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临床试验/NCT00465452
NCT00465452已完成3 期

The Impact of Switching to Continuous Release Dopamine Agonists on Non-Motor Side Effects

University of Toledo1 个研究点 分布在 1 个国家目标入组 11 人开始时间: 2007年1月最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
状态
已完成
入组人数
11
试验地点
1
主要终点
Unified Parkinson's Disease Rating Scale (UPDRS), Parts 3 (Motor Performance) and 4 (Disability).

研究概览

简要总结

The purpose of this proposal is to determine if switching PD patients treated with pramipexole to ropinirole CR reduces the non-motor side effects frequently experienced by these patients. Side effects that we will monitor in particular include somnolence, peripheral edema, cognitive decline with and without hallucinations. PD patients followed in the MUO Neurology Clinic who are being treated with pramipexole and have evidence of at least one of the following symptoms: somnolence, cognitive impairment with or without hallucinations, or peripheral edema will be offered the opportunity to participate in this study.

详细描述

The purpose of this proposal is to determine if switching PD patients treated with pramipexole to ropinirole CR reduces the non-motor side effects frequently experienced by these patients. Side effects that we will monitor in particular include somnolence, peripheral edema, cognitive decline with and without hallucinations. PD patients followed in the MUO Neurology Clinic who are being treated with pramipexole and have evidence of at least one of the following symptoms: somnolence, cognitive impairment with or without hallucinations, or peripheral edema will be offered the opportunity to participate in this study.

Fifteen subjects who are currently receiving pramipexole therapy (monotherapy or adjunctive therapy) who are experiencing one or more of the following symptoms: somnolence, cognitive decline with/without hallucinations, and peripheral edema will be asked if they are willing to participate at the time of their clinic visit at the PDMDP.

The crossover from pramipexole to ropinirole CR will be performed over a 2 week interval. During the first week, the initial drug dose will substitute ½ of the pramipexole with ½ of the target dose of ropinirole CR. If subjects are tolerating the drug change, then 100% of the target dose of ropinirole CR (and no pramipexole) will be started in the second week.

研究设计

研究类型
Interventional
分配方式
Na
干预模型
Single Group
主要目的
Treatment
盲法
None

入排标准

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

入选标准

  • Each subject must meet all of the following inclusion criteria to qualify for entrance into the study:
  • Subjects who are male or female and are aged 55 and older.
  • Subjects and/or their legal guardians must be able and willing to give informed consent.
  • Subjects must be on stable doses of pramipexole for greater than 4 weeks duration prior to screening.
  • Subjects who are female must be non-pregnant and non-nursing. Women of Child-Bearing Potential (WOCBP) must use a reliable method of contraception (e.g., oral contraceptive or long-term injectable or implantable hormonal contraceptive, double-barrier methods, such as condom and diaphragm, condom and foam, condom and sponge or intra-uterine devices) and have a negative serum pregnancy test at screening. Women are considered to not be of child-bearing potential if they have been surgically sterilized (physician-documented hysterectomy or tubal ligation) or if they are post-menopausal.
  • Subjects must have a clinical diagnosis of Parkinson's based on the presence of at least 2 of the 3 cardinal criteria - rest tremor, bradykinesia, rigidity - and no obvious history of head trauma, stroke, infectious, structural, or metabolic abnormality consistent with an alternative diagnosis to Parkinson's disease.
  • Evidence of one or more of the following symptoms: somnolence (ESS score ≥ 9), cognitive decline (MMSE < 24 ± presence of hallucinations (NPI-Q), peripheral edema (present by objective physical exam with baseline ankle and calf circumference measured in centimeters).

排除标准

  • A subject who meets any of the following criteria will NOT qualify for the study:
  • Subjects must not be receiving any treatments for excess somnolence such as amphetamine derivatives, other stimulants or Provigil.
  • Subjects with actively treated malignancies, clinically significant heart disease, kidney, liver, or pulmonary disorders will be excluded.
  • Subjects with clinical depression who are not receiving stable doses of antidepressant therapy in excess of 4 weeks duration.
  • Subjects with history of orthostatic hypotension (>30mm drop in systolic pressure and/or >20mm drop in diastolic pressure) associated with syncope.
  • Subjects started within the last 14 days on any drug known to substantially inhibit CYP1A2 (e.g., cimetidine, fluvoxamine) or induce CYP1A2 (e.g.omeprazole) (Note: Subjects already on these agents may be enrolled but must remain on the stable doses of the agents from 14 days prior to the beginning of the study).
  • Subjects who have other medical conditions that are considered clinically unstable or that may compromise the safety of the patient during this study.

研究组 & 干预措施

Continuous Release Dopamine Agonists

Experimental

Continuous Release Dopamine Agonists

干预措施: Continuous Release Dopamine Agonists (Drug)

结局指标

主要结局

Unified Parkinson's Disease Rating Scale (UPDRS), Parts 3 (Motor Performance) and 4 (Disability).

时间窗: initial visit and at end of study 24 weeks

The Unified Parkinson's Disease Rating Scale (UPDRS), parts 3 (motor performance) and 4 (disability) are standardized and validated measures of various symptoms of Parkinson's disease - total scores range from 0 to 148 with lower scores representing better Parkinson symptom control and higher scores representing worse symptoms of Parkinson's.

Mini-Mental Status Exam (MMSE), the Clock Drawing Test (CDT), the Patient Health Questionnaire (PHQ-9).

时间窗: initial visit and at end of study 24 weeks

The Mini-Mental Status Exam (MMSE) and the Clock Drawing Test (CDT) are standardized and validated measures of cognitive function. The Patient Health Questionnaire (PHQ-9) is a standardized and validated measure of quality of life. The Mini-Mental Status Exam (MMSE) scale is 0-30 with higher numbers indicating improvement. The Clock Drawing Test (CDT) range is 0-10 with higher numbers indicating improvement. the PHQ scale is 0-27 with lower numbers indicating improved outcome.

Peripheral Edema, as Measured by Quantitative Assessment of Ankle Edema

时间窗: initial visit and at end of study 24 weeks

The assessment of ankle edema was considered to be a marker of improvement possibly seen in patients who switched from regular pramipexole to extended release ropinirole. .

Patient Satisfaction Questionnaire

时间窗: initial visit and at end of study 24 weeks

The patient satisfaction/preference (Patient Satisfaction Questionnaire - PS) scores vary from 0-10 with higher scores indicating greater satisfaction with the med change.

Parkinson's Disease Questionnaire (PDQ-39)

时间窗: initial visit and at end of study 24 weeks

The Improvement in quality of life (Parkinson's Disease Questionnaire - PDQ-39 - is a standardized and validated measure of patient quality of life ranging in score from 0-100 with lower scores indicating improvement versus higher scores indicating worsening of QOL.

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Lawrence Elmer, MD, PhD

Professor, Med Dir, Cntr for Neurological Disorders

University of Toledo

研究点 (1)

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