
  11. Patient who has a history of gastroduodenal ulcer or gastroparesis within 3 months prior to administration of investigational product or is currently on medication for acute or chronic gastritis
  12. Patient who has severe kidney function injury (creatinine clearance < 30 ml/min)
  13. Patient who has a history of pancreatitis
  14. Patient who has type 1 or type 2 diabetes or HbA1c ≥ 6.5% at screening
  15. Patient who has a history or suspected to thyroid cancer or multiple endocrine adenomatosis
  16. Patient who has known or suspected intolerance in PET scan or fluoropropyl-CIT (18F)
  17. Woman childbearing potential who doesn't agree to use the medically acceptable methods of contraception* during this study and up to 24 weeks after the last injection of investigational product

    *Medically acceptable methods of contraception: oral contraceptives, intrauterine contraceptive devices, vasectomy for male partner, barrier method [condom, spermicidal foam/gel/film/cream/suppository with sealed cap (diaphragm or cervix/bolt cap)].

  18. Woman who is pregnant or breastfeeding
  19. Patient who has a history of hypersensitivity reactions to any ingredients of investigational product
  20. Patient who is not eligible for the study at the discretion of the investigator

Sites / Locations

  • Seoul National University Bundang Hospital
  • Asan Medical Center
  • Samsung Medical Center
  • Seoul Metropolitan Government Seoul National University Boramae Medical Center
  • Seoul National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

PT320 2.0mg Placebo

PT320 2.0mg treatment 1

PT320 2.5mg treatment2

Arm Description

will be injected subcutaneously once a week for 48 weeks

will be injected subcutaneously once a week for 48 weeks

will be injected subcutaneously every two weeks for 48 weeks. (Actually, patients will be injected PT320 2.5 mg and placebo alternately once a week.)

Outcomes

Primary Outcome Measures

Change of MDS-UPDRS part 3 score
Change of MDS-UPDRS (Movement Disorder Society -Unified Parkinson's Disease Rating Scale ) part 3 score from baseline at 48 weeks. The MDS-UPDRS has four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications). The MDS-UPDRS consists of five measures, 0(normal) to 4(severe), according to each item, and is evaluated as the total score per part of Part 1 to 4. A 0 means there is no disability, and the higher the score, the more the disability is reflected.

Secondary Outcome Measures

SNBR (specific to non-specific binding ratio) confirmed by PET scan
Change of SNBR (specific to non-specific binding ratio) from baseline at 48 weeks, confirmed by PET scan
MDS-UPDRS part 3 score
Change of MDS-UPDRS (Movement Disorder Society -Unified Parkinson's Disease Rating Scale ) part 3 scores from baseline at 24 and 60 weeks. The MDS-UPDRS has four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications). The MDS-UPDRS consists of five measures, 0(normal) to 4(severe), according to each item, and is evaluated as the total score per part of Part 1 to 4. A 0 means there is no disability, and the higher the score, the more the disability is reflected.
MDS-UPDRS part 1, 2 and 4 scores
Changes of MDS-UPDRS (Movement Disorder Society -Unified Parkinson's Disease Rating Scale ) part 1, 2 and 4 scores from baseline at 24, 48 and 60 weeks. The MDS-UPDRS has four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications). The MDS-UPDRS consists of five measures, 0(normal) to 4(severe), according to each item, and is evaluated as the total score per part of Part 1 to 4. A 0 means there is no disability, and the higher the score, the more the disability is reflected.
K-PDQ-39 score
Change of K-PDQ-39 (korean-The Parkinson's Disease Questionnaires-39) score from baseline at 48 and 60 weeks. PDQ-39 is an assessment of Parkinson's disease and comprises a total of 39 questions. Based on the past month's experience, each item consists of a five-point scale of 0(never) to 4 (always) and is checked by the test subjects themselves. The total score of PDQ-39 is evaluated as a percentage of 0-100%, and as the score increases, the symptom becomes more severe.
MoCA-K score
Change of MoCA-K (Montreal Cognitive Assessment-Korean) score from baseline at 24, 48 and 60 weeks. MoCA-K is designed to evaluate mild cognitive disorders. The raters evaluate cognitive functions such as attention and concentration, memory, language, conceptual thinking, calculations, and orientation. The execution time takes about 10 minutes and is evaluated by the sum of the scores of each item. A perfect score of 30 points or more is considered normal.
K-NMSS score
Change of K-NMSS (Korean-Non Motor Symptoms Scale) score from baseline at 24, 48 and 60 weeks. K-NMSS evaluates non-motorative symptoms of Parkinson's disease. It consists of a total of 30 questions, separated by nine aspects: cardiovascular function, sleep/ fatigue, sexual function, and other non-motor symptoms. The evaluation period is evaluated based on the experience of the last month. For each aspect, the grade point is evaluated as the degree of severity (level 0-3) and frequency (1-4), and the evaluation score is obtained by multiplying the degree and frequency of severity. The K-NMSS has a range of 0-360 points, and the higher the score, the more severe the symptoms are judged.
Each percentage of subjects and changing patterns in modified Hoehn and Yahr stage
Percentage of subjects per modified Hoehn and Yahr stage and the changing patterns from baseline at 24, 48 and 60 weeks
Change of the L-dopa dosage of subjects
Starting time of L-dopa treatment and percentage of subjects who have L-dopa treatment at each visit.

Full Information

First Posted
January 13, 2020
Last Updated
April 7, 2021
Sponsor
Peptron, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04269642
Brief Title
SR-Exenatide (PT320) to Eveluate Efficacy and Safety in Patients With Early Parkinson's Disease
Official Title
Phase IIa Study to Evaluate the Efficacy and Safety of Subcutaneous SR-Exenatide (PT320) in Patients With Early Parkinson's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Unknown status
Study Start Date
March 19, 2020 (Actual)
Primary Completion Date
September 29, 2021 (Anticipated)
Study Completion Date
December 31, 2021 (Anticipated)

3. Sponsor/Collaborators

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

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
This study is to evaluate the safety and efficacy of sustained release (SR)-Exenatide (PT320, Q1W and Q2W) in the treatment of patients with early Parkinson's disease (PD).
Detailed Description
This study is a multicenter, randomized, double-blind, placebo-controlled, parallel comparison, phase IIa clinical study to evaluate the efficacy and safety of sustained release (SR)-Exenatide (PT320) in the treatment of patients with early Parkinson's disease (PD). Exenatide (GLP-1) has been approved by the Food and Drug Administration (FDA) to treat patients with Type 2 Diabetes (T2D) and obesity. In addition, several research groups have confirmed that Exenatide has beneficial aspects due to the neuroprotective effects in neuronal cells in patients with PD. Peptron has developed a sustained-release (SR)-Exenatide, (PT320, Q1W and Q2W), which has shown a higher Blood-Brain Barrier (BBB) penetration rate and better patient compliance. Thus, the objective of this study is to evaluate the effect of PT320 on symptom improvement and the inhibition of disease progression in the treatment of patients with early Parkinson's disease. Also, pharmacokinetic analysis of PT320 in blood cerebrospinal fluid (CSF) and exosome analysis of biomarkers related to Exenatide will be being tested, as exploratory measurements.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Early Parkinson's Disease

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
PT320 2.0mg Placebo
Arm Type
Placebo Comparator
Arm Description
will be injected subcutaneously once a week for 48 weeks
Arm Title
PT320 2.0mg treatment 1
Arm Type
Experimental
Arm Description
will be injected subcutaneously once a week for 48 weeks
Arm Title
PT320 2.5mg treatment2
Arm Type
Experimental
Arm Description
will be injected subcutaneously every two weeks for 48 weeks. (Actually, patients will be injected PT320 2.5 mg and placebo alternately once a week.)
Intervention Type
Drug
Intervention Name(s)
PT320 2.0mg Placebo
Intervention Description
PT320 2.0mg Placebo
Intervention Type
Drug
Intervention Name(s)
PT320 2.0 mg
Intervention Description
Exenatide slowly released formulation
Intervention Type
Drug
Intervention Name(s)
PT320 2.5 mg
Intervention Description
Exenatide slowly released formulation
Primary Outcome Measure Information:
Title
Change of MDS-UPDRS part 3 score
Description
Change of MDS-UPDRS (Movement Disorder Society -Unified Parkinson's Disease Rating Scale ) part 3 score from baseline at 48 weeks. The MDS-UPDRS has four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications). The MDS-UPDRS consists of five measures, 0(normal) to 4(severe), according to each item, and is evaluated as the total score per part of Part 1 to 4. A 0 means there is no disability, and the higher the score, the more the disability is reflected.
Time Frame
48 week
Secondary Outcome Measure Information:
Title
SNBR (specific to non-specific binding ratio) confirmed by PET scan
Description
Change of SNBR (specific to non-specific binding ratio) from baseline at 48 weeks, confirmed by PET scan
Time Frame
0 and 48 weeks
Title
MDS-UPDRS part 3 score
Description
Change of MDS-UPDRS (Movement Disorder Society -Unified Parkinson's Disease Rating Scale ) part 3 scores from baseline at 24 and 60 weeks. The MDS-UPDRS has four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications). The MDS-UPDRS consists of five measures, 0(normal) to 4(severe), according to each item, and is evaluated as the total score per part of Part 1 to 4. A 0 means there is no disability, and the higher the score, the more the disability is reflected.
Time Frame
0, 24 and 60 weeks
Title
MDS-UPDRS part 1, 2 and 4 scores
Description
Changes of MDS-UPDRS (Movement Disorder Society -Unified Parkinson's Disease Rating Scale ) part 1, 2 and 4 scores from baseline at 24, 48 and 60 weeks. The MDS-UPDRS has four parts: Part I (non-motor experiences of daily living), Part II (motor experiences of daily living), Part III (motor examination) and Part IV (motor complications). The MDS-UPDRS consists of five measures, 0(normal) to 4(severe), according to each item, and is evaluated as the total score per part of Part 1 to 4. A 0 means there is no disability, and the higher the score, the more the disability is reflected.
Time Frame
0, 24, 48 and 60 weeks
Title
K-PDQ-39 score
Description
Change of K-PDQ-39 (korean-The Parkinson's Disease Questionnaires-39) score from baseline at 48 and 60 weeks. PDQ-39 is an assessment of Parkinson's disease and comprises a total of 39 questions. Based on the past month's experience, each item consists of a five-point scale of 0(never) to 4 (always) and is checked by the test subjects themselves. The total score of PDQ-39 is evaluated as a percentage of 0-100%, and as the score increases, the symptom becomes more severe.
Time Frame
0, 48 and 60 weeks
Title
MoCA-K score
Description
Change of MoCA-K (Montreal Cognitive Assessment-Korean) score from baseline at 24, 48 and 60 weeks. MoCA-K is designed to evaluate mild cognitive disorders. The raters evaluate cognitive functions such as attention and concentration, memory, language, conceptual thinking, calculations, and orientation. The execution time takes about 10 minutes and is evaluated by the sum of the scores of each item. A perfect score of 30 points or more is considered normal.
Time Frame
0, 24, 48 and 60 weeks
Title
K-NMSS score
Description
Change of K-NMSS (Korean-Non Motor Symptoms Scale) score from baseline at 24, 48 and 60 weeks. K-NMSS evaluates non-motorative symptoms of Parkinson's disease. It consists of a total of 30 questions, separated by nine aspects: cardiovascular function, sleep/ fatigue, sexual function, and other non-motor symptoms. The evaluation period is evaluated based on the experience of the last month. For each aspect, the grade point is evaluated as the degree of severity (level 0-3) and frequency (1-4), and the evaluation score is obtained by multiplying the degree and frequency of severity. The K-NMSS has a range of 0-360 points, and the higher the score, the more severe the symptoms are judged.
Time Frame
0, 24, 48 and 60 weeks
Title
Each percentage of subjects and changing patterns in modified Hoehn and Yahr stage
Description
Percentage of subjects per modified Hoehn and Yahr stage and the changing patterns from baseline at 24, 48 and 60 weeks
Time Frame
0, 24, 48 and 60 weeks
Title
Change of the L-dopa dosage of subjects
Description
Starting time of L-dopa treatment and percentage of subjects who have L-dopa treatment at each visit.
Time Frame
0, 2, 4, 8, 12, 24, 36, 48 and 60 weeks
Other Pre-specified Outcome Measures:
Title
Pharmacokinetics test with blood
Description
Pharmacokinetics test will assess Cmax (Maxi mum Plasma Concentration) and Tmax (Time of Maximum Plasma Concentration) in blood (pre-dose, 12, 24, 36, 48 and 60 weeks)
Time Frame
0, 12, 24, 36, 48 and 60 weeks
Title
Pharmacokinetics test with CSF
Description
Pharmacokinetics test will assess Cmax (Maximum Plasma Concentration) and Tmax (Time of Maximum Plasma Concentration) in Cerebrospinal Fluid (CSF; pre-dose and 48 weeks only)
Time Frame
0, 12, 24, 36, 48 and 60 weeks
Title
Anti-exenatide antibodies test in blood
Description
Check if antibody of exenatide (PT320) is created
Time Frame
0, 12, 24, 36, 48 and 60 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient who is male or female aged 40-75 and is diagnosed with Parkinson's Disease (using Queen Square Brain Bank criteria) Patient who is diagnosed of Parkinson's Disease less than 24 months prior to the screening Patient who has a modified Hoehn and Yahr stage ≤ 2. 5 Patient who has been taking L-dopa stable-dose less than 600 mg/day or who has not previously taken any medication for the treatment of Parkinson's Disease from 4 weeks prior to the screening. Patient who is able to inject an Investigational Product by himself/herself or a his/her guardian. Patient or legally acceptable representative who signs the informed consent form voluntarily and is able to comply with all study procedures Exclusion Criteria: Patient who is diagnosed or suspected to have Parkinson-plus syndromes (e.g., Multiple System Atrophy, Progressive Supranuclear Palsy, Corticobasal Degeneration, Diffuse Lewy Body Disease, and etc.) Patient who has a BMI < 18.5 at the screening Patient who has known abnormalities on CT or MRI brain imaging that may have an impact on the protocol compliance and/or PET scan Patient who has dementia with MoCA-K ≤ 22 Patient who has a history of severe heart failure (NYHA class III to IV), stroke, cerebral ischemic attack, or seizure within 1 year prior to screening; or a history myocardial infarction or unstable angina within 6 months prior to screening. Patient who has severe liver disease or has AST or ALT level 3 times more than ULN at the screening Patient who has clinically significant depression [> 18 of Korean Beck Depression Inventory II score (K-BDI-II)] Patient who has a history of brain surgery for any treatment of Parkinson's disease Patient who has participated in any clinical trials for the treatment of Parkinson's Disease within 3 months prior to screening Patient who took exenatide within 90 days prior to randomization Patient who has a history of gastroduodenal ulcer or gastroparesis within 3 months prior to administration of investigational product or is currently on medication for acute or chronic gastritis Patient who has severe kidney function injury (creatinine clearance < 30 ml/min) Patient who has a history of pancreatitis Patient who has type 1 or type 2 diabetes or HbA1c ≥ 6.5% at screening Patient who has a history or suspected to thyroid cancer or multiple endocrine adenomatosis Patient who has known or suspected intolerance in PET scan or fluoropropyl-CIT (18F) Woman childbearing potential who doesn't agree to use the medically acceptable methods of contraception* during this study and up to 24 weeks after the last injection of investigational product *Medically acceptable methods of contraception: oral contraceptives, intrauterine contraceptive devices, vasectomy for male partner, barrier method [condom, spermicidal foam/gel/film/cream/suppository with sealed cap (diaphragm or cervix/bolt cap)]. Woman who is pregnant or breastfeeding Patient who has a history of hypersensitivity reactions to any ingredients of investigational product Patient who is not eligible for the study at the discretion of the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Min Ho Ihm
Organizational Affiliation
Peptron, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Seoul National University Bundang Hospital
City
Seongnam-si
Country
Korea, Republic of
Facility Name
Asan Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul Metropolitan Government Seoul National University Boramae Medical Center
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul National University Hospital
City
Seoul
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

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SR-Exenatide (PT320) to Eveluate Efficacy and Safety in Patients With Early Parkinson's Disease

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