Parkinson DiseasePhase 3QE3NCT00740714
Effects of Coenzyme Q10 (CoQ) in Parkinson Disease
A Phase 3 study testing Coenzyme Q10 with vitamin E in people with Parkinson Disease, run by Weill Medical College of Cornell University at 68 sites in 2 countries.
Trial summary
The purpose of this study is to evaluate the safety and effectiveness of high dosages of Coenzyme Q10 in slowing clinical decline in people who have early Parkinson disease. Read more about this study
- Who is it for?
- Ages 30 years and older
- Conditions the study is for
- Parkinson Disease
- What is being tested?
- Coenzyme Q10 with vitamin E
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 600 participants
- Where
- 68 sitesin 2 countries
- Study dates
- Dec 2008to Aug 2011
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Presence of all 3 of the cardinal features of Parkinson disease (resting tremor, bradykinesia and rigidity). The clinical signs must be asymmetric.
- The diagnosis of Parkinson disease within 5 years prior to the Screening Visit.
- Age 30 or older.
- Female subjects must not be of childbearing potential or must use an approved form of contraception for the duration of the trial.
Who cannot join
- Use of any Parkinson disease medication within 60 days prior to the Baseline Visit.
- Duration of previous use of symptomatic medication for Parkinson disease cannot exceed 90 days such as levodopa, dopaminergic agonists (including ropinirole, pramipexole, pergolide, cabergoline, and the rotigotine transdermal system), selegiline, rasagiline, amantadine, and anticholinergic agents.
- Parkinsonism due to drugs including neuroleptics, alphamethyldopa, reserpine, metoclopramide, valproic acid.
- Use of antioxidants (such as selegiline, rasagiline, vitamins E and C), additional supplemental vitamins or minerals, regular use of neuroleptics, chloramphenicol, valproic acid, warfarin.
- Other parkinsonian disorders.
- Modified Hoehn and Yahr score of 3 or greater at Screening Visit or Baseline Visit.
Show all 22Show fewer
- UPDRS tremor score of 3 or greater at Screening Visit or Baseline Visit.
- Mini-Mental State Examination (MMSE) score of 25 or less.
- History of stroke.
- Disability sufficient to require treatment with dopaminergic medication or anticipated need for dopaminergic medication within next 3 months.
- Other serious illness, including psychiatric illness.
- Patients with active cardiovascular, peripheral vascular or cerebrovascular disease within the past year.
- Clinically serious abnormalities in the Screening Visit laboratory studies or electrocardiogram.
- Use of methylphenidate, cinnarizine, reserpine, amphetamine or a MAO-A inhibitor within 6 months prior to the Baseline Visit.
- Unstable dose of CNS active therapies.
- Use of appetite suppressants within 60 days prior to the Baseline Visit.
- History of active epilepsy within the last 5 years.
- Revised Hamilton Rating Scale for Depression of 11 or greater.
- Participation in other drug studies or use of other investigational drugs within 30 days prior to Screening Visit.
- History of electroconvulsive therapy.
- History of any brain surgery for Parkinson disease.
- History of structural brain disease such as prior trauma causing damage detected on a CT scan or MRI, hydrocephalus, or prior brain neoplasms.
Trial locations and contacts
68 sites in 2 countries.
68 sites in 2 countries
United States59 sites
Albany Medical College, Parkinson'S Disease & Movement Disorders Ctr, 47 New Scottland Avenue
Albany, New York, 12208
Emory University School of Medicine, Wesley Woods Health Center, 1841 Clifton Road NE Room 328
Atlanta, Georgia, 30329
Movement Disorders Program, Department of Neurology, Medical College of Georgia
Augusta, Georgia, 30912
Department of Neurology/Mail Stop B185, 12631 East 17Th Avenue Room 5209, Academic Office 1 Po Box 6511
Aurora, Colorado, 80045
University of Maryland School of Medicine, 22 South Greene Street, N4 W49-B
Baltimore, Maryland, 21201
Johns Hopkins, 601 North Caroline Street, Suite 5064
Baltimore, Maryland, 21287-0875
University of Alabama, Birmingham, 350 Sparks Center, 1720 7Th Avenue South
Birmingham, Alabama, 35233
Boston University Medical Center, Department of Neurology, 715 Albany Street C329
Boston, Massachusetts, 02118
Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Shapiro 809D
Boston, Massachusetts, 02215
Suny Downstate Medical Center , 450 Clarkson Avenue , Box 1213
Brooklyn, New York, 11203
University of Vermont , Department of Neurology Given Building C-219 , 89 Beaumont Avenue
Burlington, Vermont, 05405
Medical University of South Carolina, Charleston Memorial Hospital, 326 Calhoun Street Suite 308
Charleston, South Carolina, 29401
Northwestern University, 710 North Lake Shore Drive
Chicago, Illinois, 60611
Rush University Medical Center Department of Neurological Sciences, 1725 West Harrison Suite 755
Chicago, Illinois, 60612
University of Chicago, 5841 South Maryland Avenue, Mc2030
Chicago, Illinois, 60637
University Neurology Inc., 222 Piedmont Avenue, Suite 3200
Cincinnati, Ohio, 45219
The Cleveland Clinic Foundation, 9500 Euclid Avenue S-31
Cleveland, Ohio, 44195
Ohio State University Medical Center, 1581 Dodd Drive, 371 McCampbell Hall
Columbus, Ohio, 43210
Duke University Medical Center, Duke Health Center At Morreene Road, 932 Morreene Road Room 213
Durham, North Carolina, 27705
Parkinson & Movement Dis Center If Maryland, 8180 Lark Brown Road, Suite 101
Elkridge, Maryland, 21075
The Parkinson'S & Movement Disorder Institute, 9940 Talbert Avenue, Suite 204
Fountain Valley, California, 92708
University of Florida, McKnight Brain Institute Po Box 100236, 100 S Newell Drive L3-100
Gainsville, Florida, 32610-5806
Penn State Milton S Hershey Med Center, Department of Neurology Mc H109 Room 2846, 500 University Drive Po Box 850
Hershey, Pennsylvania, 17033
Baylor College of Medicine - Parkinson'S, Disease Center and Movement Disorders Clinic, 65501 Fannin St, Suite 1801
Houston, Texas, 77030
Indiana University School of Medicine, Outpatient Clinical Research Facility, 535 Barnhill Drive Room #150
Indianapolis, Indiana, 46202
University of Iowa Hospitals, 2133 Rcp Department of Neurology, 200 Hawkins Drive
Iowa City, Iowa, 52242
University of California Irvine, 100 Irvine Hall
Irvine, California, 92697-4275
The University of Kansas Medical Center, Department of Neurology Ms #2012, 3599 Rainbow Boulevard
Kansas City, Kansas, 66160
Booth Gardner Parkinson'S Care Center, 13030 121St Way North East Suite 203
Kirkland, Washington, 98034
University of California San Diego, Alzheimer'S Disease Research Center, 9500 Gilman Drive
La Jolla, California, 92093-0948
Colorado Neurological Institute, 701 East Hampden Avenue, Suite 510
Littleton, Colorado, 80113
UCLA Medical Center, 710 Westwood Plaza, A-253
Los Angeles, California, 900095
University of Louisville, Movement Disorder Clinic, Frazier Rehab, 220 Abraham Flexner, Suite 606
Louisville, Kentucky, 40202
Northshore-Lij Health System, the Feinstein Institute Fpr Medical Research, 350 Community Drive Room 100
Manhasset, New York, 11030
Semmes Murphey Clinic, 1211 Union Avenue, Suite 200
Memphis, Tennessee, 38104
University of Miami, 1501 North West 9Th Avenue Second Floor, Department of Neurology D4-5
Miami, Florida, 33136
Medical College of Wisconsin, Department of Neurology, 9200 West Wisconsin Avenue
Milwaukee, Wisconsin, 53226-0099
University of Minnesota, 420 Delaware Street SE, Mmc 295
Minneapolis, Minnesota, 55455
The Institute For Neurodegenerative Disorders, 60 Temple Street, Suite 8B
New Haven, Connecticut, 06510
Ochsner Clinic Foundation, 1514 Jefferson Highway, Dept of Neurology 7Th Floor
New Orleans, Louisiana, 70121
Beth Israel Medical Center, 10 Union Square East, Suite 5Hh2
New York, New York, 10003
Beth Israel Medical Center, Phillips Ambulatory Care Center, 10 Union Square East Room 5Ho1
New York, New York, 10003
Parkinson'S Dis & Movement Disorders Inst, 428 East 72Nd Street, Suite 400
New York, New York, 10021
Weill Medical College of Cornell
New York, New York, 10021
Columbia University, 710 West 168Th Street, 3Rd Floor
New York, New York, 10032
University of Pennsylvania, Pennsylvania Hospital Department of Neurology, 330 South 9Th Street
Philadelphia, Pennsylvania, 19107
Barrow Neurological Clinics At St Joseph'S Hospital & Medical Center, 500 West Thomas Road Suite 720
Phoenix, Arizona, 85013
Oregon Health & Science University, Dept of Neurology, 3181 SW Sam Jackson Park Road Op-32
Portland, Oregon, 97239-3098
University of Rochester Department of Neurology, 919 Westfall Road Building C Suite 220
Rochester, New York, 14618
UC Davis Dept of Neurology, 4860 Y Street, Suite 3700
Sacramento, California, 95817
Mayo Clinic Arizona, 13400 East Shea Boulevard, Desk 34 3B
Scottsdale, Arizona, 85260
Lsuhsc Shreveport, Department of Neurology, 1501 Kings Highway Room 3-436
Shreveport, Louisiana, 71103
Washington University School of Medicine, 660 South Euclid, Box 8111
St Louis, Missouri, 63110-1093
Sunhealth Research Institute, 10515 West Santa Fe Drive
Sun City, Arizona, 85351
The Parkinson's Institute, 675 ALMANOR AVENUE
Sunnyvale, California, 94085
University of South Florida, 4 Columbia Drive, Suite 410
Tampa, Florida, 33606
JACOBI MEDICAL CENTER, 1400 Pelham Pkwy S
The Bronx, New York, 10461
University of Toledo , 3000 Arlington Avenue , Mail Stop 1195
Toledo, Ohio, 43614
Neurohealth Parkinson'S Disease, Movement Disorder Center, 227 Centerville Road
Warwick, Rhode Island, 02886
Canada9 sites
Un of Calgary Movement Disorders Program, Dept of Clin Neurosciences Area 3 Neurology, 3350 Hospital Dr NW Health Sciences Centre
Calgary, Alberta, T2N4NI
University of Alberta Glenrose Rehab Hosp, Rm 0601 Glen East, 10230 - 111 Avenue
Edmonton, Alberta, T5G 0B7
London Health Sciences Centre, University Campus Room 10N29, 339 Windermere Road
London, Ontario, N6A 5A5
CHUM-HOPITAL NOTRE DAME, 1560 rue SHERBROOKE est ROOM GR 1185, PAVILLON DECHAMPS etage rez-de-chaussee
Montreal, Quebec, H2L 4M1
The Ottawa Hospital-Civic Campus, 1053 Carling Avenue C2 Room 2210
Ottawa, Ontario, K1Y 4E9
Quebec Memory and Motor Skills Dis Clinic, Price Building 3Rd Floor, 65 Sainte-Anne Street
Québec, Quebec, G1R 3X5
Royal University Hospital, 103 Hospital Drive, Room 1663
Saskatoon, Saskatchewan, S7N OW8
University of Sherbrooke, 3001 12E Avenue Nord
Sherbrooke, Quebec, J1H 5N4
Toronto Western Hospital, Univ Health Network, 399 Bathurst Street Mc 7-402, Movement Disorders Centre
Toronto, Ontario, M5T 2S8
About this study
Official title: Effects of Coenzyme Q10 in Parkinson Disease - Phase III
The purpose of this study is to evaluate the safety and effectiveness of high dosages of Coenzyme Q10 in slowing clinical decline in people who have early Parkinson disease.
Read the detailed description
Parkinson disease (PD) is a progressive neurodegenerative disease that affects more than 1,000,000 Americans. Currently there is no proven therapy to reduce the rate of progression of PD. In a previous phase II clinical trial, investigators demonstrated that Coenzyme Q10 (CoQ) at dosages of 300, 600, and 1200 mg/day was safe and well-tolerated in individuals with early, untreated PD. The findings also suggested that CoQ may slow the progressive impairment of PD as measured by the Unified Parkinson Disease Rating Scale (UPDRS).
In this study, researchers will conduct a randomized, placebo-controlled, phase III trial of CoQ to confirm and extend the results of the earlier phase II study. The primary objective of this trial is to compare the effect of two dosages of CoQ (1200 and 2400 mg/day) and placebo on the total UPDRS score in people with early PD. The study also will evaluate independent function, cognition, and quality of life. Plasma CoQ levels will be measured at months 1, 8 and 16 and correlated with changes in UPDRS scores.
