Cervical DystoniaPhase 3ASPEN-1NCT03608397
Single Treatment of DaxibotulinumtoxinA for Injection in Adults With Isolated Cervical Dystonia (ASPEN-1)
A Phase 3 study testing DaxibotulinumtoxinA for injection in people with Cervical Dystonia, run by Revance Therapeutics, Inc. at 75 sites in 9 countries.
Trial summary
This is a randomized, double-blind, placebo-controlled, parallel group, multi-center trial of two doses of daxibotulinumtoxinA (DAXI) for injection (high-dose; low-dose in adult subjects with isolated (primary) cervical dystonia (CD). Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Cervical Dystonia
- What is being tested?
- DaxibotulinumtoxinA for injection
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 301 participants
- Where
- 75 sitesin 9 countries
- Study dates
- 20 Jun 2018to 16 Jun 2020
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults, 18 to 80 years of age
- Meets diagnostic criteria for isolated CD (idiopathic; dystonic symptoms localized to the head, neck, shoulder areas) with at least moderate severity at Baseline (Day 1), defined as a TWSTRS-total score of at least 20, with at least 15 on the TWSTRS-Severity subscale, at least 3 on the TWSTRS-Disability subscale, and at least 1 on the TWSTRS-Pain subscale
Who cannot join
- Cervical dystonia attributable to an underlying etiology, (e.g., traumatic torticollis or tardive torticollis)
- Predominant retrocollis or anterocollis CD
- Significant dystonia in other body areas, or is currently being treated with BoNT for dystonia in areas other than those associated with isolated CD
- Severe dysphagia (Grade 3 or 4 on the Dysphagia Severity Scale) at Screening or Baseline (prior to study treatment)
- Any neuromuscular neurological conditions that may place the subject at increased risk of morbidity with exposure to BoNT, including peripheral motor neuropathic diseases (e.g., amyotrophic lateral sclerosis and motor neuropathy, and neuromuscular junctional disorders such as Lambert-Eaton syndrome and myasthenia gravis)
- Previous treatment with any BoNT product for any condition within the 14 weeks prior to Screening
- Botulinum Neurotoxin Type A (BoNTA), except the investigational daxibotulinumtoxinA, treatment-experienced subjects who had suboptimal or no treatment response to the most recent BoNTA injection for CD, as determined by the investigator, or history of primary or secondary non-response to BoNTA injections, known to have neutralizing antibodies to BoNTA; or have a history of botulinum toxin type B (rimabotulinumtoxinB [Myobloc/Neurobloc]) injection for CD due to non-response or suboptimal response to BoNTA
Trial locations and contacts
75 sites in 9 countries.
75 sites in 9 countries
United States44 sites
Emory University
Atlanta, Georgia, 30329
Parkinson's Disease and Movement Disorders Center of Boca Raton
Boca Raton, Florida, 33486
University of Vermont Medical Center
Burlington, Vermont, 05401
Medical University of South Carolina
Charleston, South Carolina, 29425
Rush University Medical Center
Chicago, Illinois, 60612
Wesley Neurology Clinic
Cordova, Tennessee, 38018
Texas Neurology. P.A.
Dallas, Texas, 37232
Associated Neurologist, P.C.
Danbury, Connecticut, 06810
Design Neuroscience Center
Doral, Florida, 33172
Duke University
Durham, North Carolina, 27710
Michigan State University
East Lansing, Michigan, 48824
Rocky Mountain Movement Disorders Center
Englewood, Colorado, 80113
QUEST Research Institute
Farmington, Michigan, 48334
The Parkinsons and Movement Disorder Institute
Fountain Valley, California, 92708
University of Florida Center for Movement Disorders and Neurorestoration
Gainesville, Florida, 32607
Infinity Clinical Research
Hollywood, Florida, 33024
Baylor College of Medicine
Houston, Texas, 77030
Houston Methodist Neurological Institute
Houston, Texas, 77030
University of California, Irvine
Irvine, California, 92697
University of Florida Health Science Center Jacksonville
Jacksonville, Florida, 32209
Loma Linda University
Loma Linda, California, 92354
USC Keck School of Medicine
Los Angeles, California, 90033
University of Miami
Miami, Florida, 33136
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Mount Sinai Movement Disorders Center
New York, New York, 10029
University of Nebraska Medical Center
Omaha, Nebraska, 68198
Kansas Institute of Reseach
Overland Park, Kansas, 66211-1358
Care Access Research
Pasadena, California, 91101
Thomas Jefferson University
Philadelphia, Pennsylvania, 19107
University of Pennsylvania, Department of Neurology
Philadelphia, Pennsylvania, 19107
HOPE Research Institute
Phoenix, Arizona, 85018
Coastal Neurology
Port Royal, South Carolina, 29935
University of Rochester
Rochester, New York, 14618
Central Texas Neurology Consultants
Round Rock, Texas, 78681
Sutter Institute for Medical Research
Sacramento, California, 95816
Movement Disorders Center of Arizona
Scottsdale, Arizona, 85258-4581
St Louis University
St Louis, Missouri, 63105
Washington University
St Louis, Missouri, 63110
Suncoast Neuroscience Associates
St. Petersburg, Florida, 33713-8844
New England Institute for Clinical Research
Stamford, Connecticut, 06905
USF Parkinson's Disease and Movement Disorders Center
Tampa, Florida, 33613
MedStar Georgetown University Hospital
Washington D.C., District of Columbia, 20007
Henry Ford West Bloomfield Hospital
West Bloomfield, Michigan, 48322
Wake Forest Health Sciences
Winston-Salem, North Carolina, 27157
Germany6 sites
Praxis fuer Neurologie im Bismark Karrée
Berlin, 10627
Universitaetsklinikum Duesseldorf
Düsseldorf, 40225
Medizinische Hochschule Hannover
Hanover, 30625
Klinikum rechts der Isar der TUM
München, 81675
GFO Kliniken Troisdorf, Betriebsstätte St. Johannes Sieglar
Troisdorf, 53844
Universitätsklinikum Tübingen
Tübingen, 72076
Poland6 sites
Szpital sw. Wojciecha Podmiot Leczniczy Copernicus Sp. Z o.o.
Gdansk, 80462
Marta Dagmara BANACH Marta Banach Specjalistyczny Gabinet Neurologiczny
Krakow, 30539
Krakowska Akademia Neurologii
Krakow, 31505
Wojewodzki Szpital Specjalistyczny w Olsztynie
Olsztyn, 10-561
Centrum Medyczne Pratia Warszawa
Warsaw, 01868
Mazowiecki Szpital Brodnowski Sp. z o.o.
Warsaw, 03-242
Czechia5 sites
Fakultni nemocnice Olomouc, Neurologicka klinika
Olomouc, 779 00
Fakultní nemocnice Ostrava, Neurologicka klinika
Ostrava-Poruba, 70852
Lekarna Pardubicke nemocnice
Pardubice, 53203
Neurologicka klinika 1. LF UK a VFN v Praze
Prague, 12821
Vestra Clinics s.r.o.
Rychnov nad Kněžnou, 51601
France4 sites
Hôpital Neurologique Pierre Wertheimer
Bron, 69500
CHU Grenoble Alpes
Grenoble, 38043
Hôpital Roger Salengro - CHRU de Lille
Lille, 59037
CHU Caremeau, Service de Neurologie
Nîmes, 30029
Spain4 sites
Hospital Universitari Vall d'Hebron
Barcelona, 08035
Hospital de la Santa Creu i Sant Pau
Barcelona, 08041
Hospital Universitario Burgos
Burgos, 09006
Hospital Universitario de La Princesa
Madrid, 28006
United Kingdom3 sites
Royal Devon and Exeter Foundation Trust Hospital
Exeter, EX25DW
The Walton Centre NHS Foundation Trust
Liverpool, L97LJ
Salford Royal NHS Foundation Trust
Salford, M55AP
Austria2 sites
Medical University Innsbruck
Innsbruck, 6020
Universitaetsklinik fuer Neurologie
Vienna, 1090
Canada1 site
University Health Network, Toronto Western Hospital
Toronto, Ontario, M5T2S8
About this study
Official title: A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Multi-Center Trial to Evaluate the Efficacy and Safety of a Single Treatment of DaxibotulinumtoxinA for Injection in Adults With Isolated Cervical Dystonia (ASPEN-1)
This is a randomized, double-blind, placebo-controlled, parallel group, multi-center trial of two doses of daxibotulinumtoxinA (DAXI) for injection (high-dose; low-dose in adult subjects with isolated (primary) cervical dystonia (CD).
Read the detailed description
Approximately 300 subjects, recruited from approximately 80 study centers in the United States (US), Canada, and Europe will be randomized to DAXI for injection high dose, DAXI for injection low dose, or placebo group, respectively. Subjects will be stratified by treatment center and history of prior treatment with botulinum neurotoxin (BoNT).
- Conditions
- Cervical Dystonia
- Being tested
- DaxibotulinumtoxinA for injection, Placebo
- Keywords
- DAXI, Cervical Dystonia, TWSTRS, Toxin
- Medical subject headings
- Torticollis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
DaxibotulinumtoxinA for injectionBiological
DaxibotulinumtoxinA for injection is a sterile, white to off-white lyophilized product containing the active ingredient, daxibotulinumtoxinA, and inactive ingredients to be reconstituted with sterile, non-preserved, 0.9% sodium chloride solution saline.
PlaceboBiological
Placebo is a sterile lyophilized product consisting of inactive ingredients without the neurotoxin to be reconstituted with sterile, non-preserved 0.9% sodium chloride solution.
| Study group | Role | What they receive |
|---|---|---|
| DAXI for injection low dose | Experimental | Low Dose Group Receives: Biological: DaxibotulinumtoxinA for injection |
| DAXI for injection high dose | Experimental | High Dose Group Receives: Biological: DaxibotulinumtoxinA for injection |
| Placebo | Placebo comparator | Placebo Group Receives: Biological: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from Baseline Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)-total score
TWSTRS is used to assess the severity of cervical Dystonia and the success of its treatment. The average of the change from baseline in TWSTRS-total score at Weeks 4 and 6 will be determined. TWSTRS-total score has a minimum score of 0 and a maximum score of 85, where higher scores represent worse outcomes. It is made up of the summation of 3 subscales: the Torticollis Severity Scale (minimum score of 0, maximum score of 35), the Disability Scale (minimum score of 0, maximum score of 30), and the Pain Scale (minimum score of 0, maximum score of 20).
Measured: Week 4 and Week 6
Secondary outcomes (4)
Change from Baseline TWSTRS-total score
Change from baseline in TWSTRS-total score (all post-treatment time points)
Measured: Up to 36 Weeks
Duration of effect
Duration of effect based on target TWSTRS score
Measured: Up to 36 Weeks
Patient Global Impression of Change (PGIC) Improvement
Percentage responders at Week 4 or 6
Measured: Week 4 or Week 6
Incidence of treatment-emergent adverse events (Safety)
Evaluation of adverse events and serious adverse events over the course of the study.
Measured: Up to 36 Weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Aug 2018
- Study start20 Jun 2018
- Primary completion3 Dec 2019
- Study completion16 Jun 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Cervical DystoniaStudies of the same condition, open and under way.
- 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
- Model description
- Approximately 300 subjects, recruited from study centers in the United States (US), Canada, and Europe will be randomized to DAXI high dose, DAXI low dose or placebo group.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 301 participants (actual)
Sponsor and investigators
- Lead sponsor
- Revance Therapeutics, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Syneos Health
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03608397
- Sponsor's protocol ID
- 1720302
- Acronym
- ASPEN-1
- Status last verified
- Nov 2022
- First submitted
- 11 Jul 2018
- Last updated
- 5 Dec 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Comella CL, Jankovic J, Hauser RA, Patel AT, Banach MD, Ehler E, Vitarella D, Rubio RG, Gross TM; ASPEN-1 Study Group. Efficacy and Safety of DaxibotulinumtoxinA for Injection in Cervical Dystonia: ASPEN-1 Phase 3 Randomized Controlled Trial. Neurology. 2024 Feb 27;102(4):e208091. doi: 10.1212/WNL.0000000000208091. Epub 2024 Jan 31.
PubMed 38295339
Study at a glance
From the registry record, last updated by the sponsor on 5 Dec 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Multi-Center Trial to Evaluate the Efficacy and Safety of a Single Treatment of DaxibotulinumtoxinA for Injection in Adults With Isolated Cervical Dystonia (ASPEN-1)
- ClinicalTrials.gov ID
- NCT03608397
- Acronym / sponsor ID
- ASPEN-1 / 1720302
- Conditions
- Cervical Dystonia
- Keywords
- DAXI, Cervical Dystonia, TWSTRS, Toxin
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 301 participants (actual)
- Lead sponsor
- Revance Therapeutics, Inc.Industry (pharma, biotech, devices)
- Collaborators
- Syneos Health
- Study start
- 20 Jun 2018 (actual)
- Primary completion
- 3 Dec 2019 (actual)
- Study completion
- 16 Jun 2020 (actual)
- First posted
- 1 Aug 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a randomized, double-blind, placebo-controlled, parallel group, multi-center trial of two doses of daxibotulinumtoxinA (DAXI) for injection (high-dose; low-dose in adult subjects with isolated (primary) cervical dystonia (CD).
Detailed description
Approximately 300 subjects, recruited from approximately 80 study centers in the United States (US), Canada, and Europe will be randomized to DAXI for injection high dose, DAXI for injection low dose, or placebo group, respectively. Subjects will be stratified by treatment center and history of prior treatment with botulinum neurotoxin (BoNT).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
- Model description
- Approximately 300 subjects, recruited from study centers in the United States (US), Canada, and Europe will be randomized to DAXI high dose, DAXI low dose or placebo group.
| Arm | Type | Receives |
|---|---|---|
| DAXI for injection low dose | Experimental | Biological: DaxibotulinumtoxinA for injectionLow Dose Group |
| DAXI for injection high dose | Experimental | Biological: DaxibotulinumtoxinA for injectionHigh Dose Group |
| Placebo | Placebo comparator | Biological: PlaceboPlacebo Group |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Adults, 18 to 80 years of age
- Meets diagnostic criteria for isolated CD (idiopathic; dystonic symptoms localized to the head, neck, shoulder areas) with at least moderate severity at Baseline (Day 1), defined as a TWSTRS-total score of at least 20, with at least 15 on the TWSTRS-Severity subscale, at least 3 on the TWSTRS-Disability subscale, and at least 1 on the TWSTRS-Pain subscale
Key exclusion criteria (7 listed)
- Cervical dystonia attributable to an underlying etiology, (e.g., traumatic torticollis or tardive torticollis)
- Predominant retrocollis or anterocollis CD
- Significant dystonia in other body areas, or is currently being treated with BoNT for dystonia in areas other than those associated with isolated CD
- Severe dysphagia (Grade 3 or 4 on the Dysphagia Severity Scale) at Screening or Baseline (prior to study treatment)
- Any neuromuscular neurological conditions that may place the subject at increased risk of morbidity with exposure to BoNT, including peripheral motor neuropathic diseases (e.g., amyotrophic lateral sclerosis and motor neuropathy, and neuromuscular junctional disorders such as Lambert-Eaton syndrome and myasthenia gravis)
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 |
|---|---|---|
| DaxibotulinumtoxinA for injectionDaxibotulinumtoxinA for injection is a sterile, white to off-white lyophilized product containing the active ingredient, daxibotulinumtoxinA, and inactive ingredients to be reconstituted with sterile, non-preserved, 0.9% sodium chloride solution saline. | Biological | DAXI for injection high dose, DAXI for injection low dose |
| PlaceboPlacebo is a sterile lyophilized product consisting of inactive ingredients without the neurotoxin to be reconstituted with sterile, non-preserved 0.9% sodium chloride solution. | Biological | Placebo |
Primary outcome
Change from Baseline Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)-total score
Time frame: Week 4 and Week 6
TWSTRS is used to assess the severity of cervical Dystonia and the success of its treatment. The average of the change from baseline in TWSTRS-total score at Weeks 4 and 6 will be determined. TWSTRS-total score has a minimum score of 0 and a maximum score of 85, where higher scores represent worse outcomes. It is made up of the summation of 3 subscales: the Torticollis Severity Scale (minimum score of 0, maximum score of 35), the Disability Scale (minimum score of 0, maximum score of 30), and the Pain Scale (minimum score of 0, maximum score of 20).
4 secondary outcomes
Change from Baseline TWSTRS-total score
Time frame: Up to 36 Weeks
Duration of effect
Time frame: Up to 36 Weeks
Patient Global Impression of Change (PGIC) Improvement
Time frame: Week 4 or Week 6
Incidence of treatment-emergent adverse events (Safety)
Time frame: Up to 36 Weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Dec 2022.
- Derived from this study: PubMed 38295339Comella CL, Jankovic J, Hauser RA, Patel AT, Banach MD, Ehler E, Vitarella D, Rubio RG, Gross TM; ASPEN-1 Study Group. Efficacy and Safety of DaxibotulinumtoxinA for Injection in Cervical Dystonia: ASPEN-1 Phase 3 Randomized Controlled Trial. Neurology. 2024 Feb 27;102(4):e208091. doi: 10.1212/WNL.0000000000208091. Epub 2024 Jan 31.
- Individual participant dataSharing planned: No
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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.
The record lists no contact. Use the official record to reach the sponsor.
75 sites in 9 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing DaxibotulinumtoxinA for injection in people with Cervical Dystonia, run by Revance Therapeutics, Inc. at 75 sites in 9 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 2 inclusion and 7 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 5 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 75 sites in United States, Germany, Poland, Czechia, France and 4 more countries. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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 from Baseline Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS)-total score (time frame: Week 4 and Week 6). 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 NCT03608397, which also lists 1 linked publication.
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 5 Dec 2022.