Study on Tolerability of Repeat i.c.v. Administration of sNN0031 Infusion Solution in Patients With PD
Primary Purpose
Parkinson's Disease
Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
i.c.v. infusion of sNN0031 by an Implanted infusion system
i.c.v. infusion of aCSF by an Implanted infusion system
Sponsored by
About this trial
This is an interventional treatment trial for Parkinson's Disease
Eligibility Criteria
Main Inclusion Criteria:
- Disease duration ≥ 5 years (diagnosis based on medical history and neurological examination).
- Male or female, age 30 - 75 years inclusive.
- Motor fluctuations, with OFF-time >1.5 hours during the day
- A Hoehn and Yahr stage of 2 to 4 during OFF phase
- Score >22 on the UPDRS part III during ON phase
- Patients should be L-dopa responsive and demonstrate at least a 30% decrease in the UPDRS part III score after administration of L-dopa (L-dopa challenge test)
- Optimised and stable anti-Parkinson treatment for at least 3 months before screening
Main Exclusion Criteria:
- The patient has any indication of forms of parkinsonism other than idiopathic Parkinson's disease
- The patient is in a late stage of Parkinson's disease, and is experiencing severe, disabling peak-dose or biphasic dyskinesia and/or unpredictable or widely swinging fluctuations in their symptoms
- Patients who are on treatment with Duodopa or Apomorphine pump at the time of screening
- The patient has an implanted shunt for the drainage of CSF or an implanted Central Nervous System (CNS) catheter, or have received neurosurgical intervention related to PD (e.g. deep brain stimulation, thalamotomy etc.) or is scheduled to do so during the trial period
- Concurrent diagnoses of dementia with a score of 24 or lower on Mini-Mental State Examination (MMSE).
- The patient is depressed, as indicated by a Hamilton Depression Rating Scale (GRID-HAMD, 17-item scale) score > 17
- Patients who are at high risk of suicide as judged by the rating of the Columbia Symptoms Suicide Rating Scale (C-SSRS)
- Patients with a history of increased intracranial pressure
- Ophthalmologic examination (funduscopy and visual acuity by Early Treatment of Diabetic Retinopathy Study (EDTRS) and perimetry) with clinically significant findings that imply safety concerns for this study
- The patient has a current clinically significant gastrointestinal, renal, hepatic, endocrine, pulmonary or cardiovascular disease
- The patient has heart problems or a significant ECG abnormality
- Uncontrolled hypertension.
- The patient has in the past experienced psychotic symptoms (e.g. schizophrenia or psychotic depression)
- The patient has a mental or physical condition which would preclude performing study assessments
- Alcohol or substance dependence within the prior 12 months, or abuse within 3 months, with the exceptions of nicotine
- MRI examination with findings of tumours or potential sources of pathological bleedings, or any abnormality that may put the patient at risk
- History of structural brain disease including tumours and hyperplasia
- Ongoing or suspected primary or recurrent malignant disease (currently active or in remission for less than one year)
- Any disorder that precludes a surgical procedure, alters wound healing or renders chronic i.c.v. delivery or device implants medically unsuitable
- The patient has a history or a current diagnosis of HIV, Hepatitis B or C.
- Increased susceptibility to infections
- Women who are pregnant or breast feeding or unwilling to use adequate contraception during the trial (only women of child bearing potential)
Sites / Locations
- Klinikum-Bremerhaven
- Lund University Hospital
- Karolinska University Hospital Huddinge
- King's College Hospital
- John Radcliffe Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
sNN0031
Placebo
Arm Description
sNN0031 Infusion Solution (in aCSF) for intracerebroventricular (i.c.v.) administration by an implanted infusion pump
Articifial Cerebro Spinal Fluid (aCSF) for intracerebroventricular (i.c.v.) administration by an implanted infusion pump
Outcomes
Primary Outcome Measures
Tolerability of sNN0031 [Number of Adverse Events (AE) and Serious Adverse Events (SAE) occurring in each group over the study duration]
Number of AEs and SAEs occurring in each group over the study duration
Secondary Outcome Measures
Peak concentrations of sNN0031 in cerebrospinal fluid during two 14 day continuous infusion cycles
To explore peak concentrations of Platelet Derived Growth Factor-BB (PDGF-BB) levels in cerebrospinal fluid (CSF) during two different treatment cycles of 70 μg sNN0031 each separated by 3 months
Pump flow error rate
Performance of the Medtronic SynchroMed® II Infusion System - Pump flow error rate within 25%
Number of patients with AEs related to the Implanted Infusion System
Number of AEs and SAEs related to the Medtronic SynchroMed® II Infusion System occurring in each group over the study duration
Full Information
NCT ID
NCT02408562
First Posted
March 5, 2015
Last Updated
January 26, 2016
Sponsor
Newron Sweden AB
Collaborators
European Union
1. Study Identification
Unique Protocol Identification Number
NCT02408562
Brief Title
Study on Tolerability of Repeat i.c.v. Administration of sNN0031 Infusion Solution in Patients With PD
Official Title
A Phase 1, Multicentre, Randomised, Double-blind Study to Assess Safety and Tolerability of Repeated Intracerebroventricular Administration of sNN0031 Infusion Solution to Patients With Parkinson's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
January 2016
Overall Recruitment Status
Terminated
Why Stopped
Issues with development and supply of infusion system for delivery of IMP. Prolonged approval process for the clinical study sNN0031-004.
Study Start Date
January 2015 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
October 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Newron Sweden AB
Collaborators
European Union
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a phase I, randomised, placebo-controlled study to assess the safety and tolerability of two 2-weeks cycles of i.c.v. administration of sNN0031 infusion solution to patients with PD of moderate severity with persisting on-off symptoms in spite of other PD medications.
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 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1 (Actual)
8. Arms, Groups, and Interventions
Arm Title
sNN0031
Arm Type
Experimental
Arm Description
sNN0031 Infusion Solution (in aCSF) for intracerebroventricular (i.c.v.) administration by an implanted infusion pump
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Articifial Cerebro Spinal Fluid (aCSF) for intracerebroventricular (i.c.v.) administration by an implanted infusion pump
Intervention Type
Other
Intervention Name(s)
i.c.v. infusion of sNN0031 by an Implanted infusion system
Other Intervention Name(s)
rhPDGF-BB, Medtronic SynchroMed® II Infusion System
Intervention Description
I.c.v. infusion during 2 12d cycles separated by 3 mo. 6 mo follow-up after 2nd cycle.
Intervention Type
Other
Intervention Name(s)
i.c.v. infusion of aCSF by an Implanted infusion system
Other Intervention Name(s)
Placebo, Artificial Cerebrospinal fluid, Medtronic SynchroMed® II Infusion System
Intervention Description
I.c.v. infusion during 2 12d cycles separated by 3 mo. 6 mo follow-up after 2nd cycle.
Primary Outcome Measure Information:
Title
Tolerability of sNN0031 [Number of Adverse Events (AE) and Serious Adverse Events (SAE) occurring in each group over the study duration]
Description
Number of AEs and SAEs occurring in each group over the study duration
Time Frame
10 months
Secondary Outcome Measure Information:
Title
Peak concentrations of sNN0031 in cerebrospinal fluid during two 14 day continuous infusion cycles
Description
To explore peak concentrations of Platelet Derived Growth Factor-BB (PDGF-BB) levels in cerebrospinal fluid (CSF) during two different treatment cycles of 70 μg sNN0031 each separated by 3 months
Time Frame
14 days x 2
Title
Pump flow error rate
Description
Performance of the Medtronic SynchroMed® II Infusion System - Pump flow error rate within 25%
Time Frame
10 months
Title
Number of patients with AEs related to the Implanted Infusion System
Description
Number of AEs and SAEs related to the Medtronic SynchroMed® II Infusion System occurring in each group over the study duration
Time Frame
10 months
Other Pre-specified Outcome Measures:
Title
Explorative evaluation of changes to the Modified Hoehn &Yahr stage following two cycles of sNN0031
Description
To explore the change from baseline in relevant efficacy related variables:
o Modified Hoehn &Yahr stage
Time Frame
10 monhts
Title
Explorative evaluation of changes to the Unified Parkinson's disease rating scale (UPDRS) following two cycles of sNN0031
Description
To explore the change from baseline in relevant efficacy related variables:
o Unified Parkinson's disease rating scale (UPDRS)
Time Frame
10 monhts
Title
Explorative evaluation of changes to the Parkinson's disease questionnaire (PDQ-39) following two cycles of sNN0031
Description
To explore the change from baseline in relevant efficacy related variables:
o Parkinson's disease questionnaire (PDQ-39)
Time Frame
10 monhts
Title
Explorative evaluation of changes to the Dyskinesia rating scale (DRS) following two cycles of sNN0031
Description
To explore the change from baseline in relevant efficacy related variables:
o Dyskinesia rating scale (DRS)
Time Frame
10 monhts
Title
Explorative evaluation of changes to the o Non-motor symptom scale (NMSS 30) following two cycles of sNN0031
Description
To explore the change from baseline in relevant efficacy related variables:
o Non-motor symptom scale (NMSS 30)
Time Frame
10 monhts
Title
Changes in presynaptic dopamine transporter (DAT) binding
Description
To explore changes in presynaptic dopamine transporter (DAT) binding in basal ganglia by using DaTscan
Time Frame
10 months
Title
Explorative evaluation of potentially relevant biomarkers (inflammatory mediators) in plasma and CSF during and after two cycles of sNN0031
Description
To explore potentially relevant biomarkers in plasma and CSF - inflammatory mediators.
