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    Summary
    EudraCT Number:2014-003799-22
    Sponsor's Protocol Code Number:CVT-301-005
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2014-12-16
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2014-003799-22
    A.3Full title of the trial
    A Phase 3, Randomized Study Investigating the Safety of
    CVT-301 (Levodopa Inhalation Powder) in Parkinson?s Disease
    Patients With Motor Response Fluctuations (OFF Phenomena)
    Compared to an Observational Cohort Control
    Estudio de fase III aleatorizado para investigar la seguridad de CVT-301 (levodopa en polvo para inhalación) en pacientes con enfermedad de Parkinson con fluctuaciones de la respuesta motriz (fenómeno OFF) en comparación con una cohorte de observación como control
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study of the safety and drug effects of levodopa inhalation powder (CVT-301) compared to Standard of Care Observational Cohort in patients with Parkinson?s disease
    Estudio de la seguridad y los efectos farmacológicos de levodopa en polvo para inhalación (CVT-301) comparado con cohorte de observación de norma asistencial como control
    en pacientes con enfermedad de Parkinson
    A.4.1Sponsor's protocol code numberCVT-301-005
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorCivitas Therapeutics, Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportCivitas Theurapeutics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationINC Research
    B.5.2Functional name of contact pointRegulatory Affairs
    B.5.3 Address:
    B.5.3.1Street AddressRiver View, The Meadows Business Park, Station Approach
    B.5.3.2Town/ cityCamberley
    B.5.3.3Post codeGU179AB
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number44127648 1000
    B.5.5Fax number44127635 743
    B.5.6E-mailSM_Regaffairs_eu_ap@incresearch.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCVT-301
    D.3.2Product code CVT-301
    D.3.4Pharmaceutical form Inhalation powder, hard capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPInhalation use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLEVODOPA
    D.3.9.1CAS number 59-92-7
    D.3.9.2Current sponsor codeCVT-301
    D.3.9.3Other descriptive nameLEVODOPA
    D.3.9.4EV Substance CodeSUB08468MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Yes
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCVT-301
    D.3.2Product code CVT-301
    D.3.4Pharmaceutical form Inhalation powder, hard capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPInhalation use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNLEVODOPA
    D.3.9.1CAS number 59-92-7
    D.3.9.2Current sponsor codeCVT-301
    D.3.9.3Other descriptive nameLEVODOPA
    D.3.9.4EV Substance CodeSUB08468MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number42
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Yes
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Parkinson's Disease With Motor Response Fluctuations (OFF Phenomena)
    Enfermedad de Parkinson con fluctuaciones de la respuesta motriz (fenómeno OFF)
    E.1.1.1Medical condition in easily understood language
    Parkinson's Disease With Periods of Prolonged Immobility or Freezing
    Efermedad de parkinson con periodos de inmovilidad prolongada o congelación
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 17.1
    E.1.2Level LLT
    E.1.2Classification code 10034007
    E.1.2Term Parkinson's disease NOS
    E.1.2System Organ Class 100000004852
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To characterize the pulmonary safety, as assessed by spirometry (forced expiratory volume in 1 second [FEV1] and FEV1/forced vital capacity [FVC] ratio), over a 12 month period within the CVT 301 treated patients.
    Caracterizar la seguridad pulmonar, evaluada mediante espirometría (volumen espiratorio forzado en 1 segundo [VEF1] y el cociente VEF1/capacidad vital forzada [CVF]), durante un período de 12 meses, en los pacientes tratados con CVT-301.
    E.2.2Secondary objectives of the trial
    To characterize the pulmonary safety.
    To estimate the difference between the CVT 301 treated patients and the observational cohort on measures of pulmonary safety.
    To characterize the effects of CVT 301 on safety over a 12 month period
    To describe the effects of CVT-301, Time course of effect and onset of effect, Magnitude of effect
    To characterize the occurrence and severity of examiner rated dyskinesia following treatment of patients experiencing an OFF episode after the initiation of CVT 301 treatment.
    To characterize the proportion of patients achieving resolution of an OFF to an ON state within 60 minutes after study drug is administered in the clinic
    To characterize the proportion of patients with an ON state at the end of the 60-minute observation period following treatment in the clinic
    To evaluate the ability of carbon monoxide diffusing capacity (DLco) maneuver.
    To describe the effects of CVT 301 on DLco over a 12 month period.
    Caracterizar la seguridad pulmonar.
    Calcular las diferencias entre pacientes tratados con CVT-301 y cohorte de observación en lo que respecta a determinaciones de seguridad pulmonar.
    Caracterizar los efectos del CVT-301 sobre la seguridad durante 12 meses.
    Describir los efectos de CVT-301, evolución, comienzo y magnitud del efecto.
    Caracterizar:
    - la aparición e intensidad de la discinesia calificada por el examinador después del tratamiento en pacientes que presentan episodio OFF después de comenzar tratamiento con CVT-301.
    -la proporción de pacientes que logra la resolución de un estado OFF al estado ON 60 min. después de la administración del medicamento en la clínica.
    - la proporción de pacientes con estado ON al finalizar el período de observación de 60 min. posterior al tratamiento en la clínica.
    Evaluar la capacidad de la maniobra de calidad de la capacidad de difusión del monóxido de carbono (DLco).
    Describir los efectos de CVT-301 sobre la DLco durante 12 meses.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Has signed and dated an IRB/IEC-approved informed consent form before any protocol-specific screening procedures are performed.
    Is a male or female aged 30 to 80 years, inclusive. Women of child-bearing potential must use protocol-defined contraceptive measures (see Section 11.1.5) and must have a negative serum human chorionic gonadotropin (hCG) test at screening. These patients must be willing to remain on their current form of contraception for the duration of the study.
    Patients who have idiopathic PD (i.e., not induced by drugs or other diseases) as defined by fulfilling Steps 1 and 2 of the UK Brain Bank criteria, diagnosed after the age of 30 years.
    Patients who are classified as Stage 1 to 3 (in the ON state) on the modified Hoehn and Yahr scale for staging of PD severity.
    Patients who have experienced motor fluctuations for a minimum of 2 hours of average daily OFF time per waking day (excluding early morning OFF time) by self-report and confirmed by the PD Diary (on 3 consecutive days) during the screening period.
    Patients must be stable on oral LD-containing therapy for at least 2 weeks prior to SV1 with a LD/dopamine decarboxylase inhibitor (DDI) containing regimen, which must include doses at least 4 times during the waking day and a total daily LD dose of <=1600 mg (exclusive of PRN LD-containing medications).
    Patients should be stable on other PD medications for at least 4 weeks prior to SV1.
    Patients must have a >=25% difference between UPDRS Part 3 scores recorded in their ON and OFF states at screening.
    Patients must have normal cognition as confirmed by a score of >=25 on the MMSE.
    Patients must be able to perform a spirometry maneuver in the ON and OFF states, and must have a screening FEV1 >=50% of predicted and a FEV1/FVC ratio >60% in the ON state at screening. (A pulmonologist will review the spirometry tracings/morphology of any patient with FEV1 <60% or FEV1/FVC <70% in order to determine potential eligibility. All CVT 301 naïve patients with an FEV1/FVC ratio of <70% will be required to undergo a bronchodilator challenge and the results must be reviewed prior to entry into the study. Patients with an FEV1/FVC <70% will complete spirometry before and after the administration of a bronchodilator in a pulmonary function laboratory. Testing will be performed in accordance with the 2005 ATS/European Respiratory Society [ERS] criteria prior to randomization. The results of the bronchodilator challenge will be reviewed by a pulmonologist prior to potential randomization.)
    Ha firmado y fechado un formulario de consentimiento informado aprobado por el CEIC antes de que se lleve a cabo cualquier procedimiento de selección específico del protocolo.

