E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Parkinson's disease (PD) patients with wearing-off motor fluctuations |
|
E.1.1.1 | Medical condition in easily understood language |
|
E.1.1.2 | Therapeutic area | Not possible to specify |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the change in subject’s condition according to the Investigator’s Global Assessment of Change after three months of treatment with 50 mg opicapone once daily in a heterogeneous patient population reflecting daily clinical practice. |
|
E.2.2 | Secondary objectives of the trial |
To investigate the safety of opicapone 50 mg once daily in clinical practice.
To investigate the efficacy of opicapone 50 mg once daily in clinical practice. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Able to comprehend and willing to sign an informed consent form.
2. Male and female subjects aged 30 years or older.
3. Diagnosed with idiopathic PD according to the UK Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria.
4. Disease severity Stages I-IV (modified Hoehn &Yahr staging) at ON.
5. Treated with three to seven daily doses of L-dopa/DDCI or L-dopa/DDCI/entacapone, which can include a slow-release formulation.
6. Signs of “wearing-off” phenomenon according to the 9-Symptom Wearing-off Questionnaire (WOQ-9), despite optimal anti-PD therapy (based on the investigator’s judgement). The wearing-off phenomenon has to be confirmed clinically by the investigator.
7. For females: Postmenopausal for at least two years or surgically sterile for at least six months before screening. |
|
E.4 | Principal exclusion criteria |
1. Non-idiopathic PD (atypical parkinsonism, secondary [acquired or symptomatic] parkinsonism, Parkinson-plus syndrome).
2. Severe OFF periods. Patients with rare and/or short unpredictable OFF periods are eligible.
3. Previous or current use of tolcapone and/or OPC.
4. Treatment with monoamine oxidase MAO-A and MAO-B inhibitors (except selegiline up to 10 mg/day in oral formulation or 1.25 mg/day in buccal absorption formulation or rasagiline up to 1 mg/day or safinamide up to 100 mg/day) within the month before screening.
5. Concomitant treatment with entacapone.
6. Use of any other investigational medicinal product (IMP), currently or within the three months (or within five half-lives of the IMP, whichever is longer) before screening..
7. Any medical condition that might place the subject at increased risk or interfere with assessments.
8. Past (within the past year) or present history of suicidal ideation or suicide attempts.
9. Current or previous (within the past year) alcohol or substance abuse excluding caffeine or nicotine.
10. Phaeochromocytoma, paraganglioma, or other catecholamine secreting neoplasms.
11. Known hypersensitivity to the ingredients of IMP (including lactose intolerance, galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption).
12. History of neuroleptic malignant syndrome (NMS) or non-traumatic rhabdomyolysis.
13. Severe hepatic impairment (Child-Pugh Class C).
14. For females: Breastfeeding.
15. Employees of the investigator, trial centre, sponsor, clinical research organisation and trial consultants, when employees are directly involved in the trial or other studies under the direction of this investigator or trial centre, and their family members. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Primary efficacy endpoint:
Investigator’s Global Assessment of Change at Visit 4. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
Secondary efficacy endpoints:
Change in L-dopa total daily dose from baseline (Visit 1) to each on-site visit.
Number and percentage of subjects with change in number of daily L-dopa doses from baseline (Visit 1) at each on-site visit.
Number and percentage of subjects with change in L-dopa single dose (SD) from baseline (Visit 1) at each on-site visit.
Number and percentage of subjects with stable L-dopa regimen between Visit 3 and Visit 4.
Number and percentage of subjects for whom OPC will be prescribed further after trial completion.
Number and percentage of subjects who stopped treatment with OPC before trial completion or at Visit 4 due to:
AEs
Lack of efficacy
Other reasons
Investigator’s Global Assessment of Change at Visit 3.
Subject’s Global Assessment of Change at Visit 3 and Visit 4.
Absolute values and, if applicable, change from baseline at each on-site visit in WOQ-9.
Absolute values and, if applicable, change from baseline to Visit 4:
UPDRS I mentation, behaviour, and mood at ON stage
UPDRS II (activities of daily living, ADL) at OFF stage
UPDRS II (ADL) plus III (motor function) during the ON stage
UPDRS IV at ON stage
PDQ-8
NMSS.
Secondary safety endpoints:
Incidence of AEs including SAEs.
General safety information (vital signs, physical and neurological examinations). |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 80 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 100 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
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
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |