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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT00623103
Registration number
NCT00623103
Ethics application status
Date submitted
14/02/2008
Date registered
25/02/2008
Date last updated
28/11/2011
Titles & IDs
Public title
Long-term Safety of Rivastigmine Capsule and Patch in Patients With Mild to Moderately-severe Dementia Associated With Parkinson's Disease (PDD)
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Scientific title
A 76-week Prospective, Open-label, Multicenter Study to Evaluate the Long-term Effect of Rivastigmine Capsule and Transdermal Patch on Worsening of the Underlying Motor Symptoms of PD in Patients With Mild to Moderately Severe Dementia Associated With Parkinson's Disease (PDD)
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Secondary ID [1]
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CENA713B2315
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Parkinson's Disease Dementia
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Condition category
Condition code
Neurological
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Parkinson's disease
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Neurological
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0
0
0
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Dementias
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Neurological
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Alzheimer's disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Rivastigmine capsule
Treatment: Drugs - Rivastigmine transdermal patch
Experimental: Rivastigmine capsule - Rivastigmine capsules starting at a total dose of 3 mg/day (1.5 mg twice daily orally) titrated up in 3 mg/day increments every 4 weeks to a final dose of 12 mg/day (6 mg twice daily orally). The 12 mg/day dose or the highest dose tolerated was maintained until week 76.
Experimental: Rivastigmine patch - Rivastigmine patch once a day in the morning, worn for 24 hours, starting at 5 cm^2 (delivering 4.6 mg rivastigmine over a 24 hour period) for 4 weeks then titrated up to 10 cm^2 daily (delivering 9.5 mg rivastigmine over a 24 hour period). The 10 cm^2 patch or the highest well tolerated dose was maintained until week 76.
Treatment: Drugs: Rivastigmine capsule
Rivastigmine capsules orally twice a day. Target dose 12 mg/day.
Treatment: Drugs: Rivastigmine transdermal patch
Rivastigmine patch once a day in the morning, worn for 24 hours. Target dose 10 cm^2/day delivering 9.5 mg over a 24 hour period.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Participants With Adverse Events (AEs) Due, or Potentially Due, to Worsening of Parkinson Disease (PD) Motor Symptoms (Tremor, Muscle Rigidity, Bradykinesia, Fall)
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Assessment method [1]
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The AEs were summarized by presenting the number and percentage of patients having any of the 4 AEs or discontinued due to any of the 4 predefined AEs (tremor, muscle rigidity, bradykinesia, and fall)in each treatment group. The 95% CIs associated with the rates were also presented.
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Timepoint [1]
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76 Weeks
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Primary outcome [2]
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Percentage of Participants With Study Drug Discontinuations Due to Predefined AEs That Are Due, or Potentially Due, to Worsening of PD Motor Symptoms (Tremor, Muscle Rigidity, Bradykinesia, Fall)
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Assessment method [2]
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The discontinuations due to these AEs were summarized by presenting the number and percentage of patients having any of the 4 AEs or discontinued due to any of the 4 predefined AEs (tremor, muscle rigidity, bradykinesia, and fall) in each treatment group. The 95% CIs associated with these rates were also presented.
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Timepoint [2]
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76 Weeks
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Secondary outcome [1]
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Change in Unified Parkinson Disease Rating Scale (UPDRS) Part III Motor Examination Scores at Weeks 8, 16, 24, 52 and 76 (or Early Discontinuation) Compared to Baseline
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Assessment method [1]
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Unified Parkinson Disease Rating Scale (UPDRS) is a 6 part Parkinson's disease specific rating scale that estimates clinical function taking into consideration both disability (functional deficits) and impairment (objective clinical signs). Part III records the motor examination in Items 18-31 rated on a scale of 0 to 4 with (0 being absent/ normal and 4 being the worse) for a total possible score of 0 to 56.
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Timepoint [1]
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From Baseline to Weeks 8, 16, 24, 52 and 76
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Secondary outcome [2]
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Change in Mattis Dementia Rating Scale (Mattis DRS-2) Scores at Weeks 16, 24, 52 and 76 Compared to Baseline
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Assessment method [2]
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Mattis DRS-2 is a measure of cognitive status. The total score is the sum of 5 subscale scores: Attention [0-37], Initiation/Perservation [0-37] (performing alternating movements), Construction [0-6] (copying designs), Conceptualization [0-39] (similarities) and Memory [0-25] (sentence recall, design recognition)for a total possible score of 0-144. Higher score is reflective of better cognitive function, lower scores associated with more pronounced cognitive deficit. The change from baseline was calculated such that a positive number indicates an improvement.
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Timepoint [2]
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From Baseline to Weeks 16, 24, 52 and 76
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Secondary outcome [3]
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Change in Ten Point Clock Test (TPCT) Scores at Weeks 16, 24, 52 and 76 (or Early Discontinuation) Compared to Baseline
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Assessment method [3]
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The Ten Point Clock Test measures executive functioning and visuospatial skills. Participants are asked to put numbers on the face of a clock and then make the clock read 10 minutes after 11. Points are awarded on a scale of 0 to 10 for spacing of specific numbers and the positions of the hands. The change from baseline was calculated such that a positive number indicates improvement.
