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Efficacy and Safety of DYSPORT® Using 2mL Dilution in Adults With Cervical Dystonia.

Phase 3
Completed
Conditions
Cervical Dystonia
Interventions
Biological: Botulinum toxin type A
Drug: Placebo
Registration Number
NCT01753310
Lead Sponsor
Ipsen
Brief Summary

The purpose of the protocol is to evaluate the efficacy and safety of Dysport® using 2 mL dilution compared with placebo for the treatment of Cervical Dystonia.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
134
Inclusion Criteria
  • Primary diagnosis of Cervical Dystonia at least 9 months since onset and either previously untreated with botulinum toxin or currently treated with Botox at a total dosing range of 100-200 U and ≤60 U in the sternocleidomastoid muscle at the last injection cycle, and having had a satisfactory treatment response in the principal investigator's judgment during the last two sequential Botox treatment cycles.
  • TWSTRS total score≥ 20; TWSTRS-severity subscale score> 10;
Exclusion Criteria
  • In apparent remission from Cervical Dystonia
  • Diagnosis of pure retrocollis or pure anterocollis
  • For non-naïve subjects, previous poor response to either of the last two Botox treatments
  • Known requirement of <100U or >200U of Botox injected into the neck muscles

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dysport®Botulinum toxin type ADysport® (intramuscular injection), between 250 and 500 units (U)/vial using 2mL dilution, 1 cycle only
PlaceboPlaceboPlacebo, up to 2mL
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) Total Score at Week 4.4 weeks post-treatment

The change from baseline in the TWSTRS total score at Week 4 was determined for the subjects who received a single dose of Dysport® or placebo by intramuscular injection at the baseline visit (Day 1), and is expressed as weighted overall treatment difference. The TWSTRS is an assessment scale used to measure the impact of CD on subjects, and comprises 3 subscales: severity, disability and pain, each of which is scored independently. The total score from the 3 subscales gives the TWSTRS total score with a value from 0 to 85 (best to worst). The score was assessed by the investigator prior to study treatment at baseline and at all post-treatment visits.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Cervical Dystonia Impact Profile-58 (CDIP-58) Total Score at Week 4.4 weeks post-treatment

The CDIP-58 scale is a subject-based rating scale measuring the health impact of CD measured in 8 health dimensions including head and neck symptoms, pain and discomfort, upper limb activities, walking, sleep, annoyance, mood and psychosocial functioning. Subscale scores were transformed to a common theoretical range of 0 (no impact) to 100 (most impact). Negative changes from the baseline total score indicate improvement in the impact of CD on health whereas postive changes indicate worsening.

Change From Baseline in CDIP-58 Total Score at Week 2.2 weeks post-treatment

The CDIP-58 scale is a subject-based rating scale measuring the health impact of CD measured in 8 health dimensions including head and neck symptoms, pain and discomfort, upper limb activities, walking, sleep, annoyance, mood and psychosocial functioning. Subscale scores were transformed to a common theoretical range of 0 (no impact) to 100 (most impact). Negative changes from the baseline total score indicate improvement in the impact of CD on health whereas postive changes indicate worsening. The hierarchical testing procedure would only be conducted if the previous secondary efficacy endpoint (change from baseline in CDIP-58 total score at Week 4) reached a statistically significant treatment effect. This secondary efficacy endpoint (change from baseline in CDIP-58 total score at Week 2) was performed to characterise the full clinical effect.

Change From Baseline in TWSTRS Total Score at Week 2.2 weeks post-treatment

The change from baseline in the TWSTRS total score at Week 2 was determined for the subjects who received a single dose of Dysport® or placebo by intramuscular injection at the baseline visit (Day 1), and is expressed as weighted overall treatment difference. The TWSTRS is an assessment scale used to measure the impact of CD on subjects, and comprises 3 subscales: severity, disability and pain, each of which is scored independently. The total score from the 3 subscales gives the TWSTRS total score with a value from 0 to 85 (best to worst). The score was assessed by the investigator prior to study treatment at baseline and at all post-treatment visits.

Change From Baseline in Clinical Global Impression of Change (CGIC) in CD at Week 2.2 weeks post-treatment

The CGIC is an investigator-reported assessment of the global clinical change in CD since study treatment administration. The CGIC uses a seven-point Likert scale ranging from +3 (very much improved) to -3 (very much worse), and was assessed by the investigator at the Week 2 and Week 4 visits.

TWSTRS Responders at Week 2.2 weeks post-treatment

Treatment response was determined as the number of responders at Week 2 relative to the baseline TWSTRS total score. A treatment responder is defined as a subject who had at least a 30% reduction in the TWSTRS total score after treatment. This was calculated as (\[Week 2 score - baseline score\]/baseline score) \* 100.

Change From Baseline in CGIC in CD at Week 4.4 weeks post-treatment

The CGIC is an investigator-reported assessment of the global clinical change in CD since study treatment administration. The CGIC uses a seven-point Likert scale ranging from +3 (very much improved) to -3 (very much worse), and was assessed by the investigator at the Week 2 and Week 4 visits.

TWSTRS Responders at Week 4.4 weeks post-treatment

Treatment response was determined as the number of responders at Week 4 relative to the baseline TWSTRS total score. A treatment responder is defined as a subject who had at least a 30% reduction in the TWSTRS total score after treatment. This was calculated as (\[Week 4 score - baseline score\]/baseline score) \* 100.

Trial Locations

Locations (42)

Loma Linda University Healthcare, Department of Neurology

🇺🇸

Loma Linda, California, United States

Guilford Neurologic Associates

🇺🇸

West Palm Beach, Florida, United States

NeuroTrials Research Inc.

🇺🇸

Atlanta, Georgia, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

University of Cincinnati Physicians Company, LLC

🇺🇸

Cincinnati, Ohio, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Island Neurological Associates

🇺🇸

Plainview, New York, United States

USC Keck School of Medicine

🇺🇸

Los Angeles, California, United States

Parkinson's & Movement Disorders Center of Boca Raton

🇺🇸

Boca Raton, Florida, United States

Guilford Neurologic Associates; Cone Health Medical Group

🇺🇸

Greensboro, North Carolina, United States

Penn State Hershey Neurology

🇺🇸

Hershey, Pennsylvania, United States

UC Davis Medical Center

🇺🇸

Sacramento, California, United States

University of Colorado at Denver Health Sciences

🇺🇸

Aurora, Colorado, United States

University of South Florida

🇺🇸

Tampa, Florida, United States

OHSU Center for Health and Healing

🇺🇸

Portland, Oregon, United States

Movement Disorders Center of Arizona, LLC

🇺🇸

Scottsdale, Arizona, United States

University of Arizona

🇺🇸

Tucson, Arizona, United States

East Bay Physician's Group

🇺🇸

Berkeley, California, United States

Advanced Neurosciences Research

🇺🇸

Fort Collins, Colorado, United States

Associated Neurologists of Southern Connecticut

🇺🇸

Fairfield, Connecticut, United States

University of Florida Center for Movement Disorders and Neurorestoration

🇺🇸

Gainesville, Florida, United States

Georgetown University Hospital

🇺🇸

Washington, District of Columbia, United States

Premiere Research Institute at Palm Beach Neurology

🇺🇸

West Palm Beach, Florida, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Emerald Coast Center for Neurological Disorders

🇺🇸

Pensacola, Florida, United States

Kansas City Bone & Joint Clinic

🇺🇸

Kansas City, Kansas, United States

International Clinical Research Institute

🇺🇸

Overland Park, Kansas, United States

Rehabilitation Consultants PA

🇺🇸

Eagan, Minnesota, United States

University of Medicine and Dentistry of New Jersey

🇺🇸

Stratford, New Jersey, United States

Atlantic Neuroscience Institute

🇺🇸

Summit, New Jersey, United States

Kingston Neurological Associates

🇺🇸

Kingston, New York, United States

Fazzini Parkinson's Disease & Dystonia Center

🇺🇸

New York, New York, United States

The Ichan School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

Wake Forest School of Medicine

🇺🇸

Winston-Salem, North Carolina, United States

Puget Sound Neurology

🇺🇸

Tacoma, Washington, United States

Parkinson's and Movement Disorder Institute

🇺🇸

Fountain Valley, California, United States

PD Treatment Center of SW FL

🇺🇸

Port Charlotte, Florida, United States

Coastal Neurology

🇺🇸

Port Royal, South Carolina, United States

North Texas Movement Disorders Institute

🇺🇸

Bedford, Texas, United States

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