Trial Outcomes & Findings for Twelve Month Safety and Efficacy Study of CVT-301 In Parkinson's Disease Patients With OFF Episodes (NCT NCT02242487)

NCT ID: NCT02242487

Last Updated: 2019-08-14

Results Overview

To characterize the effects of CVT-301 on pulmonary safety, as assessed by spirometry FEV1 (forced expiratory volume in 1 second) by treatment group and Treatment Visit (TV). This study was a 12-month, dose-level blinded, multi-center study of 2 inhaled dose levels of CVT-301 for the treatment of up to 5 OFF periods per day in PD (Parkinson's Disease) patients experiencing motor fluctuations (OFF periods). Baseline is defined as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004 study and as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004E study for the rest of the patients.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

325 participants

Primary outcome timeframe

Change from baseline at 52 weeks

Results posted on

2019-08-14

Participant Flow

Safety population - Altogether, 325 patients were randomized and 312 patients received at least 1 dose of study drug and were included in the Safety Population. Thirteen patients were randomized but did not receive study drug.

Participant milestones

Participant milestones
Measure
CVT-301 Low Dose
Two capsules of 30 mg each (60 mg total) of levodopa inhalational powder orally inhaled up to 5 times/day for OFF episodes for 12 months duration CVT-301
CVT-301 High Dose
Two capsules of 42 mg each (84 mg total) of levodopa inhalational powder orally inhaled up to 5 times/day for OFF episodes for 12 months duration CVT-301
Overall Study
STARTED
161
164
Overall Study
COMPLETED
99
117
Overall Study
NOT COMPLETED
62
47

Reasons for withdrawal

Reasons for withdrawal
Measure
CVT-301 Low Dose
Two capsules of 30 mg each (60 mg total) of levodopa inhalational powder orally inhaled up to 5 times/day for OFF episodes for 12 months duration CVT-301
CVT-301 High Dose
Two capsules of 42 mg each (84 mg total) of levodopa inhalational powder orally inhaled up to 5 times/day for OFF episodes for 12 months duration CVT-301
Overall Study
Adverse Event
13
15
Overall Study
Lack of Efficacy
4
6
Overall Study
Protocol Violation
2
0
Overall Study
Lost to Follow-up
2
1
Overall Study
Other - Miscellaneous
4
6
Overall Study
Withdrawal by Subject
37
19

Baseline Characteristics

Twelve Month Safety and Efficacy Study of CVT-301 In Parkinson's Disease Patients With OFF Episodes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CVT-301 Low Dose
n=153 Participants
60 mg (two capsules of 30 mg) of levodopa inhalational powder used up to 5 times/day for OFF episodes for 12 months duration CVT-301
CVT-301 High Dose
n=159 Participants
84 mg (two capsules of 42 mg) of levodopa inhalational powder used up to 5 times/day for OFF episodes for 12 months duration CVT-301
Total
n=312 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
71 Participants
n=5 Participants
80 Participants
n=7 Participants
151 Participants
n=5 Participants
Age, Categorical
>=65 years
82 Participants
n=5 Participants
79 Participants
n=7 Participants
161 Participants
n=5 Participants
Age, Continuous
63.9 years
STANDARD_DEVIATION 8.76 • n=5 Participants
62.9 years
STANDARD_DEVIATION 8.34 • n=7 Participants
63.4 years
STANDARD_DEVIATION 8.55 • n=5 Participants
Sex: Female, Male
Female
43 Participants
n=5 Participants
40 Participants
n=7 Participants
83 Participants
n=5 Participants
Sex: Female, Male
Male
110 Participants
n=5 Participants
119 Participants
n=7 Participants
229 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
5 Participants
n=7 Participants
6 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Race (NIH/OMB)
White
147 Participants
n=5 Participants
150 Participants
n=7 Participants
297 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 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
Canada
4 participants
n=5 Participants
4 participants
n=7 Participants
8 participants
n=5 Participants
Region of Enrollment
Czechia
5 participants
n=5 Participants
3 participants
n=7 Participants
8 participants
n=5 Participants
Region of Enrollment
Poland
39 participants
n=5 Participants
45 participants
n=7 Participants
84 participants
n=5 Participants
Region of Enrollment
Spain
5 participants
n=5 Participants
6 participants
n=7 Participants
11 participants
n=5 Participants
Region of Enrollment
United States
100 participants
n=5 Participants
101 participants
n=7 Participants
201 participants
n=5 Participants
BMI
27.65 kg/m^2
STANDARD_DEVIATION 4.820 • n=5 Participants
27.59 kg/m^2
STANDARD_DEVIATION 4.790 • n=7 Participants
27.62 kg/m^2
STANDARD_DEVIATION 4.797 • n=5 Participants

PRIMARY outcome

Timeframe: Change from baseline at 52 weeks

Population: Safety population - Altogether, 325 patients were randomized and 312 patients received at least 1 dose of study drug and were included in the Safety Population. Thirteen patients were randomized but did not receive study drug.

To characterize the effects of CVT-301 on pulmonary safety, as assessed by spirometry FEV1 (forced expiratory volume in 1 second) by treatment group and Treatment Visit (TV). This study was a 12-month, dose-level blinded, multi-center study of 2 inhaled dose levels of CVT-301 for the treatment of up to 5 OFF periods per day in PD (Parkinson's Disease) patients experiencing motor fluctuations (OFF periods). Baseline is defined as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004 study and as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004E study for the rest of the patients.

Outcome measures

Outcome measures
Measure
CVT-301 DL1
n=153 Participants
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day.
CVT-301 DL2
n=159 Participants
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day.
Pulmonary Safety of CVT-301 Change From Baseline for FEV1.
Baseline
2.957 Liters
Standard Deviation 0.6995
3.117 Liters
Standard Deviation 0.7735
Pulmonary Safety of CVT-301 Change From Baseline for FEV1.
TV3 (Week 12)
-0.059 Liters
Standard Deviation 0.2321
-0.078 Liters
Standard Deviation 0.2108
Pulmonary Safety of CVT-301 Change From Baseline for FEV1.
TV4 (Week 24)
-0.057 Liters
Standard Deviation 0.1999
-0.058 Liters
Standard Deviation 0.2136
Pulmonary Safety of CVT-301 Change From Baseline for FEV1.
TV5 (Week 36)
-0.076 Liters
Standard Deviation 0.2155
-0.052 Liters
Standard Deviation 0.2096
Pulmonary Safety of CVT-301 Change From Baseline for FEV1.
TV6 (Week 52)
-0.086 Liters
Standard Deviation 0.2238
-0.097 Liters
Standard Deviation 0.2230

PRIMARY outcome

Timeframe: Change from baseline at 52 weeks

Population: Safety Population - Safety population - Altogether, 325 patients were randomized and 312 patients received at least 1 dose of study drug and were included in the Safety Population. Thirteen patients were randomized but did not receive study drug.

To characterize the effects of CVT-301 on pulmonary safety, as assessed by spirometry FVC, (forced vital capacity) by treatment group and Treatment Visit (TV). This study was a 12-month, dose-level blinded, multi-center study of 2 inhaled dose levels of CVT-301 for the treatment of up to 5 OFF periods per day in PD patients experiencing motor fluctuations (OFF periods). Baseline is defined as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004 study and as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004E study for the rest of the patients.

Outcome measures

Outcome measures
Measure
CVT-301 DL1
n=153 Participants
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day.
CVT-301 DL2
n=159 Participants
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day.
Pulmonary Safety for CVT-301 Change From Baseline for FVC.
Baseline
3.840 Liter
Standard Deviation 0.9047
4.045 Liter
Standard Deviation 0.9811
Pulmonary Safety for CVT-301 Change From Baseline for FVC.
TV3 (Week 12)
-0.064 Liter
Standard Deviation 0.2575
-0.086 Liter
Standard Deviation 0.2667
Pulmonary Safety for CVT-301 Change From Baseline for FVC.
TV4 (Week 24)
-0.053 Liter
Standard Deviation 0.2710
-0.062 Liter
Standard Deviation 0.2688
Pulmonary Safety for CVT-301 Change From Baseline for FVC.
TV5 (Week 36)
-0.089 Liter
Standard Deviation 0.3051
-0.050 Liter
Standard Deviation 0.2659
Pulmonary Safety for CVT-301 Change From Baseline for FVC.
TV6 (Week 52)
-0.106 Liter
Standard Deviation 0.2866
-0.089 Liter
Standard Deviation 0.2747

PRIMARY outcome

Timeframe: Change from baseline at 52 weeks

Population: Safety Population - Safety population - Altogether, 325 patients were randomized and 312 patients received at least 1 dose of study drug and were included in the Safety Population. Thirteen patients were randomized but did not receive study drug.

To characterize the effects of CVT-301 on pulmonary safety, as assessed by spirometry FEV1/FVC (FEV1-forced expiratory volume in 1 second and (FVC) forced vital capacity ratio) by treatment group and Treatment Visit (TV). This study was a 12-month, dose-level blinded, multi-center study of 2 inhaled dose levels of CVT-301 for the treatment of up to 5 OFF periods per day in PD (Parkinson's Disease) patients experiencing motor fluctuations (OFF periods). Baseline is defined as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004 study and as the last non-missing assessment before the first dose of CVT-301 in CVT-301-004E study for the rest of the patients.

