Safety, Tolerability, Pharmacokinetics and Efficacy Study of Radotinib in Parkinson's Disease

NCT ID: NCT04691661

Last Updated: 2024-07-16

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE2
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-09-09
• Study Completion Date: 2026-12-31

Brief Summary

This is a safety, tolerability, pharmacokinetic and efficacy study in subjects with Parkinson's disease

Detailed Description

This study is will be conducting to determine if Radotinib is safe and can be tolerated by patients with Parkinson's disease (PD) and to learn if Radotinib can be potential therapeutic agents for the treatment of PD.

Radotinib has been approved by Ministry of Food & Drug Safety of Korea to treat Chronic Myeloid Leukemia (CML) but it has not been approved for PD.

In nonclinical efficacy study, therapeutic effect of Radotinib HCl, c-Abl inhibitor, which exhibits improved pharmacokinetic properties and BBB penetration compared to nilotinib and other c-Abl inhibitors, was tested in a preclinical α-synuclein preformed fibrils (PFF) model of sporadic PD. As a result, the treatment of Radotinib HCl protects the α-synuclein PFFs-induced neuronal toxicity, reduces the PFFs-induced LB/LN-like pathology, and inhibits the PFFs-induced c-Abl activation in neurons. In vivo studies demonstrate that administration of Radotinib HCl prevents dopamine neuron loss and behavioral deficits following α-synuclein PFFs-induced toxicity. Taken together, these findings indicate that Radotinib HCl has beneficial neuroprotective effects in PD and provides strong evidence that selective and brain permeable c-Abl inhibitors can be potential therapeutic agents for the treatment of PD.

These data are very compelling to evaluate the effects of Radotinib in a phase II, randomized, double-blind, placebo-controlled trial in patients with PD.

Conditions

Parkinson Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Placebo: Dose escalation

Forty (40) subject will be recruited and randomized into 4 dosing groups. In each dosing group, ten (10) will be randomized and 8 of 10 will receive the active product (Radotinib) and 2 subjects will receive the matching placebo orally once daily for 6 months at each escalating dose level.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

Placebo

Radotinib HCl: Dose escalation

Forty (40) subject will be recruited and randomized into 4 dosing groups. In each dosing group, ten (10) will be randomized and 8 of 10 will receive the active product (Radotinib) and 2 subjects will receive the matching placebo orally once daily for 6 months at each escalating dose level.

The inclusion of subjects in the next dose level will be decided by the sponsor in consultation with a Data Monitoring Committee (DMC).

Group Type: EXPERIMENTAL

Radotinib HCl 50 mg

Intervention Type: DRUG

Enrolled subject will continue to administer Radotinib 50mg/day, 100mg/day, 150mg/day, 200mg/day, depending on the dose level once daily for 6 months.

Interventions

Radotinib HCl 50 mg

Enrolled subject will continue to administer Radotinib 50mg/day, 100mg/day, 150mg/day, 200mg/day, depending on the dose level once daily for 6 months.

Intervention Type: DRUG

Placebo

Placebo

Intervention Type: DRUG

Other Intervention Names

Radotinib; IY5511

Eligibility Criteria

Inclusion Criteria

1. Male and Female from 40 to 80 years old;

2. Diagnosed with "Clinically Probable Parkinson's Disease" according to the MDS clinical diagnostic criteria, with documented onset of symptoms per treating physician's records within three years of the screening visit;

3. Positive DAT-scan (e.g. a striatal dopamine transporter deficit on dopamine transporter imaging by DaT-SPECT, characterized by crescent-shaped areas of asymmetrical aspect, or of symmetrical aspect but of uneven intensity, between the right and the left brain hemisphere) confirmed by local reading;

4. Hoehn & Yahr stage ≤ 2.5;

5. Without previous symptomatic treatment for PD disease and with current clinical state not requiring started dopaminergic therapy within 6 months from Baseline;

6. Absence of a parkinsonian syndrome and other neurovascular comorbidities, confirmed by MRI

7. Female subjects must be not of childbearing potential, e.g., documented evidence that they are surgically sterile (e.g., hysterectomy, partial hysterectomy, bilateral oophorectomy, bilateral tubal ligation), or postmenopausal (at least 12 months since last menses) or using highly effective method of birth control defined as those which result in a low failure rate (i.e. less than 1% per year) when used consistently and correctly, such as combined hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal), progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable), intra uterine devices (IUDs), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion, condom, until at least one month after the last drug intake associated to a negative pregnancy test at screening;

8. Covered by Health Insurance System;

9. Able to understand and to sign the informed consent prior to screening;

10. Blood Pressure (BP) and Heart Rate (HR) considered NCS by Investigator;

11. Electrocardiogram (ECG) recording on a 12-lead ECG considered NCS by Investigator;

12. Laboratory parameters within the normal range of the laboratory. Individual values out of the normal range can be accepted if judged clinically non relevant by the Investigator.

Exclusion Criteria

1. Atypical Parkinsonism or drug-induced Parkinsonism;

2. Current, or within 60 days of screening, use of any prescription, investigational, or over the counter medication for the symptomatic treatment of PD or to slow the progression of PD.

3. Prior use of dopaminergic therapy (e.g., levodopa, dopamine agonist, amantadine, rasagiline) for 30 or more days any time in the past;

4. Cognitive impairment (MMSE ≤ 24);

5. Active psychiatric disorder (mood disorders, hallucinations or delirium with strong functional impact and not controlled by medication or which happened during the last 3 months before inclusion);

6. Severe or uncontrolled chronic disease;

7. Significant medical history of congenital or acquired bleeding disorders;

8. Treatment by Deep Brain Stimulation or continuous infusion of apomorphin/dopa gel;

9. Any below impaired cardiac function:

• LVEF <45% or < lower bound of normal limit of study site (whichever higher), confirmed by echocardiogram (if the subject has already carried out this examination during the last month before inclusion, he/she will be exempted from retaking this examination, but he/she will have to present the echocardiogram as well as the cardiologist's report. If not, this exam should be performed during the screening period)
• Subjects who cannot have QT intervals measured according to ECG
• Complete left bundle branch block
• Subjects with cardiac pacemakers
• Subjects with congenital long QT syndrome or the family history of known long QT syndrome
• History of, or presence of symptomatic ventricular or atrial tachyarrhythmias
• Clinically significant resting bradycardia (< 50 bpm).
• Mean QTcF >450msec following three consecutive ECG tests at baseline: Screening test will be performed again for QTcF after the adjustment of electrolyte if QTcF >450msec and the electrolyte is not within the normal range
• Medical history of clinically confirmed myocardial infarction
• Medical history of unstable angina (within last 12 months)
• Other clinically significant cardiac disease (e.g. congestive heart failure, or uncontrolled hypertension)

10. Participation in other investigational drug trials within 30 days prior to Screening;

11. Any concomitant medication or medication excluded that could put subject at risk, or interfere with study evaluations;

12. Subjects currently receiving treatment with a strong CYP3A4 inhibitors (e.g. erythromycin, ketoconazole, itraconazole, voriconazole, clarithromycin, telithromycin, ritonavir, mibefradil) or strong CYP3A4 inducers (e.g. dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbitol, St. John's Wort) or therapeutic Cumarin derivatives (e.g. warfarin, acenocoumarol, phenprocoumon) and that can neither stop the administration of these drugs before the start of the IP administration nor switch to other drugs

13. Subjects who are currently receiving treatment with a medication that has the potential to extend QT intervals and can neither stop the administration of the drugs before the start of the IP administration nor switch to other drugs (list of medications that have the potential to prolong QT interval is provided in the Appendix II) If subjects need to start such drug treatments during the study, this will be discussed with the sponsor, IL-YANG PHARM. Co., Ltd.

14. Subjects who are currently receiving treatment with P-gp inducers (e.g. (Ritonavir, Saquinavir, Nelfinavir, Indinavir, Amprenavir, Tipranavir…), Apalutamide, Estrone, Estriol, Trazodone, Vincristine, Tamoxifen, Doxorubicin, Carbamazepine, Oxcarbazepine, Fosphenytoin, Lorlatinib, Phenobarbital, Phenytoin, Propofol, beclomethasone, Dexamethasone, Prednisone, Hydrocortisone, Diclofenac, Rifampicin, Reserpine, Nifedipine, Digoxine, Amiodarone, Spironolactone, Levothyroxine, Tacrolimus, Sirolimus, St. John's Wort (herbal ingredient)) and that can neither stop the administration of these drugs before the start of the IP administration nor switch to other drugs;

15. Gastrointestinal disorder or gastrointestinal disease that may result in a significant change in the absorption of the investigational product;

16. Medical history of acute or chronic pancreatitis within the past one year;

17. Acute or chronic liver, pancreas, or severe kidney disease that are not associated with the disease;

18. Subjects known seropositive to human immunodeficiency virus (HIV), current acute or chronic hepatitis B (hepatitis B surface-antigen positive), hepatitis C, or cirrhosis. Inactive hepatitis B surface antigen (HBsAg) carriers, treated and stable hepatitis B (HBV DNA < 500 IU/mL or site specific local lab normal range lower limit assessed by investigator), and cured hepatitis C subjects can be enrolled;

19. Men subjects who are unwilling to use and appropriate method of contraception during the study;

20. Subjects who have hypersensitivity to active ingredient or any of the excipients of this investigational product;

21. Any medical condition that might interfere with the protocol except those defined in Section 5.3 of the study protocol;

22. Subject unable to attend scheduled visits or to comply to the protocol;

23. Subject under legal guardianship or judicial protection;

24. Subject in the exclusion period of another protocol;

25. No possibility of contact in case of emergency.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Il-Yang Pharm. Co., Ltd.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Philippe DAMIER, Pr.

Role: PRINCIPAL_INVESTIGATOR

CHU Nantes - Hôpital Nord Guillaume et René Laennec

Locations

CHRU de Lille - Hôpital Roger Salengro

Lille, , France

Site Status: NOT_YET_RECRUITING

CHU Limoges

Limoges, , France

Site Status: RECRUITING

CHU de Lyon HCL

Lyon, , France

Site Status: RECRUITING

Hôpital Nantes-Hotel Dieu

Nantes, , France

Site Status: RECRUITING

Hôpital Pitié-Salpêtrière

Paris, , France

Site Status: RECRUITING

Chu La Miletrie

Poitiers, , France

Site Status: RECRUITING

CHU de Rouen

Rouen, , France

Site Status: RECRUITING

Countries

France

Central Contacts

IL-YANG CR

Role: CONTACT

nykim@ilyanga.co.kr

+82.70.7165.7316

Facility Contacts

Luc DEFEBVRE

Role: primary

Philippe COURATIER

Role: primary

Stephane THOBOIS

Role: primary

Damier Philippe

Role: primary

LOUISE LAURE MARIANI

Role: primary

Isabelle BEBATRU

Role: primary

David MALTETE

Role: primary

References

Joshi D, Kulkarni M, Parekh P, Shah S, Greig NH, Acharya S. Targeting protein kinases in Parkinson's disease: the emerging role of phytoconstituents. Nutr Neurosci. 2025 Jul 18:1-32. doi: 10.1080/1028415X.2025.2531356. Online ahead of print.

Reference Type: DERIVED

PMID: 40680102 (View on PubMed)

Other Identifiers

RT51EP1902

Identifier Type: -

Identifier Source: org_study_id