Study to Assess the Efficacy and Safety of Dysport® in Cervical Dystonia
- Conditions
- Cervical Dystonia
- Interventions
- Biological: Botulinum toxin type A
- Registration Number
- NCT00447772
- Lead Sponsor
- Ipsen
- Brief Summary
The aim is to demonstrate equivalent efficacy and safety in the treatment of the two most frequent forms of cervical dystonia (predominantly rotational torticollis and predominantly laterocollis) with the standard initial dose of 500 units Dysport®. The patients will be assigned to one of the two basic types of cervical dystonia, either predominantly rotational torticollis or predominantly laterocollis on the basis of clinical examination. This will determine which therapy is to be administered, using the clearly defined, structured injection protocols.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 516
- De novo patients with cervical dystonia
- Outpatient
- Patients to be of age 18 years or older
- Written informed consent to participate in the study
- Pre-treatment of cervical dystonia with botulinum toxin
- Pre-treatment with botulinum toxin for any indication other than cervical dystonia within the past 12 months
- Pure retro- or antecollis
- Neurological or other diseases which may affect head and neck motor function or neuromuscular transmission, e.g. polyneuropathy with pareses, myasthenia, myopathy, motor neurone diseases, Bekhterev's disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description 1 Botulinum toxin type A -
- Primary Outcome Measures
Name Time Method Change From Baseline in the Total Score of the Tsui Rating Scale (Patient in Sitting Position) at the First On-treatment Visit (Week 4 or Week 12) Baseline to Week 4 or Week 12 (up to 12 weeks) The Tsui rating scale measures severity and duration of head deviation, shoulder elevation and head tremor. This instrument is based on 4 subscores:
* Subscore A: amplitude of rotation, deflection (tilt) and ante- / retrocollis (range: 0-9 points)
* Subscore B: duration of movement (values 1 or 2)
* Subscore C: severity and duration of shoulder elevation (range: 0-3 points)
* Subscore D: severity and duration of tremor (range: 0-4 points).
The total score was calculated as follows: total score = subscores (A x B) + C + D. The total score ranges between 0 and 25 points. A high total score represents severe CD.
The mean change in the total score of the Tsui rating scale (patient in the sitting position) between baseline (Week 0 visit) and the first on-treatment visit (Week 4 or Week 12 visit) is presented.
- Secondary Outcome Measures
Name Time Method Changes in the Items of the Patient Diary Based on Day-to-day Function and Activities, Pain and Duration of Pain Between Visit 1 (Week 0) and Visit 2 (Week 4) and Visit 3 (Week 12) Baseline to Week 4 and Week 12 The weekly recorded patient diary consists of the three items: Day-to-Day Capacities and Activities, Pain and Duration of Pain. Each item was rated by the patient on an 11-point scale ranging from 0 = no problems at all to 10 = most severe problems (the actual wording is adapted to each item in question).
The mean changes between the baseline (Week 0 visit) and the Week 4 and Week 12 visits are presented.Change in the Total Score of the Tsui Rating Scale (Patient in Sitting Position) Between Visit 1 (Week 0) and Visit 3 (Week 12) Baseline to Week 12 The Tsui rating scale measures severity and duration of head deviation, shoulder elevation and head tremor. This instrument is based on 4 subscores:
* Subscore A: amplitude of rotation, deflection (tilt) and ante- / retrocollis (range: 0-9 points)
* Subscore B: duration of movement (values 1 or 2)
* Subscore C: severity and duration of shoulder elevation (range: 0-3 points)
* Subscore D: severity and duration of tremor (range: 0-4 points).
The total score was calculated as follows: total score = subscores (A x B) + C + D. The total score ranges between 0 and 25 points. A high total score represents severe CD.