Participants will be randomly assigned to receive a placebo (an inactive substance), 1200 mg/d CoQ, or 2400 mg/d CoQ. They will be evaluated at screening, baseline, and during visits at months 1, 4, 8, 12, and 16. Information gained from this trial could lead to changes in management of people with early PD.
- Conditions
- Parkinson Disease
- Being tested
- Coenzyme Q10 with vitamin E, placebo with vitamin E
- Keywords
- Parkinson disease, PD, Coenzyme Q10, CoQ
- Medical subject headings
- Parkinson Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Coenzyme Q10 with vitamin EDrug
Also called Coenzyme Q10, ubiquinone, ubidecarenone
2400 mg dose - eight 300 mg Coenzyme Q10 chewable wafers taken orally four times a day; 1200 mg dose - four 300 mg Coenzyme Q10 and four placebo chewable wafers taken orally four times a day.
placebo with vitamin EDrug
placebo or an inactive substance (with vitamin E 1200 IU/day); Placebo - eight chewable wafers taken orally four times a day.
| Study group | Role | What they receive |
|---|---|---|
| A | Experimental | Randomized to active treatment (Coenzyme Q10 2400 mg/day with vitamin E 1200 IU/day) Receives: Drug: Coenzyme Q10 with vitamin E |
| B | Experimental | Randomized to active treatment (Coenzyme Q10 1200 mg/day with vitamin E 1200 IU/day) Receives: Drug: Coenzyme Q10 with vitamin E |
| C | Placebo comparator | Placebo (with vitamin E 1200 IU/day) Receives: Drug: placebo with vitamin E |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Unified Parkinson's Disease Rating Scale (UPDRS) (Total Score (Sum of Parts I, II and III Ranges From 0 to 176))
Outcome is defined as change in total Unified Parkinson's Disease Rating Scale (UPDRS) between the baseline visit and month 16 or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first. The UPDRS score has three components, each consisting of questions answered on a 0-4 point scale. Part I assesses mentation, behavior and mood; Part II assesses activities of daily living in the week prior to the designated visit; and Part III assesses motor abilities at the time of the visit. A total of 31 items are included in Parts I, II and III. Each item will receive a score ranging from 0 to 4 where 0 represents the absence of impairment and 4 represents the highest degree of impairment. Total score ranges from 0-176.
Measured: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Secondary outcomes (22)
Change in Modified Schwab & England Independence Scale From Baseline to 16 Months
This scale measures activities of daily living. This is an investigator and subject assessment of the subject's level of independence at all scheduled visits. The subject is scored on a percentage scale reflective of his/her ability to perform acts of daily living in relation to pre-Parkinson disease ability. Scores range in increments of 10%: 100% for normal (subject is completely independent; essentially normal) to 0% (vegetative functions such as swallowing, bladder and bowel functions are not functioning; bedridden).
Measured: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in Modified Rankin Scale From Baseline to 16 Months
The Modified Rankin Scale is a global functional health index with a strong accent on physical disability. Subjects are scored on a scale of 0 (no symptoms at all) to 5 (severe disability: bedridden incontinent, and requiring constant nursing care and attention.
Measured: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in PD Quality of Life Scale From Baseline to 16 Months
The subject will complete a questionnaire that will evaluate how Parkinson disease has affected their health and overall quality of life at each visit. The total quality of life scale measures a total of 33 aspects of quality of life. Each aspect is rated on scale of 0 (best outcome) to 4 (worst outcome). Total score range is 0-132. A higher score or increased score compared to a previous visit indicates a lowered quality of life.
Measured: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in Symbol Digit Modalities Test From Baseline to 16 Months
The Symbol Digit Modalities Test screens cognitive impairment by using a simple substitution tasks that individuals with normal functioning can easily perform. The test score range is from 0(worst outcome) to 110 (best outcome).
Measured: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in Hoehn & Yahr Score From Baseline to 16 Months
The Modified Hoehn and Yahr Scale is an 8-level Parkinson disease staging instrument. The investigator will assess disease stage at each level. The disease stages range from the best outcome of 0 (no signs of disease) to the worst outcome of 5 (wheelchair bound or bedridden unless aided).
Measured: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
CoQ10 Levels in Plasma
Based on samples analyzed to date
Measured: Baseline, 1, 8 and 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Adverse Experiences: Back Pain
Number of participants with back pain
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Constipation
Number of participants with constipation
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Insomnia
Number of participants with insomnia
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Anxiety
Number of participants with anxiety
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Tremor
Number of participants with tremor
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Nasopharyngitis
Number of participants with nasopharyngitis
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Diarrhoea
Number of participants with diarrhoea
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Headache
Number of participants with headache
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Urinary Tract Infection
Number of patients with urinary tract infections
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Nausea
Number of participants with nausea
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Hypertension
Number of participants with hypertension
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Depression
Number of participants with depression
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Constipation: Moderate/Severe
Number of participants with moderate/severe constipation
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Anxiety: Moderate/Severe
Number of participants with moderate/severe anxiety
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Back Pain: Moderate/Severe
Number of participants with moderate/severe back pain
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Insomnia: Moderate/Severe
Number of participants with moderate/severe insomnia
Measured: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Aug 2008 (estimated)
- Study startDec 2008
- Primary completionAug 2011
- Study completionAug 2011
Why it stopped: The investigational drug is unlikely to demonstrate efficacy over placebo for this indication. However, no safety issues were discovered.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for Parkinson DiseaseStudies of the same condition, open and under way.
- More trials run by Weill Medical College of Cornell UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 600 participants (actual)
Sponsor and investigators
- Lead sponsor
- Weill Medical College of Cornell University
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute of Neurological Disorders and Stroke (NINDS), University of Rochester
- Responsible party
- Sponsor
- Investigators
- M. Flint Beal, MD, Principal investigator, Weill Medical College of Cornell University, New York Hospital Department of NeurologyDavid Oakes, PhD, Principal investigator, University of Rochester, Department of BiostatisticsIra Shoulson, MD, Principal investigator, University of Rochester, Clinical Trials Coordination Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00740714
- Sponsor's protocol ID
- U01NS050324
- Other IDs
- U01NS050573
- Acronym
- QE3
- Status last verified
- Dec 2012
- First submitted
- 22 Aug 2008
- Last updated
- 31 Jan 2013
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Beal MF, Henshaw DR, Jenkins BG, Rosen BR, Schulz JB. Coenzyme Q10 and nicotinamide block striatal lesions produced by the mitochondrial toxin malonate. Ann Neurol. 1994 Dec;36(6):882-8. doi: 10.1002/ana.410360613.
PubMed 7998775Beal MF, Matthews RT, Tieleman A, Shults CW. Coenzyme Q10 attenuates the 1-methyl-4-phenyl-1,2,3,tetrahydropyridine (MPTP) induced loss of striatal dopamine and dopaminergic axons in aged mice. Brain Res. 1998 Feb 2;783(1):109-14. doi: 10.1016/s0006-8993(97)01192-x.
PubMed 9479058Beal MF. Energetics in the pathogenesis of neurodegenerative diseases. Trends Neurosci. 2000 Jul;23(7):298-304. doi: 10.1016/s0166-2236(00)01584-8.
PubMed 10856939Beal MF. Coenzyme Q10 as a possible treatment for neurodegenerative diseases. Free Radic Res. 2002 Apr;36(4):455-60. doi: 10.1080/10715760290021315.
PubMed 12069110NINDS NET-PD Investigators. A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology. 2007 Jan 2;68(1):20-8. doi: 10.1212/01.wnl.0000250355.28474.8e.
PubMed 17200487Ravina BM, Fagan SC, Hart RG, Hovinga CA, Murphy DD, Dawson TM, Marler JR. Neuroprotective agents for clinical trials in Parkinson's disease: a systematic assessment. Neurology. 2003 Apr 22;60(8):1234-40. doi: 10.1212/01.wnl.0000058760.13152.1a.
PubMed 12707423Shoulson I, Oakes D, Fahn S, Lang A, Langston JW, LeWitt P, Olanow CW, Penney JB, Tanner C, Kieburtz K, Rudolph A; Parkinson Study Group. Impact of sustained deprenyl (selegiline) in levodopa-treated Parkinson's disease: a randomized placebo-controlled extension of the deprenyl and tocopherol antioxidative therapy of parkinsonism trial. Ann Neurol. 2002 May;51(5):604-12. doi: 10.1002/ana.10191.
PubMed 12112107Shults CW, Haas RH, Passov D, Beal MF. Coenzyme Q10 levels correlate with the activities of complexes I and II/III in mitochondria from parkinsonian and nonparkinsonian subjects. Ann Neurol. 1997 Aug;42(2):261-4. doi: 10.1002/ana.410420221.
PubMed 9266740Shults CW, Beal MF, Fontaine D, Nakano K, Haas RH. Absorption, tolerability, and effects on mitochondrial activity of oral coenzyme Q10 in parkinsonian patients. Neurology. 1998 Mar;50(3):793-5. doi: 10.1212/wnl.50.3.793.
PubMed 9521279Shults CW, Oakes D, Kieburtz K, Beal MF, Haas R, Plumb S, Juncos JL, Nutt J, Shoulson I, Carter J, Kompoliti K, Perlmutter JS, Reich S, Stern M, Watts RL, Kurlan R, Molho E, Harrison M, Lew M; Parkinson Study Group. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002 Oct;59(10):1541-50. doi: 10.1001/archneur.59.10.1541.
PubMed 12374491Shults CW. Coenzyme Q10 in neurodegenerative diseases. Curr Med Chem. 2003 Oct;10(19):1917-21. doi: 10.2174/0929867033456882.
PubMed 12871093Shults CW, Flint Beal M, Song D, Fontaine D. Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson's disease. Exp Neurol. 2004 Aug;188(2):491-4. doi: 10.1016/j.expneurol.2004.05.003.
PubMed 15246848Lee IM, Cook NR, Gaziano JM, Gordon D, Ridker PM, Manson JE, Hennekens CH, Buring JE. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women's Health Study: a randomized controlled trial. JAMA. 2005 Jul 6;294(1):56-65. doi: 10.1001/jama.294.1.56.
PubMed 15998891Blatt DH, Pryor WA. High-dosage vitamin E supplementation and all-cause mortality. Ann Intern Med. 2005 Jul 19;143(2):150-1; author reply 156-8. doi: 10.7326/0003-4819-143-2-200507190-00018. No abstract available.
PubMed 16027460McDonald SR, Sohal RS, Forster MJ. Concurrent administration of coenzyme Q10 and alpha-tocopherol improves learning in aged mice. Free Radic Biol Med. 2005 Mar 15;38(6):729-36. doi: 10.1016/j.freeradbiomed.2004.11.014.
PubMed 15721983
Study at a glance
From the registry record, last updated by the sponsor on 31 Jan 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Coenzyme Q10 in Parkinson Disease - Phase III
- ClinicalTrials.gov ID
- NCT00740714
- Acronym / sponsor ID
- QE3 / U01NS050324
- Conditions
- Parkinson Disease
- Keywords
- Parkinson disease, PD, Coenzyme Q10, CoQ
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The investigational drug is unlikely to demonstrate efficacy over placebo for this indication. However, no safety issues were discovered.
- Enrolment
- 600 participants (actual)
- Lead sponsor
- Weill Medical College of Cornell UniversityUniversity, hospital or other
- Collaborators
- National Institute of Neurological Disorders and Stroke (NINDS), University of Rochester
- Study start
- Dec 2008
- Primary completion
- Aug 2011 (actual)
- Study completion
- Aug 2011 (actual)
- First posted
- 25 Aug 2008 (estimated)
- Results
- Posted 31 Jan 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the safety and effectiveness of high dosages of Coenzyme Q10 in slowing clinical decline in people who have early Parkinson disease.
Detailed description
Parkinson disease (PD) is a progressive neurodegenerative disease that affects more than 1,000,000 Americans. Currently there is no proven therapy to reduce the rate of progression of PD. In a previous phase II clinical trial, investigators demonstrated that Coenzyme Q10 (CoQ) at dosages of 300, 600, and 1200 mg/day was safe and well-tolerated in individuals with early, untreated PD. The findings also suggested that CoQ may slow the progressive impairment of PD as measured by the Unified Parkinson Disease Rating Scale (UPDRS).
In this study, researchers will conduct a randomized, placebo-controlled, phase III trial of CoQ to confirm and extend the results of the earlier phase II study. The primary objective of this trial is to compare the effect of two dosages of CoQ (1200 and 2400 mg/day) and placebo on the total UPDRS score in people with early PD. The study also will evaluate independent function, cognition, and quality of life. Plasma CoQ levels will be measured at months 1, 8 and 16 and correlated with changes in UPDRS scores.
Participants will be randomly assigned to receive a placebo (an inactive substance), 1200 mg/d CoQ, or 2400 mg/d CoQ. They will be evaluated at screening, baseline, and during visits at months 1, 4, 8, 12, and 16. Information gained from this trial could lead to changes in management of people with early PD.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| A | Experimental | Drug: Coenzyme Q10 with vitamin ERandomized to active treatment (Coenzyme Q10 2400 mg/day with vitamin E 1200 IU/day) |
| B | Experimental | Drug: Coenzyme Q10 with vitamin ERandomized to active treatment (Coenzyme Q10 1200 mg/day with vitamin E 1200 IU/day) |
| C | Placebo comparator | Drug: placebo with vitamin EPlacebo (with vitamin E 1200 IU/day) |
Who may qualify
- Ages
- 30 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Presence of all 3 of the cardinal features of Parkinson disease (resting tremor, bradykinesia and rigidity). The clinical signs must be asymmetric.
- The diagnosis of Parkinson disease within 5 years prior to the Screening Visit.
- Age 30 or older.
- Female subjects must not be of childbearing potential or must use an approved form of contraception for the duration of the trial.
Key exclusion criteria (22 listed)
- Use of any Parkinson disease medication within 60 days prior to the Baseline Visit.
- Duration of previous use of symptomatic medication for Parkinson disease cannot exceed 90 days such as levodopa, dopaminergic agonists (including ropinirole, pramipexole, pergolide, cabergoline, and the rotigotine transdermal system), selegiline, rasagiline, amantadine, and anticholinergic agents.
- Parkinsonism due to drugs including neuroleptics, alphamethyldopa, reserpine, metoclopramide, valproic acid.
- Use of antioxidants (such as selegiline, rasagiline, vitamins E and C), additional supplemental vitamins or minerals, regular use of neuroleptics, chloramphenicol, valproic acid, warfarin.
- Other parkinsonian disorders.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Coenzyme Q10 with vitamin EAlso: Coenzyme Q10, ubiquinone, ubidecarenone2400 mg dose - eight 300 mg Coenzyme Q10 chewable wafers taken orally four times a day; 1200 mg dose - four 300 mg Coenzyme Q10 and four placebo chewable wafers taken orally four times a day. | Drug | A, B |
| placebo with vitamin Eplacebo or an inactive substance (with vitamin E 1200 IU/day); Placebo - eight chewable wafers taken orally four times a day. | Drug | C |
Primary outcome
Change in Unified Parkinson's Disease Rating Scale (UPDRS) (Total Score (Sum of Parts I, II and III Ranges From 0 to 176))
Time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Outcome is defined as change in total Unified Parkinson's Disease Rating Scale (UPDRS) between the baseline visit and month 16 or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first. The UPDRS score has three components, each consisting of questions answered on a 0-4 point scale. Part I assesses mentation, behavior and mood; Part II assesses activities of daily living in the week prior to the designated visit; and Part III assesses motor abilities at the time of the visit. A total of 31 items are included in Parts I, II and III. Each item will receive a score ranging from 0 to 4 where 0 represents the absence of impairment and 4 represents the highest degree of impairment. Total score ranges from 0-176.
22 secondary outcomes
Change in Modified Schwab & England Independence Scale From Baseline to 16 Months
Time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in Modified Rankin Scale From Baseline to 16 Months
Time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in PD Quality of Life Scale From Baseline to 16 Months
Time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in Symbol Digit Modalities Test From Baseline to 16 Months
Time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Change in Hoehn & Yahr Score From Baseline to 16 Months
Time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
CoQ10 Levels in Plasma
Time frame: Baseline, 1, 8 and 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first
Adverse Experiences: Back Pain
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Constipation
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Insomnia
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Anxiety
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Tremor
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Nasopharyngitis
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Diarrhoea
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Headache
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Urinary Tract Infection
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Nausea
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Hypertension
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Depression
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Constipation: Moderate/Severe
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Anxiety: Moderate/Severe
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Back Pain: Moderate/Severe
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Adverse Experiences: Insomnia: Moderate/Severe
Time frame: Over 16 months (Screening, Baseline, 1, 4, 8, 12 and 16 month visits)
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Jan 2013.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 7998775Beal MF, Henshaw DR, Jenkins BG, Rosen BR, Schulz JB. Coenzyme Q10 and nicotinamide block striatal lesions produced by the mitochondrial toxin malonate. Ann Neurol. 1994 Dec;36(6):882-8. doi: 10.1002/ana.410360613.
