Trial Outcomes & Findings for A Study to Evaluate the Efficacy and Safety of Safinamide Mesilate as Add-on Therapy to Levodopa in Parkinson's Disease Participants With Motor Fluctuation in South Korea (NCT NCT05312632)

NCT ID: NCT05312632

Last Updated: 2024-09-23

Results Overview

Participants received diary card and information on daily 'off' time and 'on' time was collected. At 30-minutes intervals throughout the period, the participant/caregiver recorded whether the participant was in an "on" phase, in an "on" phase with dyskinesia, in an "off" phase, or asleep. An "off" phase was defined as lack of mobility, bradykinesia, or akinesia whereas in an "on" phase, the participant functioned as well as can be expected for that participant, irrespective of whether or not he or she is having dyskinesia. The daily "off" time was defined as the mean of the total daily "off" time during the last two 24 hours dairy recording periods.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

201 participants

Primary outcome timeframe

Baseline, Week 18

Results posted on

2024-09-23

Participant Flow

Participants took part in the study at 20 investigative sites in South Korea from 05 April 2022 to 25 May 2023.

A total of 222 participants were screened, of which 21 were screen failures and 201 were enrolled and treated in this study.

Participant milestones

Participant milestones
Measure
Safinamide Mesilate 100 mg
Participants with parkinson's disease received safinamide mesilate 50 milligram (mg) tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Overall Study
STARTED
201
Overall Study
Safety Analysis Population
199
Overall Study
Full Analysis Population
196
Overall Study
COMPLETED
162
Overall Study
NOT COMPLETED
39

Reasons for withdrawal

Reasons for withdrawal
Measure
Safinamide Mesilate 100 mg
Participants with parkinson's disease received safinamide mesilate 50 milligram (mg) tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Overall Study
Adverse Event
12
Overall Study
Withdrawal by Subject
10
Overall Study
Lack of Efficacy
4
Overall Study
Non-compliance with study procedures
9
Overall Study
Other
4

Baseline Characteristics

A Study to Evaluate the Efficacy and Safety of Safinamide Mesilate as Add-on Therapy to Levodopa in Parkinson's Disease Participants With Motor Fluctuation in South Korea

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Safinamide Mesilate 100 mg
n=199 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Age, Continuous
63.6 years
STANDARD_DEVIATION 7.8 • n=5 Participants
Sex: Female, Male
Female
104 Participants
n=5 Participants
Sex: Female, Male
Male
95 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
199 Participants
n=5 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino
199 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline, Week 18

Population: The full analysis set (FAS) included participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or the Parkinson's disease questionnaire (PDQ-39) after dosing. Here, Overall number of participants analyzed signifies participants who were evaluable for this outcome measure.

Participants received diary card and information on daily 'off' time and 'on' time was collected. At 30-minutes intervals throughout the period, the participant/caregiver recorded whether the participant was in an "on" phase, in an "on" phase with dyskinesia, in an "off" phase, or asleep. An "off" phase was defined as lack of mobility, bradykinesia, or akinesia whereas in an "on" phase, the participant functioned as well as can be expected for that participant, irrespective of whether or not he or she is having dyskinesia. The daily "off" time was defined as the mean of the total daily "off" time during the last two 24 hours dairy recording periods.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=189 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in Daily "OFF" Time at Week 18
-0.8 hours
Interval -11.2 to 3.7

PRIMARY outcome

Timeframe: Baseline, Week 18

Population: The FAS included all participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or PDQ-39 after dosing.

The PDQ-39 was a self-reported outcome or rater-reported outcome of 39 questions relating to 8 domains: mobility (Questions 1-10), activities of daily living (ADL) (Questions 11-16), emotional well-being (Questions 17-22), stigma (Questions 23-26), social support (Questions 27-30), cognition (Questions 31-33), communication (Questions 34-36) and bodily discomfort (Questions 37-39). Each question was answered on a 5-point scale from 0 (Never) to 4 (Always/Cannot Do At All). Scores were calculated by summing the answers to the questions in the domain and converting to a total score scale from 0 to 100. Higher scores were associated with the more severe symptoms of the disease such as tremor and stiffness.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=196 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in PDQ-39 Score at Week 18
-2.7 score on a scale
Standard Deviation 10.3

SECONDARY outcome

Timeframe: Baseline, Week 18

Population: The FAS included all participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or PDQ-39 after dosing.

MDS-UPDRS rating tool was used to follow longitudinal course of Parkinson's Disease. It was made up of 4 parts: Part 1: Non-motor aspects of experiences of daily living; Part 2: Motor aspects of experiences of daily living; Part 3: Motor examination; Part 4: Motor complications. Part 3 section of scale consisted of 18 items, with 33 separate ratings being performed on scale from 0 (normal) to 4 (severe). The total score ranged from 0 to 132, with a lower score=better motor function; higher score=more severe motor symptoms.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=196 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in Movement Disorder Society-Unified Parkinson's Disease Rating (MDS-UPDRS) Part 3 at Week 18
-1.7 score on a scale
Standard Deviation 8.4

SECONDARY outcome

Timeframe: Baseline, Week 18

Population: The FAS included all participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or PDQ-39 after dosing.

The MDS-UPDRS rating tool was used to follow longitudinal course of Parkinson's Disease. It was made up of 4 parts that assess: Part 1: Non-motor aspects of experiences of daily living; Part 2: Motor aspects of experiences of daily living; Part 3: Motor examination; Part 4: Motor complications. Part 4 raters use historical/objective information to assess 2 motor complications, dyskinesias and motor fluctuations including OFF-state dystonia. Raters use information from participant, caregiver, and the examination to answer 6 questions. The duration of disability caused and functional impact of any dyskinesias experienced by the participant were rated on a scale of 0 to 4. 6 items being performed on scale from 0 (normal) to 4 (severe), where the total score ranged from 0 to 24, lower score indicated better motor function and higher score indicated more severe motor symptoms.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=196 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in MDS-UPDRS Part 4 at Week 18
-0.7 score on a scale
Standard Deviation 2.1

SECONDARY outcome

Timeframe: Baseline, Week 18

Population: The FAS included all participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or PDQ-39 after dosing.

KPPS is a Parkinson's Disease-specific pain scale that evaluated the localization, frequency, and intensity of pain. It has 14 items in 7 domains: 1. Musculoskeletal pain; 2. Chronic pain; 3. Fluctuation-related pain; 4. Nocturnal pain; 5. Oro-facial pain; 6. Discoloration, Oedema/Swelling pain; 7. Radicular pain. Each item was scored by severity (0 \[none\] to 3 \[very severe\]) multiplied by frequency (0 \[never\] to 4 \[all the time\]), resulting in a subscore of 0 to 12, the sum of which gives the total score which ranged from 0 to 168. Higher scores indicated more severity and frequency of pain.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=196 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in King's Parkinson's Disease Pain Scale (KPPS) at Week 18
-1.5 score on a scale
Standard Deviation 11.3

SECONDARY outcome

Timeframe: Baseline, Week 18

Population: The FAS included all participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or PDQ-39 after dosing.

The MMSE is a brief practical screening test for cognitive dysfunction. The test consists of 5 sections (orientation, registration, attention and calculation, recall, and language) and has a total possible score of 30. Total scores ranged from 0 (most impaired) to 30 (no impairment). MMSE used to assess the severity of cognitive dysfunction, with a higher score indicating better cognitive state.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=196 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in Mini-Mental State Examination (MMSE) at Week 18
0.2 score on a scale
Standard Deviation 1.7

SECONDARY outcome

Timeframe: Baseline, Week 18

Population: The FAS included all participants who received at least 1 dose of study drug and had at least 1 record of daily "off" time or PDQ-39 after dosing. Here, Overall number of participants analyzed signifies participants who were evaluable for this outcome measure.

Participants received diary card and information on daily 'off' time and 'on' time was collected. At 30-minute intervals throughout the period, the participant/caregiver recorded whether the participant was in an "on" phase, in an "off" phase, or asleep. An "off" phase was defined as lack of mobility, bradykinesia, or akinesia whereas in an "on" phase, the participant functioned as well as can be expected for that participant, irrespective of whether or not he or she is having dyskinesia. The daily "on" time was defined as the sum of the time without dyskinesia during the on phase to number of days completed in the diary.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=189 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Change From Baseline in Daily "ON" Time Without Dyskinesia at Week 18
0.7 hours
Interval -6.2 to 10.0

SECONDARY outcome

Timeframe: From the first dose of the study drug up to end of the treatment (up to Week 18)

Population: The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.

A TEAE was defined as an adverse event (AE) that emerges during treatment, having been absent at pretreatment (Baseline) or reemerges during treatment, having been present at pretreatment (Baseline) but stopped before treatment, or worsens in severity during treatment relative to the pretreatment state, when the AE is continuous. SAE was any untoward medical occurrence that at any dose: results in death, was life-threatening, inpatient hospitalization, requires prolongation of existing hospitalization, results in persistent or significant disability/incapacity, was a congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), was a medically significant event.

Outcome measures

Outcome measures
Measure
Safinamide Mesilate 100 mg
n=199 Participants
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
TEAEs
80 Participants
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
SAEs
4 Participants

Adverse Events

Safinamide Mesilate 100 mg

Serious events: 4 serious events
Other events: 56 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Safinamide Mesilate 100 mg
n=199 participants at risk
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Injury, poisoning and procedural complications
Cartilage injury
0.50%
1/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Injury, poisoning and procedural complications
Muscle rupture
0.50%
1/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Injury, poisoning and procedural complications
Skin laceration
0.50%
1/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
General disorders
Condition aggravated
0.50%
1/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Infections and infestations
COVID-19
0.50%
1/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.

Other adverse events

Other adverse events
Measure
Safinamide Mesilate 100 mg
n=199 participants at risk
Participants with parkinson's disease received safinamide mesilate 50 mg tablet, orally, once daily as add-on therapy to levodopa for up to 2 weeks. After 2 weeks, at the discretion of an investigator, dose of safinamide mesilate was increased to 100 mg (two tablets of 50 mg each), orally, once daily for up to 18 weeks.
Nervous system disorders
Dyskinesia
5.5%
11/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Nervous system disorders
Dizziness
2.5%
5/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Nervous system disorders
Tremor
1.5%
3/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Nervous system disorders
Dystonia
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Nervous system disorders
Headache
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Injury, poisoning and procedural complications
Overdose
6.5%
13/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Gastrointestinal disorders
Nausea
2.5%
5/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Gastrointestinal disorders
Constipation
1.5%
3/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Gastrointestinal disorders
Vomiting
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Musculoskeletal and connective tissue disorders
Arthralgia
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Musculoskeletal and connective tissue disorders
Musculoskeletal stiffness
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Musculoskeletal and connective tissue disorders
Myalgia
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Infections and infestations
COVID-19
2.5%
5/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
General disorders
Drug ineffective
2.0%
4/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Metabolism and nutrition disorders
Decreased appetite
2.0%
4/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Psychiatric disorders
Delusion
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Respiratory, thoracic and mediastinal disorders
Cough
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.
Vascular disorders
Hypotension
1.0%
2/199 • From the first dose of the study drug up to end of the treatment (up to Week 18)
The safety analysis population included participants who received at least 1 dose of study drug and completed at least 1 post-dose safety assessment.

Additional Information

Serena SoYoun Kwon

Eisai Korea Inc. Medical department

Phone: +82-10-7409-5623

Results disclosure agreements

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