The mean change in the total score of the Tsui rating scale (patient in the sitting position) between baseline (Week 0 visit) and the Week 12 visit is presented.Change in the Total Score of the Tsui Rating Scale (Patient Walking) Between Baseline (Week 0) and Visit 2 (Week 4) and Visit 3 (Week 12) Baseline to Week 4 and Week 12 The Tsui rating scale measures severity and duration of head deviation, shoulder elevation and head tremor. This instrument is based on 4 subscores:
* Subscore A: amplitude of rotation, deflection (tilt) and ante- / retrocollis (range: 0-9 points)
* Subscore B: duration of movement (values 1 or 2)
* Subscore C: severity and duration of shoulder elevation (range: 0-3 points)
* Subscore D: severity and duration of tremor (range: 0-4 points).
The total score was calculated as follows: total score = subscores (A x B) + C + D.
The total score ranges between 0 and 25 points. A high total score represents severe CD.
The mean changes in the total score of the Tsui rating scale (patient walking) between baseline (Week 0 visit) and the Week 4 and Week 12 visits are presented.Change in the 4 Subscores of the Tsui Rating Scale (Patient in the Sitting Position) Between Visit 1 (Week 0) and Visit 2 (Week 4) and Visit 3 (Week 12) Baseline to Week 4 and Week 12 The Tsui rating scale measures severity and duration of head deviation, shoulder elevation and head tremor. This instrument is based on 4 subscores:
* Subscore A: amplitude of rotation, deflection (tilt) and ante- / retrocollis (range: 0-9 points)
* Subscore B: duration of movement (values 1 or 2)
* Subscore C: severity and duration of shoulder elevation (range: 0-3 points)
* Subscore D: severity and duration of tremor (range: 0-4 points).
A higher score for each subscale represents severe CD symptoms. The total score was calculated as follows: total score = subscores (A x B) + C + D. The total score ranges between 0 and 25 points. A high total score represents severe CD.
The mean changes in the subscores A to D of the Tsui rating scale (patient in the sitting position) between baseline (Week 0 visit) and the Week 4 and Week 12 visits are presented.Change in the Craniocervical Dystonia Questionnaire (CDQ-24) Total Score and Subscores Between Visit 1 (Week 0) and Visit 2 (Week 4) and Visit 3 (Week 12) Baseline to Week 4 and Week 12 The CDQ-24 is a disease-specific quality of life (QoL) instrument and was assessed at Visits 1 to 3. It consists of 24 items investigating problems in daily living skills related to CD.
This instrument is based on 5 subscales: Stigma, Emotional well-being, Pain, Activities of daily living (ADL), Social/family life to which a number of the 24 items are assigned. There are five possible answers to each item representing increasing severity of impairment (scores 0 to 4). The total scores ranged from 0 to 96 (best to worst QoL). In order to obtain scores of the individual subscales, the total score of each subscale (sum of the individual item scores) was transformed linearly to a 0 to 100 scale (best to worst QoL).
The mean changes in the CDQ-24 total score between baseline (Week 0 visit) and the Week 4 and Week 12 visits are presented.Categorical Changes in the Items of the Patient Diary Based on Day-to-day Function and Activities, Pain and Duration of Pain Between Visit 1 (Week 0) and Visit 2 (Week 4) and Visit 3 (Week 12) Baseline to Week 4 and Week 12 The weekly recorded patient diary consists of the three items: Day-to-Day Capacities and Activities, Pain and Duration of Pain. Each item was rated by the patient on an 11-point scale ranging from 0 = no problems at all to 10 = most severe problems (the actual wording is adapted to each item in question).