- Background: PubMed 9479058Beal MF, Matthews RT, Tieleman A, Shults CW. Coenzyme Q10 attenuates the 1-methyl-4-phenyl-1,2,3,tetrahydropyridine (MPTP) induced loss of striatal dopamine and dopaminergic axons in aged mice. Brain Res. 1998 Feb 2;783(1):109-14. doi: 10.1016/s0006-8993(97)01192-x.
- Background: PubMed 10856939Beal MF. Energetics in the pathogenesis of neurodegenerative diseases. Trends Neurosci. 2000 Jul;23(7):298-304. doi: 10.1016/s0166-2236(00)01584-8.
- Background: PubMed 12069110Beal MF. Coenzyme Q10 as a possible treatment for neurodegenerative diseases. Free Radic Res. 2002 Apr;36(4):455-60. doi: 10.1080/10715760290021315.
- Background: PubMed 17200487NINDS NET-PD Investigators. A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology. 2007 Jan 2;68(1):20-8. doi: 10.1212/01.wnl.0000250355.28474.8e.
- Background: PubMed 12707423Ravina BM, Fagan SC, Hart RG, Hovinga CA, Murphy DD, Dawson TM, Marler JR. Neuroprotective agents for clinical trials in Parkinson's disease: a systematic assessment. Neurology. 2003 Apr 22;60(8):1234-40. doi: 10.1212/01.wnl.0000058760.13152.1a.
- Background: PubMed 12112107Shoulson I, Oakes D, Fahn S, Lang A, Langston JW, LeWitt P, Olanow CW, Penney JB, Tanner C, Kieburtz K, Rudolph A; Parkinson Study Group. Impact of sustained deprenyl (selegiline) in levodopa-treated Parkinson's disease: a randomized placebo-controlled extension of the deprenyl and tocopherol antioxidative therapy of parkinsonism trial. Ann Neurol. 2002 May;51(5):604-12. doi: 10.1002/ana.10191.
- Background: PubMed 9266740Shults CW, Haas RH, Passov D, Beal MF. Coenzyme Q10 levels correlate with the activities of complexes I and II/III in mitochondria from parkinsonian and nonparkinsonian subjects. Ann Neurol. 1997 Aug;42(2):261-4. doi: 10.1002/ana.410420221.
- Background: PubMed 9521279Shults CW, Beal MF, Fontaine D, Nakano K, Haas RH. Absorption, tolerability, and effects on mitochondrial activity of oral coenzyme Q10 in parkinsonian patients. Neurology. 1998 Mar;50(3):793-5. doi: 10.1212/wnl.50.3.793.
- Background: PubMed 12374491Shults CW, Oakes D, Kieburtz K, Beal MF, Haas R, Plumb S, Juncos JL, Nutt J, Shoulson I, Carter J, Kompoliti K, Perlmutter JS, Reich S, Stern M, Watts RL, Kurlan R, Molho E, Harrison M, Lew M; Parkinson Study Group. Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol. 2002 Oct;59(10):1541-50. doi: 10.1001/archneur.59.10.1541.
- Background: PubMed 12871093Shults CW. Coenzyme Q10 in neurodegenerative diseases. Curr Med Chem. 2003 Oct;10(19):1917-21. doi: 10.2174/0929867033456882.
- Background: PubMed 15246848Shults CW, Flint Beal M, Song D, Fontaine D. Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson's disease. Exp Neurol. 2004 Aug;188(2):491-4. doi: 10.1016/j.expneurol.2004.05.003.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
M. Flint Beal, MD principal investigator
Weill Medical College of Cornell University, New York Hospital Department of Neurology
David Oakes, PhD principal investigator
University of Rochester, Department of Biostatistics
Ira Shoulson, MD principal investigator
University of Rochester, Clinical Trials Coordination Center
68 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Coenzyme Q10 with vitamin E in people with Parkinson Disease, run by Weill Medical College of Cornell University at 68 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 31 Jan 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 68 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 31 Jan 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Unified Parkinson's Disease Rating Scale (UPDRS) (Total Score (Sum of Parts I, II and III Ranges From 0 to 176)) (time frame: Baseline to 16 months or the time of sufficient disability to require dopaminergic therapy or study closure, whichever occurs first). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00740714, which also lists 18 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jan 2013.