Safety and Efficacy Study of Oral Glycopyrrolate Liquid for the Treatment of Pathologic (Chronic Moderate to Severe) Drooling in Pediatric Patients 3 to 18 Years of Age With Cerebral Palsy or Other Neurologic Conditions
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Purpose
This is an open-label clinical research study of an oral glycopyrrolate liquid for the treatment of chronic moderate to severe drooling in patients with cerebral palsy or other neurological conditions. Patients participating in the study will receive oral glycopyrrolate liquid (1 mg/5 ml) three times a day (TID) for study duration of 24 weeks. After a washout, screening, and 2-day baseline period, patients will be enrolled in a 4-week dose titration period. Glycopyrrolate liquid doses will be titrated using dose levels in the Dose Titration Schedule. Titration will begin at 0.02 mg/kg per dose TID and sequentially increased in 0.02 mg/kg per dose increments TID every 5-7 days during the first four weeks until optimal individualized response is obtained for each patient or a maximum dose of 0.1 mg/kg TID is reached, not exceeding 3 mg TID or Dose-level 5 in the Dose Titration Schedule, whichever is lesser. Optimal dose for each patient is the dose at which he/she is receiving the maximum benefit from the study drug (greatest improvement in drooling) while experiencing minimum side effects. All patients will receive close attention by study staff throughout the study.
| Condition | Intervention | Phase |
|---|---|---|
|
Cerebral Palsy Neurological Conditions Mental Retardation Sialorrhea |
Drug: Oral Glycopyrrolate Liquid |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Six-Month, Multi-Center, Open-Label Study to Assess the Safety and Efficacy of Oral Glycopyrrolate Liquid for the Treatment of Pathologic (Chronic Moderate to Severe) Drooling in Pediatric Patients 3 to 18 Years of Age With Cerebral Palsy or Other Neurologic Conditions |
- Proportion of Responders According to the Modified Teacher's Drooling Scale (mTDS) [ Time Frame: 6 months ] [ Designated as safety issue: No ]The primary efficacy variable was patient's response status using the change from baseline to Week 24 evaluations of the mTDS assessment. Each patient was classified as a responder or non-responder according to the change in their mean mTDS rating from baseline to Week 24. Responders were patients who had at least a 3-point decrease in mTDS rating from baseline
- Parent/Caregiver's Assessment of the Extent of Drooling Using Visual Analog Scale (VAS) [ Time Frame: Baseline ] [ Designated as safety issue: No ]Parents/caregivers were to complete a 10 cm "Parent/Caregiver's Assessment of Extent of Drooling for the Day" VAS assessment (0 = normal; 10 = extremely wet) to provide an overall assessment of the extent of drooling for that day.
- Parent/Caregiver's Assessment of the Extent of Drooling Using VAS [ Time Frame: Week 24 ] [ Designated as safety issue: No ]Parents/caregivers were to complete a 10 cm "Parent/Caregiver's Assessment of Extent of Drooling for the Day" VAS assessment (0 = normal; 10 = extremely wet) to provide an overall assessment of the extent of drooling for that day.
- Parent/Caregiver's Global Assessment of Treatment [ Time Frame: Week 24 ] [ Designated as safety issue: No ]The parent/caregiver performed an overall evaluation of glycopyrrolate liquid for the treatment of drooling, benefits, and side effects over the duration of the study. The parent/caregiver selected one of the following choices to assess if 'This is a worthwhile treatment': 1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, 5 = strongly disagree. A dichotomous global assessment was also performed and summarized with the categories 'responder' (strongly agree and agree responses aggregated) and 'non-responder'(neutral, disagree, and strongly disagree responses aggregated)
- Investigator's Global Assessment of Treatment [ Time Frame: Week 24 ] [ Designated as safety issue: No ]The investigator performed an overall evaluation of glycopyrrolate liquid for the treatment of drooling, benefits, and side effects over the duration of the study. The investigator selected one of the following choices to assess if 'This is a worthwhile treatment': 1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, 5 = strongly disagree. A dichotomous global assessment was also performed and summarized with the categories 'responder' (strongly agree and agree responses aggregated) and 'non-responder' (neutral, disagree, and strongly disagree responses aggregated)
| Enrollment: | 137 |
| Study Start Date: | March 2007 |
| Study Completion Date: | June 2008 |
| Primary Completion Date: | May 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Patients with Chronic Drooling
Arm receiving study drug
|
Drug: Oral Glycopyrrolate Liquid
Study medication is administered three times a day at 7-8 AM, 1-2 PM, and 7-8 PM by the parent/caregiver
|
Eligibility| Ages Eligible for Study: | 3 Years to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
To be included in this study, patients must meet the following criteria:
- Male or female, weighing at least 13 kilograms (27 pounds), aged 3 through 18 years
- Diagnosis of cerebral palsy and/or mental retardation or any other neurologic impairment or condition (cognitively capable and cognitively impaired patients may be enrolled)
- Chronic drooling in the absence of treatment to the extent that the chin or clothing becomes wet on most days by confirming the Modified Teacher's Drooling Scale score ≥ 5
- Must be living in a situation where reliable parents/caregivers are willing and capable of administering medications, as determined by the investigator
- Written informed consent signed by the parent or legally acceptable representative
- Written assent signed by the age-appropriate patient if mentally capable, as determined by the investigator, and required by the site's Institutional Review Board
- If female of childbearing potential, the patient must have a negative pregnancy test at screening and Visit 2
- If female of childbearing potential and sexually active, she must use a medically acceptable form of contraception
Exclusion Criteria:
Patients are excluded from this study if they meet any of the following criteria:
- Patients who used glycopyrrolate within approximately 24 hours prior to the start of the baseline period, which began on Day -2
- Patients who used prohibited medications within 5 plasma half-lives of the medication prior to the start of the baseline period
- Patients injected with intrasalivary gland botulinum toxin within 10 months prior to the start of the baseline period
- Patients using intraoral devices or prosthetics for the treatment of drooling within 1 week prior to the start of the baseline period
- Patients receiving acupuncture for the treatment of drooling or who have received acupuncture for the treatment of drooling within 3 months prior to the start of the baseline period
- Patients who have medical conditions contraindicating anticholinergic therapy including gastrointestinal reflux, narrow-angle glaucoma, obstructive uropathy, obstructive disease of the gastrointestinal tract (i.e., delayed gastric emptying, pyloroduodenal stenosis, etc.), paralytic ileus, intestinal atony, vesicoureteral reflux, reactive airway disease, myasthenia gravis, hyperthyroidism, cardiac arrhythmias and/or tachycardia, and/or clinically significant electrocardiogram abnormalities, as determined by the investigator
- Patients who have a known contraindication to the study medication, including allergy to the study medication or any of its components
- Patients who have poorly controlled seizures defined as daily seizures
- Patients who have a history of obstructive disease of the gastrointestinal tract (i.e., intestinal obstruction)
- Patients who have clinically significant hepatic or renal impairment, at the discretion of the investigator
- Patients who are pregnant or breastfeeding
- Patients who have received any investigational drugs within 30 days of study entry
- Patient, families, or parents/caregivers who are expected to be non-compliant with the study procedures, as judged by the investigator
- Patients who are unable to meet the requirements of the study for any reason, as determined by the investigator
- Patients who have unstable mental disease, as determined by the investigator
Contacts and Locations| United States, Colorado | |
| Rocky Mountain Pediatrics | |
| Lakewood, Colorado, United States, 80214 | |
| United States, Georgia | |
| Child Neurology Associates, PC | |
| Atlanta, Georgia, United States, 30342 | |
| United States, New York | |
| St. Mary's for Children | |
| Bayside, New York, United States, 11360 | |
| United States, Ohio | |
| Akron's Childrens | |
| Akron, Ohio, United States, 44308 | |
| Hattie Larltham Center for Children with Disabilities | |
| Mantua, Ohio, United States, 44255 | |
| United States, Oklahoma | |
| The Children's Center | |
| Bethany, Oklahoma, United States, 73008 | |
| United States, Texas | |
| Alamo City Clinical Research | |
| San Antonio, Texas, United States, 78258 | |
| Study Director: | Shionogi Clinical Trials Administrator Clinical Support Help Line | Shionogi |
More Information
No publications provided
| Responsible Party: | Shionogi Clinical Trials Administrator, Shionogi |
| ClinicalTrials.gov Identifier: | NCT00491894 History of Changes |
| Obsolete Identifiers: | NCT00425087 |
| Other Study ID Numbers: | Sc-GLYCO-06-01 |
| Study First Received: | June 22, 2007 |
| Results First Received: | August 2, 2010 |
| Last Updated: | June 5, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Shionogi Inc.:
|
Mental Retardation Neurological Impairment Cerebral Palsy Drooling Neurological Conditions |
Additional relevant MeSH terms:
|
Cerebral Palsy Mental Retardation Sialorrhea Paralysis Brain Damage, Chronic Brain Diseases Central Nervous System Diseases Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Signs and Symptoms Mental Disorders Diagnosed in Childhood Mental Disorders Salivary Gland Diseases |
Mouth Diseases Stomatognathic Diseases Glycopyrrolate Adjuvants, Anesthesia Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Muscarinic Antagonists Cholinergic Antagonists Cholinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 16, 2013