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Study of BOTOX Injections to Assess Change in Disease Symptoms in Adult Participants With Upper Limb Essential Tremor

Phase 2
Completed
Conditions
Upper Limb Essential Tremor (UL ET)
Interventions
Drug: Placebo for BOTOX
Registration Number
NCT05216250
Lead Sponsor
AbbVie
Brief Summary

Upper limb essential tremor (UL ET) is a movement disorder characterized by postural and/or kinetic tremor. It can cause difficulty with everyday tasks such as writing, pouring, and eating, and patients also experience associated social embarrassment. This study will assess how safe and effective BOTOX is in treating UL ET. Adverse events and change in disease activity will be evaluated.

BOTOX is an investigational drug being developed for the treatment of UL ET. Participants are randomly assigned to 1 of the 4 groups, called treatment arms. Each group receives different treatment. There is 1 in 2 chance that participants will be assigned to placebo. Around 174 participants, aged 18 to 80 years with UL ET will be enrolled in approximately 40 sites in North America.

Participants will receive BOTOX or placebo injections in Cycle 1 and Cycle 2. In Cycle 3, participants will receive unilateral or bilateral BOTOX injections. Each cycle is 12 weeks.

There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
174
Inclusion Criteria
  • Diagnosis of essential tremor in accordance with modified Tremor Investigation Group (TRIG) criteria as described in the protocol.

  • TREDS-Revised Scale (1-4 scale, whole numbers) unilateral score of >= 3 for the Tremor Disability Scale (TREDS) on any of the 7 unilateral items; no more than a single item score of 1 among the 7 unilateral items in the dominant limb.

  • TETRAS activities of daily living (ADL) (recorded on a 0-4 scale, whole numbers) minimum score of >= 3 on any of the 5 unilateral items; no more than a single item score of <=1 among the 5 unilateral items in the dominant limb.

  • At least one of the following criteria must also be met:

    • TETRAS UL score (0-4 scale, with 0.5 increments) of > 2 in the dominant limb on at least one of the 3 maneuvers OR
    • TETRAS Archimedes spiral task score (0-4 scale, with 0.5 increments) of > 2 in the dominant limb
Exclusion Criteria
  • Any uncontrolled clinically significant medical condition other than the one under study.
  • Any medical condition that may put the participant at increased risk with exposure to BOTOX Purified Neurotoxin Complex.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo/BOTOX UnilateralPlacebo for BOTOXParticipants will receive placebo in Cycle 1 and Cycle 2 followed by unilateral BOTOX in Cycle 3.
Placebo/BOTOX BilateralPlacebo for BOTOXParticipants will receive placebo in Cycle 1 and Cycle 2 followed by bilateral BOTOX in Cycle 3.
BOTOX/BOTOX UnilateralBOTOXParticipants will receive BOTOX in Cycle 1 and Cycle 2 and unilateral BOTOX in Cycle 3
BOTOX/BOTOX BilateralBOTOXParticipants will receive BOTOX in Cycle 1 and Cycle 2 and bilateral BOTOX in Cycle 3
Placebo/BOTOX UnilateralBOTOXParticipants will receive placebo in Cycle 1 and Cycle 2 followed by unilateral BOTOX in Cycle 3.
Placebo/BOTOX BilateralBOTOXParticipants will receive placebo in Cycle 1 and Cycle 2 followed by bilateral BOTOX in Cycle 3.
Primary Outcome Measures
NameTimeMethod
Number of Participants with Treatment Emergent Adverse Events (AEs)Up to approximately 36 weeks

An AE is defined as any untoward medical occurrence in a patient or clinical investigation in which a participant is administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment.

Change From Baseline in Tremor Disability Scale-Revised (TREDS-R) Total Score Across 7 Unilateral ItemsWeek 24

Tremor Disability Scale-Revised (TREDS-R) is a scale to assess activities of daily living (ADL) through a self-questionnaire asking participants to rate how easy or difficult it is to perform a particular activity. The scale consists of 20 items with each item rated on a scale of 1 (able to do the activity without difficulty) to 4 (cannot do the activity by yourself). 7 items included in this subset will be: use a spoon to drink soup, hold a cup of tea, pour milk from a bottle or carton, dial a telephone, pick up your change in a shop, insert an electric plug into a socket, unlock your front door with a key.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in TETRAS Activity of Daily Living (TETRAS ADL) Total Score Across 5 Unilateral ItemsWeek 24

TETRAS Activity of Daily Living (TETRAS ADL) is a clinical rating scale using the total score across 5 unilateral items of the analyzed 10-item TETRAS ADL, with each item's recorded scores of 0 and 1 (0-4 scale) combined into one category with a score of 1 for analysis on a 1-4 scale.

The 5 tasks included in this subset will be feeding with a spoon, drinking from a glass, pouring, using keys, and writing.

Change From Baseline in TETRAS Handwriting ScoreWeek 24

TETRAS Handwriting is an item of the TETRAS performance subscale that is designed to assess tremor severity. During this test, participants are instructed to write the standard sentence "This is a sample of my best handwriting" using the dominant hand only, which is then scored from 0 to 4 with 1 being tremor is "slight: untidy due to tremor that is barely visible" and 4 being "severe: completely illegible."

Change From Baseline in Clinical Global Impression of Severity (CGI-S)Week 24

CGI-S is a single item used to measure the clinician's impression of the current severity of the patient's essential tremor. The measure uses a 5-point rating scale where "0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe."

Change From Baseline in Essential Tremor Rating Assessment (TETRAS UL) ScoreWeek 24

TETRAS Upper Limb (UL) Scale is an item of the TETRAS performance subscale that is designed to assess upper limb tremor during three maneuvers: forward horizontal reach posture, lateral "wing beating" posture, and finger-nose-finger testing. Each maneuver is scored from 0 to 4, with 1 indicating a tremor amplitude that is "barely visible" and 4 indicating a tremor amplitude that is \>= 20 cm.

Change From Baseline in TETRAS Archimedes Spiral ScoreWeek 24

Tremor Research Group Essential Tremor Rating Assessment Scale (TETRAS) Archimedes Spiral is an item of the TETRAS performance subscale that is designed to assess tremor severity. During this test, participants are instructed to draw an unbroken spiral which is then scored from 0 to 4, with 1 being tremor is "barely visible" and 4 being "figure not recognizable."

Change From Baseline in Patient Global Impression of Severity (PGI-S)Week 24

PGI-S is a single item used to measure the participant's impression of severity of their essential tremor symptoms. The measure uses a 5-point rating scale where 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe.

Trial Locations

Locations (40)

Accel Research Sites - Neurology and Neurodiagnostics of Alabama, LLC /ID# 240472

🇺🇸

Hoover, Alabama, United States

Barrow Neurological Institute - Dignity Health St. Joseph's Hosp and Medical Ctr /ID# 231731

🇺🇸

Phoenix, Arizona, United States

University of Arizona /ID# 239781

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Tucson, Arizona, United States

Loma Linda University /ID# 230905

🇺🇸

Loma Linda, California, United States

University of Colorado - Anschutz Medical Campus /ID# 239869

🇺🇸

Aurora, Colorado, United States

New England Institute for Clinical Research /ID# 238404

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Stamford, Connecticut, United States

Parkinson's Disease and Movement Disorders Center of Boca Raton /ID# 231677

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Boca Raton, Florida, United States

Coastal Clinical Research Specialists /ID# 240897

🇺🇸

Fernandina Beach, Florida, United States

Coastal Clinical Research Specialists /ID# 240471

🇺🇸

Jacksonville, Florida, United States

Charter Research - Winter Park /ID# 241568

🇺🇸

Orlando, Florida, United States

CDC Research Institute LLC /ID# 242744

🇺🇸

Port Saint Lucie, Florida, United States

Emory University / Emory Brain Health Center /ID# 231911

🇺🇸

Atlanta, Georgia, United States

Accel Research Site-NeuroStudies /ID# 239881

🇺🇸

Decatur, Georgia, United States

Univ Kansas Med Ctr /ID# 231166

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Kansas City, Kansas, United States

Kansas Institute of Research /ID# 231623

🇺🇸

Overland Park, Kansas, United States

Tufts Medical Center /ID# 239929

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Boston, Massachusetts, United States

Lahey Hospital & Medical Center /ID# 233232

🇺🇸

Burlington, Massachusetts, United States

Henry Ford Health Medical Center - Jackson /ID# 231400

🇺🇸

Jackson, Michigan, United States

Dent Neurologic Institute - Amherst /ID# 255665

🇺🇸

Amherst, New York, United States

UNC Hospitals Neurology Clinic - Chapel Hill /ID# 238857

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Chapel Hill, North Carolina, United States

Neurology - Triad /ID# 239806

🇺🇸

Winston-Salem, North Carolina, United States

Atrium Health Wake Forest Baptist Medical Center /ID# 233550

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Winston-Salem, North Carolina, United States

Dayton Center for Neurological Disorders /ID# 233737

🇺🇸

Centerville, Ohio, United States

The Orthopedic Foundation /ID# 232234

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New Albany, Ohio, United States

Oregon Health and Science University /ID# 231581

🇺🇸

Portland, Oregon, United States

Thomas Jefferson University Hospital /ID# 232614

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Philadelphia, Pennsylvania, United States

University of Pittsburgh MC /ID# 233735

🇺🇸

Pittsburgh, Pennsylvania, United States

Medical University of South Carolina /ID# 233538

🇺🇸

Charleston, South Carolina, United States

Texas Neurology /ID# 250428

🇺🇸

Dallas, Texas, United States

University of Texas Southwestern Medical Center /ID# 239770

🇺🇸

Dallas, Texas, United States

Texas Movement Disorder Specialists, PLLC /ID# 242524

🇺🇸

Georgetown, Texas, United States

Baylor College of Medicine /ID# 231624

🇺🇸

Houston, Texas, United States

Univ Texas HSC San Antonio /ID# 232615

🇺🇸

San Antonio, Texas, United States

Integrated Neurology Services - Falls Church /ID# 233545

🇺🇸

Falls Church, Virginia, United States

Gamma Therapeutic Center /ID# 232547

🇺🇸

Greenfield, Wisconsin, United States

Marshfield Clinic - Marshfield /ID# 233191

🇺🇸

Marshfield, Wisconsin, United States

Vancouver Coastal Health Authority - University of British Columbia /ID# 240356

🇨🇦

Vancouver, British Columbia, Canada

Centricity Research /ID# 240587

🇨🇦

Halifax, Nova Scotia, Canada

Toronto Western Hospital /ID# 231587

🇨🇦

Toronto, Ontario, Canada

Genge Partners /ID# 251546

🇨🇦

Montreal, Quebec, Canada

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