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Sustained Effect of Droxidopa in Symptomatic Neurogenic Orthostatic Hypotension (RESTORE)

This study is currently recruiting participants.
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Verified September 2017 by Lundbeck Northera Ltd.
Sponsor:
Information provided by (Responsible Party):
Lundbeck Northera Ltd.
ClinicalTrials.gov Identifier:
NCT02586623
First received: October 23, 2015
Last updated: September 14, 2017
Last verified: September 2017
October 23, 2015
September 14, 2017
February 2016
March 2021   (Final data collection date for primary outcome measure)
Time-to-intervention [ Time Frame: Day 0 to Week 12 of double-blind period ]

Need for intervention is defined as meeting ANY of the following criteria during the Double-Blind Period:

  • Orthostatic Hypotension Symptom Assessment (OHSA) Item #1 ≥2 unit worsening from Randomization (Visit 6) AND lack of efficacy as judged by the investigator; OR
  • OHSA Item #1 ≥2 unit worsening from Randomization (Visit 6) at 2 consecutive visits; OR
  • OHSA Item #1 ≥2 unit worsening from Randomization (Visit 6) at the visit before early discontinuation; OR
  • Patient stops IMP or withdraws from study for patient-reported lack of efficacy.

The timing of the need for intervention in the above criteria is defined as the first occurrence of a worsening of OHSA Item #1 by ≥ 2 units or when the patient stops taking IMP or withdraws due to a patient-reported lack of efficacy.

Time-to-intervention [ Time Frame: Randomization to week 12 ]

Need for intervention is defined as meeting ANY of the following criteria during the Double-Blind Period:

  • Orthostatic Hypotension Symptom Assessment (OHSA) Item #1 ≥2 unit worsening from Randomization (Visit 6) AND lack of efficacy as judged by the investigator; OR
  • OHSA Item #1 ≥2 unit worsening from Randomization (Visit 6) at 2 consecutive visits; OR
  • OHSA Item #1 ≥2 unit worsening from Randomization (Visit 6) at the visit before early discontinuation; OR
  • Patient stops IMP or withdraws from study for patient-reported lack of efficacy.

The timing of the need for intervention in the above criteria is defined as the first occurrence of a worsening of OHSA Item #1 by ≥ 2 units or when the patient stops taking IMP or withdraws due to a patient-reported lack of efficacy.

Complete list of historical versions of study NCT02586623 on ClinicalTrials.gov Archive Site
  • Time to all cause discontinuation [ Time Frame: Day 0 to Week 12 of double-blind period ]
    Discontinuation for any reason
  • Mean change in OHSA item #1 score from Randomization (Visit 6) to all post-Randomization visits [ Time Frame: Day 0 to Week 12 of double-blind period ]
    Mean change in OHSA item #1 score from Randomization (Visit 6) to all post-Randomization visits
  • Mean change in Orthostatic Hypotension Questionnaire (OHQ) composite score from Randomization (Visit 6) to all post-Randomization visits [ Time Frame: Day 0 to Week 12 of double-blind period ]
    Mean change in Orthostatic Hypotension Questionnaire (OHQ) composite score from Randomization (Visit 6) to all post-Randomization visits
  • Clinician-rated Clinical Global Impressions - Severity (CGI-S) at all post-Randomization visits (Visits 7-12) [ Time Frame: Week 2 to Week 12 of double-blind period ]
    Clinician-rated Clinical Global Impressions - Severity (CGI-S) scores at all post-Randomization visits (Visits 7-12)
  • Patient-rated Clinical Global Impressions - Severity (CGI-S) at all post-Randomization visits (Visits 7-12) [ Time Frame: Week 2 to Week 12 of double-blind period ]
    Patient-rated Clinical Global Impressions - Severity (CGI-S) scores at all post-Randomization visits (Visits 7-12)
  • Proportion of patients who need intervention over the 12-week Double-Blind Treatment period [ Time Frame: Day 0 to Week 12 of double-blind period ]
    Proportion of patients who need intervention over the 12-week Double-Blind Treatment period
  • Time to all cause discontinuation [ Time Frame: Randomization to week 12 ]
  • Mean change in OHSA item #1 score from Randomization (Visit 6) to all post-Randomization visits [ Time Frame: Randomization to week 12 ]
  • Mean change in Orthostatic Hypotension Questionnaire (OHQ) composite score from Randomization (Visit 6) to all post-Randomization visits [ Time Frame: Randomization to week 12 ]
  • Clinician-rated Clinical Global Impressions - Severity (CGI-S) at all post-Randomization visits (Visits 7-12) [ Time Frame: Randomization to week 12 ]
  • Patient-rated CGI-S at all post-Randomization visits (Visits 7-12) [ Time Frame: Randomization to week 12 ]
  • Cumulative number of patients who need intervention over the 12-week Double-Blind Treatment period [ Time Frame: Randomization to week 12 ]
Not Provided
Not Provided
 
Sustained Effect of Droxidopa in Symptomatic Neurogenic Orthostatic Hypotension
RESTORE: A Clinical Study of Patients With Symptomatic Neurogenic Orthostatic Hypotension to Assess Sustained Effects of Droxidopa Therapy
To evaluate the time to treatment intervention in patients with Parkinson's Disease (PD), Multiple System Atrophy (MSA), Pure Autonomic Failure (PAF), Non-Diabetic Autonomic Neuropathy (NDAN) or Dopamine Beta Hydroxylase (DBH) Deficiency who have been previously stabilized with droxidopa therapy for symptoms of neurogenic orthostatic hypotension (NOH) (dizziness, light-headedness, or feelings that they are about to black out)

This is a multi-site, placebo-controlled, double-blind, randomized withdrawal, time to intervention study with a duration of up to 36 weeks, consisting of 5 periods:

Screening Period: up to 4 weeks duration; Open-Label Titration Period (Titration Period): up to 4 weeks duration; Open-Label Treatment Period (Open-Label Period): 12 weeks duration; Double-Blind Treatment Period (Double-Blind Period): 12 weeks duration; Safety Follow-Up Period: 4 weeks duration

Interventional
Phase 4
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Symptomatic Neurogenic Orthostatic Hypotension
  • Drug: Droxidopa capsules
    100, 200 or 300 mg
    Other Name: Northera
  • Drug: Placebo capsules
  • Experimental: Droxidopa capsules
    100, 200, 300, 400, 500, or 600 mg three times daily (TID) orally (equal to patients individual dose at the end of the Open-Label Period). During the Titration Period and Open-Label Period, patients will receive 100, 200, 300, 400, 500, or 600 mg TID of droxidopa, orally.
    Intervention: Drug: Droxidopa capsules
  • Experimental: Placebo capsules
    Matching placebo three times daily orally
    Intervention: Drug: Placebo capsules
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
482
March 2021
March 2021   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • 18 years or older and able to stand (with or without limited assistance)
  • Clinical diagnosis of symptomatic orthostatic hypotension associated with Primary Autonomic Failure (PD, MSA or PAF) or NDAN or DBH Deficiency
  • Score of at least 4 or greater on Orthostatic Hypotension Symptom Assessment (OHSA) Item #1 (measured at Screening [Visit 1] and the first Titration Visit [Visit 2a] prior to dosing)
  • A documented drop of at least 20 millimeters of mercury (mmHg) in SBP, within 3 minutes of standing. This can either be documented in the patient history or assessed during Screening prior to the first Titration Visit (Visit 2a)

Additional inclusion criteria for patients taking prescribed droxidopa prior to study entry:

Patients who are taking prescribed droxidopa therapy are eligible to participate in the study if they meet the other inclusion criteria and also have been on a stable dose of prescribed droxidopa for at least 2 weeks prior to the Screening Visit (Visit 1). In addition, they must meet either of the following at the Screening Visit (Visit 1):

  • The patient's Visit 1 OHSA Item #1 score is ≥ 7 AND the prescribed dose is ≤ 300 mg three times daily (TID); OR
  • The patient's Visit 1 OHSA Item #1 score is ≤6 AND worsens by ≥ 2 units when retested after washing out of droxidopa for at least 3 days

Exclusion Criteria:

  • In the investigator's opinion, the patient is not able to understand or cooperate with study procedures
  • Known or suspected alcohol or substance use disorder within the past 12 months (DSM-5 criteria)
  • Women who are pregnant or breastfeeding
  • Women of childbearing potential (WOCP) who are not using at least one method of contraception with their partner
  • Sustained supine hypertension greater than or equal to 180 mmHg systolic or 110 mmHg diastolic. Sustained is defined as the average of 3 observations each at least 10 minutes apart with the patient having been supine and at rest for at least 5 minutes prior to each measurement.
  • Untreated closed angle glaucoma
  • Diagnosis of hypertension that requires treatment with antihypertensive medications (short-acting antihypertensives to treat nocturnal supine hypertension are allowed in this study)
  • Any significant uncontrolled cardiac arrhythmia
  • History of myocardial infarction, within the past 2 years
  • Current unstable angina
  • Congestive heart failure (NYHA Class 3 or 4)
  • Diabetic autonomic neuropathy

Additional protocol defined inclusion and exclusion criteria do apply

Sexes Eligible for Study: All
18 Years and older   (Adult, Senior)
No
Contact: Email contact via H. Lundbeck A/S LundbeckClinicalTrials@Lundbeck.com
Contact: Stephen W Gorny, MS 704-499-9682 STGO@Lundbeck.com
United States
 
 
NCT02586623
16306A
NOH402 ( Other Identifier: NOH402 )
No
Not Provided
Not Provided
Lundbeck Northera Ltd.
Lundbeck Northera Ltd.
Not Provided
Study Director: Email contact via H. Lundbeck A/S LundbeckClinicalTrials@Lundbeck.com
Lundbeck Northera Ltd.
September 2017

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP