Trial Outcomes & Findings for COmedication Study Assessing Mono- and cOmbination Therapy With Levodopa-carbidopa inteStinal Gel (NCT NCT03362879)

NCT ID: NCT03362879

Last Updated: 2020-01-06

Results Overview

The percentage of participants on LCIG monotherapy from immediately following LCIG initiation to 12 months. LCIG monotherapy means that the participant is not on any add-on Parkinson's (PD) medication/PD therapy at the respective time point (monotherapy 1) or that the participant is allowed to take an add-on PD medication/PD therapy at the respective time point but only in the evening after the LCIG infusion is completed (monotherapy 2).

Recruitment status

COMPLETED

Target enrollment

412 participants

Primary outcome timeframe

12 months

Results posted on

2020-01-06

Participant Flow

In total, 412 participants were enrolled in the study and 409 of these participants fulfilled all inclusion and none of the exclusion criteria and, thus, were included in the full analysis set.

Participant milestones

Participant milestones
Measure
Participants With Advanced Parkinson's Disease
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Overall Study
STARTED
409
Overall Study
COMPLETED
409
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

COmedication Study Assessing Mono- and cOmbination Therapy With Levodopa-carbidopa inteStinal Gel

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Age, Continuous
69.1 years
STANDARD_DEVIATION 7.9 • n=93 Participants
Sex: Female, Male
Female
142 Participants
n=93 Participants
Sex: Female, Male
Male
267 Participants
n=93 Participants
Race/Ethnicity, Customized
White
405 Participants
n=93 Participants
Race/Ethnicity, Customized
Asian
2 Participants
n=93 Participants
Race/Ethnicity, Customized
Other
2 Participants
n=93 Participants

PRIMARY outcome

Timeframe: 12 months

Population: Full analysis set (FAS): Participants that fulfilled all inclusion and none of the exclusion criteria.

The percentage of participants on LCIG monotherapy from immediately following LCIG initiation to 12 months. LCIG monotherapy means that the participant is not on any add-on Parkinson's (PD) medication/PD therapy at the respective time point (monotherapy 1) or that the participant is allowed to take an add-on PD medication/PD therapy at the respective time point but only in the evening after the LCIG infusion is completed (monotherapy 2).

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Percentage of Participants on Levodopa-Carbidopa Intestinal Gel (LCIG) Monotherapy From LCIG Initiation to 12 Months
Monotherapy 1
29.3 percentage of participants
Percentage of Participants on Levodopa-Carbidopa Intestinal Gel (LCIG) Monotherapy From LCIG Initiation to 12 Months
Monotherapy 2
52.3 percentage of participants

SECONDARY outcome

Timeframe: 12 months

Population: FAS of participants starting add-on medication

LCIG monotherapy means that the participant is not on any add-on PD medication/PD therapy at the respective time point (monotherapy 1) or that the participant is allowed to take an add-on PD medication/PD therapy at the respective time point but only in the evening after the LCIG infusion is completed (monotherapy 2). PD medications were captured by time point and category from the initiation of LCIG therapy until the introduction of each add-on PD medication taken. Categories included levodopa, catechol-O-methyltransferase (COMT) inhibitors,dopamine agonist (excluding apomorphine), monoamine oxidase (MAO) inhibitor, n-methyl-d-aspartate receptor (NMDA) antagonist, apomorphine, anticholinergics, surgical therapy, or other. Participants may have initiated more than one PD medication or category.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=260 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Levodopa/carbidopa
35.0 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Levodopa/benserazide
23.8 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Levodopa/carbidopa/entacapone
7.3 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Pramipexole
15.4 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Rotigotine
13.8 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Ropinirole
11.5 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Rasagiline
15.4 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Safinamide
0.8 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Selegiline
0.8 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Amantadine
16.9 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Other
5.0 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Anticholinergics
2.7 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Deep brain stimulation
1.2 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Pallidotomy
0.4 percentage of participants
Percentage of Participants Starting Add-On PD Medication Within 12 Months of LCIG Monotherapy Initiation
Entacapone
1.2 percentage of participants

SECONDARY outcome

Timeframe: 12 months

Population: FAS and only participants with non-missing data.

Physicians were asked to document the LCIG infusion details at 12 months after LCIG initiation, including the total daily dose. Total dose per day was calculated as morning dose + continuous dose x duration of infusion + extra dose. Abbreviations: ml = milliliters.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=377 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Total Daily Dose (in Milliliters) of LCIG Infusion at 12 Months After LCIG Initiation
69.2 total LCIG dose per day (ml)
Standard Deviation 26.0

SECONDARY outcome

Timeframe: 12 months

Population: FAS

The HCRU questionnaire is used to assess healthcare resource utilization. Participants were asked about their occupational status (primary occupation), caregiver support (change in amount of caregiver help needed with daily activities/home care), and participant´s opinion on Parkinson's disease medication (number of pills in addition to LCIG the participant was willing to take each day). Physicians were asked to report details regarding participant visits and hospital admissions in the 12 months prior to the study visit.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Healthcare Resource Utilization (HCRU): Primary Occupation by Number of Participants
Retired
372 participants
Healthcare Resource Utilization (HCRU): Primary Occupation by Number of Participants
On sick leave
6 participants
Healthcare Resource Utilization (HCRU): Primary Occupation by Number of Participants
Unemployed
16 participants
Healthcare Resource Utilization (HCRU): Primary Occupation by Number of Participants
Working full time
5 participants
Healthcare Resource Utilization (HCRU): Primary Occupation by Number of Participants
Working part-time
10 participants

SECONDARY outcome

Timeframe: 12 months

Population: FAS

The HCRU questionnaire is used to assess healthcare resource utilization. Participants were asked about their occupational status (primary occupation), caregiver support (change in amount of caregiver help needed with daily activities/home care), and participant´s opinion on Parkinson's disease medication (number of pills in addition to LCIG the participant was willing to take each day). Physicians were asked to report details regarding participant visits and hospital admissions in the 12 months prior to the study visit.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
HCRU: Caregiver Support by Number of Participants
Less help with daily activities or home care
160 participants
HCRU: Caregiver Support by Number of Participants
More help with daily activities or home care
83 participants
HCRU: Caregiver Support by Number of Participants
About same amount help daily activities/home care
96 participants
HCRU: Caregiver Support by Number of Participants
Patient does not remember
5 participants
HCRU: Caregiver Support by Number of Participants
Patient does not require any help
65 participants

SECONDARY outcome

Timeframe: 12 months

Population: Number of physicians stating LCIG as monotherapy is their overall treatment preference.

The overall preference for treatment using LCIG as monotherapy compared with LCIG plus add-on PD medication, as stated by the physician.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=56 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Percentage of Physicians With Overall Preference for LCIG Monotherapy
LCIG as monotherapy
71.4 percentage of physicians
Percentage of Physicians With Overall Preference for LCIG Monotherapy
LCIG plus add-on PD medication
28.6 percentage of physicians

SECONDARY outcome

Timeframe: 12 months

Population: FAS

LCIG monotherapy 1 means that the participant is not on any add-on Parkinson's (PD) medication/PD therapy at the respective time point. The influence of predefined variables was evaluated using multivariable logistic regression models. The target variables were analyzed using two different sets of potential predictors: one set containing participant data and one set containing site and physician data.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Predictors for Monotherapy (Participant Data): Forward Selection for Monotherapy 1 (12 Months After LCIG Initiation)
Number of motor symptoms
0.842 odds ratio estimate
Interval 0.751 to 0.944
Predictors for Monotherapy (Participant Data): Forward Selection for Monotherapy 1 (12 Months After LCIG Initiation)
Any dopamine agonists in the past Yes
1.564 odds ratio estimate
Interval 0.999 to 2.45
Predictors for Monotherapy (Participant Data): Forward Selection for Monotherapy 1 (12 Months After LCIG Initiation)
Gross National Income
0.974 odds ratio estimate
Interval 0.957 to 0.991

SECONDARY outcome

Timeframe: 12 months

Population: FAS

LCIG monotherapy 1 means that the participant is not on any add-on Parkinson's (PD) medication/PD therapy at the respective time point. The influence of predefined variables was evaluated using multivariable logistic regression models. The target variables were analyzed using two different sets of potential predictors: one set containing participant data and one set containing site and physician data. Physician data in table shown as "average frequency of routine visits" includes average frequency of routine visits for advanced Parkinson's disease (APD) participants on device aided therapy ≥3x/years.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Predictors for Monotherapy (Physician Data): Forward Selection for Monotherapy 1 (12 Months After LCIG Initiation)
Average frequency of routine visits
2.760 odds ratio estimate
Interval 1.504 to 5.066
Predictors for Monotherapy (Physician Data): Forward Selection for Monotherapy 1 (12 Months After LCIG Initiation)
Average number of PD and APD participants per year
1.000 odds ratio estimate
Interval 0.999 to 1.0

SECONDARY outcome

Timeframe: 12 months

Population: FAS participants who reached the respective monotherapy (monotherapy 1 or monotherapy 2)

LCIG monotherapy means that the participant is not on any add-on PD medication/PD therapy at the respective time point (monotherapy 1) or that the participant is allowed to take an add-on PD medication/PD therapy at the respective time point but only in the evening after the LCIG infusion is completed (monotherapy 2). Duration of LCIG monotherapy was calculated for all participants who reached the respective monotherapy as time from LCIG initiation until LCIG is given as a monotherapy (separately for monotherapy 1 and monotherapy 2 definition).

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Duration (Days) of LCIG Monotherapy 1 or Monotherapy 2
Duration of LCIG monotherapy 1
932.6 days
Standard Deviation 621.5
Duration (Days) of LCIG Monotherapy 1 or Monotherapy 2
Duration of LCIG monotherapy 2
945.1 days
Standard Deviation 645.7

SECONDARY outcome

Timeframe: 12 months

Population: FAS that includes only participants with substantial dose adjustments by each country that had participants meeting these criteria

Time for substantial change was determined as the time from LCIG initiation until the first substantial dose change in days 12 months after LCIG initiation. A substantial change was defined as a change of at least 20% compared to the LCIG dose at LCIG initiation.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Austria
111.7 days
Standard Deviation 80.6
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Canada
283.2 days
Standard Deviation 181.0
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Czech Republic
298.9 days
Standard Deviation 770.1
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Hungary
387.4 days
Standard Deviation 446.7
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Israel
343.2 days
Standard Deviation 423.7
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Romania
460.8 days
Standard Deviation 501.8
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Spain
534.9 days
Standard Deviation 750.1
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustments by Country
Sweden
394.7 days
Standard Deviation 463.5

SECONDARY outcome

Timeframe: 12 months

Population: FAS that includes only participants with substantial dose adjustments

Time for substantial change was determined as the time from LCIG initiation until the first substantial dose change in days 12 months after LCIG initiation. A substantial change was defined as a change of at least 20% compared to the LCIG dose at LCIG initiation.

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=122 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Time (Days) From Initial LCIG Administration to Substantial Dose Adjustment
409.2 days
Standard Deviation 555.5

SECONDARY outcome

Timeframe: 12 months

Population: FAS

Time (in days) from LCIG initiation until monotherapy was calculated for those participants who were not on monotherapy (i.e., needed additional PD medication during LCIG infusion) at LCIG initiation, but reached monotherapy during the study. LCIG monotherapy means that the participant is not on any add-on PD medication/PD therapy at the respective time point (monotherapy 1) or that the participant is allowed to take an add-on PD medication/PD therapy at the respective time point but only in the evening after the LCIG infusion is completed (monotherapy 2).

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Days From Initial LCIG Administration to the Initiation of LCIG Monotherapy
Until Monotherapy 1
89.5 days
Standard Deviation 220.9
Days From Initial LCIG Administration to the Initiation of LCIG Monotherapy
Until Monotherapy 2
70.4 days
Standard Deviation 240.1

SECONDARY outcome

Timeframe: 12 months

Population: FAS

LCIG monotherapy means that the participant is not on any add-on PD medication/PD therapy at the respective time point (monotherapy 1). The number of days for tapering process is the number of days between maximum and minimum daily dose; participants with minimum (or maximum, respectively) daily dose not at the end of the tapering process were checked. A maximum duration of approximately 2 months of the tapering process was allowed (otherwise the tapering process was set to missing).

Outcome measures

Outcome measures
Measure
Participants With Advanced Parkinson's Disease
n=409 Participants
Participants with advanced Parkinson's disease on current treatment with levodopa-carbidopa intestinal gel (LCIG) for at least 12 months.
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Levodopa/carbidopa
21.3 days
Standard Deviation 13.6
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Levodopa/benserazide
34.0 days
Standard Deviation 11.3
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Levodopa/carbidopa/entacapone
21.0 days
Standard Deviation 17.5
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Entacapone
9.0 days
Standard Deviation 7.0
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Pramipexole
34.3 days
Standard Deviation 26.5
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Ropinirole
24.0 days
Standard Deviation 2.8
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Rotigotine
6.0 days
Standard Deviation NA
Standard deviation not calculated due to insufficient number of participants analyzed.
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Safinamide
32.0 days
Standard Deviation NA
Standard deviation not calculated due to insufficient number of participants analyzed.
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Rasagiline
57.0 days
Standard Deviation NA
Standard deviation not calculated due to insufficient number of participants analyzed.
Tapering Duration (Days) From Initial LCIG Administration of Each PD Medication
Amantadine
34.3 days
Standard Deviation 25.1

Adverse Events

Participants With Advanced Parkinson's Disease

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

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Global Medical Services

AbbVie

Phone: 800-633-9110

Results disclosure agreements

  • Principal investigator is a sponsor employee AbbVie requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. AbbVie requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if AbbVie needs to secure patent or proprietary protection.
  • Publication restrictions are in place

Restriction type: OTHER