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临床试验/NCT02969369
NCT02969369已完成2 期

A Multicenter Randomized Double-blind Followed by an Open-label Extension Study to Evaluate the Efficacy, Safety, and Tolerability of SEP-363856 in Subjects With Parkinson's Disease Psychosis

Otsuka Pharmaceutical Development & Commercialization, Inc.24 个研究点 分布在 1 个国家目标入组 39 人开始时间: 2016年12月31日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
2 期
状态
已完成
入组人数
39
试验地点
24
主要终点
Change From Double Blind (DB) Baseline in Total Scale for Assessment of Positive Symptoms - Parkinson's Disease ( SAPS-PD) Score at Week 6

研究概览

简要总结

A study to evaluate the safety and tolerability of SEP-363856 in subjects with Parkinson's Disease Psychosis. This study is accepting male and female participants 55 years of age and older who have been diagnosed with Parkinson's Disease. This study will be conducted in 24 study centers in the United States.

The study will last approximately 21 weeks.

详细描述

This is a multicenter, randomized, parallel-group, placebo-controlled study evaluating the efficacy, safety, and tolerability of double-blind SEP-363856 flexibly dosed at 25, 50, or 75 mg/day for 6 weeks followed by 12 weeks of open-label extension of SEP-363856 flexibly-dosed at 25, 50, or 75 mg/day in male and female subjects ≥ 55 years of age with a clinical diagnosis of PDP. The study will randomize approximately 36 subjects to 2 treatment groups in a 2:1 ratio (approximately 24 subjects to SEP-363856 and 12 to placebo). The study will consist of 4 periods: Screening/Washout Period (up to 14 days prior to Double-blind Treatment), Double-blind Treatment Period (6 weeks), Open-label SEP-363856 Treatment Period (12 weeks), and Follow-up Period (1 week after last dose) as shown in the following figure. All postBaseline clinic visits will have a window of ± 2 days relative to the date of the Baseline visit (Visit 3).

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)

入排标准

年龄范围
55 Years 至 105 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Subject, caregiver, and/or legally authorized representative understands and is willing to sign informed consent to participate in the study.
  • Subject must be willing and able to comply with the study procedures and visit schedules and must be able to follow verbal and written instructions.
  • Subject is male or postmenopausal female ≥ 55 years of age.
  • Subject meets established diagnostic criteria for Parkinson's disease of at least one year duration, consistent with the UK Brain Bank criteria
  • Subject has psychotic symptoms that began after the diagnosis of PD for at least one month, occurring at least weekly in the month prior to screening (according to subject or caregiver), and severe enough to warrant treatment with antipsychotics.
  • Subject has a combined score of at least 6 or an individual score of at least 4 on the neuropsychiatric inventory (NPI) Item A (delusions) and/or Item B (hallucinations). This crieterion must be met at Visit 1 and Visit
  • Subject has a Mini-mental status examination (MMSE) score > 21 points out of
  • Subject has a caregiver (spouse or family member) who will be required to attend all visits and is able to provide study information on various scales such as the NPI.
  • Subject is taking antiparkinsonian drugs or deep brain stimulation, with a stable dose/dose regimen and settings for 3 months before enrolment.
  • Female subject must be postmenopausal defined as being amenorrheic for greater than two years with an appropriate clinical profile.
  • Male subjects with female partner(s) of childbearing potential must agree to avoid fathering a child and use acceptable methods of birth control from screening until at least 30 days after the last study drug administration.
  • Subject is, in the opinion of the Investigator, medically stable based on screening medical history, PE, neurological examination, vital signs, clinical laboratory values (hematology, serum chemistry, urinalysis, lipid panel, coagulation panel, thyroid panel, and serum prolactin).
  • Subject has had a stable living arrangement at the time of screening.

排除标准

  • Subject has psychosis secondary to other toxic or metabolic disorders.
  • Subject has atypical Parkinson's disease, Parkinsonism secondary to medication or other neurodegenerative disorders, such as progressive supranuclear palsy or multiple system atrophy.
  • Subject has dementia diagnosed concurrent with or before Parkinson's disease, motor symptoms that began less than one year before the onset of dementia or symptoms consistent with the diagnosis of lewy body dementia (LBD), or if the psychosis occurred after ablative stereotaxic surgery.
  • Subject failed 2 or more antipsychotic agents given at adequate doses for at least 4 weeks within 1 year before screening.
  • Subject has had a stroke or other uncontrolled serious medical or neurological illness within 6 months of baseline.
  • Subject answers "yes" to "Suicidal Ideation" Item 4 (active suicidal ideation with some intent to act, without specific plan) or Item 5 (active suicidal ideation with specific plan and intent) on the C SSRS at Screening (ie, in the past one month), or baseline (ie, since last visit).
  • Subject does not tolerate venipuncture or has poor venous access that would cause difficulty for collecting blood samples.
  • Subject has participated in an investigational drug study and received investigational drug within 30 days (or longer if the half-life is known to be ≥ 150 hours) prior to the screening visit, or who is currently participating in another clinical study. Subject has previously received SEP
  • Subject has any clinically significant unstable medical condition or any clinically significant chronic disease that in the opinion of the Investigator, would limit the subject's ability to complete and/or participate in the study:
  • Subject has hematological (including deep vein thrombosis) or bleeding disorder, renal, metabolic, endocrine, pulmonary, gastrointestinal, urological, cardiovascular, hepatic, neurologic, or allergic disease that is clinically significant or unstable (except for untreated, asymptomatic, seasonal allergies at time of dosing).
  • Subject has a history of cancer or significant neoplasm.
  • Subject has a disorder or history of a condition or previous gastrointestinal surgery (eg, cholecystectomy, vagotomy, bowel resection, or any surgical procedure) that may interfere with drug absorption, distribution, metabolism, excretion, gastrointestinal motility, or pH, or a clinically significant abnormality of the hepatic or renal system, or a history of malabsorption.
  • Subject has Alcohol or Substance Abuse Disorder (DSM 5 criteria). The only exceptions are caffeine or nicotine.
  • Subject has a clinically significant abnormal 12 lead ECG that may jeopardize the subject's ability to complete the study or a screening 12 lead ECG demonstrating any one of the following: heart rate > 100 beats per minute, QRS > 120 ms, QT interval corrected for heart rate using Fridericia's formula (QTcF) > 450 ms (males), QTcF > 470 ms (females), or PR > 220 ms.
  • Subjects with known human immunodeficiency virus (HIV) seropositivity will be excluded.
  • Female subject who is pregnant or lactating.
  • Subject has a presence or history of a medically diagnosed, clinically significant psychiatric disorder.
  • Subject is at significant risk of harming him/herself or others according to the Investigator's judgment.
  • Subject has attempted suicide within 3 months prior to screening.
  • Subject has a history of allergic reaction or suspected sensitivity to any substance that is contained in the formulation.
  • Subject has any clinically significant abnormal laboratory values (hematology, serum chemistry, urinalysis, lipid panel, coagulation panel, thyroid panel, serum prolactin, and urine drug screen(Note: abnormal findings that may be clinically significant or of questionable significance will be discussed with the Medical Monitor prior to including subject).
  • Subjects with serum alanine transaminase (ALT) or aspartate transaminase (AST) levels ≥ 3 times, serum blood urea nitrogen (BUN) or creatine ≥ 1.5 X the upper limit of the reference ranges provided by the central laboratory require retesting. If on retesting, the laboratory value remains equal to or above the ULN, the subject will be excluded.
  • Subjects with a random (non-fasting) blood glucose at screening ≥ 200 mg/dL (11.1 mmol/L) and HbA1c ≥ 6.5% will be excluded.
  • Subject has a prolactin concentration > 100 ng/mL at screening or has a history of pituitary adenoma.
  • Subject's BMI is ≥ 30 mg/kg/m
  • Subject has experienced significant blood loss (≥ 473 mL) or donated blood within 60 days prior to first dose of study drug; has donated plasma within 72 hours prior to the first dose of study drug or intends to donate plasma or blood or undergo elective surgery during study participation or within 60 days after the last study visit.
  • Subject consumes more than 300 mg of caffeine per day (5 cups of coffee or equivalent in caffeinated beverages).
  • Subject has used disallowed prescription medications or anticipates the need for any disallowed medication during their participation in this study. Subject is a staff member or the relative of a staff member.
  • Subject is in the opinion of the Investigator, unsuitable in any other way to participate in this study.
  • Continuation into Open-label Extension Cirteria
  • Subject must have completed the 6-week double-blind treatment.
  • Subject has not taken any medication other than the study drug for the purpose of controlling PDD symptoms
  • . • There has been no clinically significant change in the subject's medical condition or Parkinson's disease, in the opinion of the investigator.
  • Subject has not answered "yes" to "suicidal ideation" item 4 (active suicidal ideation with some intent to act, without specific plan) or item 5 (active suicidal ideation with specific plan and intent) on the C-SSRS assessment at any time during the DB treatment period.

研究组 & 干预措施

SEP-363856

Experimental

SEP-363856 (25, 50, or 75mg/day), once daily

干预措施: SEP-363856 (Drug)

Placebo Capsule

Placebo Comparator

Placebo once daily

干预措施: Placebo capsule (Drug)

结局指标

主要结局

Change From Double Blind (DB) Baseline in Total Scale for Assessment of Positive Symptoms - Parkinson's Disease ( SAPS-PD) Score at Week 6

时间窗: SAPS-PD assessments during DB treatment period, Baseline and Week 6

There are seven items assessing individual symptoms (four items for hallucinations and three items for delusions), a global hallucinations item and a global delusions item. Separate items are rated from 0 (absent) to 5 (severe), so that higher values represent a worse outcome. Total score is equal to the sum of the seven items plus the global hallucinations, plus the global delusions. Therefore a total possible score on the SAPS-PD ranges from 0 to 45. The primary analysis of the primary efficacy variable will use a mixed model for repeated measures (MMRM).

次要结局

  • Change From Double-blind (DB) Baseline in Mini Mental State Evaluation (MMSE) at Week 6(MMSE assessments during DB treatment period, Baseline and Week 6)
  • Change From Double Blind (DB) Baseline in the Clinical Global Impression-Severity of Illness (CGI-S) at Week 6.(CGI-S assessments during DB treatment period, Baseline and Week 6)
  • Change From Double Blind (DB) Baseline in Neuropsychiatric Inventory (NPI) at Week 6(NPI assessments during DB treatment period, Baseline and Week 6)

研究者

申办方类型
Industry
责任方
Sponsor

研究点 (24)

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