    Es hombre o mujer de 30 a 80 años de edad, inclusive. Las mujeres con capacidad para procrear deben tomar medidas anticonceptivas definidas en el protocolo (véase la Sección 11.1.5) y tener un resultado negativo en una prueba de gonadotropina coriónica humana (hCG) en suero en el momento de la selección. Estas pacientes deben estar dispuestas a seguir usando su método anticonceptivo actual durante todo el estudio.

    Pacientes con EP idiopática (es decir, no inducida por medicamentos u otras enfermedades), como se define por cumplimiento de los pasos 1 y 2 de los criterios del Banco de Cerebros del Reino Unido, diagnosticada después de los 30 años de edad.

    Pacientes clasificados como estadios 1 a 3 (en estado ON) según la escala de Hoehn y Yahr modificada para estadificación de la gravedad de la EP.

    Pacientes que hayan presentado fluctuaciones motrices durante al menos 2 horas al día, en promedio, en estado OFF, durante la vigilia diurna (excluido el tiempo OFF por la mañana temprano) según autoinformes y confirmadas por el diario de la EP (durante 3 días consecutivos) durante el período de selección.

    Los pacientes deben haber estado recibiendo un tratamiento estable por vía oral con LD durante al menos 2 semanas antes de la VS1, con un tratamiento que contenga LD/inhibidor de la dopamina descarboxilasa (DDI), que debe incluir administraciones al menos en 4 momentos durante la vigilia diurna y una dosis diaria total de LD de <=1.600 mg (excluidos los medicamentos que contienen LD PRN).

    Los pacientes deben haber recibido dosis estables de otros medicamentos para la EP durante al menos 4 semanas antes de la VS1.

    Los pacientes deben tener una diferencia >=25 % entre las puntuaciones de la parte 3 de la UPDRS registradas en los estados ON y OFF en el momento de la selección.

    Los pacientes deben presentar cognición normal, confirmada por una puntuación >=25 en el MMSE.

    Los pacientes deben tener la capacidad de efectuar una maniobra de espirometría en los estados ON y OFF, y presentar un valor VEF1 en la selección >=50 % del valor previsto y un cociente VEF1/CVF >60 % en estado ON en el momento de la selección. (Un neumólogo revisará los trazados/morfología de la espirometría de todos los pacientes con un valor VEF1 <60 % o un cociente VEF1/CVF <70 % para determinar su posible elegibilidad. Todos los pacientes que no hayan recibido tratamiento previo con CVT-301 que tengan un cociente VEF1/CVF <70 % deberán someterse a una prueba de provocación con un broncodilatador y los resultados deberán revisarse antes de la entrada al estudio al estudio. Los pacientes con un cociente VEF1/CVF <70 % efectuarán la espirometría antes y después de la administración de un broncodilatador en un laboratorio de función pulmonar. Las pruebas se efectuarán de acuerdo con los criterios de la ATS/Sociedad Respiratoria Europea (European Respiratory Society, ERS) del año 2005, antes de la aleatorización. Los resultados de la prueba provocación con el broncodilatador serán revisados por un neumólogo antes de la posible aleatorización).
    E.4Principal exclusion criteria
    Patients who have dyskinesia of a severity that would significantly interfere with their ability to participate or perform study procedures.
    Pregnant or lactating females or females wishing to become pregnant.
    Patients who have any known contraindication to the use of LD, including a history of malignant melanoma or a history of narrow-angle glaucoma.
    Patients who have had previous surgery for PD (including but not limited to deep brain stimulation [DBS] or cell transplantation).
    Patients with a history of psychotic symptoms requiring treatment, or suicide ideation or attempt within the prior 12 months (stable regimens [for at least 4 weeks prior to SV1] of anti-depressant and certain low-dose atypical antipsychotic medications are permitted).
    Patients who have cancer with the exception of the following: basal cell carcinoma or successfully treated squamous cell carcinoma of the skin; cervical carcinoma in situ; prostatic carcinoma in situ; or other malignancies curatively treated and with no evidence of disease recurrence for at least 3 years.
    Patients taking certain prohibited medications (see Section 9.4.2).
    Patients with a history of drug or alcohol abuse within the prior 12 months.
    Patients with chronic obstructive pulmonary disease (COPD), asthma, or other chronic respiratory disease within the last 5 years (or if a patient is receiving treatment for any of these conditions).
    Patients with any contraindication to performing routine spirometry or who are unable to perform a spirometry maneuver (see Appendix 20 for a list of contraindications).
    Patients with a current history of symptomatic orthostatic hypotension despite adequate treatment.
    Patients with any condition that in the investigator?s opinion would make patients unsuitable or interfere with their participation in the study. Potential issues of concern should be raised to the medical monitor during eligibility review.
    Patients who have any clinically significant abnormality or finding from examination, tests, or history that may compromise patient safety.
    Prior exposure to CVT-301 is not a study exclusion.
    Pacientes con discinesia de una intensidad tal que interferiría significativamente con su capacidad de participar o de llevar a cabo los procedimientos del estudio.

    Mujeres embarazadas o en período de lactancia, o mujeres que desean concebir.

    Pacientes con cualquier contraindicación conocida para el uso de LD, incluidos los antecedentes de melanoma maligno o de glaucoma de ángulo estrecho.

    Pacientes que se hayan sometido a intervenciones quirúrgicas previas para la EP (incluidas, entre otras, la estimulación cerebral profunda [ECP] o el trasplante de células).

    Pacientes con antecedentes de síntomas psicóticos que requieran tratamiento, o ideas o intentos de suicidio en los 12 meses anteriores (se permiten tratamientos estables [durante al menos las 4 semanas anteriores a la VS1] de antidepresivos y de ciertos medicamentos antipsicóticos atípicos en bajas dosis).

    Pacientes con cáncer, excepto los siguientes: carcinoma basocelular o carcinoma espinocelular tratado satisfactoriamente, carcinoma in situ del cuello uterino, carcinoma de próstata in situ u otros tumores malignos tratados curativamente sin pruebas de recidiva de la enfermedad durante al menos 3 años.

    Pacientes que usan ciertos medicamentos prohibidos (véase la Sección 9.4.2).

    Pacientes con antecedentes de drogadicción o alcoholismo en los 12 meses anteriores.

    Pacientes con enfermedad pulmonar obstructiva crónica (EPOC), asma u otra enfermedad respiratoria crónica en los últimos 5 años (o si el paciente está recibiendo tratamiento para cualquiera de estos problemas médicos)

    Pacientes con cualquier contraindicación para efectuar las espirometrías de rutina o que no puedan efectuar una maniobra de espirometría (véase en el Anexo 20 una lista de las contraindicaciones).
    Pacientes con historia actual de hipotensión ortostática sintomática a pesar de recibir el tratamiento adecuado.

    Pacientes con cualquier problema médico que, según la opinión del investigador, haga que los pacientes sean inadecuados o que puedan interferir con su participación en el estudio. Los posibles temas de preocupación deben comunicarse al monitor médico durante la revisión de la elegibilidad.

    Pacientes que tienen cualquier anomalía o hallazgo en el examen o en las pruebas clínicamente importantes, o antecedentes que pueden comprometer la seguridad del paciente.

    La exposición previa a CVT-301 no es una causa de exclusión del estudio.
    E.5 End points
    E.5.1Primary end point(s)
    Spirometry forced expiratory volume in 1 second [FEV1] and FEV1/forced vital capacity [FVC] ratio
    Espirometría (volumen espiratorio forzado en 1 segundo [VEF1] y el cociente VEF1/capacidad vital forzada [CVF])
    E.5.1.1Timepoint(s) of evaluation of this end point
    At each patient visit throughout the study
    En cada visita de paciente a lo largo del estudio.
    E.5.2Secondary end point(s)
    Mean change from pre-dose in average Unified Parkinson?s Disease Rating Scale (UPDRS) Part 3 motor score at 10 to 60 minutes following treatment of patients experiencing an OFF episode in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT-301 treatment.
    Time-course of the change in UPDRS Part 3 motor score from pre-dose to 10, 20, 30, and 60 minutes following treatment in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT-301 treatment.
    Mean change from pre-dose in average UPDRS Part 3 motor score at 10 to 20 minutes following treatment of patients experiencing an OFF episode in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT-301 treatment.
    Mean best change and best percent change in the UPDRS Part 3 motor score from pre-dose at 10 to 60 minutes following treatment of patients experiencing an OFF episode in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT-301 treatment.
    Mean change in the UPDRS item 23 (Finger Taps) from pre dose to 10 minutes following treatment of patients experiencing an OFF episode in the clinic at 1, 3, 6, 9 and 12 months after the initiation of CVT-301 treatment.
    Mean change in the UPDRS item 31 (Body Bradykinesia and Hypokinesia) from pre-dose to 10 minutes following treatment of patients experiencing an OFF episode in the clinic at 1, 3, 6, 9 and 12 months after the initiation of CVT-301 treatment.
    Proportion of patients with a ?3 point, >=6 point, and >=11 point reduction in the UPDRS Part 3 motor score from pre dose to post dose, by assessing the number and proportion of patients achieving on objective motor response overall and at 10, 20, 30, and 60 minutes following treatment in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT 301 treatment.
    Occurrence and severity of examiner rated dyskinesia following treatment of patients experiencing an OFF episode in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT 301 treatment.
    Proportion of patients achieving resolution of an OFF to an ON state within 60 minutes after study drug is administered in the clinic (per the examiner?s subjective assessment) at 1, 3, 6, 9, and 12 months after the initiation of CVT 301 treatment.
    Proportion of patients with an ON state at the end of the 60-minute observation period (per the examiner?s subjective assessment) following treatment in the clinic at 1, 3, 6, 9, and 12 months after the initiation of CVT 301 treatment.
    Patient reported total daily OFF time, total daily ON time without dyskinesia, total daily ON time with non troublesome dyskinesia, and total daily ON time with troublesome dyskinesia, assessed by the patient and recorded in the patient diary for the 3 consecutive days immediately prior to visits at 1, 3, 6, 9, and 12 months after the initiation of CVT-301 treatment.
    Mean change from baseline in the 39-Item Parkinson?s Disease Questionnaire (PDQ-39) quality of life instrument measured pre dose at 3, 6, and 12 months after the initiation of CVT 301 treatment.
    Patient Global Impression of Change (PGI-C) rating scale measured pre dose at 3, 6, and 12 months after the initiation of CVT 301 treatment.
    Mean change from baseline in the Schwab and England (S&E) Activities of Daily Living (ADL) score measured pre dose at 3, 6, and 12 months after the initiation of CVT-301 treatment.
    Mean change from baseline in the UPDRS Part 2 score measured pre dose at 3, 6, and 12 months after the initiation of CVT-301 treatment.
    Mean change from baseline in the UPDRS Part 4 measures of motor fluctuations (dyskinesias [Q32-35] and wearing off [Q36 39]) measured pre dose at 3, 6, and 12 months after the initiation of CVT-301 treatment.
    The ability of Parkinson?s disease (PD) patients to perform American Thoracic Society (ATS) quality carbon monoxide diffusing capacity (DLco) maneuver.
    DLco over a 12 month period.
    Cambio medio en la puntuación promedio motriz, parte 3 de la Escala de valoración unificada de la enfermedad de Parkinson (Unified Parkinson?s Disease Rating Scale, UPDRS) entre los 10 a 60 min. siguientes al tratamiento con respecto a la puntuación previa a la dosis, en pacientes que presentan un episodio OFF en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Evolución del cambio medio en la puntuación motriz, parte 3 de la UPDRS a los 10, 20, 30 y 60 min. posteriores al tratamiento en la clínica con respecto a la puntuación previa a la dosis, 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Cambio medio en la puntuación promedio motriz, parte 3 de la UPDRS a los 10 y 20 min. siguientes al tratamiento con respecto a la puntuación previa a la dosis, en pacientes que presentan un episodio OFF en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Mejor cambio medio y mejor cambio porcentual en la puntuación motriz, Parte 3 de la UPDRS, entre los 10 a 60 min. siguientes al tratamiento con respecto a la puntuación previa a la dosis, en pacientes que presentan un episodio OFF en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Cambio medio en la puntuación:
    - de la pregunta 23 (tamborileo de los dedos) entre antes de la administración ya los 10 min. siguientes al tratamiento con respecto a la puntuación previa a la dosis, en pacientes que presentan un episodio OFF en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    - de la pregunta 31 (bradicinesia e hipocinesia corporales) a los 10 min. siguientes al tratamiento con respecto a la puntuación previa a la dosis, en pacientes que presentan un episodio OFF en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Proporción de pacientes con una disminución de >=3 puntos, >=6 puntos y >=11 puntos en la puntuación motriz de la parte 3 de la UPDRS, entre antes y después de la administración de la dosis, mediante la evaluación de la cantidad y la proporción de pacientes que logran una respuesta motriz objetiva en general y en los 10, 20, 30 y 60 min. posteriores al tratamiento en la clínica, 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Aparición e intensidad de la discinesia calificada por el examinador después del tratamiento en pacientes que presentan un episodio OFF en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    Proporción de pacientes:
    - que logran la resolución de un estado OFF al estado ON en los 60 minutos después de la administración del medicamento en la clínica (según la evaluación subjetiva del examinador) 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.
    - con estado ON al finalizar el período de observación de 60 minutos (según la evaluación subjetiva del examinador) posterior al tratamiento en la clínica 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.

    Valores informados por el paciente de tiempo diario total en OFF, tiempo diario total en ON sin discinesia, tiempo diario total ON con discinesia no problemática, y tiempo diario total ON con discinesia problemática, evaluados por el paciente y registrados en el diario del paciente durante 3 días consecutivos inmediatamente antes de las visitas de 1, 3, 6, 9 y 12 meses después de comenzar el tratamiento con CVT-301.

    Cambio medio, con respecto al valor inicial, en el instrumento de calidad de vida del Cuestionario para la enfermedad de Parkinson de 39 preguntas (Parkinson?s Disease Questionnaire, PDQ-39) medido antes de la administración de la dosis a los 3, 6 y 12 meses después de comenzar el tratamiento con CVT-301.

    Escala de valoración de Impresión global de cambio del paciente (Patient Global Impression of Change, PGI-C) medida antes de la administración de la dosis a los 3, 6 y 12 meses después de comenzar el tratamiento con CVT-301.
    Cambio medio, con respecto al valor inicial, en:
    - la puntuación de Actividades de la vida diaria (AVD) de Schwab y England (S&E), medida antes de la administración de la dosis a los 3, 6 y 12 meses después de comenzar el tratamiento con CVT 301.
    -la puntuación de la parte 2 de la UPDRS, medida antes de la administración de la dosis a los 3, 6 y 12 meses después de comenzar el tratamiento con CVT-301.
    - las medidas de la parte 4 de la UPDRS sobre fluctuaciones motrices (discinesias [P32 a 35] y pérdida del efecto, [P36 a 39]), medidas antes de la administración de la dosis a los 3, 6 y 12 meses después de comenzar el tratamiento con CVT-301.
    Capacidad de los pacientes con enfermedad de Parkinson (EP) para efectuar la maniobra de calidad de la capacidad de difusión del monóxido de carbono (DLco) de la Sociedad Torácica Americana (American Thoracic Society, ATS).
    DLco durante un período de 12 meses.
    E.5.2.1Timepoint(s) of evaluation of this end point
    These will be repeated throughout the study where necessary as indicated above
    Éstos serán repetidos a lo largo del estudio cuando sea necesario tal como se indica arriba
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Norma asistencial
    Standard of Care Treatment
    E.8.2.4Number of treatment arms in the trial1
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA59
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Austria
    Belgium
    Czech Republic
    France
    Germany
    Hungary
    Israel
    Italy
    Poland
    Romania
    Serbia
    Spain
    United Kingdom
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    Última visita del último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months3
    E.8.9.1In the Member State concerned days7
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months3
    E.8.9.2In all countries concerned by the trial days7
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 255
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 110
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state32
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 328
    F.4.2.2In the whole clinical trial 365
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None
    Ninguno
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2015-02-02
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-01-09
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2017-05-16
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