E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Frontotemporal Dementia |
Demenza fronto-temporale |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10029205 |
E.1.2 | Term | Nervous system disorders |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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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 investigate the potential clinical impact of DA agonists on cognitive and behavioral functions in FTD patients. |
Valutare nei pazienti con demenza Fronto-Temporale il potenziale impatto clinico degli agonisti dopaminergici (Rotigotina) sulle funzioni cognitive e comportamentali. |
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E.2.2 | Secondary objectives of the trial |
To test if DA agonists treatment changes brain metabolism and brain physiology of FTD patients. |
Valutare nei pazienti con demenza Fronto-Temporale le modifiche indotte dalla terapia dopaminergica sul metabolismo cerebrale e sull’attività fisiologica cerebrale. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. The patient has a diagnosis of probable Frontotemporal dementia behavioural variant (bv-FTD) based on the International consensus clinical diagnostic criteria described by Rascovsky et al., 2011. 2. The patient is a man or a woman, aged from 40 to 80 years. 3. The patient has a Clinical Dementia Rating-FTD (CDR-FTD) total score of =2 at Screening. 4. The patient has not been treated with acetylcholinesterase inhibitor (AChEI), i.e., donepezil, galantamine, or rivastigmine, at the time of screening. 5. The patient is able to comply with the study procedures in the view of the investigator. 6. Evidence of frontotemporal hypometabolism at PET imaging. 7. Evidence of amyloid markers excluding Alzheimer’s disease (cerebrospinal fluid Abeta/Tau dosages or amyloid PET imaging). |
Tutti i pazienti dovranno avere una diagnosi di probabile demenza Fronto-Temporale variante comportamentale, in base al consenso internazionale dei criteri clinici-diagnostici descritti da Rascovsky et al., 2011. - I pazienti possono essere uomo o donna, con un’età compresa tra i 40 e gli 80 anni. - Tutti i pazienti, in seguito ad uno screening, dovranno avere un punteggio totale = 2 nel Clinical Dementia Rating-FTD (CDR-FTD). - I pazienti, in fase di screening, non sono stati trattati con inibitori dell’Acetilcolinesterasi (AchEI) come Donepezil, Galantamina, Rivastgmina. - Evidenza di ipometabolismo Fronto-Temporale nelle indagini PET - Evidenza dei marker di amiloide che escludono la malattia di Alzheimer (dosaggi di Abeta/Tau nel liquido cerebrospinale o Pet amiloide). |
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E.4 | Principal exclusion criteria |
1. Significant neurodegenerative disorder of the central nervous system other than FTD e.g., Alzheimer’s disease, Lewy body dementia, Parkinson’s disease, multiple sclerosis, progressive supranuclear palsy, normal pressure hydrocephalus, Huntington’s disease, any condition directly or indirectly caused by Transmissible Spongiform Encephalopathy (TSE), Creutzfeldt-Jakob Disease (CJD), variant Creutzfeldt-Jakob Disease (vCJD), or new variant Creutzfeldt-Jakob Disease (nvCJD) 2. Significant intracranial focal or vascular pathology seen on brain MRI scan within a maximum of 6 months before Baseline leading to a diagnosis other than probable FTD. 3. The patients has history of seizure (with the exception of febrile seizures in childhood). 4. Metal implants in the head (except dental), pacemaker, cochlear implants, or any other non-removable items that are contraindications to MR imaging. 5. Treatment currently or within 3 months before Baseline with any of the following medications: Typical and Atypical antipsychotics (i.e., Clozapine, Olanzapine); Antiepileptics drugs (i.e., Carbamazepine, Primidone, Pregabalin, Gabapentin); Antidepressants (i.e., Citalopram, Duolxetine, Paroxetine). 6.Evidenza di patologie clinicamente significative o scompensate incluse, ma non limitate a patologie polmonari, gastrointestinali, renali, epatiche, endocrine, malattie cardiovascolari o metaboliche. Evidenza di ipotensione ortostatica o disautonomia.. 7.Trattamento corrente o entro i 6 mesi precedenti al Baseline con agenti antiparkinsoniani (es L-dopa, dopamino-agonisti, inibitori delle COMT, inibitori delle MAO, farmaci anticolinergici). |
Disturbi del Sistema Nervoso Centrale diversi dalla demenza Fronto-Temporale, come malattia di Alzheimer, demenza a corpi di Lewy, Morbo di Parkinson, Paralisi Sopranucleare Progressiva, Sclerosi multipla, Idrocefalo a pressione normale, malattia di Huntington, qualsiasi condizione direttamente o indirettamente causata da encefalopatia spongiforme trasmissibile (TSE), malattia di Creutzfeldt-Jakob (CJD), variante della malattia di Creutzfeldt-Jakob (vCJD) o nuova variante della malattia di Creutzfeldt-Jakob ( nvCJD). - Presenza di una significativa patologia intracranica o vascolare osservata sulla RMN cerebrale entro un massimo di 6 mesi prima del basale che porta a una diagnosi diversa dal probabile FTD. - I pazienti hanno una storia di convulsioni (ad eccezione delle convulsioni febbrili nell'infanzia). - Protesi metalliche nella testa (eccetto quelle dentistiche), pacemaker, impianti cocleari o qualsiasi altro oggetto non rimovibile che sono controindicazioni all'imaging RM. - Trattamento attualmente o entro 3 mesi prima dela visita basaline con uno qualsiasi dei seguenti farmaci: antipsicotici tipici e atipici (cioè, clozapina, olanzapina); Farmaci antiepilettici (cioè Carbamazepina, Primidone, Pregabalin, Gabapentin); Antidepressivi (cioè Citalopram, Duolxetina, Paroxetina). |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from Baseline to Week 24 in the Frontal Assessment Battery (FAB) to evaluate effects of RTG on frontal lobe functions. |
