MOTION, Safinamide in Early IPD, as add-on to Dopamine Agonist



Status:Completed
Conditions:Parkinsons Disease
Therapuetic Areas:Neurology
Healthy:No
Age Range:30 - 80
Updated:10/14/2017
Start Date:November 2007
End Date:March 2012

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A Phase III, Double-blind, Placebo-controlled Randomised Trial to Determine the Efficacy and Safety of a Low (50 mg/Day) and High (100 mg/Day) Dose of Safinamide, as add-on Therapy, in Subjects With Early Idiopathic Parkinson's Disease Treated With a Stable Dose of a Single Dopamine Agonist

Parkinson's disease is a major neurodegenerative disorder in which there is a progressive
loss of nigrostriatal dopaminergic neurons. The understanding that PD is a syndrome of
dopamine (DA) deficiency led to the introduction in the clinical practice of L-dopa, a
precursor of DA that crosses the blood brain barrier, and also to the use of selective
inhibitors of MAO B, the major DA metabolising enzyme in man.

This is a double-blind, placebo-controlled, parallel-group, randomised, multi-centre, multi
national, Phase III trial, comparing two doses of safinamide (50 and 100 mg p.o. q.a.m.)
versus placebo as add-on therapy to a stable dose of a single dopamine agonist in subjects
with early idiopathic Parkinson's Disease.

The principal efficacy measure, i.e., change in mean value of UPDRS - Section III total score
from baseline to endpoint, was chosen based on regulatory guidance and prior use in other
trials in similar populations.


Inclusion Criteria:

1. Diagnosis of idiopathic Parkinson's Disease of less than 5 years duration, with a
Hoehn and Yahr stage of I-III. The diagnosis should be based on medical history and
neurological examination.

2. 30 to 80 years, inclusive, at screening.

3. If female, be either post menopausal for at least 2 years, surgically sterilised or
have undergone hysterectomy or, if of child bearing potential they must be willing to
avoid pregnancy by using an adequate method of contraception for four weeks prior to,
during and four weeks after the last dose of study medication. For the purposes of
this study, women of childbearing potential are defined as all female subjects after
puberty unless they are post-menopausal for at least two years, are surgically sterile
or are sexually inactive.

4. Receiving treatment with a single dopamine agonist at a stable dose for at least 4
weeks prior to the screening visit.

5. Willing and able to participate in the study and have provided written, informed
consent.

Exclusion Criteria:

To be eligible for inclusion in this study the subjects must not meet any of the following
criteria:

1. Any indication of forms of Parkinsonism, other than idiopathic Parkinson's Disease.

2. If female, be pregnant or lactating.

3. Current diagnosis of substance abuse or history of alcohol or drug abuse in the past 3
months.

4. Currently experiencing end of dose wearing off or on-off phenomena, disabling peak
dose or biphasic dyskinesias, or unpredictable or widely swinging fluctuations.

5. Current clinically significant gastrointestinal, renal, hepatic, endocrine, pulmonary
or cardiovascular disease, including acute gastric ulcer, hypertension that is not
well controlled, asthma, chronic obstructive pulmonary disease (COPD), and Type I
diabetes. Subjects with a history of gastric ulcer who have not had a recent episode
of acute gastritis and are not currently experiencing gastric pain will be eligible
for inclusion.

6. Second- or third-degree atrioventricular block or sick sinus syndrome, uncontrolled
atrial fibrillation, severe or unstable angina, congestive heart failure, myocardial
infarction within 3 months of the screening visit, or significant ECG abnormality,
including QTc ≥ 450 msec (males) or ≥ 470 msec (females), where QTc is based on
Bazett's correction method.

7. Have received treatment with safinamide previously.

8. Concomitant disease likely to interfere with the study medication (e.g. capable of
altering absorption, metabolism or elimination of the study drug).

9. History of, or current psychosis (e.g. schizophrenia or psychotic depression) or a
score ≥ 3 on item 2 (thought disorder) or 3 (depression) of the UPDRS, Section I at
screening.

10. Evidence of dementia or cognitive dysfunction, as indicated by a MMSE score < 24 or a
score ≥ 3 on item 1 (mentation) of the UPDRS, Section I at screening.

11. Depression, as indicated by a GRID-HAMD (17-item scale) score > 17 at screening.

12. History of allergic response to anticonvulsants or anti-Parkinsonian agents.

13. Mental or physical condition (e.g., neurotic behaviour, crippling degenerative
arthritis, or limb amputation), which would preclude performing efficacy or safety
assessments.

14. Hypersensitivity or contraindications to MAO B inhibitors.

15. Current history of severe dizziness or fainting on standing, due to postural
hypotension.

16. Neoplastic disorder, which is either currently active or has been in remission for
less than one year.

17. Participation in a clinical trial within 30 days of entry into the trial (screening
visit) or has received treatment with any investigational compound within 30 days or 5
half-lives, whichever is longer, prior to screening.

18. Treatment of their Parkinsonian symptoms with a medication, other than a stable dose
of a single dopamine agonist, during the 8 weeks preceding the screening visit.

19. Treatment with any agent known to significantly inhibit or induce drug-metabolising
enzymes (e.g., barbiturates, phenothiazines, etc.) within 4 weeks preceding the
screening visit.

20. Treatment with opioids (e.g., tramadol, meperidine derivatives), SNRIs (e.g.,
venlafaxine, duloxetine), tri- or tetra-cyclic antidepressants, MAO inhibitors (e.g.
selegiline), in the 8 weeks prior to the screening visit. Dextromethorphan will be
permitted if used for treating cough.

21. Treatment with a depot neuroleptic within one injection cycle, or oral neuroleptics
within 4 weeks prior to the screening visit.

22. Treatment with a drug that has hepatotoxic potential, e.g., tamoxifen, within 4 weeks,
or received radiation therapy or a drug with cytotoxic potential, e.g., chemotherapy,
within one year prior to the screening visit.

23. Diagnosis of HIV, or tests positive for Hepatitis C antibodies, or Hepatitis B surface
antigen.

24. Any abnormality that the investigator deems to be clinically relevant, either on
medical history, physical examination, ECG or in a diagnostic laboratory test.

25. Ophthalmologic history including any of the following conditions: albino subjects,
family history of hereditary retinal disease, progressive and/or severe diminution of
visual acuity (i.e., 20/70), retinitis pigmentosa, retinal pigmentation due to any
cause, any active retinopathy or ocular inflammation (uveitis), or diabetic
retinopathy.

26. Signs and symptoms suggestive of transmissible spongiform encephalopathy, or family
members who suffer(ed) from such.
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