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Tocotrienols in Parkinson's Disease (PD)

Primary Purpose

Neuro-Degenerative Disease, Parkinson Disease

Status
Recruiting
Phase
Phase 2
Locations
Singapore
Study Type
Interventional
Intervention
Tocovid Suprabio (HOV-12020)
Placebo
Sponsored by
National Neuroscience Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neuro-Degenerative Disease focused on measuring Parkinson Disease, Vitamin E, Neurodegenerative Disease, Neurology

Eligibility Criteria

40 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Men or women aged between 40 - 90 years (inclusive).
  • Able to provide written informed consent and able to comply with study protocol.
  • Idiopathic PD of more than 1 years duration from diagnosis. The diagnosis must be confirmed by presence of bradykinesia and at least 1 other cardinal sign (resting tremor, rigidity), without any other known or suspected cause of parkinsonism.
  • Hoehn & Yahr => 2 with treatment.
  • Patients on PD medication(s) e.g. levodopa, dopamine agonists, amantadine and/or Monoamine oxidase (MAO)-B inhibitors, must be on stable dose, for at least 30 days prior to screening. Medication and dose adjustments are allowed but must be documented.
  • Patients on anti-depressant or anxiolytic medication must be on stable dose for at least 90 days prior to screening.
  • The patient is willing to abstain from Vitamin E supplements (tocopherols and tocotrienols) and other dietary supplements which contain Vitamin E (tocopherols and tocotrienols) up to 14 days before baseline visit, and throughout the clinical study, unless prescribed by their physician for medical reasons.

Exclusion Criteria:

  • Any other neurodegenerative disorder, such as Alzheimer's disease, Huntington's disease, or Creutzfeldt - Jakob disease.
  • Current, clinically-significant hematological, cardiac, pulmonary, metabolic, neurologic or psychiatric disorders, uncontrolled seizures, untreated hypertension, disorders increasing risk of bleeding (Hemophilia), or any other significant active medical condition which, in the Investigator's opinion, would impact participation in this study.
  • History of psychotic symptoms requiring treatment with a neuroleptic medication within the past 12 months.
  • History of surgical or invasive intervention for PD (pallidotomy, thalamotomy, deep brain stimulation, etc.)
  • Medical history indicating drug-induced parkinsonism (e.g., metoclopramide, flunarizine), metabolic identified neurogenetic disorders (e.g., Wilson's disease), encephalitis, or other atypical Parkinsonian syndromes (e.g., progressive supranuclear palsy, multiple system atrophy).
  • History of myocardial infarction within 3 months prior to Screening, or current active angina pectoris, or symptomatic heart failure.
  • Known liver disease or liver enzymes (AST, ALT) more than 5 times upper limit normal within 1 month of screening and enrolment.
  • eGFR <60 within 1 month of screening and enrolment.
  • Current participation in another investigational interventional study.

Sites / Locations

  • National Neuroscience InstituteRecruiting
  • Singapore General HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Tocovid Suprabio (HOV-12020)

Placebo

Arm Description

200mg, twice 1 day, 12 months

200mg, twice 1 day, 12 months

Outcomes

Primary Outcome Measures

Mean change from Baseline to Week 104 in Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Score
Score range is 0 to 199, with severity increasing with higher scores.

Secondary Outcome Measures

Mean change from baseline to week 104 in disease severity
Mean change from baseline to week 104 in individual cognitive domain z scores on comprehensive neuropsychological testing mean score change from baseline to week 104 in the MDS-UPDRS score for total score
Severity of disease increases with higher score.
Mean change from Baseline to Week 104 in quality of life, as measured by the Parkinson's Disease Questionnaire (PDQ-39)
Score range is 0 to 100. A lower score will indicate a better quality of life.
Difference proportion of patients with change from Baseline to Week 104, above or equal to the minimal clinically important difference (MCID) of the motor score, as measured by Part II and III subscales of MDS-UPDRS.
Severity of disease increases with higher score.
Mean change in levels of blood-based biomarkers (including total antioxidant status TAS, oxidative stress biomarkers and αsynuclein).
Between treatment difference of type and incidence of Adverse Events (AEs) and Serious AEs (SAEs)
Mean score change from Baseline to Week 104 in the MDS-UPDRS Part II scale
Severity of disease increases with higher score.
Mean score change from Baseline to Week 104 in the Schwab and England Activities of Daily Living (SE-ADL) scale.
The scale uses percentages to assess the difficulties completing daily activities/chores, from 0% to 100%. A higher percentage will indicate a better outcome (i.e. more independence for an individual).

Full Information

First Posted
July 22, 2020
Last Updated
September 14, 2022
Sponsor
National Neuroscience Institute
Collaborators
Hovid Berhad
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1. Study Identification

Unique Protocol Identification Number
NCT04491383
Brief Title
Tocotrienols in Parkinson's Disease (PD)
Official Title
Tocotrienols in Parkinson's Disease (PD): A Pilot, Randomised, Placebo-controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 1, 2021 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Neuroscience Institute
Collaborators
Hovid Berhad

4. Oversight

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

5. Study Description

Brief Summary
A study using Parkinson's disease animal model, transgenic fruit flies, demonstrated the potential of using tocotrienols (HOV-12020) as a therapeutic agent for delaying Parkinsonian motor dysfunctions. The proposed study aims to enrol 100 PD patients in a randomized placebo-controlled trial to investigate the effects of tocotrienols (HOV-12020) in motor and non-motor outcomes. Patients will be given oral tocotrienols (400mg/day) or placebo for 104 weeks. They will be assessed using the standard assessments scales in PD at baseline, Week 52 and Week 104. Neuropsychological evaluation will also be completed at these intervals to monitor progression of cognitive impairment (if any). Additional PD staging using MDSUPDRS (Part III), Hoehn & Yahr (H&Y) will be conducted at Week 26 and week 78. Blood samples will be collected to evaluate PD biomarkers and for safety monitoring (liver function, renal function and hematology).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neuro-Degenerative Disease, Parkinson Disease
Keywords
Parkinson Disease, Vitamin E, Neurodegenerative Disease, Neurology

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Experimental (Tocovid Suprabio (HOV-12020)) vs Control (Placebo)
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
This is a double-blind clinical trial.
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Tocovid Suprabio (HOV-12020)
Arm Type
Experimental
Arm Description
200mg, twice 1 day, 12 months
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
200mg, twice 1 day, 12 months
Intervention Type
Drug
Intervention Name(s)
Tocovid Suprabio (HOV-12020)
Intervention Description
Dietary supplement: Tocotrienol (HOV-12020) Palm oil-derived vitamin E, tocotrienol
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Dietary supplement: Placebo. Placebo.
Primary Outcome Measure Information:
Title
Mean change from Baseline to Week 104 in Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Score
Description
Score range is 0 to 199, with severity increasing with higher scores.
Time Frame
104 weeks
Secondary Outcome Measure Information:
Title
Mean change from baseline to week 104 in disease severity
Time Frame
104 weeks
Title
Mean change from baseline to week 104 in individual cognitive domain z scores on comprehensive neuropsychological testing mean score change from baseline to week 104 in the MDS-UPDRS score for total score
Description
Severity of disease increases with higher score.
Time Frame
104 weeks
Title
Mean change from Baseline to Week 104 in quality of life, as measured by the Parkinson's Disease Questionnaire (PDQ-39)
Description
Score range is 0 to 100. A lower score will indicate a better quality of life.
Time Frame
104 weeks
Title
Difference proportion of patients with change from Baseline to Week 104, above or equal to the minimal clinically important difference (MCID) of the motor score, as measured by Part II and III subscales of MDS-UPDRS.
Description
Severity of disease increases with higher score.
Time Frame
104 weeks
Title
Mean change in levels of blood-based biomarkers (including total antioxidant status TAS, oxidative stress biomarkers and αsynuclein).
Time Frame
104 weeks
Title
Between treatment difference of type and incidence of Adverse Events (AEs) and Serious AEs (SAEs)
Time Frame
104 weeks
Title
Mean score change from Baseline to Week 104 in the MDS-UPDRS Part II scale
Description
Severity of disease increases with higher score.
Time Frame
104 weeks
Title
Mean score change from Baseline to Week 104 in the Schwab and England Activities of Daily Living (SE-ADL) scale.
Description
The scale uses percentages to assess the difficulties completing daily activities/chores, from 0% to 100%. A higher percentage will indicate a better outcome (i.e. more independence for an individual).
Time Frame
104 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men or women aged between 40 - 90 years (inclusive). Able to provide written informed consent and able to comply with study protocol. Idiopathic PD of more than 1 years duration from diagnosis. The diagnosis must be confirmed by presence of bradykinesia and at least 1 other cardinal sign (resting tremor, rigidity), without any other known or suspected cause of parkinsonism. Hoehn & Yahr => 2 with treatment. Patients on PD medication(s) e.g. levodopa, dopamine agonists, amantadine and/or Monoamine oxidase (MAO)-B inhibitors, must be on stable dose, for at least 30 days prior to screening. Medication and dose adjustments are allowed but must be documented. Patients on anti-depressant or anxiolytic medication must be on stable dose for at least 90 days prior to screening. The patient is willing to abstain from Vitamin E supplements (tocopherols and tocotrienols) and other dietary supplements which contain Vitamin E (tocopherols and tocotrienols) up to 14 days before baseline visit, and throughout the clinical study, unless prescribed by their physician for medical reasons. Exclusion Criteria: Any other neurodegenerative disorder, such as Alzheimer's disease, Huntington's disease, or Creutzfeldt - Jakob disease. Current, clinically-significant hematological, cardiac, pulmonary, metabolic, neurologic or psychiatric disorders, uncontrolled seizures, untreated hypertension, disorders increasing risk of bleeding (Hemophilia), or any other significant active medical condition which, in the Investigator's opinion, would impact participation in this study. History of psychotic symptoms requiring treatment with a neuroleptic medication within the past 12 months. History of surgical or invasive intervention for PD (pallidotomy, thalamotomy, deep brain stimulation, etc.) Medical history indicating drug-induced parkinsonism (e.g., metoclopramide, flunarizine), metabolic identified neurogenetic disorders (e.g., Wilson's disease), encephalitis, or other atypical Parkinsonian syndromes (e.g., progressive supranuclear palsy, multiple system atrophy). History of myocardial infarction within 3 months prior to Screening, or current active angina pectoris, or symptomatic heart failure. Known liver disease or liver enzymes (AST, ALT) more than 5 times upper limit normal within 1 month of screening and enrolment. eGFR <60 within 1 month of screening and enrolment. Current participation in another investigational interventional study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Elaine Ang
Phone
(65) 65762660
Email
elaine.ang.s.l@sgh.com.sg
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eng King Tan
Organizational Affiliation
National Neuroscience Institute Singapore
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Adeline Su-Lyn Ng
Organizational Affiliation
National Neuroscience Institute Singapore
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Neuroscience Institute
City
Singapore
Country
Singapore
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elaine Ang
First Name & Middle Initial & Last Name & Degree
Adeline Su Lyn Ng
Facility Name
Singapore General Hospital
City
Singapore
Country
Singapore
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elaine Ang
First Name & Middle Initial & Last Name & Degree
Eng King Tan

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
There is not a plan to make IPD available.
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Tocotrienols in Parkinson's Disease (PD)

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