The following categorical changes between the baseline (Week 0 visit) and the Week 4 and Week 12 visits are presented: Improvement, No change and Deterioration.Number of Patients Without Pain and/or With a Reduction in Pain Based on a Global Assessment of Pain by the Investigator and by the Patient at Visit 2 (Week 4) and Visit 3 (Week 12) Week 4 visit and Week 12 visit Global pain was assessed at Visit 2 (Week 4) and Visit 3 (Week 12); investigators and patients assessed change in global pain according to the following response categories:
1. = no pain (anymore)
2. = less pain
3. = no change
4. = more pain
The numbers of patients falling under each of these categories as assessed by the investigator and patient at Weeks 4 and 12 are presented.Global Assessment of Efficacy by the Investigator and by the Patient at Visit 2 (Week 4) and Visit 3 (Week 12) Week 4 and Week 12 At Visit 2 (Week 4) and Visit 3 (Week 12) investigators and patients assessed global efficacy of injection of 500 U Dysport® according to the following response categories:
1. = very good
2. = good
3. = moderate
4. = insufficient
The numbers of patients falling under each of these categories as assessed by the investigator and patient at Weeks 4 and 12 are presented.
Trial Locations
- Locations (83)
Städt. Krankenhaus Martha-Maria
🇩🇪Halle, Germany
Gemeinschaftspraxis für Neurologie/Psychiatrie
🇩🇪Lüneburg, Germany
Westpfalz-Klinikum GmbH
🇩🇪Kaiserslautern, Germany
Krankenhaus der Barmherzigen Brüder
🇦🇹Graz, Austria
NÖ LKH Grimmenstein-Hochegg
🇦🇹Grimmenstein, Austria
Konventhospital der Barmherzigen Brüder
🇦🇹Linz, Austria
Neurolog. Klinik des RWTH Aachen
🇩🇪Aachen, Germany
Praxis für Neurologie
🇩🇪Stralsund, Germany
Praxis für Neurologie und Psychiatrie
🇩🇪Ostfildern, Germany
Sächsisches Krankenhaus
🇩🇪Arnsdorf, Germany
Krankenhaus Hohe Warte
🇩🇪Bayreuth, Germany
Neurologische Rehabilitationsklinik
🇩🇪Beelitz, Germany
NRZ Neurologisches Rehabilitationszentrum Leipzig
🇩🇪Bennewitz, Germany
Neurologisches Facharztzentrum am St.-Gertrauden-KH
🇩🇪Berlin, Germany
Universitätsklinikum Charité, Campus Benjamin Franklin
🇩🇪Berlin, Germany
Universitätsklinikum Charité, Campus Virchow-Klinikum
🇩🇪Berlin, Germany
Krankenhaus Henningsdorf
🇩🇪Berlin, Germany
Gemeinschaftspraxis für Neurologie
🇩🇪Wolfenbüttel, Germany
SALUS Fachkrankenhaus Bernburg
🇩🇪Bernburg, Germany
Berufsg. Kliniken Bergmannsheil
🇩🇪Bochum, Germany
St.-Josef-Hospital
🇩🇪Bochum, Germany
Medizinische Einrichtung Rhein. F.-Wilhelms-Universität Bonn
🇩🇪Bonn, Germany
Zentralkrankenhaus Bremen-Ost
🇩🇪Bremen, Germany
Klinikum Chemnitz gGmbH
🇩🇪Chemnitz, Germany
Bezirksklinikum Mainkofen
🇩🇪Deggendorf, Germany
Malteser Krankenhaus St. Anna
🇩🇪Duisburg, Germany
University Hospital, Neurology Clinic
🇩🇪Düsseldorf, Germany
HELIOS Klinikum Erfurt
🇩🇪Erfurt, Germany
Alfried-Krupp-Krankenhaus
🇩🇪Essen, Germany
Universitätsklinik Essen
🇩🇪Essen, Germany
Kreiskrankenhaus Freiberg
🇩🇪Freiberg, Germany
Bezirkskrankenhaus Günzburg
🇩🇪Günzburg, Germany
Klinikum Ambrock
🇩🇪Hagen, Germany
Uniklinik Jena
🇩🇪Jena, Germany
Universitätsklinikum Kiel
🇩🇪Kiel, Germany
Kath. Klinikum/Brüderkrankenhaus
🇩🇪Koblenz, Germany
Neurologische Praxis
🇩🇪Straubing, Germany
Universitätsklinikum Leipzig
🇩🇪Leipzig, Germany
Klinikum Lippe-Lemgo GmbH
🇩🇪Lemgo, Germany
Klinikum der Stadt Ludwigshafen
🇩🇪Ludwigshafen, Germany
Universitätsklinikum Münster
🇩🇪Münster, Germany
Uniklinik Erlangen
🇩🇪Erlangen, Germany
O.Ö. Landes-Nervenklinik Wagner-Jauregg
🇦🇹Linz, Austria
Praxis für Anästhesiologie
🇩🇪Ahaus, Germany
Klinikum für Rehabilitation
🇩🇪Bad Oeynhausen, Germany
Neurologische Klinik GILEAD im Evang. KH Bielefeld EVKB
🇩🇪Bielefeld, Germany
Landesklinik Eberswalde
🇩🇪Eberswalde, Germany
Universitätsklinikum Carl Gustav Carus
🇩🇪Dresden, Germany
Zentrum für Neurologie
🇩🇪Giessen, Germany
Sächsisches Krankenhaus für Psychiatrie, Psychotherapie und Neurolgie
🇩🇪Großschweidnitz, Germany
Katholisches Krankenhaus Hagen
🇩🇪Hagen, Germany
Universitätskliniken des Saarlandes
🇩🇪Homburg, Germany
Neurologische Uniklinik
🇩🇪Hannover, Germany
Klinikum Koeln-Merheim
🇩🇪Koeln, Germany
Universitätsklinikum
🇩🇪Rostock, Germany
Neurologisches Krankenhaus München
🇩🇪München, Germany
Kliniken Maria Hilf GmbH
🇩🇪Mönchengladbach, Germany
Klinikum Minden
🇩🇪Minden, Germany
Klinikum rechts der Isar
🇩🇪München, Germany
Praxis für Neurologie und Nervenheilkunde
🇩🇪Neubrandenburg, Germany
Evangelisches Krankenhaus Oldenburg
🇩🇪Oldenburg, Germany
St.-Josefs-Krankenhaus
🇩🇪Potsdam, Germany
Klinikum Nürnberg-Süd
🇩🇪Nürnberg, Germany
St. Vincenz-Krankenhaus GmbH
🇩🇪Paderborn, Germany
Klinikum Ernst von Bergmann
🇩🇪Potsdam, Germany
Zentrum für Psychiatrie Weissenau
🇩🇪Ravensburg, Germany
Knappschafts-Krankenhaus
🇩🇪Recklinghausen, Germany
Klinikum Uckermark GmbH
🇩🇪Schwedt/Oder, Germany
Evang.-Freichkirchl. Krankenhaus
🇩🇪Rüdersdorf, Germany
EMSA
🇩🇪Singen, Germany
HELIOS Kliniken Schwerin
🇩🇪Schwerin, Germany
Landesklinik Teupitz
🇩🇪Teupitz, Germany
Landesfachkrankenhaus für Psychatrie und Neurologie
🇩🇪Stadtroda, Germany
Asklepios Kliniken Schildautal
🇩🇪Seesen, Germany
Zentrum für Neurologie und Hertie-Institut für Klinische Hirnforschung
🇩🇪Tübingen, Germany
Klinikum Weiden
🇩🇪Weiden, Germany
Stiftung Deutsche Klinik für Diagnostik
🇩🇪Wiesbaden, Germany
Klinikum Wuppertal
🇩🇪Wuppertal, Germany
Medizinisches Studienzentrum
🇩🇪Würzburg, Germany
Universitätsklinikum Würzburg
🇩🇪Würzburg, Germany
Paracelsus Klinik
🇩🇪Zwickau, Germany
Klinikum Mannheim
🇩🇪Mannheim, Germany
Univ.-Klinik für Neurologie
🇦🇹Innsbruck, Austria