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Timepoint [3]
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From Baseline to Weeks 16, 24, 52 and 76
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Secondary outcome [4]
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Change in Neuropsychiatric Inventory-10 (NPI-10) Scores at Weeks 16, 24, 52 and 76 (or Early Discontinuation) Compared to Baseline
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Assessment method [4]
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The parameter for analysis was the change from baseline of total score of 10 items on the NPI scale (NPI-10). The total score is a sum of the 10 domains, where the score for a domain is defined as the product of frequency (range: 1-4) and severity (range: 1-3). Each domain has a maximum score of 12 and all domains were equally weighted for total score(thus the range for the total score is 0 to 120 with 0 being completely healthy to 120 which is the worse score patient can get). The change from baseline was calculated such that a negative number indicates an improvement (symptom reduction).
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Timepoint [4]
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At Week 16, 24, 52 and 76 (or early discontinuation)
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Secondary outcome [5]
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Change in Alzheimer's Disease Cooperative Study-Activities Of Daily Living (ADCS-ADL) Scores at Weeks 16, 24, 52 and 76 (or Early Discontinuation) Compared to Baseline
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Assessment method [5]
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The 23 item caregiver-based ADL scale of the dementia Alzheimer's disease Cooperative Study-Activities of Daily Living (ADCS-ADL) was used for analysis. This is a caregiver rated questionnaire of 23 items, with possible scores over a range of 0-78, where 78 denote full functioning with no impairment. The total score was derived by adding up the item scores of the 23 items.
The change from baseline was calculated such that a positive change indicates an improvement.
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Timepoint [5]
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From Baseline to Week 16, 24, 52 and 76 (or early discontinuation)
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Secondary outcome [6]
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UPDRS Part V Stage (Modified Hoehn and Yahr Staging)at Baseline, Week 8,16,24,52 and 76 (or Early Discontinuation)
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Assessment method [6]
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Unified Parkinson Disease Rating Scale (UPDRS) is a 6 part Parkinson's disease specific rating scale that estimates clinical function taking into consideration both disability (functional deficits) and impairment (objective clinical signs). UPDRS Part V is assessed by the modified Hoehn and Yahr Staging Scale. The scale ranges from 0 (no signs of disease) to 5 (wheelchair bound or bedridden unless aided).
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Timepoint [6]
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From Baseline to Week 8, 16, 24, 52 and 76 (or early discontinuation)
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Eligibility
Key inclusion criteria
- Diagnosis of idiopathic Parkinson's disease, according to the UK Parkinson's disease
Society Brain Bank criteria
- Diagnosis of Parkinson's disease dementia according to Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, with onset of symptoms
of dementia at least 2 years following the first diagnosis of idiopathic Parkinson's
disease
- Mini Mental State Examination score of =10 and = 26 (at Screening Visit only)
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Minimum age
50
Years
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Maximum age
85
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- An advanced, severe, or unstable disease of any type that may interfere with the
primary and secondary variable evaluations
- A score of 5 (wheelchair bound or bedridden) in the "on"-state on the Modified Hoehn
and Yahr Staging (UPDRS Part V)
- A current diagnosis of any primary neurodegenerative disorder other than idiopathic PD
- A current diagnosis of any treatable dementia (hypothyroidism, syphilis, vitamin B12
or folate deficiency) that is verified by the investigator to be the cause of
dementia.
- A current diagnosis of probably vascular dementia according to the National Institute
of Neurological Disorders and Stroke and the Association International pour la
Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) criteria
- A current diagnosis of a major depressive episode according to DSM-IV criteria
- A history of stereotaxic brain surgery for Parkinson's disease
- A known exaggerated pharmacological sensitivity or hypersensitivity to drugs similar
to rivastigmine or to other cholinergic compounds
Other protocol-defined inclusion/exclusion criteria may apply.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/01/2008
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
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Accrual to date
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Final
583
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Novartis Investigative Site - Kogarah
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Novartis Investigative Site - Heidelberg
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Novartis Investigative Site - Malvern
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Novartis Investigative Site - Melbourne
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Recruitment hospital [5]
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Novartis Investigative Site - Prahran
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Recruitment postcode(s) [1]
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2217 - Kogarah
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Recruitment postcode(s) [2]
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3084 - Heidelberg
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Recruitment postcode(s) [3]
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3144 - Malvern
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Recruitment postcode(s) [4]
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3050 - Melbourne
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Recruitment postcode(s) [5]
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3181 - Prahran
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Recruitment outside Australia
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Blackburn
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Blandford Forum, Dorset
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Christchurch, Dorset
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Newcastle
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Oxford
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Peterborough
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Southampton
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Vale of Glamorgan
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Novartis
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to provide long-term safety data for rivastigmine capsule and
transdermal patch treatments, in particular the effect of rivastigmine on worsening of the
underlying motor symptoms of Parkinson's Disease (PD), in patients with mild to moderately
severe dementia associated with PD.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT00623103
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Public notes
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Contacts
Principal investigator
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Novartis Pharmaceuticals
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Novartis Pharmaceuticals
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Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT00623103
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