Parkinson DiseasePhase 2STEADY-PDNCT00909545
Safety, Tolerability and Efficacy Assessment of Dynacirc CR in Parkinson Disease
A Phase 2 study testing Isradipine CR 5mg, Isradipine CR 10mg and Isradipine CR 20mg in people with Parkinson Disease, run by Northwestern University at 20 sites in 2 countries.
Trial summary
The primary purpose of this study is to establish a dosage of isradipine CR that is tolerable and demonstrates preliminary efficacy for utilization in future pivotal efficacy studies. 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?
- Isradipine CR 5mg, Isradipine CR 10mg and Isradipine CR 20mg
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 99 participants
- Where
- 20 sitesin 2 countries
- Study dates
- Jul 2009to Feb 2012
- Phase
- Phase 2
- 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
- Subjects with early idiopathic PD. If tremor is not present, subjects must have unilateral onset and persistent asymmetry of the symptoms.
- Be over 30 years old at the time of diagnosis of PD.
- Hoehn \& Yahr stage is less than or equal to 2.5.
- Currently not receiving dopaminergic therapy and not projected to require dopaminergic therapy for at least 6 months from enrollment.
- Use of MAO-B inhibitors (rasagiline, selegiline), amantadine, or anticholinergics will be allowed. The dosage has to be stable for 3 months prior to baseline visit and throughout the duration of the study.
Who cannot join
- Subjects with a diagnosis of an atypical Parkinsonism
- Subjects unwilling or unable to give informed consent
- Use of CoQ10 at a dosage >600mg daily or use of creatine >5 grams daily within the 60 days prior to randomization
- Exposure to dopaminergic PD therapy within 60 days prior to enrollment or for 3 months or more at any point in the past
- History of clinically significant orthostatic hypotension or presence of orthostatic hypotension at the screening visit defined as > 20 mmHg change in systolic BP and >10mm change in diastolic BP after 2 min of standing, or baseline BP <90/60
- History of congestive heart failure
Show all 20Show fewer
- History of bradycardia defined as heart rate <55
- Presence of 2nd or 3rd degree atrioventricular block or other significant ECG abnormalities that in the investigator's opinion would compromise participation in study
- Clinically significant abnormalities in the Screening Visit laboratory studies or electrocardiogram.
- Presence of other known medical or psychiatric comorbidity that in the investigator's opinion would compromise participation in the study
- Prior exposure to isradipine or other calcium channel blockers within 6 months of baseline
- Subjects with history of hypertension treated with a maximum of 2 other antihypertensive agents will be allowed provided that the doses of concomitant anti HTN therapy can be reduced/adjusted during the study based on the BP readings in consultation with the subject's primary care physician or cardiologist.
- Use of grapefruit juice, Ginkgo biloba, St. John's wart and/or ginseng will be prohibited during the study (as they interfere with the metabolism of isradipine).
- Presence of cognitive dysfunction defined by a Mini Mental Status Exam ( MMSE) score < 26 at screening
- Subjects with clinically significant depression as determined by a Beck Depression Inventory (BDI) score >15 at screening
- History of exposure to typical or atypical antipsychotics or other dopamine blocking agents within 6 months prior to enrollment
- Subjects have to be on a stable regimen of central nervous system acting medications (benzodiazepines, antidepressants, hypnotics) for 30 days prior to enrollment
- Lactating women or women of childbearing potential who are not surgically sterilized have to use a reliable measure of contraception and have a negative serum pregnancy test at screening
- Participation in other investigational drug trials within 30 days prior to screening
- History of brain surgery for PD
Trial locations and contacts
20 sites in 2 countries.
20 sites in 2 countries
United States18 sites
Emory University School of Medicine
Atlanta, Georgia, 30329
Boston University
Boston, Massachusetts, 02118
Northwestern University
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
University of Cincinnati
Cincinnati, Ohio, 45219
Michigan State University
East Lansing, Michigan, 48824
Park Nicolet Clinic
Golden Valley, Minnesota, 55427
Pacific Health Institute
Honolulu, Hawaii, 96817
Mayo Clinic Jacksonville
Jacksonville, Florida, 32224
University of Tennessee
Memphis, Tennessee, 38104
University of Miami
Miami, Florida, 33136
University of Minnesota
Minneapolis, Minnesota, 55455
Institute for Neurodegenerative Disorders
New Haven, Connecticut, 06510
University of Pittsburgh
Pittsburgh, Pennsylvania, 15213
University of Rochester
Rochester, New York, 14618
Washington University
St Louis, Missouri, 63110
Parkinson Institute
Sunnyvale, California, 94805
University of South Flordia
Tampa, Florida, 33606
Canada2 sites
Ottowa Hospital Civic Site
Ottawa, Ontario, K1Y 4E9
Toronto Western Hospital
Toronto, Ontario, M5T 2S8
About this study
Official title: A Pilot Phase II Double-Blind, Placebo-Controlled, Tolerability and Dosage Finding Study of Isradipine CR as a Disease Modifying Agent in Patients With Early Parkinson Disease
The primary purpose of this study is to establish a dosage of isradipine CR that is tolerable and demonstrates preliminary efficacy for utilization in future pivotal efficacy studies.
Read the detailed description
There is solid scientific rational and preclinical data supporting a clinical trial of isradipine CR as a potential disease modifying agent in early PD. Human pharmacokinetic data demonstrate that it is feasible to achieve the serum concentrations in humans that were neuroprotective in preclinical models with the FDA approved dosage range. Pilot data demonstrate acceptable tolerability of isradipine CR in the PD population. Tolerability is inversely proportional to the dosage dependent. Considering that tolerability of isradipine CR is inversely proportional to the dosage exposure, it is essential to proceed with the dose selection tolerability study in preparation for the future efficacy trials.
The tolerability, defined as the ability to complete the study, of three dosages of isradipine CR relative to placebo in subjects with early Parkinson's disease will be examined first. The dosage that is tolerable and demonstrates preliminary efficacy will be evaluated further in the future pivotal efficacy studies.
- Conditions
- Parkinson Disease
- Being tested
- Isradipine CR 5mg, Isradipine CR 10mg, Isradipine CR 20mg, Placebo
- Keywords
- Early Parkinson disease
- Medical subject headings
- Parkinson Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Isradipine CR 5mgDrug
Also called Isradipine CR, Dynacirc CR
5mg dose: 1 Dynacirc CR 5mg tablet, 3 tablets placebo once daily
Isradipine CR 10mgDrug
Also called Isradipine CR, Dynacirc CR
10mg dose: 2 Dynacirc CR 5mg tablets, 2 tablets placebo once daily
Isradipine CR 20mgDrug
Also called Isradipine CR, Dynacirc CR
20mg dose: 4 Dynacirc CR 5mg tablets once daily
PlaceboDrug
4 Placebo to Match (PTM) tablets once daily
| Study group | Role | What they receive |
|---|---|---|
| Isradipine CR 5mg | Active comparator | Isradipine CR 5mg/day Receives: Drug: Isradipine CR 5mg |
| Isradipine CR 10mg | Active comparator | Isradipine CR 10mg/day Receives: Drug: Isradipine CR 10mg |
| Isradipine CR 20mg | Active comparator | Isradipine CR 20mg/day Receives: Drug: Isradipine CR 20mg |
| Placebo | Placebo comparator | Placebo Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Tolerability of the Three Dosages(5mg, 10mg and 20mg) of Isradipine CR.
Tolerability will be judged by the proportion of subjects enrolled in a dosage group able to complete the 12 month study or to the time of initiation of dopaminergic therapy on their original assigned dosage. Tolerability of each active arm will be compared to placebo group.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Secondary outcomes (31)
Efficacy: Change in Unified Parkinson's Disease Rating Scale (UPDRS)
Outcome is defined as change in total Unified Parkinson's Disease Rating Scale (UPDRS) between the baseline visit and month 12 or the time to require dopaminergic therapy (last visit before subject goes on dopaminergic therapy), whichever occurs first. The UPDRS score has 4 components. Part I assesses mentation; Part II assesses activities of daily living; Part III assesses motor abilities; Part IV assesses complications of therapy. A total of 44 items are included in Parts I-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. Part IV contains 11 items, 4 of these items are scored 0-4 in the same manner, and 7 are scored 0-1, with 0 indicating the absence of impairment and 1 indicating the presence of impairment. Total UPDRS score represents the sum of these items in Parts I-IV. A total of 199 points are possible. 199 represents the worst (total) disability), 0--no disability.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Mental Subscales of the Unified Parkinson's Disease Rating Scale
The outcome is defined as change in Mental subscale of Unified Parkinson's Disease Rating Scale(UPDRS Part I) between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. UPDRS Part I: Mentation, behavior and mood, consisting of 4 questions answered on a 0-4 point scale where 0 represents the absence of impairment and 4 represents the highest degree of impairment. Total score represents the sum of these 4 questions. A greater increase in score indicates a greater increase in disability. A total of 16 points are possible. 16 represents the worst (total) disability), 0--no disability.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Activities of Daily Living(ADL) Subscale of the Unified Parkinson's Disease Rating Scale
The outcome is defined as change in ADL subscale of the Unified Parkinson's Disease Rating Scale(UPDRS Part II) between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. UPDRS Part II: Activities of Daily Living in the week prior to the designated visit, consisting of 13 questions answered on a 0-4 point scale where 0 represents the absence of impairment and 4 represents the highest degree of impairment. Total Part II score represents the sum of these 13 questions. A greater increase in score indicates a greater increase in disability. A total of 52 points are possible. 52 represents the worst (total) disability), 0--no disability
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Motor Subscale of the Unified Parkinson's Disease Rating Scale
The outcome is defined as change in Motor subscale of the Unified Parkinson's Disease Rating Scale(UPDRS Part III) between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. UPDRS Part III: motor abilities at the time of the visit, consisting of 27 items (including 13 general questions and 14 sub-questions) each answered on a 0-4 point scale where 0 represents the absence of impairment and 4 represents the highest degree of impairment. Total Part III score represents the sum of these 27 items. A total of 108 points are possible. 108 represents the worst (total) disability), 0--no disability.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Modified Hoehn & Yahr Scale
The Modified Hoehn \& Yahr Scale is an 8-level Parkinson's disease staging instrument. The outcome is defined as change in Modified Hoehn \& Yahr Scale between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. A greater increase in stage indicates a greater increase in disability. Stage ranges from 0-5 (also including 1.5 and 2.5) with 0 indicating no disability and 5 indicating maximum disability.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Modified Schwab & England Independence Scale
The Schwab \& England scale is an investigator and subject assessment of the subject's level of independence at all scheduled study visits. The subject will be scored on a percentage scale reflective of his/her ability to perform acts of daily living in relation to what he/she did before Parkinson's disease appeared. The outcome is defined as change in Schwab \& England Independence Scale between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. Higher decrease in score indicates higher disability. Score ranges from 100% (complete independence) to 0% (total disability).
