Study to Evaluate the Safety and Efficacy of Davunetide for the Treatment of Progressive Supranuclear Palsy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01110720
Recruitment Status : Completed
First Posted : April 27, 2010
Last Update Posted : January 17, 2013
Information provided by (Responsible Party):
Allon Therapeutics

Brief Summary:
The purpose of the study is to evaluate the safety and efficacy of davunetide for the treatment of Progressive Supranuclear Palsy.

Condition or disease Intervention/treatment Phase
Progressive Supranuclear Palsy Drug: Davunetide Drug: Placebo Phase 2 Phase 3

Detailed Description:
A Phase 2/3,Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Efficacy of Davunetide for the Treatment of Progressive Supranuclear Palsy

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 313 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 2/3, Randomized, Double-Blind, Placebo-Controlled, Study to Evaluate the Safety and Efficacy of Davunetide for the Treatment of Progressive Supranuclear Palsy
Study Start Date : October 2010
Actual Primary Completion Date : November 2012
Actual Study Completion Date : December 2012

Arm Intervention/treatment
Experimental: Davunetide 30 mg BID Drug: Davunetide
Davunetide Nasal Spray 30 mg BID IN 52 weeks

Placebo Comparator: Placebo Drug: Davunetide
Davunetide Nasal Spray 30 mg BID IN 52 weeks

Drug: Placebo
Placebo Nasal Spray BID IN 52 weeks

Primary Outcome Measures :
  1. Efficacy, as measured by change from baseline scores of the Progressive Supranuclear Palsy Rating Scale (PSPRS) at 52 weeks [ Time Frame: 52 weeks ]
  2. Efficacy, as measured by the change from baseline of the Schwab and England Activities of Daily Living Scale (SEADL) at 52 weeks [ Time Frame: 52 weeks ]
  3. Safety, as measured by reported AEs, electrocardiograms (ECG), nasal examinations and clinical laboratory measures [ Time Frame: 52 weeks ]

Secondary Outcome Measures :
  1. Efficacy, as measured by the Clinical Global Impression of Change (CGI-C) at 52 weeks [ Time Frame: 52 weeks ]
  2. Brain atrophy, as measured by change from baseline of ventricular volumes measured by volumetric brain MRI at 52 weeks. [ Time Frame: 52 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   41 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Probable or possible PSP defined as:

    • at least a 12-month history of postural instability or falls during the first 3 years that symptoms are present; and
    • at screening, a decreased downward saccade velocity defined as observable eye movement (deviation from the "main sequence" linear relationship between saccade amplitude and saccade velocity) or, supranuclear ophthalmoplegia defined as 50% reduction in upward gaze or 30% reduction in downward gaze; and
    • age at symptom onset of 40 to 85 years by history; and
    • an akinetic-rigid syndrome with prominent axial rigidity.
  • Aged 41 to 85 years at the time of screening.
  • Judged by investigator to be able to comply with neuropsychological evaluation at baseline and throughout the study.
  • Must have reliable caregiver accompany subject to all study visits. Caregiver must read, understand, and speak local language fluently to ensure comprehension of informed consent form and informant-based assessments of subject. Caregiver must also have frequent contact with subject (at least 3 hours per week at one time or at different times) and be willing to monitor study medication compliance and the subject's health and concomitant medications throughout the study.
  • Modified Hachinski score ≤ 3 (Appendix 7). This modified Hachinski will not include the focal neurological signs, symptoms or pseudobulbar affect questions, given the prominence of all 3 in PSP.
  • Score ≥ 15 on the mini-mental state examination (MMSE) at screening (Visit 1).
  • Written informed consent provided by subject (or legally-appointed representative, as appropriate) and caregiver (if not the legally-appointed representative) who are both fluent local language speakers.
  • Subject resides outside a skilled nursing facility or dementia care facility at the time of screening, and admission to such a facility is not planned. Residence in an assisted living facility is allowed.
  • If the subject is receiving levodopa/carbidopa, levodopa/benserazide, a dopamine agonist, catechol-o-methyltransferase (COMT) inhibitor, or other Parkinson's medication,with teh exception of Azilect(rasagiline), the dose must have been stable for at least 60 days prior to the screening visit (Visit 1) and must remain stable for the duration of the study. No such medication can be initiated during the study. Subjects receiving rasagiline or CoQ10 must be on a stable dose for at least 90 days prior to the screening visit.
  • Able to tolerate the MRI scan during screening with either no sedation or low dose lorazepam.
  • Able to ambulate independently or with assistance defined as the ability to take at least 5 steps with a walker (guarding is allowed provided there is no contact) or the ability to take at least 5 steps with the assistance of another person who can only have contact with one upper extremity.
  • Presence of symptoms for less than 5 years or the presence of symptoms for more than 5 years with a PSPRS baseline score ≥ 40.
  • Stable on all other chronic medications for at least 30 days prior to the screening visit (Visit 1).

Exclusion Criteria:

  • Insufficient fluency in local language to complete neuropsychological and functional assessments.
  • A diagnosis of Amyotrophic Lateral Sclerosis or other motor neuron disease.
  • Any of the following:

    • Abrupt onset of symptoms defined in inclusion criteria 1 associated with ictal events,
    • Head trauma related to onset of symptoms defined in inclusion criteria 1,
    • Severe amnesia within 6 months of the symptoms defined in inclusion criteria 1,
    • Cerebellar ataxia,
    • Choreoathetosis,
    • Early, symptomatic autonomic dysfunction; or
    • Tremor while at rest.
  • Presence of other significant neurological or psychiatric disorders including (but not limited to) Alzheimer's disease; dementia with Lewy bodies; prion disease; Parkinson's disease (which has not subsequently been revised to PSP); any psychotic disorder; severe bipolar or unipolar depression; seizure disorder; tumor or other space-occupying lesion; or history of stroke or head injury with loss of consciousness for at least 15 minutes within the past 20 years.
  • Within 4 weeks of screening or during the course of the study, concurrent treatment with memantine; acetylcholinesterase inhibitors; antipsychotic agents (other than quetiapine) or mood stabilizers (e.g., valproate, lithium); or benzodiazepines (except as below).

    • Low dose lorazepam (not more than 2 mg) may be used for sedation prior to MRI scans for those subjects requiring sedation. Neuropsychological testing may not be performed after lorazepam administration.
    • Subjects who take short acting benzodiazepines (only temazepam or zolpidem are allowed) for sleep may continue to do so if they have been on a stable dose for 30 days prior to screening.
    • Clonazepam may be used for treatment of dystonia or painful rigidity associated with PSP if the dose has been stable for 90 days prior to screening and is not expected to change during the course of the study.
  • Treatment with lithium, methylene blue, tramiprosate, ketone bodies, latrepirdine, or any putative disease-modifying agent directed at tau within 90 days of screening.
  • A history of alcohol or substance abuse within 1 year prior to screening and deemed to be clinically significant by the site investigator.
  • Any malignancy (other than non-metastatic dermatological conditions) within 5 years of the screening visit (Visit 1) or current clinically significant hematological, endocrine, cardiovascular, renal, hepatic, gastrointestinal, or neurological disease. For the non-cancer conditions, if the condition has been stable for at least one year before the screening visit and is judged by the site investigator not to interfere with the subject's participation in the study, the subject may be included.
  • Clinically significant laboratory abnormalities at screening, including creatinine ≥ 2.5 mg/dL, alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 3 times the upper limit of the normal reference range, vitamin B12 below the laboratory normal reference range, or thyroid stimulating hormone TSH above laboratory normal reference range.
  • The systolic blood pressure measurement is > 190 or < 85 mm Hg. The diastolic blood pressure measurement is > 105 or < 50 mm Hg at screening.
  • Abnormal ECG tracing at screening and judged to be clinically significant by the site investigator.
  • Treatment with any investigational drugs or device within 90 days of screening.
  • Known history of serum or plasma progranulin level less than one standard deviation below the normal subject mean for the laboratory performing the assay.
  • Known presence of known disease-associated mutation in TDP-43, PGRN, CHMPB2, or VCP genes or any other frontotemporal lobar degeneration (FTLD) causative genes not associated with underlying tau pathology (e.g., Chromosome 9 associated FTD).
  • History of deep brain stimulator (DBS) surgery other than sham surgery for DBS clinical trial.
  • History of early, prominent rapid eye movement (REM) sleep behavior disorder.
  • Women who are pregnant or lactating and women of childbearing potential who are not using at least two different forms of medically recognized and highly effective methods of birth control, resulting in a low failure rate when used consistently and correctly such as implants, injectables, combined oral contraceptives, some IUDs, sexual abstinence or vasectomised partner.
  • An employee or relative of an employee of the Sponsor, a clinical site, or Contract Research Organization participating in the study.
  • Significant anatomical nasal abnormality (e.g., septal deviation obstructing airflow to at least one nostril or septal perforation) or history of nasal turbinate surgery.
  • History of a clinically significant medical condition that would interfere with the subject's ability to comply with study instructions, would place the subject at increased risk, or might confound the interpretation of the study results.
  • Contraindication to MRI examination for any reason (e.g., severe claustrophobia, ferromagnetic metal in body).
  • Structural abnormality on MRI that precludes diagnosis of PSP, such as cortical infarct in brain region that might account for subject's symptoms.
  • In subjects receiving anti-Parkinson's Disease medication at the time of screening, in the opinion of the investigator substantial worsening of motor signs or symptoms compared with normal functioning following overnight withdrawal of the anti-Parkinson medication.
  • Known hypersensitivity to davunetide or any ingredient of the formulation.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01110720

  Hide Study Locations
United States, Alabama
University of Alabama - Birmingham
Birmingham, Alabama, United States, 35294
United States, Arizona
Muhammed Ali Parkinson Center and Movement Disorders Clinic
Phoenix, Arizona, United States, 85013
Mayo Clinic, AZ
Scottsdale, Arizona, United States, 85259
United States, California
USC Keck School of Medicine
Los Angeles, California, United States, 90033
David Geffen School of Medicine - UCLA
Los Angeles, California, United States, 90095
UCSD/VA Neurology Service
San Diego, California, United States, 92161
UCSF Memory and Aging Center
San Francisco, California, United States, 94143
United States, Colorado
Colorado Neurological Institute - Rocky Mountain Movement Disorders Ctr, PC
Englewood, Colorado, United States, 80113
United States, Florida
Parkinson's Disease and Movement Disorders Center of Boca Raton
Boca Raton, Florida, United States, 33486
Mayo Clinic, Florida
Jacksonville, Florida, United States, 32224
The Frances J. Zesiewicz Foundation for Parkinson's Disease at USF
Tampa, Florida, United States, 33612
United States, Illinois
University of Chicago Medical Center
Chicago, Illinois, United States, 60637
United States, Kansas
University of Kansas Medical Center Parkinson Disease & Movement Disorders Center
Kansas City, Kansas, United States, 66160
United States, Kentucky
University of Louisville Division of Movement Disorders
Louisville, Kentucky, United States, 40202
United States, Maryland
John Hopkins Hospital
Baltimore, Maryland, United States, 21287
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02115
Lahey Clinic
Burlington, Massachusetts, United States, 01805
United States, Michigan
University of Michigan Medical Center
Ann Arbor, Michigan, United States, 48109
United States, Minnesota
University of Minnesota Department of Neuology
Minneapolis, Minnesota, United States, 55455
Mayo Clinic, Rochester, MN
Rochester, Minnesota, United States, 55905
United States, New Jersey
UMDNJ - Robert Wood Johnson Medical Center
New Brunswick, New Jersey, United States, 08901
United States, New York
Columbia University
New York, New York, United States, 10032
United States, North Carolina
Univeristy of North Carolina Department of Neurology
Chapel Hill, North Carolina, United States, 27599
United States, Ohio
University Hospitals Case Medical CenterNI Movement Disorders Center
South Euclid, Ohio, United States, 44121
United States, Pennsylvania
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19104
United States, Texas
University of Texas Southwestern Medical Center
Dallas, Texas, United States, 75390
Baylor College of Medicine
Houston, Texas, United States, 77030
United States, Utah
University of Utah Center for Alzheimer's Care, Imaging &Research
Salt Lake City, Utah, United States, 84108
Australia, Victoria
The Alfred Hospital
Melbourne, Victoria, Australia, 3004
Canada, Ontario
London Sciences Health Center University Hospital
London, Ontario, Canada, N6A 5A5
Parkinson's Disease & Movement Disorders Clinic
Ottawa, Ontario, Canada, K1Y 4E9
Toronto Western Hospital University Health Network
Toronto, Ontario, Canada, M5T 2S8
Canada, Quebec
CHUM-Notre Dame Hospital Unité de Troubles du Mouvement
Montreal, Quebec, Canada, H2L 4M1
McGill University Health Centre - Montreal General Hospital
Montreal, Quebec, Canada, H3G 1A4
Limoges University Hospital
Limoges, France, 87042
Hopital Timone
Marseille, France, 13385
Hôpitaux de Paris
Paris, France, 75013
Humboldt University Charité
Berlin, Germany, 13353
Neurologisch Klinik der Ruhr-Universität im St. Josef-Hospital
Bochum, Germany, 44791
Universitätsklinikum Carl Carus an der Technischen Universität
Dresden, Germany, 01307
Paracelsus-Elena Klinik
Kassel, Germany, 34128
Philipps Universität Marburg
Marburg, Germany, 35039
Klinikum Großhadern
München, Germany, 81377
Universität Rostock Zentrum für Nervenheilkunde und Poliklinik
Rostock, Germany, 18147
Universitäts- und Rehabilitationskliniken Ulm
Ulm, Germany, 89081
United Kingdom
Princess Royal Hospital
Haywards Heath, United Kingdom, RH16 4EX
Clinical Ageing Research Unit (CARU) Newcastle University
Newcastle, United Kingdom, NE4 5PL
Greater Manchester Neuroscience Centre
Salford, United Kingdom, M6 8HD
Sponsors and Collaborators
Allon Therapeutics
Principal Investigator: Adam Boxer, M.D., PhD. Memory and Aging Center, University of California, San Francisco

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Allon Therapeutics Identifier: NCT01110720     History of Changes
Other Study ID Numbers: AL-108-231
First Posted: April 27, 2010    Key Record Dates
Last Update Posted: January 17, 2013
Last Verified: January 2013

Additional relevant MeSH terms:
Supranuclear Palsy, Progressive
Basal Ganglia Diseases
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Movement Disorders
Ocular Motility Disorders
Cranial Nerve Diseases
Neurodegenerative Diseases
Neurologic Manifestations
Eye Diseases
Signs and Symptoms