Trial Outcomes & Findings for Erythromycin in Parkinson's Disease (NCT NCT02005029)

NCT ID: NCT02005029

Last Updated: 2017-02-03

Results Overview

Mean gastric emptying time in minutes as measured by SmartPill

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

18 participants

Primary outcome timeframe

2 weeks, between visits 2 and 3

Results posted on

2017-02-03

Participant Flow

Eighteen patients were screened for eligibility between April 2013 and June 2015 at the Virginia Commonwealth University Parkinson's and Movement Disorders Center.

10 of 18 participants were randomized. Of those not randomized, 7 did not meet eligibility criteria and 1 was withdrawn by the principal investigator prior to randomization due to noncompliance with the protocol.

Participant milestones

Participant milestones
Measure
Placebo First Then Erythromycin
One time IV dose of placebo followed by 1 time IV dose of Erythromycin (after 2 week washout)
Erythromycin Then Placebo
One time IV dose of 100 mg Erythromycin followed by 1 time IV dose of placebo (after 2 week washout)
First Intervention (1 Day)
STARTED
5
5
First Intervention (1 Day)
COMPLETED
4
5
First Intervention (1 Day)
NOT COMPLETED
1
0
Washout (2 Weeks)
STARTED
4
5
Washout (2 Weeks)
COMPLETED
4
5
Washout (2 Weeks)
NOT COMPLETED
0
0
Second Intervention (1 Day)
STARTED
4
5
Second Intervention (1 Day)
COMPLETED
4
5
Second Intervention (1 Day)
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo First Then Erythromycin
One time IV dose of placebo followed by 1 time IV dose of Erythromycin (after 2 week washout)
Erythromycin Then Placebo
One time IV dose of 100 mg Erythromycin followed by 1 time IV dose of placebo (after 2 week washout)
First Intervention (1 Day)
participant withdrawn for noncompliance
1
0

Baseline Characteristics

Erythromycin in Parkinson's Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo First Then Erythromycin
n=5 Participants
One time IV dose of placebo followed by 1 time IV dose of Erythromycin (after 2 week washout)
Erythromycin Then Placebo
n=5 Participants
One time IV dose of 100 mg Erythromycin followed by 1 time IV dose of placebo (after 2 week washout)
Total
n=10 Participants
Total of all reporting groups
Age, Continuous
64.6 years
n=5 Participants
64.0 years
n=7 Participants
64.3 years
n=5 Participants
Gender
Female
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Gender
Male
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original ten participants; one participant's data was excluded due to symptomatic orthostasis which likely confounded her results, one participant was withdrawn early due to noncompliance, and four participants were unable to complete a SmartPill evaluation.

Mean gastric emptying time in minutes as measured by SmartPill

Outcome measures

Outcome measures
Measure
Erythromycin
n=4 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=4 Participants
Mean gastric emptying time for participants receiving placebo
Gastric Emptying Time
105 minutes
Standard Deviation 66.5
180 minutes
Standard Deviation 40.6

PRIMARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original ten participants; one participant's data was excluded due to symptomatic orthostasis which likely confounded her results, one participant was withdrawn early due to noncompliance, and one participant had undetectable plasma levodopa levels through out the study and was thus excluded from the pharmacokinetic analysis.

Mean Area under the Curve 0-4 hours for plasma levodopa after erythromycin versus placebo. Plasma samples were collected at the following times post-levodopa dose: 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, and 240 minutes.

Outcome measures

Outcome measures
Measure
Erythromycin
n=7 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=7 Participants
Mean gastric emptying time for participants receiving placebo
Area Under the Curve 0-4 Hours for Plasma Levodopa After Erythromycin Versus Placebo
123237 ng/mL*min
Standard Deviation 137561
103584 ng/mL*min
Standard Deviation 106271

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Change in motor function as assessed by 9-hole peg test for upper extremity manipulation/dexterity. This test measures the total time required to place and remove 9 holes in a pegboard. Each hand is tested separately.

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
9-hole Peg Test Right Hand
25.36 seconds
Standard Deviation 4.37
25.80 seconds
Standard Deviation 4.23

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Change in motor function as assessed by 9-hole peg test for upper extremity manipulation/dexterity. This test measures the total time required to place and remove 9 holes in a pegboard. Each hand is tested separately.

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
9-hole Peg Test Left Hand
29.36 seconds
Standard Deviation 6.27
27.33 seconds
Standard Deviation 6.45

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Change in motor function as measured by Five times sit-to-stand test. This test measures the total time to complete 5 repetitions of sit to stand.

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
Five Times Sit-to-stand Test
11.09 seconds
Standard Deviation 2.24
10.09 seconds
Standard Deviation 2.48

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Change in motor function as assessed by comfortable 20 feet gait speed (CGS)

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
Comfortable 20 Feet Gait Speed (CGS)
4.26 seconds
Standard Deviation 0.44
4.10 seconds
Standard Deviation 0.69

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Change in motor function as assessed by timed up and go test (comfortable speed). This test measures the total time to stand from a chair, walk 10 feet, and return to sitting.

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
Timed up and go Test (TUAG) Comfortable Speed
8.67 seconds
Standard Deviation 1.33
8.26 seconds
Standard Deviation 1.05

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Change in motor function as assessed by timed up and go test (fast speed). This test measures the total time to stand from a chair, walk 10 feet, and return to sitting.

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
Timed up and go Test (TUAG) Fast Speed
6.79 seconds
Standard Deviation 0.927
6.85 seconds
Standard Deviation 1.06

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original 10 participants, one participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Mean total AIMS (Abnormal Involuntary Movements Scale) score after receiving erythromycin minus mean total AIMS score after receiving placebo. The AIMS test has a total of twelve items rating involuntary movements of various areas of the patient's body. Ten of the items are rated on a five-point scale of severity from 0-4. The scale is rated from 0 (none), 1 (minimal), 2 (mild), 3 (moderate), 4 (severe). Two of the items are not scored. Total score range is from 0 to 40. Higher scores represent more severe dyskinesia (a worse outcome).

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
Change in Dyskinesia
0.875 units on a scale
Standard Deviation 1.458
0.375 units on a scale
Standard Deviation 1.061

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: One participant's data was excluded due to symptomatic orthostasis which likely confounded her results and one participant was withdrawn early due to noncompliance.

Part 3 of this scale is a standardized physical assessment that quantifies the total burden of motor symptoms in Parkinson's disease patients. Each of the 18 items on the scale is rated from 0 (none, 1 (slight), 2 (mild), 3 (moderate) and 4 (severe). Scores range from 0-72. Higher scores represent a more severe burden of motor symptoms (a worse outcome).

Outcome measures

Outcome measures
Measure
Erythromycin
n=8 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=8 Participants
Mean gastric emptying time for participants receiving placebo
MDS-UPDRS Part 3 (Movement Disorders Society- Unified Parkinson's Disease Rating Scale)
Before or "off" levodopa
30.75 units on a scale
Standard Deviation 13.26
25.37 units on a scale
Standard Deviation 11.09
MDS-UPDRS Part 3 (Movement Disorders Society- Unified Parkinson's Disease Rating Scale)
After or "on" levodopa
17.13 units on a scale
Standard Deviation 11.48
16.50 units on a scale
Standard Deviation 8.38

SECONDARY outcome

Timeframe: 2 weeks, between visits 2 and 3

Population: Of the original ten participants; one participant's data was excluded due to symptomatic orthostasis which likely confounded her results, one participant was withdrawn early due to noncompliance, and one participant had undetectable plasma levodopa levels throughout the study and was thus excluded from the pharmacokinetic analysis.

Mean Cmax of plasma levodopa after erythromycin versus placebo. Plasma samples were collected at the following times post-levodopa dose: 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, and 240 minutes.

Outcome measures

Outcome measures
Measure
Erythromycin
n=7 Participants
Mean gastric emptying time for participants receiving erythromycin
Placebo
n=7 Participants
Mean gastric emptying time for participants receiving placebo
Mean Cmax of Plasma Levodopa After Erythromycin Versus Placebo
1267 ng/mL
Standard Deviation 1012
1395 ng/mL
Standard Deviation 1015

Adverse Events

Erythromycin

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Erythromycin
n=9 participants at risk
Participants who received a one time dose of IV erythromycin
Placebo
n=10 participants at risk
Participants who received a one time dose of placebo
Cardiac disorders
symptomatic orthostasis
11.1%
1/9 • Number of events 1 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
10.0%
1/10 • Number of events 1 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
Nervous system disorders
akathisia
11.1%
1/9 • Number of events 1 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
0.00%
0/10 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
Gastrointestinal disorders
diarrhea
11.1%
1/9 • Number of events 1 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
0.00%
0/10 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
Renal and urinary disorders
possible hematuria
11.1%
1/9 • Number of events 1 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
0.00%
0/10 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
Hepatobiliary disorders
transaminitis
0.00%
0/9 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.
10.0%
1/10 • Number of events 1 • 1 year, 10 months
Participants were followed from the beginning to the end of their active participation or the resolution of any adverse events.

Additional Information

Dr. Leslie Cloud

Virginia Commonwealth University

Phone: 804-662-5304

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place