Single-Centre Study of VR040(Inhaled Apomorphine) in Idiopathic Parkinson's Disease

This study has been completed.
Sponsor:
Collaborator:
Vectura Limited
Information provided by (Responsible Party):
Dr Donald Grosset, South Glasgow University Hospitals NHS Trust
ClinicalTrials.gov Identifier:
NCT01683292
First received: September 7, 2012
Last updated: NA
Last verified: September 2012
History: No changes posted
  Purpose

In this first study of inhaled apomorphine in Parkinson's disease patients, the primary objective is to find the minimum efficacious dose of apomorphine that is useful in rescuing patients during 'off' periods. Safety, tolerability and pharmacokinetics of inhaled apomorphine will be assessed during the study.


Condition Intervention Phase
Parkinson's Disease
Drug: Inhaled VR040
Drug: Placebo for VR040
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: An Ascending-Dose, Single-Centre Study Investigating the Safety, Tolerability, Efficacy, and Pharmacokinetics of VR040(Inhaled Apomorphine)in Parkinson's Disease

Resource links provided by NLM:


Further study details as provided by South Glasgow University Hospitals NHS Trust:

Primary Outcome Measures:
  • The proportion of patients "on" at any time post-dosing. [ Time Frame: up to 80 minutes ] [ Designated as safety issue: No ]
    Parkinson's motor severity assessed by a clinician, and disease state assessment by the patient, were performed at baseline during an 'off' state, and at specified times after test drug administration.


Secondary Outcome Measures:
  • Duration that patients remain in an "on" state. [ Time Frame: until return to "off" up to 3 hours ] [ Designated as safety issue: No ]
    Time from when patient switched "on" after inhalation of study product, until patient returned to "off" state.


Enrollment: 29
Study Start Date: January 2006
Study Completion Date: May 2007
Primary Completion Date: June 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Inhaled VR040
Inhaled apomorphine, dry powder, VR040 at fine particle doses (FPD) of 0.2mg, 0.5mg and 0.8mg. A single dose, followed by a second dose at 12 minutes if efficacy end point was not attained.
Drug: Inhaled VR040
Other Name: Inhaled apomorphine
Placebo Comparator: Placebo
Inhaled dry powder. A single dose, followed by a second dose at 12 minutes if efficacy end point was not attained.
Drug: Placebo for VR040
Placebo arm

Detailed Description:

Objectives:

  Eligibility

Ages Eligible for Study:   30 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patients with established idiopathic PD (via fulfilment of Steps 1 and 2 of the UK Brain Bank Criteria), of at least 3 years duration prior to study entry, who were on specific and optimised anti-Parkinson medication (levodopa and/or dopamine agonists), and with motor fluctuations.
  2. Patients with a modified Hoehn and Yahr disease severity scoring of between 2 and 4 in an "on" state.
  3. Men or women aged over 30 years.
  4. Patients with a signed and dated written valid consent obtained prior to participation.
  5. Female patients must have been of non-childbearing potential (ie, physiologically incapable of becoming pregnant, including any female who was post-menopausal) or of child-bearing potential with a negative pregnancy test (urine or serum) at screening.
  6. Patients who experienced motor fluctuations with recognisable "off" periods in control of motor symptoms, as assessed by the motor fluctuation questionnaire (patients were to have reported at least 1 "Yes" response to the questions in the motor fluctuation questionnaire).
  7. Patient willing and able to comply with study procedures.-

Exclusion Criteria:

  1. Patients who had participated in a trial with an investigational product within 3 months prior to randomisation at Visit 2.
  2. Patients with serious uncontrolled disease including serious psychological disorders likely to interfere with the study and/or likely to cause death within 6 months of the study completion.
  3. Patients with previous intolerance to apomorphine.
  4. Patients with a previous significant complication from oral dopamine agonist therapy including hospitalisation following dopamine agonist introduction and/or the development of hallucinations or other adverse neuropsychiatric features following introduction of sc apomorphine.
  5. Women lactating, pregnant, or of child-bearing potential not using a reliable contraceptive method.
  6. Patients with known HIV or active chronic hepatitis B or C infection.
  7. Patients with any clinically significant abnormality following review of screening laboratory data and full physical examination.
  8. Patients who, in the Investigator's opinion, were unsuitable for the study for any reason.
  9. Patients with clinically significant blood test abnormalities and previous medical history/intercurrent illnesses that may have compromised the safety of the patient in the study.
  10. Patients with major ECG abnormalities (as judged by the Investigator).
  11. Patients with a FEV1 <65%.
  12. Patients showing a postural decrease in systolic blood pressure (BP) of > 20 mm Hg, or showing significant clinical symptoms associated with orthostatic hypotension.
  13. Patients with persistent elevation of BP, with average systolic readings of 160 mm Hg or average diastolic readings of 100 mm Hg.
  14. Patients taking anabolic steroids, traditional antipsychotics (unless low dose), and antiemetics other than domperidone.
  15. Patients taking agents of the 5HT3 antagonist class including ondansetron, granisetron, dolasetron, palonosetron, and alosetron.
  16. Patients with existing cancer and those in remission for less than 5 years.
  17. Patients with evidence (as ascertained from examination, tests or history) to indicate cardiovascular, gastrointestinal tract, liver, kidney, central nervous system, pulmonary system, or bone marrow disorders that in the Investigator's opinion compromised patient safety.
  18. Patients who were known non-responders to apomorphine treatment for "off" episodes.
  19. Patients with a history of drug or alcohol abuse in the 12 months prior to entry.
  20. Patients with a history of clinically significant allergies to VR040 formulation constituents (including lactose and opioids) and domperidone.
  21. Patients with signs or symptoms suggestive of schizophrenia, dementia, "Parkinson plus" syndromes, or unstable systemic disease
  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: NCT01683292

Locations
United Kingdom
Southern General Hospital
Glasgow, United Kingdom, G51 4TF
Sponsors and Collaborators
South Glasgow University Hospitals NHS Trust
Vectura Limited
  More Information

No publications provided

Responsible Party: Dr Donald Grosset, Consultant Neurologist, South Glasgow University Hospitals NHS Trust
ClinicalTrials.gov Identifier: NCT01683292     History of Changes
Other Study ID Numbers: VR040/001
Study First Received: September 7, 2012
Last Updated: September 7, 2012
Health Authority: United Kingdom: Medicines and Healthcare Products Regulatory Agency

Keywords provided by South Glasgow University Hospitals NHS Trust:
apomorphine
inhaled
motor fluctuations

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

ClinicalTrials.gov processed this record on July 28, 2014