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TerminatedNCT02153645ALLAY-LID-IUpdated Feb 16, 2022Results posted

Efficacy and Safety of Amantadine Hydrochloride (HCl) ER Tablets to Treat Parkinson's Disease Patients With LID.

A Phase 3 interventional study of 240mg Amantadine HCl ER tablets and Placebo tablets in Parkinson's Disease and Levodopa Induced Dyskinesias (LID), sponsored by Adamas Pharmaceuticals, Inc.. Terminated at 56 sites in 5 countries. Open to participants aged 30 Years to 85 Years. Per ClinicalTrials.gov, last updated 2022-02-16.

Sponsored by Adamas Pharmaceuticals, Inc. · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
87
Allocation
Randomized
Ages
30 Years to 85 Years
Sex
All
01

Study summary

This study was terminated early due to slow enrollment with 87 of 162 planned subjects enrolled. The purpose of this multi-center, randomized, double-blind, parallel-group, 16 week study is to compare the efficacy and safety of two different dose levels of Amantadine Extended Release Tablets to placebo for the treatment of levodopa induced dyskinesia in patients with Parkinson's disease.

Read the detailed description

This study was terminated early due to slow enrollment with 87 of 162 planned subjects enrolled. Amantadine has been used for many years as a treatment for Parkinson's disease. It has been reported in the literature to effectively treat the motor complications of levodopa, especially dyskinesia, but it must be given 2 to 4 times a day. The purpose of this multi-center, randomized, double-blind, parallel-group, 16 week study is to compare the efficacy and safety of two different dose levels of Amantadine Extended Release Tablets to placebo for the treatment of levodopa induced dyskinesia in patients with Parkinson's disease. The dose will be given once a day in the morning so that amantadine concentrations are maintained throughout the day for treating the levodopa induced dyskinesia, but will be lower during the night, potentially reducing the negative impact of amantadine on sleep.

02

Conditions studied

  • Parkinson's Disease
  • Levodopa Induced Dyskinesias (LID)

Keywords

  • Parkinson's Disease
  • Levodopa Induced Dyskinesias (LID)
  • Dyskinesias
  • Parkinsonism
03

Who can participate

Ages eligible
30 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Signed Investigational Review Board/Independent Ethics Review Committee (IRB/IEC) informed consent form.,
  • Idiopathic Parkinson's disease per the United Kingdom (UK) Parkinson's Disease Society Brain Bank criteria.
  • Male or female 30 to 85 years old.
  • Levodopa induced, predictable peak-effect dyskinesia considered problematic and/or disabling.
  • Screening serum creatinine level within normal range
  • On stable doses of all oral anti-Parkinson's medication, including any levodopa preparation, for 30 days and be willing to remain on the same doses throughout the trial.
  • The subject/caregiver must demonstrate the ability to complete an accurate home diary based on training and evaluation during the screening period.

Exclusion criteria

Exclusion Criteria:

  • Secondary parkinsonian syndrome, such as vascular, postinflammatory,drug-induced, neoplastic and post-traumatic parkinsonism or any atypical parkinsonian syndrome (e.g., Progressive Supranuclear Palsy, Multi-System Atrophy, etc.);
  • Use of amantadine within 14 days before study start, or previously had an adverse event to amantadine
  • Currently taking neuroleptics and atypical antipsychotic agents, acetylcholinesterase inhibitors, apomorphine, rimantadine, memantine and dextromethorphan and quinidine if used in combination for treating dyskinesia.
  • History of neurosurgical intervention for treating Parkinson's s disease (i.e. pallidotomy or implanted with a deep brain stimulator).
  • Any medical condition or past medical history that would increase the risk of exposure to Amantadine HCl Extended Release Tablets or interfere with safety and efficacy evaluations.
  • History of cancer within 5 years of screening with following exceptions: adequately treated non-melanomatous skin cancers, localized bladder cancer, non-metastatic prostate cancer or in situ cervical cancer.
  • History or current diagnosis of schizophrenia or bipolar disorder;
  • Inadequately treated Major Depressive Disorder. Subjects on stable doses of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) are eligible for the study.
  • Is at imminent risk of suicide or had a suicide attempt within 6 months of screening
  • History or current diagnosis of Impulse Control Disorder
  • Calculated plasma creatinine clearance of \<60 mL/min at screening
  • History of or currently has any of the following clinically significant conditions, cardiovascular, respiratory, renal, hepatic, or gastrointestinal disease
  • Any clinically significant vital sign, ECG, or laboratory abnormalities:
  • A positive test for HIV antibody or history of HIV; hepatitis B surface antigen unless the positive test followed a recent (\<28 days) vaccination for hepatitis B; hepatitis C antibody.
  • A positive urine drug test.
  • Pregnant or breastfeeding at screening or has a positive pregnancy test
  • If a sexually active female, is not surgically sterile or at least 2 years post-menopausal, or does not agree to utilize an effective method of contraception from the screening visit to at least 4 weeks after the completion of study treatment.
  • History of alcohol or narcotic substance abuse ≤1 year before screening.
  • Has dementia or another psychiatric illness that prevents provision of informed consent.
  • Has a known hypersensitivity to the study treatment(s), based on known allergies to drugs of the same class including rimantadine HCl and memantine HCl.
  • Has participated in other studies involving investigational drugs or surgeries within the last 30 days or investigational biologics within the last 6 months prior to screening.
  • Plans to undergo major elective surgery during the course of the study.
  • Received administration of Live Attenuated Influenza Vaccine (LAIV) within 2 weeks.
  • Cognitive impairment, as evidenced by a score \<26 on the Montreal Cognitive Assessment (MoCA) at the screening visit.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
87 participants (actual)

Study arms

  • Experimental
    240mg Amantadine HCl ER tablets

    Amantadine HCl ER Tablets 240mg daily for 12 weeks post two week titration phase.

    Drug: 240mg Amantadine HCl ER tablets

  • Experimental
    320mg Amantadine HCl ER tablets

    Amantadine HCl ER Tablets 320mg daily for 12 weeks post a two week dose titration phase.

    Drug: 320mg Amantadine HCl ER tablets

  • Placebo comparator
    Placebo tablets

    Placebo Tablets matching Amantadine HCl ER Tablets taken daily for 16 weeks.

    Drug: Placebo tablets

Interventions

  • Drug240mg Amantadine HCl ER tablets

    Also known as: Osmolex ER 240 mg Tablet

  • DrugPlacebo tablets
  • Drug320mg Amantadine HCl ER tablets

    Also known as: Osmolex ER 320mg Tablet

05

What researchers measure

Primary outcomes

  1. Unified Dyskinesia Rating Scale

    The Unified Dyskinesia Rating Scale is a validated tool for assessment of dyskinesia (involuntary movements) in Parkinson's Disease patients. Rating consists of the change from baseline to Day 98 of the sum of the 26 questions comprising the questionnaire. Each question in the questionnaire is rated on a 5 point scale from 0-4 where 0 is a better outcome. Questions assess: over the past week total hours with dyskinesia and total hours without dyskinesia; problems with speech, chewing and swallowing, eating, dressing, hygiene, handwriting, hobbies, balance, socializing, emotions, spasm or cramps, pain without dystonia (spasm or cramps) and pain from dystonia, the degree of impairment for each of 7 body parts, and the degree of disability in communication, drinking from a cup, dressing and ambulation. The minimum score is 0 (better) and the maximum score is 130 (worse).

    Time frame: From baseline to Day 98

Secondary outcomes

  1. Mobility State Self-Assessment - Subject Diary Cards

    Change from baseline in the number of awake hours without troublesome dyskinesia (involuntary movements). Every half hour the subject will indicate in the diary if the medication has ("ON") or has not ("OFF") produced benefits in terms of mobility, slowness and rigidity. Valid diaries of the 3 consecutive days prior to each visit will be averaged with respect to the number of awake hours without troublesome dyskinesia. The change from baseline in the number of waking hours that subjects report being "ON" without troublesome dyskinesias will be analyzed at analysis visits Day 14 and Day 98 of treatment. Higher scores mean a better outcome and the maximum value is 24 hours.

    Time frame: Day 14 and Day 98 of treatment

06

Results

Posted Apr 2, 2019

Participant flow

Participant flow — Overall Study
Milestone240mg Amantadine Hydrochloride (HCl) ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for Amantadine
Started302928
Completed171918
Not completed131010

Outcome measures

PrimaryUnified Dyskinesia Rating Scale

The Unified Dyskinesia Rating Scale is a validated tool for assessment of dyskinesia (involuntary movements) in Parkinson's Disease patients. Rating consists of the change from baseline to Day 98 of the sum of the 26 questions comprising the questionnaire. Each question in the questionnaire is rated on a 5 point scale from 0-4 where 0 is a better outcome. Questions assess: over the past week total hours with dyskinesia and total hours without dyskinesia; problems with speech, chewing and swallowing, eating, dressing, hygiene, handwriting, hobbies, balance, socializing, emotions, spasm or cramps, pain without dystonia (spasm or cramps) and pain from dystonia, the degree of impairment for each of 7 body parts, and the degree of disability in communication, drinking from a cup, dressing and ambulation. The minimum score is 0 (better) and the maximum score is 130 (worse).

Time frame:
From baseline to Day 98
Reported as:
Mean · score on a scale
Unified Dyskinesia Rating Scale
score on a scale240 mg Amantadine HCl ER Tablets320 mg Amantadine HCl ER TabletsPlacebo Amantadine HCl ER Tablets
Visit 2 (Baseline)46.2 ± 13.1939.2 ± 11.9138.7 ± 11.23
Visit 7 (Day 98)/Stable Dose LOCF [1]27.5 ± 19.1326.4 ± 13.1728.7 ± 13.70
Change from Baseline (SD)-18.8 ± 16.38-13.3 ± 13.73-9.6 ± 14.87
Statistical analysis
  • 240 mg Amantadine HCl ER Tablets vs 320 mg Amantadine HCl ER Tablets vs Placebo Amantadine HCl ER Tablets · ANCOVA · p = 0.179 · Mean difference (final values): -5.6 · 95% CI -13.9 to 2.6
  • 320 mg Amantadine HCl ER Tablets · ANCOVA · p = 0.458 · Mean difference (final values): -3.1 · 95% CI -11.2 to 5.1
SecondaryMobility State Self-Assessment - Subject Diary Cards

Change from baseline in the number of awake hours without troublesome dyskinesia (involuntary movements). Every half hour the subject will indicate in the diary if the medication has ("ON") or has not ("OFF") produced benefits in terms of mobility, slowness and rigidity. Valid diaries of the 3 consecutive days prior to each visit will be averaged with respect to the number of awake hours without troublesome dyskinesia. The change from baseline in the number of waking hours that subjects report being "ON" without troublesome dyskinesias will be analyzed at analysis visits Day 14 and Day 98 of treatment. Higher scores mean a better outcome and the maximum value is 24 hours.

Time frame:
Day 14 and Day 98 of treatment
Reported as:
Mean · score on a scale
Mobility State Self-Assessment - Subject Diary Cards
score on a scale240 mg Amantadine HCl ER Tablets320 mg Amantadine HCl ER TabletsPlacebo Amantadine HCl ER Tablets
Visit 2 (Baseline)3.5 ± 2.023.3 ± 2.634.3 ± 2.59
Visit 7 (Day 98)/Stable Dose LOCF [1]4.1 ± 2.482.8 ± 2.243.8 ± 2.36
Change from Baseline (SD)0.8 ± 2.92-0.5 ± 2.180.1 ± 2.78

Adverse events

Collected over Three months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
240mg Amantadine HCl ER Tablets1/30 (3.3%)3/30 (10%)20/30 (66.7%)
320mg Amantadine HCl ER Tablets0/29 (0%)1/29 (3.4%)24/29 (82.8%)
Placebo Tablets for Amantadine0/28 (0%)2/28 (7.1%)15/28 (53.6%)
Most frequent serious events
Most frequent serious events
Event240mg Amantadine HCl ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for Amantadine
impulse-control disorderPsychiatric disorders0/300/291/28
arrhythmia supraventricularCardiac disorders0/300/291/28
syncopeBlood and lymphatic system disorders0/301/290/28
traumatic haemothroaxBlood and lymphatic system disorders1/300/290/28
megacolon multi-organ failureGastrointestinal disorders1/300/290/28
arthralgia osteonecrosisMusculoskeletal and connective tissue disorders1/300/290/28
Most frequent other events
Showing 10 of 111
Most frequent other events
Event240mg Amantadine HCl ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for Amantadine
Oedema peripheralGeneral disorders2/304/290/28
NasopharyngitisInfections and infestations1/304/290/28
HallucinationPsychiatric disorders0/304/291/28
DyskinesiaNervous system disorders3/301/293/28
Dry MouthGastrointestinal disorders1/303/290/28
DizzinessNervous system disorders1/303/290/28
HypertensionVascular disorders1/303/290/28
NauseaGastrointestinal disorders0/301/292/28
Urinary tract infectionInfections and infestations2/301/292/28
HeadacheNervous system disorders2/300/292/28

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)240mg Amantadine HCl ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for AmantadineTotal
<=18 years0000
Between 18 and 65 years30292887
>=65 years0000
Age, Continuous
Age, Continuous(years)240mg Amantadine HCl ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for AmantadineTotal
Mean68.6 ± 8.0263.3 ± 9.1766.1 ± 8.0466.1 ± 8.61
Sex: Female, Male
Sex: Female, Male(Participants)240mg Amantadine HCl ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for AmantadineTotal
Female16101238
Male14191649
Region of Enrollment
Region of Enrollment(participants)240mg Amantadine HCl ER Tablets320mg Amantadine HCl ER TabletsPlacebo Tablets for AmantadineTotal
Canada1012
United States716831
France881026
Germany63312
Spain82616
07

Study locations

56 sites
  • Tucson, Arizona 85724, United States
  • Fountain Valley, California 92708, United States
  • Irvine, California 92697, United States
  • Pasadena, California 91105, United States
  • Reseda, California 91335, United States
  • Ventura, California 93001, United States
  • Ventura, California 93003, United States
  • Boulder, Colorado 80304, United States
  • Hollywood, Florida 33021, United States
  • Miami, Florida 33101, United States
  • North Palm Beach, Florida 33403, United States
  • Tampa, Florida 33612, United States
  • Chicago, Illinois 60612, United States
  • Indianapolis, Indiana 46202, United States
  • Baton Rouge, Louisiana 70810, United States
  • Ann Arbor, Michigan 48103, United States
  • Ann Arbor, Michigan 48109, United States
  • Summit, New Jersey 07901, United States
  • Brooklyn, New York 11203, United States
  • Manhasset, New York 11020, United States
  • Patchogue, New York 11772, United States
  • Raleigh, North Carolina 27612, United States
  • Columbus, Ohio 43221, United States
  • Round Rock, Texas 78681, United States
  • Orem, Utah 84058, United States
  • Kirkland, Washington 98034, United States
  • London, Ontario, Canada
  • Ottawa, Ontario, Canada
  • Rennes, Ille-et-Vilaine, France
  • Amiens, France
  • Bron, 69677, France
  • Clermont-Ferrand, France
  • Creteil, France
  • Lille, France
  • Marseille, 13385, France
  • Montauban, France
  • Nimes, France
  • Paris, France
  • Poitiers, France
  • Toulouse, France
  • Haag, Bayern, Germany
  • Weissensee, Berlin, Germany
  • Erbach, Hessen, Germany
  • Achim, Niedersachsen, Germany
  • Bochum, Nordrhein-Westfalen, Germany
  • Berlin, 13088, Germany
  • Berlin, Germany
  • Wurzburg, 97080, Germany
  • Manresa, Barcelona, Spain
  • Sevilla, Barcelona, Spain
  • Alcorcón, Madrid, Spain
  • Castellana, Madrid, Spain
  • Barcelona, 08036, Spain
  • Barcelona, 08041, Spain
  • Barcelona, Spain
  • Pamplona, 31008, Spain
08

Registry details

Key details

Study ID
NCT02153645
Lead sponsor
Adamas Pharmaceuticals, Inc.
Responsible party
Sponsor
First posted
Jun 3, 2014
Start date
Aug 18, 2014
Primary completion
May 20, 2016
Completion
May 20, 2016
Results posted
Apr 2, 2019
Last update
Feb 16, 2022

Study contacts

Angela Dentiste, MBA
study chair · Osmotica Pharmaceutical US LLC

Oversight

Data monitoring committee
No
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