Time Frame
10 months
Title
Explorative evaluation of potentially relevant biomarkers (urate) in plasma and CSF during and after two cycles of sNN0031
Description
To explore potentially relevant biomarkers in plasma and CSF - urate.
Time Frame
10 months
Title
Explorative evaluation of potentially relevant biomarkers (DJ-1/Park7) in plasma and CSF during and after two cycles of sNN0031
Description
To explore potentially relevant biomarkers in plasma and CSF - DJ-1/Park7.
Time Frame
10 months
Title
Explorative evaluation of potentially relevant biomarkers (alpha-synuclein) in plasma and CSF during and after two cycles of sNN0031
Description
To explore potentially relevant biomarkers in plasma and CSF - alpha-synuclein.
Time Frame
10 months
Title
Explorative evaluation of potentially relevant biomarkers (haemoglobin) in plasma and CSF during and after two cycles of sNN0031
Description
To explore potentially relevant biomarkers in plasma and CSF - haemoglobin.
Time Frame
10 months
Title
Explorative evaluation of potentially relevant biomarkers (nitrite/nitrate) in plasma and CSF during and after two cycles of sNN0031
Description
To explore potentially relevant biomarkers in plasma and CSF - nitrite/nitrate.
Time Frame
10 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria:
Disease duration ≥ 5 years (diagnosis based on medical history and neurological examination).
Male or female, age 30 - 75 years inclusive.
Motor fluctuations, with OFF-time >1.5 hours during the day
A Hoehn and Yahr stage of 2 to 4 during OFF phase
Score >22 on the UPDRS part III during ON phase
Patients should be L-dopa responsive and demonstrate at least a 30% decrease in the UPDRS part III score after administration of L-dopa (L-dopa challenge test)
Optimised and stable anti-Parkinson treatment for at least 3 months before screening
Main Exclusion Criteria:
The patient has any indication of forms of parkinsonism other than idiopathic Parkinson's disease
The patient is in a late stage of Parkinson's disease, and is experiencing severe, disabling peak-dose or biphasic dyskinesia and/or unpredictable or widely swinging fluctuations in their symptoms
Patients who are on treatment with Duodopa or Apomorphine pump at the time of screening
The patient has an implanted shunt for the drainage of CSF or an implanted Central Nervous System (CNS) catheter, or have received neurosurgical intervention related to PD (e.g. deep brain stimulation, thalamotomy etc.) or is scheduled to do so during the trial period
Concurrent diagnoses of dementia with a score of 24 or lower on Mini-Mental State Examination (MMSE).
The patient is depressed, as indicated by a Hamilton Depression Rating Scale (GRID-HAMD, 17-item scale) score > 17
Patients who are at high risk of suicide as judged by the rating of the Columbia Symptoms Suicide Rating Scale (C-SSRS)
Patients with a history of increased intracranial pressure
Ophthalmologic examination (funduscopy and visual acuity by Early Treatment of Diabetic Retinopathy Study (EDTRS) and perimetry) with clinically significant findings that imply safety concerns for this study
The patient has a current clinically significant gastrointestinal, renal, hepatic, endocrine, pulmonary or cardiovascular disease
The patient has heart problems or a significant ECG abnormality
Uncontrolled hypertension.
The patient has in the past experienced psychotic symptoms (e.g. schizophrenia or psychotic depression)
The patient has a mental or physical condition which would preclude performing study assessments
Alcohol or substance dependence within the prior 12 months, or abuse within 3 months, with the exceptions of nicotine
MRI examination with findings of tumours or potential sources of pathological bleedings, or any abnormality that may put the patient at risk
History of structural brain disease including tumours and hyperplasia
Ongoing or suspected primary or recurrent malignant disease (currently active or in remission for less than one year)
Any disorder that precludes a surgical procedure, alters wound healing or renders chronic i.c.v. delivery or device implants medically unsuitable
The patient has a history or a current diagnosis of HIV, Hepatitis B or C.
Increased susceptibility to infections
Women who are pregnant or breast feeding or unwilling to use adequate contraception during the trial (only women of child bearing potential)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Håkan Widner, Prof
Organizational Affiliation
Lund University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinikum-Bremerhaven
City
Bremerhaven
ZIP/Postal Code
DE-27574
Country
Germany
Facility Name
Lund University Hospital
City
Lund
ZIP/Postal Code
22185
Country
Sweden
Facility Name
Karolinska University Hospital Huddinge
City
Stockholm
ZIP/Postal Code
141 86
Country
Sweden
Facility Name
King's College Hospital
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
John Radcliffe Hospital
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom
12. IPD Sharing Statement
Learn more about this trial
Study on Tolerability of Repeat i.c.v. Administration of sNN0031 Infusion Solution in Patients With PD
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