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Parkinson's DiseasePhase 2NCT01280123

Pioglitazone in Early Parkinson's Disease

A Phase 2 study testing Pioglitazone in people with Parkinson's Disease, run by University of Rochester at 38 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a multi-center, double-blind, placebo controlled clinical trial of two dosages of oral pioglitazone (15 milligram(mg) and 45 milligram (mg)) for safety, tolerability, and futility. Read more about this study

Who is it for?
Ages 30 years and older
Conditions the study is for
Parkinson's Disease
What is being tested?
Pioglitazone
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
210 participants
Where
38 sitesUnited States
Study dates
Mar 2011to May 2014
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

  • Willing and able to give informed consent.
  • Men and women with idiopathic PD of less than 5 years duration from diagnosis with a Hoehn and Yahr Stage < 2.
  • On stable dosage of rasagiline 1 mg/day or selegiline 10 mg/day for at least 8 weeks but not more than 8 months prior to baseline. Expected to remain on stable dose of rasagiline or selegiline as the only treatment for their PD for the duration of the study (44 weeks).
  • Diagnosis must be confirmed by bradykinesia plus one of the other cardinal signs (resting tremor, rigidity) being present, without any other known or suspected cause of parkinsonism. The clinical signs must be asymmetric.
  • Subjects may be taking stable doses (30 days) of anticholinergics or creatine (< 5gm/day) but must be expected to remain on the same dose.
  • Age > 30 years.
  • Women who are not postmenopausal or surgically sterile must use a medically accepted contraceptive regimen for at least 60 days before the baseline visit, and agree to continue such use throughout the duration of the study and for 30 days after the final dose of study drug.

Who cannot join

  • Exposure to dopaminergic PD therapy or amantadine within 60 days prior to baseline visit or for 90 days or more at any point in the past
  • Use of any of the following drugs within 180 days prior to baseline: neuroleptics, metoclopramide, alpha-methyldopa, clozapine, olanzapine and flunarizine.
  • Use of any of the following drugs within 90 days prior to baseline: methylphenidate, cinnarizine, reserpine, tetrabenazine, amphetamine or monoamine oxidase (MAO)-A inhibitors (pargyline, phenelzine, and tranylcypromine).
  • Presence of drug-induced parkinsonism (e.g., metoclopramide, flunarizine), metabolic identified neurogenetic disorders (e.g., Wilson's disease), encephalitis, or other atypical Parkinsonian syndromes (e.g., progressive supranuclear palsy, multiple system atrophy).
  • Participation in other drug studies or receipt of other investigational drugs within 30 days prior to baseline or during the study.
  • Presence of freezing.
Show all 23Show fewer
  • Any clinically significant psychiatric or medical condition or laboratory abnormality, which would in the judgment of the Investigator interfere with the subject's ability to participate.
  • History of stereotaxic brain surgery for PD
  • Clinically significant structural brain disease that the investigator believes would interfere with study evaluations.
  • History of congestive heart failure.
  • Use of pioglitazone or rosiglitazone within 90 days before randomization.
  • Known intolerance to pioglitazone or rosiglitazone.
  • Allergy to rasagiline or selegiline, or contraindication to rasagiline or selegiline use.
  • Type I or Type II diabetes mellitus.
  • HgbA1C greater than or equal to 6% at Screening.
  • Known liver disease or elevation of AST or ALT greater than 2.5 times the upper limit of normal.
  • Known history of osteoporosis. All women ≥ 65 years of age or men and woman at high risk of osteoporosis should have documented evidence of screening for osteoporosis. Factors associated with high risk of osteoporosis include: previous non traumatic fracture, chronic glucocorticoid use, body weight under 58 kg, family history of hip fracture, current cigarette smoking, and excessive alcohol intake.
  • Drug or alcohol use or dependence that, in the opinion of the Investigator, would interfere with the safe conduct of the study.
  • Significant peripheral edema (2+ or more) of the extremities of any etiology.
  • Current or planned use of gemfibrozil or rifampin during the trial.
  • History of bladder cancer.
  • Evidence of hematuria which has not been evaluated for evidence of bladder cancer. (Documentation of work up or a repeat urine test that was negative for hematuria and the primary care physician or urologist does not feel that further work up is required.)
  • History of macular edema.

Trial locations and contacts

38 sites in 1 country.

38 sites in 1 country

United States38 sites
  • University of Michigan

    Ann Arbor, Michigan, 48109-5316

  • Emory University School of Medicine

    Atlanta, Georgia, 30329

  • Medical College of Georgia

    Augusta, Georgia, 30912

  • Univeristy of Colorado Denver

    Aurora, Colorado, 80045

  • Johns Hopkins University

    Baltimore, Maryland, 21287-0875

  • Univeristy of Alabama at Birmingham

    Birmingham, Alabama, 35294-0017

  • Brigham & Women's Hospital

    Boston, Massachusetts, 02115

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

  • SUNY Downstate Medical Center

    Brooklyn, New York, 11203-2098

  • University of Vermont

    Burlington, Vermont, 05405

  • Medical University of South Carolina

    Charleston, South Carolina, 29401

  • University of Virginia

    Charlottesville, Virginia, 22903

  • Northwestern University

    Chicago, Illinois, 60611

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • University of Texas Southwestern Medical Center

    Dallas, Texas, 75390-9036

  • Duke University

    Durham, North Carolina, 27705

  • Michigan State University

    East Lansing, Michigan, 48824

  • The Parkinson's & Movement Disorder Institute

    Fountain Valley, California, 92708

  • University of Florida

    Gainsville, Florida, 32610

  • Struthers Parkinson's Center

    Golden Valley, Minnesota, 55427

  • Pacific Health Research & Education Institute

    Honolulu, Hawaii, 96819

  • University of Florida, Jacksonville

    Jacksonville, Florida, 32209

  • University of Kansas Medical Center

    Kansas City, Kansas, 66160

  • Dartmouth Hitchcock Medical Center

    Lebanon, New Hampshire, 03756

  • University of Kentucky

    Lexington, Kentucky, 40536

  • University of Southern California

    Los Angeles, California, 90083

  • North Shore - LIJ Health System

    Manhasset, New York, 11030

  • University of Miami

    Miami, Florida, 33136

  • Vanderbilt University

    Nashville, Tennessee, 37232

  • Ochsner Clinic Foundation

    New Orleans, Louisiana, 70121

  • Thomas Jefferson University

    Philadelphia, Pennsylvania, 19107

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19107

  • Barrow Neurological Institute

    Phoenix, Arizona, 85013

  • Oregon Health & Science University

    Portland, Oregon, 97239-3098

  • University of California San Fransisco

    San Francisco, California, 94143-0114

  • LSU Health Science Center Shreveport

    Shreveport, Louisiana, 71103

  • Washington University

    St Louis, Missouri, 63110

  • University of South Florida

    Tampa, Florida, 33606

Other trials in United States

About this study

Official title: A Multi-Center, Double-Blind, Placebo-Controlled Phase II Study of Pioglitazone in Early Parkinson's Disease

This is a multi-center, double-blind, placebo controlled clinical trial of two dosages of oral pioglitazone (15 milligram(mg) and 45 milligram (mg)) for safety, tolerability, and futility.

Subjects who are on stable dose of rasagiline 1 mg/day or selegiline 10 mg/day for at least 8 weeks but no more than 8 months, will be randomized to one of two dosages of oral pioglitazone (15 mg and 45 mg) or matching placebo.

The study will measure disease progression by the change in total Unified Parkinson's Disease Rating Scale (UPDRS) score between the baseline visit and 44 weeks.

Read the detailed description

A Multi-Center, Double-Blind, Placebo-Controlled Phase II Study of Pioglitazone in Early Parkinson's Disease (PD). The patient population has early stage PD (< 5 years from diagnosis), must be treated with 1 mg/day of rasagiline or 10 mg/day of selegiline for at least 8 weeks but not more than 8 months prior to enrollment.

The primary objective of this clinical trial is to assess the futility of pioglitazone on PD disease progression as measured by the change in total UPDRS score between the baseline visit and 44 weeks. The secondary objectives of the study are to collect additional efficacy and safety/tolerability data to be used in planning a subsequent Phase III trial of pioglitazone in early, treated PD. Measures of cognition, mood and blood- and urine-based biomarkers will also be explored. Subjects in this trial are randomly assigned in a 1:1:1 ratio to one of three study arms: 15 mg, 45 mg or placebo.

Being tested
Pioglitazone, placebo
Keywords
Parkinson's Disease, Biomarkers
Medical subject headings
Parkinson Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PioglitazoneDrug

    Also called Pioglitazone Hydrochloride, ACTOS (R)

    Oral capsules of Pioglitazone (15 mg capsules) either 15 mg/qd or 45 mg/qd

    Subjects will titrate in a blinded fashion to 30 mg/day after 2 weeks and to 45 mg per day) 2 weeks later as tolerated.

  • placeboDrug

    Placebo will contain microcrystalline cellulose. An over-encapsulation process will be conducted in accordance with Clinical Good Manufacturing Procedures (cGMP) regulations to create a dosage form for the active study drug that will be indistinguishable from the comparator (Placebo) capsule.

Study groups in NCT01280123
Study groupRoleWhat they receive
15 mg pioglitazoneExperimental15 mg pioglitazone
Receives: Drug: Pioglitazone
45 mg pioglitazoneExperimental45 mg pioglitazone
Receives: Drug: Pioglitazone
Matching PlaceboPlacebo comparatorPlacebo
Receives: Drug: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Total Unified Parkinson's Disease Rating Scale (UPDRS) Score From Baseline to 44 Weeks

    Change in total UPDRS score from baseline to 44 weeks (in subjects treated with rasagiline 1 mg/day or selegiline 10 mg/day).

    The Total UPDRS is the sum of parts I, II, and III. The possible range of the total UPDRS is from 0-176. Higher values indicate worse outcomes.

    The change is 44 weeks - baseline.

    Measured: 44 weeks

Secondary outcomes (5)
  1. Change in Ambulatory Capacity From Baseline to 44 Weeks

    This is the sum of the 5 UPDRS questions regarding ambulatory capacity: falling, freezing, walking, gait, postural stability.

    Ambulatory Capacity is calculated as the sum of items 13-15, 29, 30 of the Unified Parkinson's Disease Rating Scale (UPDRS). It ranges from 0-20. Higher scores are worse. Change is 44 weeks - baseline.

    Measured: 44 weeks

  2. Change in Schwab and England Scale From Baseline to 44 Weeks

    The modified Schwab and England Activities of Daily Living is a single question ranging from 0-100% with anchors for each 10% interval. Higher scores are better (100% completely independent- 0% vegetative).

    Measured: 44 weeks

  3. Change in Parkinson's Disease Questionnaire (PDQ-39) From Baseline to 44 Weeks

    The Parkinson's Disease Questionnaire (PDQ-39) is a short, 39 item measure of quality of life in subjects with Parkinson's disease. The questionnaire covers 8 aspects of quality of life: mobility, activities of daily living, emotional well-being, stigma, social support, cognitions, communication and bodily discomfort.

    The total score ranges from 0 (never have difficulty) to 100 (always have difficulty). Lower scores reflect better quality of life.

    Measured: 44 weeks

  4. Change in the Mattis Dementia Rating Scale (DRS-2)From Baseline to 44 Weeks

    The Mattis dementia rating scale is a psychometric instrument designed to assess the extent and nature of dementia. Mattis Dementia Rating scale (DRS-2) raw score is the sum of 5 raw sub-scores (attention has possible 37 points, initiation/perseveration has possible 37 points, construction has possible 6 points, conceptualization has possible 39 points, memory has possible 25 points). Total range is 0-144. Higher scores are better.

    Measured: 44 weeks

  5. Change in the 15-item Geriatric Depression Scale (GDS-15)From Baseline to 44 Weeks

    The Geriatric Depression Scale - 15 is a short 15 yes or no question instrument for assessing depression in the elderly. It has been found to be particularly useful in assessing depression in Parkinson's Disease. A score of 0 to 5 is normal. A score greater than 5 suggests depression.

    Measured: 44 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jan 2011 (estimated)
  2. Study startMar 2011
  3. Primary completionMay 2014
  4. Study completionMay 2014

Resources

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
210 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01280123
Sponsor's protocol ID
FS-ZONE
Other IDs
5U01NS043128-12
Status last verified
Sep 2013
First submitted
3 Dec 2010
Last updated
14 Oct 2015
Data monitoring committee
Yes

Publications

  • NINDS Exploratory Trials in Parkinson Disease (NET-PD) FS-ZONE Investigators. Pioglitazone in early Parkinson's disease: a phase 2, multicentre, double-blind, randomised trial. Lancet Neurol. 2015 Aug;14(8):795-803. doi: 10.1016/S1474-4422(15)00144-1. Epub 2015 Jun 23.

    PubMed 26116315
  • Carta AR, Simuni T. Thiazolidinediones under preclinical and early clinical development for the treatment of Parkinson's disease. Expert Opin Investig Drugs. 2015 Feb;24(2):219-27. doi: 10.1517/13543784.2015.963195. Epub 2014 Sep 17.

    PubMed 25227476

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pioglitazone in people with Parkinson's Disease, run by University of Rochester at 38 sites in United States.

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 7 inclusion and 23 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 14 Oct 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 38 sites in United States. 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 14 Oct 2015). 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 Total Unified Parkinson's Disease Rating Scale (UPDRS) Score From Baseline to 44 Weeks (time frame: 44 weeks). 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 NCT01280123, which also lists 2 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 14 Oct 2015.

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