A Study to Assess the Safety and Efficacy of the of the Gastric-retentive AP-CD/LD in Advanced Parkinson's Patients

NCT ID: NCT02605434

Last Updated: 2019-08-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-03-31

Study Completion Date

2019-12-31

Brief Summary

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The purpose of this study is to determine whether the gastric retentive Accordion Pill™ Carbidopa/Levodopa (AP-CD/LD) is more effective than the commercially available immediate release Carbidopa/Levodopa in reducing motor fluctuations such as "off time" in advanced Parkinson's Disease patients.

Detailed Description

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A multi-center, global, randomized, double-blind, double-dummy, active-controlled, parallel-group study in adult subjects with fluctuating PD. The study will have 2 open label Titration periods of 6 weeks each prior to the double blind Maintenance period. In the open label periods all patients will be stabilized on the active comparator Sinemet® and then on AP-CD/LD. The double blind Maintenance period will be 13 weeks long.

Conditions

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Parkinson's Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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AP-CD/LD

Accordion Pill™ Carbidopa/Levodopa Capsule 50/400mg , b.i.d or t.i.d or Accordion Pill™ Carbidopa/Levodopa Capsule 50/500mg , b.i.d or t.i.d and Placebo IR Carbidopa/ levodopa

Group Type EXPERIMENTAL

Accordion Pill™ Carbidopa/Levodopa

Intervention Type DRUG

AP-CD/LD capsule containing 50 mg carbidopa with 400 mg or 500 mg levodopa administered orally twice or 3 times a day

Placebo -AP-CD/LD

Intervention Type DRUG

Placebo for AP-CD/LD capsule

SINEMET®

IR Carbidopa/ levodopa tablets 25/100 mg at least 4 times a day and placebo AP-CD/LD

Group Type ACTIVE_COMPARATOR

Sinemet®

Intervention Type DRUG

Sinemet® tables containing carbidopa and levodopa 25/100 mg will be administered orally at least 4 times a day according to patients need

Placebo- Sinemet

Intervention Type DRUG

Placebo for Sinemet tables

Interventions

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Accordion Pill™ Carbidopa/Levodopa

AP-CD/LD capsule containing 50 mg carbidopa with 400 mg or 500 mg levodopa administered orally twice or 3 times a day

Intervention Type DRUG

Sinemet®

Sinemet® tables containing carbidopa and levodopa 25/100 mg will be administered orally at least 4 times a day according to patients need

Intervention Type DRUG

Placebo -AP-CD/LD

Placebo for AP-CD/LD capsule

Intervention Type DRUG

Placebo- Sinemet

Placebo for Sinemet tables

Intervention Type DRUG

Other Intervention Names

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AP-CD/LD IR Carbidopa/Levodopa

Eligibility Criteria

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Inclusion Criteria

1. Subjects must be approved for suitability by an Enrollment Approval Committee
2. Able and willing to give written (signed and dated) informed consent and adhere to visit schedule and available to complete the study
3. Men or women 30 years of age and higher at initial screening assessment. (For the 100 subjects who enter the Gastroscopy sub study, the age limits are 30-80 years of age, inclusive, at initial screening assessment)
4. Diagnosed with Parkinson's disease, consistent with UK brain bank criteria
5. Has a good response to Levodopa and is taking at least 4 doses of a Levodopa containing medication (or 3 doses of Rytary) per day during waking hours (not including nighttime long acting levodopa) at a stable dose for at least 28 days prior to initial screening assessment
6. Other Anti-PD treatment (such as dopamine agonists, selective MAO-B inhibitors, anticholinergic agents or Amantadine) are permitted if stable for at least 28 days prior to study entry and provided they are not anticipated to be changed during the course of the study
7. Total LD immediate release daily dose of 400 mg to 1300 mg or equivalent prior to initial screening assessment. Specifically for Rytary, doses up to 1755 mg daily are acceptable.
8. Able to complete a Hauser Home Diary and can tell the difference between "On" and "Off" time

1. Achieved at least 75% diary concordance with an approved site rater in a 4-hour training session including at least one "Off time" assessment
2. Returned a valid 2-day practice diary after training has been completed.
9. At least 2.5 hours "Off time" per day during waking hours on Screening 2-day Practice Hauser Home Diary (morning akinesia should be incorporated into the total "Off time" assessment).
10. Other than PD, the subject is in satisfactory health, as assessed by physical examination and screening tests. No clinically significant medical, psychiatric or laboratory abnormality that could compromise safety or interfere with study procedures in the opinion of either the investigator or the Enrollment Approval Committee/Sponsor.
11. Living in an area that is within 3 hours driving distance from the study site or is willing to stay in such a place the night before each study visit

Exclusion Criteria

1. Participation in another drug clinical trial within 28 days prior to initial screening assessment (calculated from the previous study's last dosing date)
2. Atypical Parkinsonism (subjects with Parkinsonian features caused by disorder such as multiple system atrophy, progressive supranuclear palsy, dementia with Lewy bodies or multiple brain infarcts)
3. Clinically significant cardiac, pulmonary, hepatic or renal disease or other condition or any major complication/illness which contraindicates his/her participation in the opinion of either the investigator or the Enrollment Approval Committee/Sponsor.
4. Severe dyskinesia in the opinion of either the investigator or the Enrollment Approval Committee.
5. Treatment with non-selective monoamine oxidase (MAO) inhibitors during the last 28 days prior to initial screening assessment or planning to take during study participation
6. Previous or planned neurosurgical treatment for Parkinson's Disease (e.g., procedures including ablation or deep brain stimulation) during the course of the study
7. Significant cognitive impairment as defined by the Mini-Mental State Examination (MMSE) score \< 26.
8. Clinically significant psychiatric illness, including major depression (Hamilton Depression Rating Scale-17 ≥14). Subjects with a lifetime history of suicidal attempt (including an active attempt, interrupted attempt or aborted attempt)
9. Current or previous treatment for more than 1 month within the past 2 years with any neuroleptic drug (antipsychotic) or any other drug with anti-dopaminergic properties (e.g. metoclopramide, domperidone)
10. Currently experiencing or any known history of psychosis or delusions within 2 years prior to Screening.
11. Known history of substance abuse within the past 2 years
12. Moderate or greater level of alcohol consumption
13. Unable to swallow large pills (e.g., large vitamin pills)
14. History of Melanoma or suspicious skin lesion which could be a Melanoma
15. Narrow-angle Glaucoma
16. History of small bowel or gastric surgery (Including PEG-J placement for Duopa/Duodopa) or bowel obstruction, diagnosis of small bowel narrowing, diagnosis of Crohn's disease, or frequent nausea or emesis, regardless of etiology, (Previous appendectomy or hernioplasty will not be exclusionary).
17. Active peptic ulcer disease or a history of peptic ulcer or upper GI bleeding
18. Regular use of opioids (Intermittent opioid use is not exclusionary)
19. Symptomatic gastroparesis with frequent vomiting (at least once a week)
20. Concomitant use of NSAIDs and oral steroids within the past 28 days
21. Allergy to the study drug or any of its excipients, or to Yellow Dye #5 (tartrazine)
22. Women who are pregnant or nursing. Women of childbearing potential who are not willing to use a medically acceptable method of contraception.
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Intec Pharma Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter A LeWitt, MD

Role: PRINCIPAL_INVESTIGATOR

Henry Ford Hospital - West Bloomfield

Locations

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University Alabama Hospital Neurology

Birmingham, Alabama, United States

Site Status

Saint Joseph's Hospital and Medical Center Muhammad Ali Parkinson Research Center

Phoenix, Arizona, United States

Site Status

Parkinson's Disease & Movement Disorders Center, Dept of Neu

Fountain Valley, California, United States

Site Status

Loma Linda University Medical Center

Loma Linda, California, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

SC3 Research

Pasadena, California, United States

Site Status

SC3 Research

Reseda, California, United States

Site Status

UC Davis Medical Center

Sacramento, California, United States

Site Status

University of Colorado Dept. of Neurology

Aurora, Colorado, United States

Site Status

Hartford HealthCare

Vernon, Connecticut, United States

Site Status

Parkinson's Disease and Movement Disorders Center of Boca Raton

Boca Raton, Florida, United States

Site Status

Collier Neurologic Specialists, LLC

Naples, Florida, United States

Site Status

Bioclinica Research

Orlando, Florida, United States

Site Status

Parkinson's Disease and Movement Disorders Center

Tampa, Florida, United States

Site Status

Rush University Medical Center

Chicago, Illinois, United States

Site Status

The University of Kansas Hospital

Kansas City, Kansas, United States

Site Status

Boston University School of Medicine

Boston, Massachusetts, United States

Site Status

Michigan State University

East Lansing, Michigan, United States

Site Status

Quest Research Institute

Farmington Hills, Michigan, United States

Site Status

Henry Ford Hospital

West Bloomfield, Michigan, United States

Site Status

Dartmouth Hitchcock Neurology

Lebanon, New Hampshire, United States

Site Status

Atlantic Health System Hospital Corp.-Overlook Hospital

Summit, New Jersey, United States

Site Status

David L. Kreitzman, MD., PC

Commack, New York, United States

Site Status

Fresco Institute for Parkinson's and Movement Disorders

New York, New York, United States

Site Status

Weill Cornell Medical College of Cornell University

New York, New York, United States

Site Status

Asheville Neurology Specialists

Asheville, North Carolina, United States

Site Status

University of Cincinnati

Cincinnati, Ohio, United States

Site Status

University of Toledo

Toledo, Ohio, United States

Site Status

The Movement Disorder Clinic of Oklahoma

Tulsa, Oklahoma, United States

Site Status

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Vanderbilt University Medical Center Vanderbilt Clinical Neurosciences

Nashville, Tennessee, United States

Site Status

North Texas Movement Disorders Institute

Bedford, Texas, United States

Site Status

Baylor College of Medicine Department of Neurology

Houston, Texas, United States

Site Status

Charlottesville Medical Research

Charlottesville, Virginia, United States

Site Status

Booth Garner Parkinson's Care Center

Kirkland, Washington, United States

Site Status

MHAT 'Sv.Pantaleymon - Pleven' OOD

Pleven, , Bulgaria

Site Status

University Multiprofile Hospital for Active Treatment "Sveti Georgi" EAD

Plovdiv, , Bulgaria

Site Status

Clinic for Neurology and Sleep Medicine

Sofia, , Bulgaria

Site Status

Clinic of Neurological Diseases

Sofia, , Bulgaria

Site Status

Multiprofile Hospital for Active Treatment "Sveta Marina'' EAD

Varna, , Bulgaria

Site Status

Neuroakademie Alzenau GbR

Aschaffenburg, , Germany

Site Status

Praxis für Neurologie und Psychiatrie

Berlin, , Germany

Site Status

Uniklinikum Carl-Gustav Carus an der TU Dresden

Dresden, , Germany

Site Status

Technischen Universitaet Muenchen (TUM) - Klinikum Rechts der Isar

München, , Germany

Site Status

Praxis für Neurologie und Psychiatrie

Westerstede, , Germany

Site Status

Rambam Medical Center

Haifa, , Israel

Site Status

Rabin Medical Center

Petah Tikva, , Israel

Site Status

Chaim Sheba Medical Center at Tel Hashomer

Ramat Gan, , Israel

Site Status

Tel Aviv Sourasky Medical Center

Tel Aviv, , Israel

Site Status

Ospedale Generale Regionale Francesco Miulli

Acquaviva delle Fonti, , Italy

Site Status

Ospedali Riuniti di Ancona

Ancona, , Italy

Site Status

Spedali Civili Di Brescia Azienda Ospedaliera

Brescia, , Italy

Site Status

Azienda Ospedaliera Universitaria Federico II

Napoli, , Italy

Site Status

IRCCS Neurologico Fondazione "C. Mondino"

Pavia, , Italy

Site Status

Azienda Ospedaliero-Universitaria Pisana

Pisa, , Italy

Site Status

IRCCS San Raffaele Pisana

Roma, , Italy

Site Status

Fondazione Policlinico Universitario Agostino Gemelli

Roma, , Italy

Site Status

Azienda Ospedaliera Universitaria San Giovanni di Dio Ruggi d'Aragona

Salerno, , Italy

Site Status

Ospedale di Circolo e Fondazione Macchi

Varese, , Italy

Site Status

Azienda Unitá Locale Socio Sanitaria 12 Veneziana - Ospedale dell'Angelo

Venezia, , Italy

Site Status

Casa di Cura Villa Margherita

Vicenza, , Italy

Site Status

Centrum Medyczne Damiana Holding

Warsaw, Masovian Voivodeship, Poland

Site Status

VITAMED Galaj i Cichomski spólka jawna

Bydgoszcz, , Poland

Site Status

Anna Kapustecka Prywatna Przychodnia Specjalistyczna STOMED

Częstochowa, , Poland

Site Status

NEURO-CARE Site Management Organization Gabriela Klodowska-Duda

Katowice, , Poland

Site Status

Centrum Medyczne Pratia Katowice I

Katowice, , Poland

Site Status

Krakowska Akademia Neurologii Sp. z o. o.

