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Completed

NCT Number: NCT02448914

A Study to Compare Plasma Levels of Levodopa, Carbidopa and Entacapone After TRIGEL or Duodopa Infusion in PD Patients

This study evaluates the continuous addition of entacapone to infused levodopa and carbidopa on the pharmacokinetic (PK) profile in patients with advanced Parkinson's disease (PD). All patients will receive both study drugs, i.e. TRIGEL (levodopa, carbidopa, and entacapone) and Duodopa (levodopa and carbidopa), in randomized order.

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Key information

Age range

30 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Clinical Trial Consultants AB

Uppsala, SE-75185, Sweden

About this study

Intestinal infusion of Duodopa (levodopa and carbidopa) provides faster absorption, comparable levodopa bioavailability and significantly reduced intra-patient variability in levodopa concentrations relative to oral administration. TRIGEL also contains a third ingredient, entacapone. In tablet form, entacapone is shown to improve the bioavailability of levodopa and might extend the half-life of levodopa, avoiding deep troughs in levodopa plasma levels, and providing more continuous delivery of levodopa to the brain.

The intention with the study is to confirm that TRIGEL administration increases the area under the curve (AUC) for levodopa by combining levodopa, carbidopa, and entacapone and thereby lower the daily levodopa dose needed. It is expected that TRIGEL administration will result in a similar intra-patient variability in plasma levodopa concentrations as Duodopa during continuous administration.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Willing and able to provide informed consent and judged by the Investigator to have decision-making capacity
  • Advanced levodopa-responsive idiopathic PD currently treated with Duodopa infusion since minimum 30 days
  • 30 years of age or older
  • BMI between 17.0 and 31.0 kg/m2, both inclusive
  • Agreed to use adequate contraceptive measures:

Female patients who have been post-menopausal for more than one year or female patients of childbearing potential using a highly efficient method of contraception during the study (i.e. a method with less than 1% failure rate [e.g. sterilisation, hormone implants, hormone injections, some intrauterine devices, or vasectomised partner]). Oral contraceptives in combination with other contraceptives are accepted.

Male patients being vasectomised or agreeing to use condoms during the study and having a partner who is using a highly efficient method of contraception as described above.

Exclusion criteria

  • Hypersensitivity or allergy to the investigational medicinal product (IMP) or to chemically related products
  • Contraindications for the use of levodopa or carbidopa or entacapone
  • Needing a daily total dose of Duodopa during study participation exceeding 125 mL
  • Increased fluctuation in clinical PD symptoms within 7 days prior to Screening
  • Administration of an investigational drug within 3 months prior to Screening and/or current participation in another clinical study involving a pharmaceutical or a medical device class III
  • Use of any forbidden medication as specified in Section 9.6 of the protocol
  • Known hepatitis B, hepatitis C or HIV infection
  • Donation of blood or plasma or major blood loss (≥500 mL) within 3 months prior to Screening
  • Positive urine drug test (amphetamine, benzodiazepines, tetrahydrocannabinol, cocaine or opiates) at Screening
  • Known alcohol abuse
  • Unwilling to meet the requirements of the protocol
  • Other medical or social reasons for exclusion at the discretion of the Investigator

Treatment and study plan

TRIGEL

Drug

All patients will receive TRIGEL. Treatment order is determined by randomization.

Other names: Lecigon

Duodopa

Drug

All patients will receive Duodopa. Treatment order is determined by randomization.

Other names: Duopa

Primary outcomes

  1. Dose Adjusted Area Under the Curve (AUC) (0-14h) for Levodopa

    Time frame: During 14 h infusion on 2 consecutive days

Secondary outcomes

  1. Intra-individual Coefficient of Variation (3-14h) for Levodopa

    Time frame: During 3-14h infusion on 2 consecutive days

    The individual patient's coefficient of variation (CV) of levodopa plasma concentration during administration of TRIGEL and Duodopa respectively between 3 and 14 h after start of study drug. CV=100*sqrt (exp (SDlog*SDlog)-1) were SDlog denotes the standard deviation computed on logged plasma concentrations.

  2. Dose Adjusted AUC (0-14h) for Carbidopa

    Time frame: During 14 h infusion on 2 consecutive days

  3. Number of Adverse Events

    Time frame: Patients will be followed for the duration of the hospital stay, an expected average of 3 days

  4. Dose Adjusted AUC (0-14h) for 3-O-Methyldopa

    Time frame: During 14 h infusion on 2 consecutive days

Other outcomes

  1. Treatment Response Scale (ON/OFF Effect) - Mean % of Time Patients Were in Functional ON State During 3-14 h

    Time frame: TRS assessments were made every 30 minutes from start of study drug administration until 3 h, every hour between 3 and 14 h and every 30 minutes between 14 and 17 h.

    Dyskinesia and parkinsonism symptoms were evaluated throughout the study period as an assessment of the clinical response. To assess the ON/OFF effect the Treatment Response Scale (TRS) was used. The TRS ranges from -3 (severe "OFF") to +3 ("ON" with severe dyskinesia). Results from the TRS recordings are presented as the mean percentage of time patients were in functional ON state (TRS: -1 to +1) during the time interval 3-14 h.

Sponsors and collaborators

Lead sponsor

LobSor Pharmaceuticals AB

Industry

Collaborators

  • TFS Trial Form Support

Registry information

Official study title

A Single Centre, Two-period, Open Label, Randomised, Cross-over Study to Assess Plasma Levodopa, Carbidopa and Entacapone Concentrations After Continuous Infusion of TRIGEL or Duodopa in Patients With Advanced Parkinson´s Disease

Important dates

Study start
2015
Primary completion
2015
Study completion
2015
First posted
May 20, 2015
Registry last updated
May 23, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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