Pramipexole Versus Placebo in Parkinson's Disease (PD) Patients With Depressive Symptoms

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Boehringer Ingelheim
ClinicalTrials.gov Identifier:
NCT00297778
First received: February 28, 2006
Last updated: June 3, 2014
Last verified: April 2014
  Purpose

Parkinsons Disease (PD) is caused by a decrease of dopamine in a particular part of the brain. Dopamine is a messenger substance (neurotransmitter) that is used by the cells of the brain (nerve cells) to control and harmonize muscle movements. Consequently, the main manifestations of the disease affect movement and include tremor, muscular rigidity, slowness in performing movements and loss of balance.

However, the disease affects also other, non motor functions and may cause other disorders, such as depression. Depression may be a reaction to the disability caused by the disease, but many studies show that depression is more common in PD than in other chronic debilitating illnesses. Moreover, there is also a biological explanation for the phenomenon: dopamine is also used in brain circuits involved in the experience of pleasure, and loss of pleasure in daily physical or social activity is one of the key manifestations of depression.

The objective of the study is to assess whether pramipexole, at doses approved for the treatment of PD symptoms, is more effective than placebo in resolving depressive symptoms in PD patients.

Also data on the safety of the product in the disease will be collected.


Condition Intervention Phase
Parkinson Disease
Depression
Drug: Pramipexole
Other: Placebo
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Placebo-controlled, Parallel Group Efficacy Study of Pramipexole and Placebo Administered Orally Over a 12 Week Treatment Phase in Parkinson's Disease Patients With Stable Motor Function and Depressive Symptoms

Resource links provided by NLM:


Further study details as provided by Boehringer Ingelheim:

Primary Outcome Measures:
  • Change From Baseline in the Beck Depression Inventory-Version 1A (BDI-IA) Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The BDI measures symptoms of depression on an ordinal scale ranging from 0 (no symptoms) to 63 (worst symptoms)


Secondary Outcome Measures:
  • Change in BDI-IA Clinical Response (at Least 50% Reduction in Symptoms) at Week 12 [ Time Frame: Week 12 ] [ Designated as safety issue: No ]
    BDI clinical response was defined as a reduction of ≥50% from baseline

  • Change From Baseline in the Geriatric Depression Scale-Short Form (GDS-SF) (15-item Version) Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The GDS measures symptoms of depression on an ordinal scale ranging from 0 (no symptoms) to 15 (worst symptoms)

  • Change From Baseline in Snaith-Hamilton Pleasure Scale (SHAPS) Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The SHAPS measures anhedonia (inability to experience pleasure) on an ordinal scale ranging from 0 (no anhedonia) to 14 (worst anhedonia)

  • Change From Baseline in the Unified Parkinson's Disease Rating Scale (UPDRS) Part I Depression Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The UPDRS part I depression score measures depression on an ordinal scale ranging from 0 (none) to 4 (sustained depression/suicidal thoughts)

  • Change From Baseline in the UPDRS Part II Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    Unified Parkinson's Disease Rating Scale part II total score on FAS The UPDRS part II total score measures the impact of PD on activities of daily living on an ordinal scale ranging from 0 (normal) to 52 (worst symptoms)

  • Change From Baseline in the UPDRS Part III Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The UPDRS part III total score measures the impact of PD on motor skills on an ordinal scale ranging from 0 (normal) to 108 (worst symptoms)

  • Change From Baseline in the UPDRS Part II+III Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The UPDRS part II+III total score measures the impact of PD on activities of daily living and motor skills on an ordinal scale ranging from 0 (normal) to 160 (worst symptoms)

  • Clinical Global Impressions of Global Improvement (CGI-I) at Week 12 [ Time Frame: Week 12 ] [ Designated as safety issue: No ]
    The CGI-I measures the overall improvement in the participants condition from baseline on an ordinal scale ranging from 1 (very much improved) to 7 (very much worse)

  • Change From Baseline in the Parkinson's Disease Questionnaire-39 (PDQ-39) Overall Index Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The PDQ-39 measures aspects of health in PD participants, the overall index score is the mean of the eight individual domain scores measured on a continuous scale ranging from 0 (no problem at all) to 100 (maximum level of the problem)

  • Change From Baseline in the European Quality of Life Scale (EUROQOL (EQ)-5D) Overall Index Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    This is a 5-item patient reported measure of health status developed for use in evaluating health and healthcare. It produces a numeric score for health status on which full health has a value of 1 and death has a value of 0. Euro-QOL describes health status in terms of 5 dimensions: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. The EQ-5D measures health status on a continuous scale ranging from 0 (dead) to 1 (full health)

  • Change From Baseline to End of Maintenance Phase in European Quality of Life Visual Analogue Scale (EUROQOL (EQ) VAS) Pain Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The VAS is a method used for the measurement of pain. The patient is asked to place a mark on an uncalibrated (usually 0 - 10 cm) line representing the patient's degree of general pain. The two extremities of the line were taken to represent 'no pain' and 'unbearable pain', respectively. VAS pain scores could range from 0 (no pain) to 100 (unbearable pain).