Krakow, , Poland

Site Status

Gabinet Lekarski Prof. Andrzej Bogucki

Lodz, , Poland

Site Status

Centrum Medyczne Pratia Warszawa

Warsaw, , Poland

Site Status

Neurologicka ambulancia, Euro-Neuro s.r.o.

Bratislava, , Slovakia

Site Status

KONZÍLIUM s.r.o.

Považská Bystrica, , Slovakia

Site Status

NEURON - D.T. s.r.o.

Žilina, , Slovakia

Site Status

HM Puerta del Sur

Móstoles, Madrid, Spain

Site Status

Hospital Universitari Quirón Dexeus

Barcelona, , Spain

Site Status

Hospital Universitari Vall D'Hebron

Barcelona, , Spain

Site Status

Hospital Clinic i Provincial de Barcelona

Barcelona, , Spain

Site Status

Hospital Universitario La Princesa

Madrid, , Spain

Site Status

Hospital General Universitario Gregorio Marañon

Madrid, , Spain

Site Status

Hospital Ruber Internacional

Madrid, , Spain

Site Status

Hospital Puerta de Hierro Majadahonda

Majadahonda, , Spain

Site Status

Hospital Infanta Sofía

San Sebastián de los Reyes, , Spain

Site Status

Hospital General de Cataluña

Sant Cugat del Vallès, , Spain

Site Status

Ukrainian State Scientific Research Institution of Medical and Social Problems of Disability

Cherkasy, , Ukraine

Site Status

Dnipropetrovsk medical academy MOH of Ukraine

Dnipro, , Ukraine

Site Status

Institute of Neurology, Psychiatry and Narcology of NAMS of Ukraine

Kharkiv, , Ukraine

Site Status

State Institution "Institute of Gerontology of the AMS of Ukraine"

Kyiv, , Ukraine

Site Status

Lviv City Clinical Hospital

Lviv, , Ukraine

Site Status

Regional Clinical Hospital n.a. N.V. Sklifosovskyi

Poltava, , Ukraine

Site Status

Municipal Institution "Zaporizhzhya City Clinical Multidisciplinary Hospital #9"

Zaporizhzhya, , Ukraine

Site Status

Municipal Institution 6¿ City Clinical Hospital

Zaporizhzhya, , Ukraine

Site Status

Clinical Hospital #2

Zaporozh’ye, , Ukraine

Site Status

Municipal Institution Zaporizhzhia Regional Clinical Hospital of Zaporizhzhia Regional Council

Zaporozh’ye, , Ukraine

Site Status

Fairfield General Hospital

Bury, , United Kingdom

Site Status

Newcastle University Clinical Ageing Research

Newcastle upon Tyne, , United Kingdom

Site Status

Queens Medical Centre Nottingham, University Hospital

Nottingham, , United Kingdom

Site Status

University Hospitals of North Midlands NHS Trust

Stoke-on-Trent, , United Kingdom

Site Status

Countries

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United States Bulgaria Germany Israel Italy Poland Slovakia Spain Ukraine United Kingdom

References

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McFarthing K, Prakash N, Simuni T. CLINICAL TRIAL HIGHLIGHTS: 1. GENE THERAPY FOR PARKINSON'S, 2. PHASE 3 STUDY IN FOCUS - INTEC PHARMA'S ACCORDION PILL, 3. CLINICAL TRIALS RESOURCES. J Parkinsons Dis. 2019;9(2):251-264. doi: 10.3233/JPD-199001. No abstract available.

Reference Type DERIVED
PMID: 31127735 (View on PubMed)

Other Identifiers

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IN 11 004

Identifier Type: -

Identifier Source: org_study_id

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