Comparing Different Levodopa/Carbidopa/Entacapone Treatment Regimens (PARTEST)

Tracking Information
First Submitted Date ICMJE	February 14, 2011
First Posted Date ICMJE	February 15, 2011
Last Update Posted Date	September 12, 2011
Study Start Date ICMJE	February 2011
Actual Primary Completion Date	July 2011 (Final data collection date for primary outcome measure)
Current Primary Outcome Measures ICMJE; (submitted: February 14, 2011)	Duration of motor response by UPDRS III [ Time Frame: 20 minute intervals ]; Statistical method for the primary comparison will be analysis of variance (ANOVA) with the following grouping factors: treatment, sequence, subject, and period. Differences between Stalevo and treatment regimen A will be evaluated using orthogonal contrasts with 5% significance level.
Original Primary Outcome Measures ICMJE	Same as current
Change History	Complete list of historical versions of study NCT01296464 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures ICMJE	Not Provided
Original Secondary Outcome Measures ICMJE	Not Provided
Current Other Outcome Measures ICMJE	Not Provided
Original Other Outcome Measures ICMJE	Not Provided
Descriptive Information
Brief Title ICMJE	Comparing Different Levodopa/Carbidopa/Entacapone Treatment Regimens
Official Title ICMJE	Duration of Motor Response After Administration of Experimental Levodopa/Carbidopa/Entacapone Treatment Regimens Compared to Standard Treatment (Stalevo®);a Randomised,Double-blind,Crossover,Multicentre,Single Dose Study in Patients With Parkinson?s Disease and Wearing-off Symptoms
Brief Summary	The primary objective is to assess the effect of a single dose of two experimental levodopa/carbidopa/entacapone (L/C/E) treatment regimens versus standard L/C/E treatment regimen in Parkinson's disease (PD) patients with end-of-dose motor fluctuations in terms of duration of motor response after the first morning dose of levodopa. The secondary objective is to evaluate the safety of the L/C/E treatment regimens in patients with PD.
Detailed Description	This is a randomised, double-blind, 3-period crossover study comparing the effects of a single dose of two L/C/E treatment regimens (A and B) and standard L/C/E treatment regimen (Stalevo) on the duration of motor response in PD patients with wearing-off symptoms after the first morning dose of levodopa. The study consists of a screening visit, 3 treatment visits and an end-of-study visit. Within 14 days of the screening visit, the patients will receive a single morning dose of study drug (either of the two L/C/E treatment regimens) or Stalevo. The order of the 3 treatment periods will be randomised according to a crossover design and the duration of each period is 2 days, followed by a wash-out period (1-9 days) during which the patients will be on their individual standard PD treatment. Before each study day, patients will arrive at the study centre in the previous evening. The patients' own standard PD treatments will be discontinued at the latest by 22:00 to be continued after completion of the motor part (part III) of the Unified Parkinson's Disease Rating Scale (UPDRS III) next day. After completion of the UPDRS III, patients will return to their own standard PD treatments. Duration of the study will be 2 to 7 weeks per patient, depending on the length of the screening and wash-out periods.
Study Type ICMJE	Interventional
Study Phase	Phase 2
Study Design ICMJE	Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor); Primary Purpose: Prevention
Condition ICMJE	Parkinson's Disease
Intervention ICMJE	Drug: Carbidopa; Capsules
Study Arms	Experimental: Stalevo levodopa/carbidopa/entacapone Intervention: Drug: Carbidopa; Placebo Comparator: Placebo Intervention: Drug: Carbidopa
Publications *	Not Provided
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status ICMJE	Completed
Estimated Enrollment ICMJE; (submitted: February 14, 2011)	27
Original Estimated Enrollment ICMJE	Same as current
Actual Study Completion Date	July 2011
Actual Primary Completion Date	July 2011 (Final data collection date for primary outcome measure)
Eligibility Criteria ICMJE	Inclusion Criteria: Written informed consent (IC) obtained.; Male or female patients with idiopathic PD according to the United Kingdom brain bank criteria with end-of-dose motor fluctuations; Hoehn and Yahr stage 2-4 performed during the "ON" state.; Duration of response between 1.5 and 4 hours (based on medical history) to the patient's first morning dose of levodopa/dopa decarboxylase inhibitor (DDCI) with or without entacapone.; Treatment with 3-8 daily doses of levodopa/DDCI with or without entacapone with a total daily levodopa dose in the range of 300-1200 mg. One evening dose of controlled-release formulation of levodopa/DDCI is allowed provided that it is included in the total of 3-8 daily doses of levodopa/DDCI mentioned above.; Unchanged levodopa/DDCI with or without entacapone and other antiparkinsonian medication(dopamine agonists, monoamine oxidase [MAO] B inhibitor, amantadine and/or anticholinergics with approved doses), if any, for at least 6 weeks prior to the screening visit.; Age of 30 years or above Exclusion Criteria: Secondary or atypical parkinsonism.; Use of tolcapone within 6 weeks prior to the first treatment period.; Previous tolerability problems with entacapone or tolcapone.; Concomitant treatment with apomorphine, MAO-A inhibitors or nonselective MAO inhibitors.; Concomitant treatment with drugs having antidopaminergic action including alpha-methyldopa, reserpine and antipsychotic drugs (also D2 receptor blocking antiemetics except domperidone). As an exception, an evening dose of an atypical antipsychotic is allowed.; Use of any iron preparations.; Intensity of dyskinesias which would, in the opinion of the investigator, interfere with the interpretation of motor part (part III of the Unified Parkinson's Disease Rating Scale (UPDRS III) scoring during the levodopa challenge test.; Currently active hallucinations.; Severe orthostatic hypotension as judged by the investigator.; Mini-Mental State Examination (MMSE) score < 26; History of neuroleptic malignant syndrome (NMS) and/or non-traumatic rhabdomyolysis.; Past or current treatment with deep brain stimulation (DBS) or other surgical treatment for PD.; Treatment with levodopa or dopamine agonist infusion or injection; Active malignancy, narrow-angle glaucoma or pheochromocytoma.; Clinically significant cardiovascular, pulmonary, gastrointestinal, hepatic, renal, neurological or psychiatric disorder or any other major concurrent illness that in the opinion of the investigator would interfere with the interpretation of the study results or constitute a health risk for the subject if he/she takes part into the study.; Alanine aminotransferase or aspartate aminotransferase > upper limit of normal at screening.; Any other abnormal value of laboratory, vital signs or electrocardiogra (ECG) which would in the opinion of the investigator interfere with the interpretation of the study results or cause health risk for the subject if he/she takes part into the study.; Female patients of childbearing potential (i.e. menstruating or less than 2 years postmenopausal) if they are not using proper contraception (hormonal contraception, intrauterine device [IUD] or surgical sterilisation, spermicidal foam in conjunction with condom on male partner).; Patients with pre-planned elective surgery.; Known hypersensitivity to active substances or to any of the excipients of the study drugs.; Participation in a drug study within 60 days prior to entry to this study.; Any other condition that in the opinion of the investigator would interfere with the interpretation of the study results or constitute a health risk for the subject if he/she takes part into the study.
Sex/Gender	Sexes Eligible for Study: All
Ages	30 Years and older (Adult, Senior)
Accepts Healthy Volunteers	No
Contacts ICMJE	Contact information is only displayed when the study is recruiting subjects
Listed Location Countries ICMJE	Finland, Sweden
Removed Location Countries
Administrative Information
NCT Number ICMJE	NCT01296464
Other Study ID Numbers ICMJE	2939136
Has Data Monitoring Committee	No
U.S. FDA-regulated Product	Not Provided
IPD Sharing Statement	Not Provided
Responsible Party	Orion Corporation, Orion Pharma
Study Sponsor ICMJE	Orion Corporation, Orion Pharma
Collaborators ICMJE	Not Provided
Investigators ICMJE	Principal Investigator: Vilho Myllylä, Prof Oulu Deaconess Instutute
PRS Account	Orion Corporation, Orion Pharma
Verification Date	September 2011
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP