Intranasal Glutathione in Parkinson's Disease (inGSH in PD)
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Purpose
Excessive free radical formation and depletion of the brain's primary antioxidant, glutathione, are established components of Parkinson's disease (PD) pathophysiology. While there is rationale for the therapeutic use of reduced glutathione (GSH) in PD, and even some preliminary evidence to suggest the use of GSH can lead to symptomatic improvement, obstacles surrounding currently employed delivery methods have hindered the clinical utility of this therapy. Intranasal GSH, (in)GSH, is a novel method of delivery for this popular CAM therapy in patients with PD, and bypasses the obstacles associated with other delivery methods. It has been used in clinical practice since 2005. The aim of this study is to evaluate safety, tolerability, and preliminary absorption data of (in)GSH in volunteers with PD in a Phase I single ascending dose escalation study.
| Condition | Intervention | Phase |
|---|---|---|
|
Parkinson's Disease (PD) |
Drug: Intranasal glutathione - (in)GSH Drug: Saline Intranasal Delivery |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Phase 1 Study of Intranasal Reduced Glutathione in Parkinson's Disease |
- Determination of Safety [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
1a. Laboratory monitoring for adverse events will include CBC, ALT, AST, BUN, creatinine, uric acid, and urinalysis. Data will be collected throughout the 12-week intervention and at 1-mo following cessation of the study medication.
1b. Clinical adverse events will be measured using a daily patient diary and record score cards specifically screening for sinus irritation. Monitoring of Side Effects System (MOSES) will be used to screen for systemic and generalized adverse events.
1c. Effect on PD symptoms will be measured by the UPDRS to screen for accelerated disease activity.
- Determination of Tolerability [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]Participants will be asked to keep a daily log and unused study medication will be measured at each clinical visit. Tolerability will be measured by frequency and severity of reported adverse events and withdrawal from study. The goal will be to identify the maximum tolerated dose (MTD) which will be defined as the highest dose achieving adherence, as defined as 80% of the group taking the prescribed dose 80% of the time.
- Description of systemic absorption characteristics [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]Red blood cell GSH levels will be measured at baseline, 4 weeks, and 12 weeks.
| Estimated Enrollment: | 34 |
| Study Start Date: | July 2012 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Intranasal GSH 100mg/ml
100mg/ml of intranasal glutathione (n=10)
|
Drug: Intranasal glutathione - (in)GSH
Tripeptide glutathione 100 mg/ml. 1ml TID X 12 weeks
|
|
Active Comparator: Intranasal glutathione 200mg/ml
200mg/ml of intranasal glutathione (n=10)
|
Drug: Intranasal glutathione - (in)GSH
Tripeptide glutathione - 200mg/ml. 1 ml TID X 12 weeks
|
|
Placebo Comparator: Saline intranasal delivery
Intranasal saline delivery (n=10)
|
Drug: Saline Intranasal Delivery
Saline administration
|
|
No Intervention: Watchful waiting
No intervention, watchful waiting only (n=4)
|
Eligibility| Ages Eligible for Study: | 21 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of Parkinson's Disease made by neurologist within previous 10 years
- Modified Hoehn and Yahr Stage <3
- Age >20
- Subjects must be able to attend study visits at screening, baseline, weeks 4, 8, 12, 16
- Subjects must be able to demonstrate self-administration of study medication or have active caregiver who can administer daily.
- Dose and frequency of all pharmaceutical medications must be stable for one month prior to enrollment.
- Diet, exercise and supplementation must be kept constant throughout participation in study
- Ability to read and speak English
Exclusion Criteria:
- Dementia as evidenced by Montreal Cognitive Assessment (MoCA) <24
- Diseases with features common to Parkinson's Disease (eg. essential tremor, multiple system atrophy, progressive supranuclear palsy)
- Epilepsy
- History of stroke, CVA
- Elevated levels of ALT, AST, BUN or creatinine
- Chronic sinusitis as defined by SNOT-20 score >1.0 on items 1-10.
- Presence of other serious illness
- History of brain surgery
- History of structural brain damage
- History of intranasal telangiectasia
- Supplementation with glutathione and agents shown to increase glutathione will not be permitted and will require a 90 day washout period.
- Pregnant or at risk of becoming pregnant.
Contacts and Locations| United States, Washington | |
| Bastyr Clinical Research Center | |
| Kenmore, Washington, United States, 98023 | |
| Principal Investigator: | Laurie Mischley, ND | Bastyr University |
More Information
Additional Information:
No publications provided
| Responsible Party: | Bastyr University |
| ClinicalTrials.gov Identifier: | NCT01398748 History of Changes |
| Other Study ID Numbers: | BU-H32B11, 5K01AT004404 |
| Study First Received: | July 19, 2011 |
| Last Updated: | March 27, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Bastyr University:
|
Parkinson's disease Neuroprotection Glutathione Intranasal |
Additional relevant MeSH terms:
|
Parkinson Disease Parkinsonian Disorders Basal Ganglia Diseases Brain Diseases |
Central Nervous System Diseases Nervous System Diseases Movement Disorders Neurodegenerative Diseases |
ClinicalTrials.gov processed this record on May 23, 2013