Cambiamenti pre-post trattamento (24 settimane) nella “Frontal Assessment Battery” (FAB) per valutare gli effetti della Rotigotina sulle funzioni dei lobi frontali. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
12 and 24 weeks |
12 e 24 settimane |
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E.5.2 | Secondary end point(s) |
• Change from Baseline to Week 24 in the Neuropsychiatric Inventory (NPI) scale, to evaluate efficacy of RTG on behavior. • Change from Baseline to Week 24 in the Clinical Dementia Rating scale-Frontotemporal dementia Sum Of Boxes (CDR-FTDSOB), to evaluate efficacy of RTG on global disease severity. • Change from Baseline to Week 24 in the Screening for aphasia in Neurodegeneration (SAND) scale, to evaluate efficacy of RTG on language functions. • Change from Baseline to Week 24 in the Mini Mental State Examination (MMSE), to evaluate efficacy of RTG on global cognition. • Change from Baseline to Week 24 in the Addenbrooke's Cognitive Examination Revised (ACE-R), to evaluate efficacy of RTG on global cognition. • Change from Baseline to Week 24 in the Alzheimer's Disease Cooperative Study – Activities of Daily Living (ADCS-ADL): to evaluate efficacy of RTG on activities of daily living. • Change from baseline to week 24 in 18F-FDG CT/PET, to evaluate the effects of RTG on brain metabolism. • Change from baseline to week 24 in the SICI, LICI and SAI paired pulse TMS protocols, to evaluate the effects of RTG on synaptic transmission. • Change from Baseline to Week 24 in the iTBS protocol, to evaluate effects of RTG on cortical plasticity. • Change from Baseline to Week 24 in the TMS/EEG protocol, to evaluate effects of RTG on DLPFC cortical activity, oscillatory activity and connectivity. • Nature, frequency and severity of adverse events (AEs): to assess the safety and tolerability of RTG 4mg/day given for up to 24 Weeks. |
- Cambiamenti pre-post trattamento (24 settimane) nel “Neuropsychiatric Inventory” (NPI) per valutare gli effetti della Rotigotina sul comportamento. - cambiamenti pre-post trattamento (24 settimane) nel “Clinical Dementia Rating scale-Frontotemporal dementia Sum Of Boxes” (CDR-FTDSOB) per valutare gli effetti della Rotigotina sulla gravità globale della malattia. - cambiamenti pre-post trattamento (24 settimane) nel “Screening for aphasia in Neurodegeneration” (SAND) per valutare gli effetti della Rotigotina sul linguaggio. - cambiamenti pre-post trattamento (24 settimane) nel “Mini Mental State Examination” (MMSE) per valutare gli effetti della Rotigotina sul funzionamento cognitivo globale. - cambiamenti pre-post trattamento (24 settimane) nel “Addenbrooke's Cognitive Examination Revised” (ACE-R) per valutare gli effetti della Rotigotina sul funzionamento cognitivo globale. - cambiamenti pre-post trattamento (24 settimane) nel “Alzheimer's Disease Cooperative Study – Activities of Daily Living” (ADCS-ADL) per valutare gli effetti della Rotigotina sulle attività di vita quotidiana. - cambiamenti pre-post trattamento (24 settimane) nel in 18F-FDG CT/PET, per valutare gli effetti della Rotigotina sul metabolismo cerebrale. - cambiamenti pre-post trattamento (24 settimane) nei protocolli neurofisiologici SICI, LICI e SAI, per valutare gli effetti della Rotigotina sulla trasmissione sinaptica. - cambiamenti pre-post trattamento (24 settimane) nel protocollo iTBS, per valutare gli effetti della Rotigotina sulla plasticità corticale. - cambiamenti pre-post trattamento (24 settimane) nel protocollo TMS-EEG, per valutare gli effetti della Rotigotina sull’attività corticale, sulle oscillazioni corticali e sulla connettività della Corteccia PreFrontale Dorsolaterale (DLPC). - Natura, frequenza e gravità degli eventi avversi, per valutare la sicurezza e la tollerabilità della Rotigotina ad un dosaggio di 4 mg o 6mg / die somministrati per un massimo di 24 settimane. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
E.6.4 | Safety | No |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
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) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 2 |
E.8.5 | The trial involves multiple Member States | No |
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 | Information not present in EudraCT |
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
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At the end of the 24th week of the last patient |
A completamento della 24esima settimana del paziente 75 |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |