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
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.
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.
Exclusion Criteria:
Amantadine HCl ER Tablets 240mg daily for 12 weeks post two week titration phase.
Drug: 240mg 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 Tablets matching Amantadine HCl ER Tablets taken daily for 16 weeks.
Drug: Placebo tablets
Also known as: Osmolex ER 240 mg Tablet
Also known as: Osmolex ER 320mg Tablet
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
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
| Milestone | 240mg Amantadine Hydrochloride (HCl) ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine |
|---|---|---|---|
| Started | 30 | 29 | 28 |
| Completed | 17 | 19 | 18 |
| Not completed | 13 | 10 | 10 |
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).
| score on a scale | 240 mg Amantadine HCl ER Tablets | 320 mg Amantadine HCl ER Tablets | Placebo Amantadine HCl ER Tablets |
|---|---|---|---|
| Visit 2 (Baseline) | 46.2 ± 13.19 | 39.2 ± 11.91 | 38.7 ± 11.23 |
| Visit 7 (Day 98)/Stable Dose LOCF [1] | 27.5 ± 19.13 | 26.4 ± 13.17 | 28.7 ± 13.70 |
| Change from Baseline (SD) | -18.8 ± 16.38 | -13.3 ± 13.73 | -9.6 ± 14.87 |
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.
| score on a scale | 240 mg Amantadine HCl ER Tablets | 320 mg Amantadine HCl ER Tablets | Placebo Amantadine HCl ER Tablets |
|---|---|---|---|
| Visit 2 (Baseline) | 3.5 ± 2.02 | 3.3 ± 2.63 | 4.3 ± 2.59 |
| Visit 7 (Day 98)/Stable Dose LOCF [1] | 4.1 ± 2.48 | 2.8 ± 2.24 | 3.8 ± 2.36 |
| Change from Baseline (SD) | 0.8 ± 2.92 | -0.5 ± 2.18 | 0.1 ± 2.78 |
Collected over Three months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| 240mg Amantadine HCl ER Tablets | 1/30 (3.3%) | 3/30 (10%) | 20/30 (66.7%) |
| 320mg Amantadine HCl ER Tablets | 0/29 (0%) | 1/29 (3.4%) | 24/29 (82.8%) |
| Placebo Tablets for Amantadine | 0/28 (0%) | 2/28 (7.1%) | 15/28 (53.6%) |
| Event | 240mg Amantadine HCl ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine |
|---|---|---|---|
| impulse-control disorderPsychiatric disorders | 0/30 | 0/29 | 1/28 |
| arrhythmia supraventricularCardiac disorders | 0/30 | 0/29 | 1/28 |
| syncopeBlood and lymphatic system disorders | 0/30 | 1/29 | 0/28 |
| traumatic haemothroaxBlood and lymphatic system disorders | 1/30 | 0/29 | 0/28 |
| megacolon multi-organ failureGastrointestinal disorders | 1/30 | 0/29 | 0/28 |
| arthralgia osteonecrosisMusculoskeletal and connective tissue disorders | 1/30 | 0/29 | 0/28 |
| Event | 240mg Amantadine HCl ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine |
|---|---|---|---|
| Oedema peripheralGeneral disorders | 2/30 | 4/29 | 0/28 |
| NasopharyngitisInfections and infestations | 1/30 | 4/29 | 0/28 |
| HallucinationPsychiatric disorders | 0/30 | 4/29 | 1/28 |
| DyskinesiaNervous system disorders | 3/30 | 1/29 | 3/28 |
| Dry MouthGastrointestinal disorders | 1/30 | 3/29 | 0/28 |
| DizzinessNervous system disorders | 1/30 | 3/29 | 0/28 |
| HypertensionVascular disorders | 1/30 | 3/29 | 0/28 |
| NauseaGastrointestinal disorders | 0/30 | 1/29 | 2/28 |
| Urinary tract infectionInfections and infestations | 2/30 | 1/29 | 2/28 |
| HeadacheNervous system disorders | 2/30 | 0/29 | 2/28 |
| Age, Categorical(Participants) | 240mg Amantadine HCl ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine | Total |
|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 30 | 29 | 28 | 87 |
| >=65 years | 0 | 0 | 0 | 0 |
| Age, Continuous(years) | 240mg Amantadine HCl ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine | Total |
|---|---|---|---|---|
| Mean | 68.6 ± 8.02 | 63.3 ± 9.17 | 66.1 ± 8.04 | 66.1 ± 8.61 |
| Sex: Female, Male(Participants) | 240mg Amantadine HCl ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine | Total |
|---|---|---|---|---|
| Female | 16 | 10 | 12 | 38 |
| Male | 14 | 19 | 16 | 49 |
| Region of Enrollment(participants) | 240mg Amantadine HCl ER Tablets | 320mg Amantadine HCl ER Tablets | Placebo Tablets for Amantadine | Total |
|---|---|---|---|---|
| Canada | 1 | 0 | 1 | 2 |
| United States | 7 | 16 | 8 | 31 |
| France | 8 | 8 | 10 | 26 |
| Germany | 6 | 3 | 3 | 12 |
| Spain | 8 | 2 | 6 | 16 |
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Adamas Pharmaceuticals, Inc.