Trial Outcomes & Findings for Therapeutic Potential for Intranasal Levodopa in Parkinson's Disease -Off Reversal (NCT NCT03541356)

NCT ID: NCT03541356

Last Updated: 2020-08-12

Results Overview

Assessment of treatment emergent adverse events after single dosing with INP103 (L-dopa or L-dopa/carbidopa)

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

32 participants

Primary outcome timeframe

7 days

Results posted on

2020-08-12

Participant Flow

Parkinson's disease patients at movement disorder clinics in Australia

Confirmation of L-dopa responsiveness at Visit 2, prior to randomization

Participant milestones

Participant milestones
Measure
Placebo
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Overall Study
STARTED
8
6
6
6
6
Overall Study
COMPLETED
8
6
6
6
6
Overall Study
NOT COMPLETED
0
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Therapeutic Potential for Intranasal Levodopa in Parkinson's Disease -Off Reversal

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Total
n=32 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
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
n=5 Participants
3 Participants
n=7 Participants
1 Participants
n=5 Participants
3 Participants
n=4 Participants
5 Participants
n=21 Participants
18 Participants
n=10 Participants
Age, Categorical
>=65 years
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
3 Participants
n=4 Participants
1 Participants
n=21 Participants
14 Participants
n=10 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
2 Participants
n=4 Participants
3 Participants
n=21 Participants
12 Participants
n=10 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
4 Participants
n=7 Participants
4 Participants
n=5 Participants
4 Participants
n=4 Participants
3 Participants
n=21 Participants
20 Participants
n=10 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
8 Participants
n=5 Participants
6 Participants
n=7 Participants
6 Participants
n=5 Participants
6 Participants
n=4 Participants
6 Participants
n=21 Participants
32 Participants
n=10 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
4 Participants
n=10 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
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Race (NIH/OMB)
White
6 Participants
n=5 Participants
4 Participants
n=7 Participants
6 Participants
n=5 Participants
6 Participants
n=4 Participants
6 Participants
n=21 Participants
28 Participants
n=10 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=10 Participants
Region of Enrollment
Australia
8 participants
n=5 Participants
6 participants
n=7 Participants
6 participants
n=5 Participants
6 participants
n=4 Participants
6 participants
n=21 Participants
32 participants
n=10 Participants

PRIMARY outcome

Timeframe: 7 days

Assessment of treatment emergent adverse events after single dosing with INP103 (L-dopa or L-dopa/carbidopa)

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Number of Participants With Treatment Emergent Adverse Events
5 Participants
5 Participants
3 Participants
4 Participants
5 Participants

SECONDARY outcome

Timeframe: For L-dopa 35 mg, 70 mg, 140 mg plasma samples were taken at pre-dose, 30, 60, 90 and 120 minutes post-dose. For L-dopa 70 mg/carbidopa 7 mg, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 min

Population: Subjects who received L-dopa or L-dopa/carbidopa. Placebo subjects therefore not included.

Area under the Plasma Concentration-time Curve for L-dopa from Time = 0 to Time = 2 hours post dose. For the L-dopa 35 mg, L-dopa 70 mg, L-dopa 140 mg plasma samples were taken at pre-dose, 30, 60, 90 and 120 minutes post-dose. For the L-dopa 70 mg/carbidopa 7 mg treatment arm, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose.

Outcome measures

Outcome measures
Measure
Placebo
n=6 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
AUC0-2hr for L-dopa
240.71 hours*ng/mL
Standard Deviation 117.819
463.49 hours*ng/mL
Standard Deviation 260.093
725.29 hours*ng/mL
Standard Deviation 456.566
552.75 hours*ng/mL
Standard Deviation 177.979

SECONDARY outcome

Timeframe: For L-dopa 35 mg, 70 mg, 140 mg plasma samples were taken at pre-dose, 30, 60, 90 and 120 minutes post-dose. For L-dopa 70 mg/carbidopa 7 mg, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose.

Population: Subjects who received L-dopa. Placebo subjects not included.

Maximum Observed Plasma Concentration of L-dopa from Time = 0 to Time = 2 hours post dose. For the L-dopa 35 mg, L-dopa 70 mg, L-dopa 140 mg plasma samples were taken at pre-dose, 30, 60, 90 and 120 minutes post-dose. For the L-dopa 70 mg/carbidopa 7 mg treatment arm, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose.

Outcome measures

Outcome measures
Measure
Placebo
n=6 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Cmax of L-dopa
185.80 ng/mL
Standard Deviation 78.144
362.68 ng/mL
Standard Deviation 195.265
643.65 ng/mL
Standard Deviation 462.469
445.75 ng/mL
Standard Deviation 183.746

SECONDARY outcome

Timeframe: For L-dopa 35 mg, 70 mg, 140 mg plasma samples were taken at pre-dose, 30, 60, 90 and 120 minutes post-dose. For L-dopa 70 mg/carbidopa 7 mg, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose.

Population: Subjects who received L-dopa. Placebo subjects not included.

Time to Reach the Maximum Plasma Concentration (Cmax) of L-dopa

Outcome measures

Outcome measures
Measure
Placebo
n=6 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Tmax of L-dopa
60.17 minutes
Standard Deviation 37.950
66.00 minutes
Standard Deviation 38.735
70.00 minutes
Standard Deviation 15.505
92.00 minutes
Standard Deviation 27.481

SECONDARY outcome

Timeframe: For L-dopa 35 mg, 70 mg, 140 mg, assessment occurred at pre-dose, 15, 30, 45, 60, 90 and 120 minutes post-dose. For L-dopa 70 mg/carbidopa 7 mg, assessment occurred at pre-dose, 30, 60, 90 and 120 minutes post-dose.

Population: All participants were analyzed.

MDS-UPDRS is a clinimetric assessment of subjective and objective symptoms and signs of Parkinson's disease created by the Movement Disorder Society with high internal consistency. MDS-UPDRS retains the four-scale structure with a reorganization of the various subscales. The subscale used in this study is Part III, motor examination (18 items). The subscale has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Maximum score is 132, minimum is zero. High score means worse outcome. For the L-dopa 35 mg, L-dopa 70 mg, L-dopa 140 mg treatment groups, assessment occurred at pre-dose, 15, 30, 45, 60, 90 and 120 minutes post-dose. For the L-dopa 70 mg/carbidopa 7 mg treatment arm, assessment occurred at pre-dose, 30, 60, 90 and 120 minutes post-dose.

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Mean Change From Baseline in MDS-UPDRS Score Over 2 Hours for C1, C2, C3 and Change From Baseline at 30, 60, 90, 120 Minutes for C4, in MDS-UPDRS Part III Score
15 minutes
-3.5 score on a scale
Standard Deviation 3.89
-4.5 score on a scale
Standard Deviation 4.46
0.8 score on a scale
Standard Deviation 9.20
-9.0 score on a scale
Standard Deviation 6.16
NA score on a scale
Standard Deviation NA
Participants in this arm were not tested at this time point.
Mean Change From Baseline in MDS-UPDRS Score Over 2 Hours for C1, C2, C3 and Change From Baseline at 30, 60, 90, 120 Minutes for C4, in MDS-UPDRS Part III Score
30 minutes
-8.5 score on a scale
Standard Deviation 6.52
-6.7 score on a scale
Standard Deviation 4.89
-8.5 score on a scale
Standard Deviation 9.09
-12.7 score on a scale
Standard Deviation 7.79
-3.7 score on a scale
Standard Deviation 3.83
Mean Change From Baseline in MDS-UPDRS Score Over 2 Hours for C1, C2, C3 and Change From Baseline at 30, 60, 90, 120 Minutes for C4, in MDS-UPDRS Part III Score
45 minutes
-13.5 score on a scale
Standard Deviation 7.09
-4.7 score on a scale
Standard Deviation 4.03
-12.8 score on a scale
Standard Deviation 11.05
-13.7 score on a scale
Standard Deviation 8.91
NA score on a scale
Standard Deviation NA
Participants in this arm were not tested at this time point.
Mean Change From Baseline in MDS-UPDRS Score Over 2 Hours for C1, C2, C3 and Change From Baseline at 30, 60, 90, 120 Minutes for C4, in MDS-UPDRS Part III Score
60 minutes
-12.5 score on a scale
Standard Deviation 7.87
-6.8 score on a scale
Standard Deviation 4.54
-15.7 score on a scale
Standard Deviation 9.58
-13.5 score on a scale
Standard Deviation 8.29
-0.8 score on a scale
Standard Deviation 10.63
Mean Change From Baseline in MDS-UPDRS Score Over 2 Hours for C1, C2, C3 and Change From Baseline at 30, 60, 90, 120 Minutes for C4, in MDS-UPDRS Part III Score
90 minutes
-10.8 score on a scale
Standard Deviation 9.35
-10.3 score on a scale
Standard Deviation 13.56
-15.5 score on a scale
Standard Deviation 10.03
-9.0 score on a scale
Standard Deviation 5.76
-3.7 score on a scale
Standard Deviation 10.76
Mean Change From Baseline in MDS-UPDRS Score Over 2 Hours for C1, C2, C3 and Change From Baseline at 30, 60, 90, 120 Minutes for C4, in MDS-UPDRS Part III Score
120 minutes
-8.8 score on a scale
Standard Deviation 10.61
-11.0 score on a scale
Standard Deviation 9.47
-13.8 score on a scale
Standard Deviation 11.97
-7.2 score on a scale
Standard Deviation 9.09
-3.2 score on a scale
Standard Deviation 9.22

SECONDARY outcome

Timeframe: 2 hours

Population: All participants were analyzed.

MDS-UPDRS is a clinimetric assessment of subjective and objective symptoms and signs of Parkinson's disease created by the Movement Disorder Society with high internal consistency. MDS-UPDRS retains the four-scale structure with a reorganization of the various subscales. The subscale used in this study is Part III, motor examination (18 items). The subscale now has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe.

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Time to Response (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
45.0 minutes
Interval 35.0 to
The upper bound of the 95% CI could not be calculated due to the number of participants not achieving a response in the analysis time frame
NA minutes
Interval 40.0 to
The median and the upper bound of the 95% CI could not be calculated due to the number of participants not achieving a response in the analysis time frame
54.0 minutes
Interval 15.0 to
The upper bound of the 95% CI could not be calculated due to the number of participants not achieving a response in the analysis time frame
30.0 minutes
Interval 15.0 to
The upper bound of the 95% CI could not be calculated due to the number of participants not achieving a response in the analysis time frame
NA minutes
Interval 32.0 to
The median and the upper bound of the 95% CI could not be calculated due to the number of participants not achieving a response in the analysis time frame

SECONDARY outcome

Timeframe: From time = 0 to 2 hours post-dose

Population: All participants were analyzed.

MDS-UPDRS is a clinimetric assessment of subjective and objective symptoms and signs of Parkinson's disease created by the Movement Disorder Society with high internal consistency. MDS-UPDRS retains the four-scale structure with a reorganization of the various subscales. The subscale used in this study is Part III, motor examination (18 items). The subscale now has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe.

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Cumulative Number of Responders (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
60 minutes
6 Participants
1 Participants
4 Participants
5 Participants
2 Participants
Cumulative Number of Responders (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
15 minutes
0 Participants
0 Participants
1 Participants
2 Participants
NA Participants
Subjects in this arm were not analyzed at this time point.
Cumulative Number of Responders (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
30 minutes
3 Participants
1 Participants
1 Participants
5 Participants
1 Participants
Cumulative Number of Responders (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
45 minutes
4 Participants
1 Participants
3 Participants
5 Participants
NA Participants
Subjects in this arm were not analyzed at this time point.
Cumulative Number of Responders (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
90 minutes
6 Participants
2 Participants
5 Participants
5 Participants
3 Participants
Cumulative Number of Responders (Defined as Improvement of 30% in MDS-UPDRS Part III Score From Baseline)
120 minutes
6 Participants
2 Participants
5 Participants
5 Participants
3 Participants

SECONDARY outcome

Timeframe: For L-dopa 35 mg, 70 mg, 140 mg, assessments were made at pre-dose, 15, 30, 45, 60, 90, 120 minutes post-dose. For L-dopa 70 mg/carbidopa 7 mg, assessments were made at pre-dose, 50, 60, 90, 120 minutes post-dose.

Population: All participants were included in the analysis

MDS-UPDRS is a clinimetric assessment of subjective and objective symptoms and signs of Parkinson's disease created by the Movement Disorder Society with high internal consistency. MDS-UPDRS retains the four-scale structure with a reorganization of the various subscales. The subscale used in this study is Part III, motor examination (18 items). The subscale now has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe.

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Area Under the Curve (AUC) of Change From Baseline in MDS-UPDRS Part III Scores
15 minutes
-26.25 change in score*minutes
Standard Deviation 29.144
-33.50 change in score*minutes
Standard Deviation 33.697
7.00 change in score*minutes
Standard Deviation 69.206
-67.50 change in score*minutes
Standard Deviation 46.233
NA change in score*minutes
Standard Deviation NA
Participants in this arm were not assessed at this time point.
Area Under the Curve (AUC) of Change From Baseline in MDS-UPDRS Part III Scores
30 minutes
-237.63 change in score*minutes
Standard Deviation 276.197
-138.58 change in score*minutes
Standard Deviation 138.105
-50.50 change in score*minutes
Standard Deviation 203.053
-232.83 change in score*minutes
Standard Deviation 153.638
-230.08 change in score*minutes
Standard Deviation 250.832
Area Under the Curve (AUC) of Change From Baseline in MDS-UPDRS Part III Scores
45 minutes
-264.92 change in score*minutes
Standard Deviation 178.969
-201.92 change in score*minutes
Standard Deviation 162.256
-210.50 change in score*minutes
Standard Deviation 334.216
-426.83 change in score*minutes
Standard Deviation 274.566
NA change in score*minutes
Standard Deviation NA
Participants in this arm were not assessed at this time point.
Area Under the Curve (AUC) of Change From Baseline in MDS-UPDRS Part III Scores
60 minutes
-573.88 change in score*minutes
Standard Deviation 371.782
-296.50 change in score*minutes
Standard Deviation 241.271
-424.25 change in score*minutes
Standard Deviation 464.545
-630.58 change in score*minutes
Standard Deviation 401.947
-295.25 change in score*minutes
Standard Deviation 412.042
Area Under the Curve (AUC) of Change From Baseline in MDS-UPDRS Part III Scores
90 minutes
-919.75 change in score*minutes
Standard Deviation 530.872
-575.17 change in score*minutes
Standard Deviation 486.241
-896.67 change in score*minutes
Standard Deviation 671.116
-968.08 change in score*minutes
Standard Deviation 587.629
-362.75 change in score*minutes
Standard Deviation 676.456
Area Under the Curve (AUC) of Change From Baseline in MDS-UPDRS Part III Scores
120 minutes
-1215.75 change in score*minutes
Standard Deviation 765.287
-903.67 change in score*minutes
Standard Deviation 804.196
-1324.83 change in score*minutes
Standard Deviation 863.122
-1210.58 change in score*minutes
Standard Deviation 714.512
-465.25 change in score*minutes
Standard Deviation 932.842

SECONDARY outcome

Timeframe: From time = 0 to 2 hours post-dose

Population: All subjects were included in this analysis

MDS-UPDRS is a clinimetric assessment of subjective and objective symptoms and signs of Parkinson's disease created by the Movement Disorder Society with high internal consistency. MDS-UPDRS retains the four-scale structure with a reorganization of the various subscales. The subscale used in this study is Part III, motor examination (18 items). The subscale now has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. The total of the subscales has a maximum value of 132 and a minimum value of zero. Lower scores indicate better motor function. A negative change from baseline indicates improved motor function.

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Mean Maximum Change From Baseline in MDS-UPDRS Part III Score
-15.5 score on a scale
Standard Deviation 6.35
-14.0 score on a scale
Standard Deviation 11.15
-20.3 score on a scale
Standard Deviation 11.18
-15.3 score on a scale
Standard Deviation 8.12
-7.5 score on a scale
Standard Deviation 6.72

SECONDARY outcome

Timeframe: 4 hours

Population: All participants were included in the analysis

Investigators will evaluate subjects' fluctuations in motor functions at 15, 30, 45, 60, 90, 120, and 240 minutes post-dose to determine if they are "ON".

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Subjective Time to "ON" as Evaluated by the Investigator
45.0 minutes
Interval 30.0 to 240.0
240.0 minutes
Interval 90.0 to
One or more subjects in this arm did not achieve ON by the end of the assessment period. Therefore upper range was \>240 minutes.
30.0 minutes
Interval 15.0 to 240.0
30.0 minutes
Interval 15.0 to 240.0
240.0 minutes
Interval 30.0 to 240.0

SECONDARY outcome

Timeframe: 4 hours

Population: All participants were included in the analysis.

Subjects were asked to provide self-assessments at 15, 30, 45, 60, 90, 120, and 240 minutes post-dose as to whether they considered themselves to be "ON".

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Assessment of Time to "ON" as Evaluated by Subject Self-assessment
40.0 minutes
Interval 15.0 to 240.0
240.0 minutes
Interval 95.0 to
One or more participants in this arm did not perceive themselves to be "ON" by the end of the assessment period, therefore the full range is 95 to \>240 minutes
39.0 minutes
Interval 15.0 to 240.0
30.0 minutes
Interval 15.0 to 240.0
232.5 minutes
Interval 31.0 to 240.0

SECONDARY outcome

Timeframe: Plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose and AUC calculated from these from time 0 to 120 minutes.

Population: Subjects who received the combination of L-dopa/carbidopa

Area under the concentration time curve for carbidopa

Outcome measures

Outcome measures
Measure
Placebo
n=6 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
AUC0-2h for Carbidopa
114.80 hours*ng/mL
Standard Deviation 30.384

SECONDARY outcome

Timeframe: For L-dopa 70 mg/carbidopa 7 mg, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose.

Population: Subjects who received L-dopa/carbidopa

Maximum concentration of carbidopa

Outcome measures

Outcome measures
Measure
Placebo
n=6 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Cmax of Carbidopa
80.23 ng/mL
Standard Deviation 22.945

SECONDARY outcome

Timeframe: For L-dopa 70 mg/carbidopa 7 mg, plasma samples were taken at pre-dose, 5, 10, 15, 30, 45, 60, 90 and 120 minutes post-dose.

Population: Subjects who received L-dopa/carbidopa

Time to reach the maximum concentration of carbidopa

Outcome measures

Outcome measures
Measure
Placebo
n=6 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Tmax of Carbidopa
44.50 minutes
Standard Deviation 13.882

SECONDARY outcome

Timeframe: 2 hours

Population: All participants were analyzed.

MDS-UPDRS is a clinimetric assessment of subjective and objective symptoms and signs of Parkinson's disease created by the Movement Disorder Society with high internal consistency. MDS-UPDRS retains the four-scale structure with a reorganization of the various subscales. The subscale used in this study is Part III, motor examination (18 items). The subscale has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Maximum score is 132, minimum is zero. High score means worse outcome.

Outcome measures

Outcome measures
Measure
Placebo
n=8 Participants
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 Participants
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 Participants
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 Participants
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 Participants
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Duration of Response, Where Response is Defined as an Improvement of 30% in MDS-UPDRS Part III Score From Baseline.
66.9 minutes
Standard Deviation 48.35
23.3 minutes
Standard Deviation 36.70
57.3 minutes
Standard Deviation 42.72
37.5 minutes
Standard Deviation 42.25
15.0 minutes
Standard Deviation 25.10

Adverse Events

Placebo

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

L-dopa 35 mg

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

L-dopa 70 mg

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

L-dopa 140 mg

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

L-dopa 70 mg/Carbidopa 7 mg

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Placebo
n=8 participants at risk
Placebo: Delivered via the I231 POD (Precision Olfactory Delivery) device
L-dopa 35 mg
n=6 participants at risk
L-dopa 35 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device via one puff to one nostril
L-dopa 70 mg
n=6 participants at risk
L-dopa 70mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
L-dopa 140 mg
n=6 participants at risk
L-dopa 140 mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with four puffs, two to each nostril
L-dopa 70 mg/Carbidopa 7 mg
n=6 participants at risk
L-dopa 70mg/carbidopa 7mg: Delivered via the I231 POD (Precision Olfactory Delivery) device with two puffs, one to each nostril
Respiratory, thoracic and mediastinal disorders
upper respiratory tract infection
0.00%
0/8 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
rhinorrhoea
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
sinus pain
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Respiratory, thoracic and mediastinal disorders
cough
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
dry throat
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
dyspnoea
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Respiratory, thoracic and mediastinal disorders
nasal congestion
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Respiratory, thoracic and mediastinal disorders
nasal discomfort
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
nasal dryness
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
nasal oedema
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Respiratory, thoracic and mediastinal disorders
paranasal sinus discomfort
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Respiratory, thoracic and mediastinal disorders
paranasal sinus hyposecretion
0.00%
0/8 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Respiratory, thoracic and mediastinal disorders
sneezing
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Nervous system disorders
headache
0.00%
0/8 • 7 days
33.3%
2/6 • Number of events 2 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Nervous system disorders
somnolence
0.00%
0/8 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Nervous system disorders
dizziness
0.00%
0/8 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
General disorders
fatigue
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
General disorders
feeling abnormal
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
General disorders
hyperthermia
0.00%
0/8 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Vascular disorders
hypertension
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Vascular disorders
orthostatic hypotension
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Infections and infestations
rhinitis
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Infections and infestations
urinary tract infection
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
Musculoskeletal and connective tissue disorders
joint noise
0.00%
0/8 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Musculoskeletal and connective tissue disorders
muscle spasms
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Cardiac disorders
tachycardia
12.5%
1/8 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
Eye disorders
lacrimation increased
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days
Injury, poisoning and procedural complications
procedural pain
0.00%
0/8 • 7 days
0.00%
0/6 • 7 days
0.00%
0/6 • 7 days
16.7%
1/6 • Number of events 1 • 7 days
0.00%
0/6 • 7 days

Additional Information

Karen Craig, PhD (Medical Writer)

Impel NeuroPharma

Phone: 206-568-1466

Results disclosure agreements

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