  • Change From Baseline in the UPDRS Part I Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The UPDRS part I total score measures depression on an ordinal scale ranging from 0 to 16. UPDRS Part I total scores could range from 0 to 16; where higher scores were indicative of worse symptoms.

  • Change From Baseline in the UPDRS Part IV Total Score at Week 12 [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: No ]
    The UPDRS Part IV measures motor complications (dyskinesia) and the total score could range from 0 to 23; where higher scores were indicative of worse symptoms.

  • Abnormal Findings: Clinical Laboratory Evaluations (Biochemistry and Haematology)and Vital Signs [ Time Frame: Baseline and Week 12 ] [ Designated as safety issue: Yes ]

Enrollment: 296
Study Start Date: March 2006
Primary Completion Date: May 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: pramipexole
A daily dose of pramipexole 0.125 mg t.i.d.; titration-to-response up to 1.0 mg t.i.d.
Drug: Pramipexole
Dopamine agonist
Placebo Comparator: placebo
Placebo (matching) tablets
Other: Placebo

  Eligibility

Ages Eligible for Study:   30 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. 15-item Geriatric Depression Scale (GDS) > or = 5
  2. Unified Parkinson's Disease Rating Scale (UPDRS) Part I Score on Question #3 > or = 2
  3. Folsteins Mini-Mental State Examination (MMSE) score > 24
  4. Male or female patient with PD (UK PD Brain Bank criteria).
  5. Patients diagnosed with idiopathic PD, Stage I-III by the Modified Hoehn and Yahr Scale and optimally controlled PD symptoms .
  6. Male or female patients aged 30 - 80 years.
  7. Ability to provide written informed consent.
  8. Women of childbearing potential must have a negative serum beta-humanchoriongonadotropin (Beta-HCG) pregnancy test at the Screening visit unless surgically sterile or last menstruation >or = 12 months prior to signing informed consent.
  9. Women of childbearing potential must be using an accepted contraceptive.
  10. Patients who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

Exclusion Criteria:

  1. Previous history of allergic response, lack of efficacy or complications with pramipexole or its excipients.
  2. History of suicidal attempts in the last twelve months; presence of suicidal tendencies/potential.
  3. Atypical PD syndromes due to drugs, metabolic disorders, encephalitis or degenerative diseases.
  4. History of PD stereotactic brain surgery.
  5. Surgery within 180 days of randomization that would negatively impact the patients participation in the study.
  6. History of active epilepsy within the past year.
  7. Current psychotherapy or behavior therapy while participating the trial
  8. Symptomatic orthostatic hypotension prior to randomization.
  9. Malignant melanoma or history of previously treated malignant melanoma.
  10. Patients who have received typical neuroleptics, metoclopramide, alpha methyldopa, methylphenidate, reserpine, selegiline or amphetamine derivatives within the past 3 months.
  11. Patients who have received dopamine agonists within the past 30 days
  12. Electroconvulsive therapy during the 90 days preceding the screening visit (Visit 1).
  13. Patients who are currently lactating.
  14. Participation in other investigational drug studies or use of other investigational drugs within the previous 30 days prior to randomization.
  15. Any other laboratory assay abnormality, which could interfere with patient participation or interpretation of results, or could increase the risk for the patient
  16. Any other clinically significant medical/psychiatric condition, which could interfere with patient participation or interpretation of results, or could increase the risk for the patient
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00297778

  Show 77 Study Locations
Sponsors and Collaborators
Boehringer Ingelheim
Investigators
Study Chair: Boehringer Ingelheim Boehringer Ingelheim
  More Information

Additional Information:
No publications provided by Boehringer Ingelheim

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Boehringer Ingelheim
ClinicalTrials.gov Identifier: NCT00297778     History of Changes
Other Study ID Numbers: 248.596, Eudract 2005-003788-22
Study First Received: February 28, 2006
Results First Received: May 22, 2009
Last Updated: June 3, 2014
Health Authority: Austria: Federal Office for Safety in Health Care
Finland: Finnish Medicines Agency
France: Afssaps
Germany: Ethikkommission bei der Landesaerztekammer Baden-Wuerttemberg
Italy: Comitato Etico Ospedale Civile S. Spirito, Università "G. D'Annunzio"
Netherlands: Medish Etische toetsingscommissie Atrium MC
Norway: Norwegian Medicines Agency (Statens Legemiddelverk)
Romania: National Medicines Agency, Bucharest
Russia: Ministry of Healthcare and Social Development of Russian Federation, Moscow
South Africa: Medicines Council Country
Spain: Unidad de Registro y Tasas, Agencia Espanola del medicamento y productos sanitarios
Sweden: Medical Products Agency
Ukraine: Ministry of Health Care of Ukraine (MoH of Ukraine)

Additional relevant MeSH terms:
Depression
Parkinson Disease
Basal Ganglia Diseases
Behavioral Symptoms
Brain Diseases
Central Nervous System Diseases
Movement Disorders
Nervous System Diseases
Neurodegenerative Diseases
Parkinsonian Disorders
Pramipexole
Anti-Dyskinesia Agents
Antioxidants
Antiparkinson Agents
Central Nervous System Agents
Dopamine Agents
Dopamine Agonists
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on October 21, 2014