Outcome measures

Outcome measures
Measure
CVT-301 DL1
n=153 Participants
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day.
CVT-301 DL2
n=159 Participants
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day.
Pulmonary Safety for CVT-301 Change From Baseline for (FEV1/FVC).
Baseline
77.2 Ratio %
Standard Deviation 5.24
77.2 Ratio %
Standard Deviation 6.00
Pulmonary Safety for CVT-301 Change From Baseline for (FEV1/FVC).
TV3 (Week 12)
-0.2 Ratio %
Standard Deviation 3.35
-0.3 Ratio %
Standard Deviation 2.89
Pulmonary Safety for CVT-301 Change From Baseline for (FEV1/FVC).
TV4 (Week 24)
-0.3 Ratio %
Standard Deviation 3.64
-0.3 Ratio %
Standard Deviation 2.91
Pulmonary Safety for CVT-301 Change From Baseline for (FEV1/FVC).
TV5 (Week 36)
-0.3 Ratio %
Standard Deviation 2.75
-0.3 Ratio %
Standard Deviation 3.02
Pulmonary Safety for CVT-301 Change From Baseline for (FEV1/FVC).
TV6 (Week 52)
-0.2 Ratio %
Standard Deviation 3.36
-0.7 Ratio %
Standard Deviation 3.51

SECONDARY outcome

Timeframe: At Treatment Visit - TV6 (Week 52)

Population: ITT (Intent-to-Treat) Population

Count of patients achieving resolution of an OFF to an ON state within 60 minutes after study drug is administered in the clinic, and maintaining the ON state at 60 minutes after study drug administration (per the examiner's subjective assessment).

Outcome measures

Outcome measures
Measure
CVT-301 DL1
n=144 Participants
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day.
CVT-301 DL2
n=153 Participants
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day.
Count of Patients Achieving Resolution of an OFF to an ON State Within 60 Minutes.
78 Participants
92 Participants

SECONDARY outcome

Timeframe: Change from baseline through 12 months duration of outpatient use

Population: ITT - (Intent-to-Treat) Population. Patients who discontinue the study prior to a treatment visit are not included in the analysis for that treatment visit. Therefore, the number of patients decreases with each successive treatment visit.

Patient reported total daily OFF time and was assessed by the patient and recorded in the patient Diary. An "OFF state" is defined as the time when medication is not providing benefit with respect to mobility, slowness, and stiffness. OFF episodes may be heralded by non-motor symptoms (e.g., pain, anxiety) prior to the appearance of motor symptoms. Patients will record their ON and OFF states in their diaries at home.

Outcome measures

Outcome measures
Measure
CVT-301 DL1
n=144 Participants
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day.
CVT-301 DL2
n=153 Participants
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day.
Change From Baseline in OFF Time.
TV2 (Week 4)
-0.33 Hours
Standard Error 0.221
-0.55 Hours
Standard Error 0.217
Change From Baseline in OFF Time.
TV3 (Week 12)
-0.23 Hours
Standard Error 0.232
-0.38 Hours
Standard Error 0.227
Change From Baseline in OFF Time.
TV4 (Week 24)
-0.65 Hours
Standard Error 0.235
-0.73 Hours
Standard Error 0.227
Change From Baseline in OFF Time.
TV5 (Week 36)
-0.49 Hours
Standard Error 0.238
-0.92 Hours
Standard Error 0.230
Change From Baseline in OFF Time.
TV6 (Week 52)
-0.70 Hours
Standard Error 0.239
-0.88 Hours
Standard Error 0.229

Adverse Events

CVT-301 Low Dose

Serious events: 22 serious events
Other events: 81 other events
Deaths: 0 deaths

CVT-301 HIgh Dose

Serious events: 13 serious events
Other events: 69 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
CVT-301 Low Dose
n=153 participants at risk
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day for OFF episodes for 12 months duration.
CVT-301 HIgh Dose
n=159 participants at risk
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day for OFF episodes for 12 months duration.
Injury, poisoning and procedural complications
Hip fracture
1.3%
2/153 • Number of events 2 • 12-month period
0.00%
0/159 • 12-month period
Injury, poisoning and procedural complications
Radius fracture
0.65%
1/153 • Number of events 1 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Injury, poisoning and procedural complications
Concussion
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Injury, poisoning and procedural complications
Fall
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Injury, poisoning and procedural complications
Femoral neck fracture
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Injury, poisoning and procedural complications
Rib fracture
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Injury, poisoning and procedural complications
Wound dehiscence
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Musculoskeletal and connective tissue disorders
Osteoarthritis
2.0%
3/153 • Number of events 3 • 12-month period
0.00%
0/159 • 12-month period
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion
0.65%
1/153 • Number of events 1 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Musculoskeletal and connective tissue disorders
Intervertebral disc degeneration
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Musculoskeletal and connective tissue disorders
Osteoporotic fracture
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Musculoskeletal and connective tissue disorders
Spinal column stenosis
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Cardiac disorders
Angina pectoris
1.3%
2/153 • Number of events 2 • 12-month period
0.00%
0/159 • 12-month period
Cardiac disorders
Atrial fibrillation
0.65%
1/153 • Number of events 1 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Cardiac disorders
Mycardial infarction
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Cardiac disorders
Sinus node dysfunction
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Gastrointestinal disorders
Dysphagia
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Gastrointestinal disorders
Gastrointestinal haemorrhage
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Gastrointestinal disorders
Gastrooesophageal reflux disease
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Gastrointestinal disorders
Inguinal hernia
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Gastrointestinal disorders
Intestinal obstruction
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Gastrointestinal disorders
Megacolon
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Gastrointestinal disorders
Naseau
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Gastrointestinal disorders
Oesophageal achalasia
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Gastrointestinal disorders
Pancreatitis
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Gastrointestinal disorders
Vomititng
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Infections and infestations
Clostridium difficile infection
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Infections and infestations
Hepatitis C
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Infections and infestations
Necrotising soft tissue infection
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Infections and infestations
Pneumonia
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Infections and infestations
Urinary tract infection
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Nervous system disorders
Central nervous system lesion
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Nervous system disorders
Metabolic encephalopathy
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Nervous system disorders
Parkinson's disease
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Nervous system disorders
Presyncope
0.65%
1/153 • Number of events 2 • 12-month period
0.00%
0/159 • 12-month period
Respiratory, thoracic and mediastinal disorders
Dyspnoea
1.3%
2/153 • Number of events 2 • 12-month period
0.00%
0/159 • 12-month period
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
General disorders
Chest pain
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
General disorders
Oedema peripheral
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Prostrate cancer
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Prostrate cancer metastatic
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Endocrine disorders
Goitre
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Metabolism and nutrition disorders
Dehydration
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Product Issues
Device connection tissue
0.65%
1/153 • Number of events 1 • 12-month period
0.00%
0/159 • 12-month period
Psychiatric disorders
Impulse-control disorder
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Psychiatric disorders
Suicide threat
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period
Surgical and medical procedures
Bone graft
0.00%
0/153 • 12-month period
0.63%
1/159 • Number of events 1 • 12-month period

Other adverse events

Other adverse events
Measure
CVT-301 Low Dose
n=153 participants at risk
60 mg (two capsules of 30 mg each) of Levodopa Inhalational Powder (LIP) up to 5 times a day for OFF episodes for 12 months duration.
CVT-301 HIgh Dose
n=159 participants at risk
84 mg (two capsules of 42 mg each) of Levodopa inhalation powder (LIP) up to 5 times a day for OFF episodes for 12 months duration.
Respiratory, thoracic and mediastinal disorders
Cough
16.3%
25/153 • Number of events 28 • 12-month period
14.5%
23/159 • Number of events 27 • 12-month period
Injury, poisoning and procedural complications
Fall
15.7%
24/153 • Number of events 26 • 12-month period
10.7%
17/159 • Number of events 22 • 12-month period
Infections and infestations
Upper respiratory tract infection
6.5%
10/153 • Number of events 10 • 12-month period
7.5%
12/159 • Number of events 13 • 12-month period
Infections and infestations
Nasopharyngitis
5.2%
8/153 • Number of events 8 • 12-month period
2.5%
4/159 • Number of events 5 • 12-month period
Nervous system disorders
Dyskinesia
3.9%
6/153 • Number of events 6 • 12-month period
6.3%
10/159 • Number of events 11 • 12-month period
Musculoskeletal and connective tissue disorders
Back pain
5.2%
8/153 • Number of events 9 • 12-month period
1.9%
3/159 • Number of events 4 • 12-month period

Additional Information

Dr. Charles Oh, Senior Vice President - Clinical Development

Acorda Therapeutics

Phone: 914-326-5455

Results disclosure agreements

  • Principal investigator is a sponsor employee The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding the study results for a period up to 30 days from the date the communication is submitted to the sponsor. The sponsor shall have the right to defer proposed publication an additional 60 days from the end of the review period. The sponsor cannot require changes to the communication and cannot unilaterally extend the embargo.
  • Publication restrictions are in place

Restriction type: OTHER