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Beck Depression Inventory II (BDI-II)
The Beck Depression Inventory (BDI) is a validated self-reported 21-item depression scale that was tested and validated as a reliable instrument for screening for depression in PD. The outcome is defined as change in BDI-II between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. Total BDI score represents the sum of these 21-items. A higher change in score indicates a greater increase in disability. Total score of 0-13 is considered minimal, 14-19 is mild, 20-28 is moderate, and 29-63 is severe.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Montreal Cognitive Assessment
The Montreal Cognitive Assessment(MoCA) is a brief 30-point screening instrument that was developed and validated to identify subjects with mild cognitive impairment. The outcome is defined as change in MoCA between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. Total MoCA score represents the sum of these 30-points, with a lower score indicating greater cognitive impairment. 30 is the maximum score, with a score of 26 or higher considered normal and below 26 indicative of Mild Cognitive Impairment.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Parkinson Disease Quality of Life Questionnaire-39(PDQ-39)
The PD Quality of Life Scale(PDQ-39) asks the subject to evaluate how Parkinson disease has affected their health and overall quality of life at that point in time. The total quality of life scale includes subscales relating to social role, self-image/sexuality, sleep, outlook, physical function and urinary function. The outcome is defined as change in PDQ-39 between the baseline visit and month 12 or the time of sufficient disability to require dopaminergic therapy. It is scored on a scale of zero to 100, with lower scores indicating better health and higher scores more severe disability.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Systolic Standing
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Systolic Supine
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Diastolic Standing
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Diastolic Supine
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Pulse Standing
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Pulse Supine
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Oedema Peripheral
General disorders and administration site conditions. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Dizziness
Nervous system disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Nasopharyngitis
Infections and infestations. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Headache
Nervous System disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Constipation
Gastrointestinal Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Fatigue
General Disorders and Administration Site Conditions. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Nausea
Gastrointestinal Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Upper Respiratory Tract Infection
Infections and Infestations. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Depression
Psychiatric Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Somnolence
Nervous System Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Insomnia
Psychiatric Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Dyspepsia
Gastrointestinal Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Diarrhoea
Gastrointestinal Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Sinusitis
Infections and Infestations. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Back Pain
Musculoskeletal and Connective Tissue Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Hypotension
Vascular Disorders. Common adverse experience/event is defined as AE occurs to 5(about 5%) or more subjects. They will also be tabulated by treatment groups.
Measured: Baseline to 12 months or the time to require dopaminergic therapy
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 May 2009 (estimated)
- Study startJul 2009
- Primary completionDec 2011
- Study completionFeb 2012
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 (35)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 Northwestern 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 99 participants (actual)
Sponsor and investigators
- Lead sponsor
- Northwestern University
- Sponsor type
- University, hospital or other
- Collaborators
- Michael J. Fox Foundation for Parkinson's Research, Northwestern University Dixon Fund, The Parkinson Study Group
- Responsible party
- Principal investigator, Tanya Simuni, Northwestern University
- Investigators
- Tanya Simuni, MS, Study chair, Northwestern University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00909545
- Sponsor's protocol ID
- CTCC Protocol #124
- Acronym
- STEADY-PD
- Status last verified
- Apr 2013
- First submitted
- 26 May 2009
- Last updated
- 17 Apr 2013
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease. N Engl J Med. 1993 Jan 21;328(3):176-83. doi: 10.1056/NEJM199301213280305.
PubMed 8417384Parkinson Study Group. Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. JAMA. 2002 Apr 3;287(13):1653-61. doi: 10.1001/jama.287.13.1653.
PubMed 11926889Parkinson Study Group. A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease. Arch Neurol. 2004 Apr;61(4):561-6. doi: 10.1001/archneur.61.4.561.
PubMed 15096406NINDS NET-PD Investigators. A randomized, double-blind, futility clinical trial of creatine and minocycline in early Parkinson disease. Neurology. 2006 Mar 14;66(5):664-71. doi: 10.1212/01.wnl.0000201252.57661.e1. Epub 2006 Feb 15.
PubMed 16481597NINDS 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 17200487Becker C, Jick SS, Meier CR. Use of antihypertensives and the risk of Parkinson disease. Neurology. 2008 Apr 15;70(16 Pt 2):1438-44. doi: 10.1212/01.wnl.0000303818.38960.44. Epub 2008 Feb 6.
PubMed 18256367Braak H, Ghebremedhin E, Rub U, Bratzke H, Del Tredici K. Stages in the development of Parkinson's disease-related pathology. Cell Tissue Res. 2004 Oct;318(1):121-34. doi: 10.1007/s00441-004-0956-9. Epub 2004 Aug 24.
PubMed 15338272Chan CS, Guzman JN, Ilijic E, Mercer JN, Rick C, Tkatch T, Meredith GE, Surmeier DJ. 'Rejuvenation' protects neurons in mouse models of Parkinson's disease. Nature. 2007 Jun 28;447(7148):1081-6. doi: 10.1038/nature05865. Epub 2007 Jun 10.
PubMed 17558391Christensen HR, Antonsen K, Simonsen K, Lindekaer A, Bonde J, Angelo HR, Kampmann JP. Bioavailability and pharmacokinetics of isradipine after oral and intravenous administration: half-life shorter than expected? Pharmacol Toxicol. 2000 Apr;86(4):178-82. doi: 10.1034/j.1600-0773.2000.d01-32.x.
PubMed 10815751de Lau LM, Breteler MM. Epidemiology of Parkinson's disease. Lancet Neurol. 2006 Jun;5(6):525-35. doi: 10.1016/S1474-4422(06)70471-9.
PubMed 16713924Dodel RC, Singer M, Kohne-Volland R, Szucs T, Rathay B, Scholz E, Oertel WH. The economic impact of Parkinson's disease. An estimation based on a 3-month prospective analysis. Pharmacoeconomics. 1998 Sep;14(3):299-312. doi: 10.2165/00019053-199814030-00006.
PubMed 10186468Dorsey ER, Constantinescu R, Thompson JP, Biglan KM, Holloway RG, Kieburtz K, Marshall FJ, Ravina BM, Schifitto G, Siderowf A, Tanner CM. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology. 2007 Jan 30;68(5):384-6. doi: 10.1212/01.wnl.0000247740.47667.03. Epub 2006 Nov 2.
PubMed 17082464Elm JJ, Goetz CG, Ravina B, Shannon K, Wooten GF, Tanner CM, Palesch YY, Huang P, Guimaraes P, Kamp C, Tilley BC, Kieburtz K; NET-PD Investigators. A responsive outcome for Parkinson's disease neuroprotection futility studies. Ann Neurol. 2005 Feb;57(2):197-203. doi: 10.1002/ana.20361.
PubMed 15668964Fahn S, Oakes D, Shoulson I, Kieburtz K, Rudolph A, Lang A, Olanow CW, Tanner C, Marek K; Parkinson Study Group. Levodopa and the progression of Parkinson's disease. N Engl J Med. 2004 Dec 9;351(24):2498-508. doi: 10.1056/NEJMoa033447.
PubMed 15590952Gill DJ, Freshman A, Blender JA, Ravina B. The Montreal cognitive assessment as a screening tool for cognitive impairment in Parkinson's disease. Mov Disord. 2008 May 15;23(7):1043-1046. doi: 10.1002/mds.22017.
PubMed 18381646
Study at a glance
From the registry record, last updated by the sponsor on 17 Apr 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Pilot Phase II Double-Blind, Placebo-Controlled, Tolerability and Dosage Finding Study of Isradipine CR as a Disease Modifying Agent in Patients With Early Parkinson Disease
- ClinicalTrials.gov ID
- NCT00909545
- Acronym / sponsor ID
- STEADY-PD / CTCC Protocol #124
- Conditions
- Parkinson Disease
- Keywords
- Early Parkinson disease
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 99 participants (actual)
- Lead sponsor
- Northwestern UniversityUniversity, hospital or other
- Collaborators
- Michael J. Fox Foundation for Parkinson's Research, Northwestern University Dixon Fund, The Parkinson Study Group
- Study start
- Jul 2009
- Primary completion
- Dec 2011 (actual)
- Study completion
- Feb 2012 (actual)
- First posted
- 28 May 2009 (estimated)
- Results
- Posted 17 Apr 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this study is to establish a dosage of isradipine CR that is tolerable and demonstrates preliminary efficacy for utilization in future pivotal efficacy studies.
Detailed description
There is solid scientific rational and preclinical data supporting a clinical trial of isradipine CR as a potential disease modifying agent in early PD. Human pharmacokinetic data demonstrate that it is feasible to achieve the serum concentrations in humans that were neuroprotective in preclinical models with the FDA approved dosage range. Pilot data demonstrate acceptable tolerability of isradipine CR in the PD population. Tolerability is inversely proportional to the dosage dependent. Considering that tolerability of isradipine CR is inversely proportional to the dosage exposure, it is essential to proceed with the dose selection tolerability study in preparation for the future efficacy trials.
The tolerability, defined as the ability to complete the study, of three dosages of isradipine CR relative to placebo in subjects with early Parkinson's disease will be examined first. The dosage that is tolerable and demonstrates preliminary efficacy will be evaluated further in the future pivotal efficacy studies.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Isradipine CR 5mg | Active comparator | Drug: Isradipine CR 5mgIsradipine CR 5mg/day |
| Isradipine CR 10mg | Active comparator | Drug: Isradipine CR 10mgIsradipine CR 10mg/day |
| Isradipine CR 20mg | Active comparator | Drug: Isradipine CR 20mgIsradipine CR 20mg/day |
| Placebo | Placebo comparator | Drug: PlaceboPlacebo |
Who may qualify
- Ages
- 30 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Subjects with early idiopathic PD. If tremor is not present, subjects must have unilateral onset and persistent asymmetry of the symptoms.
- Be over 30 years old at the time of diagnosis of PD.
- Hoehn \& Yahr stage is less than or equal to 2.5.
- Currently not receiving dopaminergic therapy and not projected to require dopaminergic therapy for at least 6 months from enrollment.
- Use of MAO-B inhibitors (rasagiline, selegiline), amantadine, or anticholinergics will be allowed. The dosage has to be stable for 3 months prior to baseline visit and throughout the duration of the study.
Key exclusion criteria (20 listed)
- Subjects with a diagnosis of an atypical Parkinsonism
- Subjects unwilling or unable to give informed consent
- Use of CoQ10 at a dosage >600mg daily or use of creatine >5 grams daily within the 60 days prior to randomization
- Exposure to dopaminergic PD therapy within 60 days prior to enrollment or for 3 months or more at any point in the past
- History of clinically significant orthostatic hypotension or presence of orthostatic hypotension at the screening visit defined as > 20 mmHg change in systolic BP and >10mm change in diastolic BP after 2 min of standing, or baseline BP <90/60
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 |
|---|---|---|
| Isradipine CR 5mgAlso: Isradipine CR, Dynacirc CR5mg dose: 1 Dynacirc CR 5mg tablet, 3 tablets placebo once daily | Drug | Isradipine CR 5mg |
| Isradipine CR 10mgAlso: Isradipine CR, Dynacirc CR10mg dose: 2 Dynacirc CR 5mg tablets, 2 tablets placebo once daily | Drug | Isradipine CR 10mg |
| Isradipine CR 20mgAlso: Isradipine CR, Dynacirc CR20mg dose: 4 Dynacirc CR 5mg tablets once daily | Drug | Isradipine CR 20mg |
| Placebo4 Placebo to Match (PTM) tablets once daily | Drug | Placebo |
Primary outcome
Tolerability of the Three Dosages(5mg, 10mg and 20mg) of Isradipine CR.
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Tolerability will be judged by the proportion of subjects enrolled in a dosage group able to complete the 12 month study or to the time of initiation of dopaminergic therapy on their original assigned dosage. Tolerability of each active arm will be compared to placebo group.
31 secondary outcomes
Efficacy: Change in Unified Parkinson's Disease Rating Scale (UPDRS)
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Mental Subscales of the Unified Parkinson's Disease Rating Scale
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Activities of Daily Living(ADL) Subscale of the Unified Parkinson's Disease Rating Scale
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Motor Subscale of the Unified Parkinson's Disease Rating Scale
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Modified Hoehn & Yahr Scale
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Modified Schwab & England Independence Scale
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Beck Depression Inventory II (BDI-II)
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Montreal Cognitive Assessment
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Efficacy: Change in Parkinson Disease Quality of Life Questionnaire-39(PDQ-39)
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Systolic Standing
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Systolic Supine
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Diastolic Standing
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Diastolic Supine
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Pulse Standing
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Vital Signs: Change in Pulse Supine
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Oedema Peripheral
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Dizziness
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Nasopharyngitis
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Headache
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Constipation
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Fatigue
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Nausea
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Upper Respiratory Tract Infection
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Depression
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Somnolence
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Insomnia
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Dyspepsia
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Diarrhoea
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Sinusitis
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Back Pain
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Common Adverse Events: Hypotension
Time frame: Baseline to 12 months or the time to require dopaminergic therapy
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Apr 2013.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 8417384Parkinson Study Group. Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease. N Engl J Med. 1993 Jan 21;328(3):176-83. doi: 10.1056/NEJM199301213280305.
- Background: PubMed 11926889Parkinson Study Group. Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. JAMA. 2002 Apr 3;287(13):1653-61. doi: 10.1001/jama.287.13.1653.
- Background: PubMed 15096406Parkinson Study Group. A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease. Arch Neurol. 2004 Apr;61(4):561-6. doi: 10.1001/archneur.61.4.561.
- Background: PubMed 16481597NINDS NET-PD Investigators. A randomized, double-blind, futility clinical trial of creatine and minocycline in early Parkinson disease. Neurology. 2006 Mar 14;66(5):664-71. doi: 10.1212/01.wnl.0000201252.57661.e1. Epub 2006 Feb 15.
- 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 18256367Becker C, Jick SS, Meier CR. Use of antihypertensives and the risk of Parkinson disease. Neurology. 2008 Apr 15;70(16 Pt 2):1438-44. doi: 10.1212/01.wnl.0000303818.38960.44. Epub 2008 Feb 6.
- Background: PubMed 15338272Braak H, Ghebremedhin E, Rub U, Bratzke H, Del Tredici K. Stages in the development of Parkinson's disease-related pathology. Cell Tissue Res. 2004 Oct;318(1):121-34. doi: 10.1007/s00441-004-0956-9. Epub 2004 Aug 24.
- Background: PubMed 17558391Chan CS, Guzman JN, Ilijic E, Mercer JN, Rick C, Tkatch T, Meredith GE, Surmeier DJ. 'Rejuvenation' protects neurons in mouse models of Parkinson's disease. Nature. 2007 Jun 28;447(7148):1081-6. doi: 10.1038/nature05865. Epub 2007 Jun 10.
- Background: PubMed 10815751Christensen HR, Antonsen K, Simonsen K, Lindekaer A, Bonde J, Angelo HR, Kampmann JP. Bioavailability and pharmacokinetics of isradipine after oral and intravenous administration: half-life shorter than expected? Pharmacol Toxicol. 2000 Apr;86(4):178-82. doi: 10.1034/j.1600-0773.2000.d01-32.x.
- Background: PubMed 16713924de Lau LM, Breteler MM. Epidemiology of Parkinson's disease. Lancet Neurol. 2006 Jun;5(6):525-35. doi: 10.1016/S1474-4422(06)70471-9.
- Background: PubMed 10186468Dodel RC, Singer M, Kohne-Volland R, Szucs T, Rathay B, Scholz E, Oertel WH. The economic impact of Parkinson's disease. An estimation based on a 3-month prospective analysis. Pharmacoeconomics. 1998 Sep;14(3):299-312. doi: 10.2165/00019053-199814030-00006.
- Background: PubMed 17082464Dorsey ER, Constantinescu R, Thompson JP, Biglan KM, Holloway RG, Kieburtz K, Marshall FJ, Ravina BM, Schifitto G, Siderowf A, Tanner CM. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology. 2007 Jan 30;68(5):384-6. doi: 10.1212/01.wnl.0000247740.47667.03. Epub 2006 Nov 2.
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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.
Tanya Simuni, MS study chair
Northwestern University
20 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Isradipine CR 5mg, Isradipine CR 10mg and Isradipine CR 20mg in people with Parkinson Disease, run by Northwestern University at 20 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 5 inclusion and 20 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: finished, as of the sponsor's last update on 17 Apr 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 20 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 17 Apr 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?
Tolerability of the Three Dosages(5mg, 10mg and 20mg) of Isradipine CR. (time frame: Baseline to 12 months or the time to require dopaminergic therapy). 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 NCT00909545, which also lists 35 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 17 Apr 2013.