Parallel-Group Study to Assess the Effect of Rasagiline on Cognition in Patients With Parkinson’s Disease

Overview

This is a 24-week, multicenter, randomized, double-blind, placebo-controlled, add-on, parallel-group study to evaluate the effect of rasagiline on cognitive function in adults with mild cognitive impairment (MCI) in Parkinson's disease (PD-MCI).

Full Title of Study: “A 24-Week, Multicenter, Randomized, Double-blind, Placebo-Controlled, Add-on, Parallel-Group Study to Assess the Effect of Rasagiline on Cognition in Patients With Parkinson’s Disease”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Participant, Investigator)
  • Study Primary Completion Date: January 2015

Interventions

  • Drug: Rasagiline
  • Drug: Placebo

Arms, Groups and Cohorts

  • Experimental: Rasagiline 1.0 mg/day
    • Rasagiline 1 mg oral tablets once daily for 24 weeks
  • Placebo Comparator: Placebo
    • Placebo oral tablets once daily for 24 weeks

Clinical Trial Outcome Measures

Primary Measures

  • Mean Change From Baseline to Week 24 in the Scales for Outcomes in Parkinson’s Disease-Cognition (SCOPA-COG) Summary Score
    • Time Frame: Baseline to Week 24 (or early discontinuation)
    • The SCOPA-COG consists of evaluations in 4 domains: memory, attention, executive functioning, and visuospatial functioning.Scores range from 0 to 43, with higher scores reflecting better performance.

Secondary Measures

  • Change From Baseline to Week 24 in the Montreal Cognitive Assessment (MoCA) Score
    • Time Frame: Baseline to Week 24 (or early discontinuation)
    • The MoCA assesses 8 cognitive areas: visuospatial/executive, naming, memory, attention, language, abstraction, delayed recall, and orientation. Scores range from 0 (worst) to 30 (best).
  • Change From Baseline to Week 24 in the Penn Daily Activities Questionnaire (PDAQ) Score
    • Time Frame: Baseline to Week 24 (or early discontinuation)
    • The PDAQ is a 15-item questionnaire that assesses the patient’s difficulty with activities of daily living. The total score has a range of 0 (no impairment) to 60 (severe impairment).
  • Alzheimer’s Disease Cooperative Study’s Clinical Global Impression of Change Modified for Mild Cognitive Impairment (ADCS MCI-CGIC) Score at Week 24
    • Time Frame: Week 24 (or early discontinuation)
    • The ADCS MCI-CGIC score is generated in the context of a semi-structured interview and is an indication of the change in the participant’s global status, cognition, behavior, and functional abilities (FA) on a 7-point scale, with the best score being ‘marked improvement’ and the worst being ‘marked worsening.’
  • Change From Baseline to Week 24 in the Unified Parkinson’s Disease Rating Scale (UPDRS), Motor Subscale (Part 3), Version 3, Score
    • Time Frame: Baseline to Week 24 (or early discontinuation)
    • UPDRS Part 3 (motor examination subscale) comprises 14 items assessing the motor disabilities of the patient at the time of the visit. The participant’s speech, facial expressions, ability to arise from a chair (with arms folded), posture, gait, postural stability (retropulsion test), and body bradykinesia and hypokinesia are assessed. In addition, the following evaluations require assessment of the face, neck or extremities: tremor at rest, action or postural tremor of hands, rigidity, finger taps, hand movements (open and close), rapid alternating movements of hands (pronation and supination), and leg agility (tap heel on ground). This evaluation is performed while the participant is in the ‘on’ phase. Each item is assessed on a scale from 0 (normal, absent, or none) to 4 (severe impairment), which are summed to get the sub-scale score. The total scale is 0-57 with a higher score indicating more severe symptoms; a decrease in the scores indicates improvement.
  • Change From Baseline to Week 24 in UPDRS, Activities of Daily Living (ADL) Subscale (Part 2), Version 3, Score
    • Time Frame: Baseline to week 24 (or early discontinuation)
    • UPDRS Part 2 (ADL subscale) comprises 13 items evaluating the impact of PD on patients’ ADL (in both the on and off states) in the week prior to the visit. The following 13 ADL are assessed: speech, salivation, swallowing, handwriting, cutting food and handling utensils, dressing, hygiene, turning in bed and adjusting bed clothes, falling (unrelated to freezing), freezing when walking, walking, tremor, and sensory complaints related to Parkinsonism. Each item is assessed on a scale from 0 (normal, absent, or none) to 4 (severe impairment), which are summed to get the sub-scale score. The total scale is 0-52 with a higher score indicating more severe symptoms; a decrease in the scores indicates improvement.

Participating in This Clinical Trial

Inclusion Criteria

1. Nondemented man or woman 45 through 80 years of age with idiopathic Parkinson's disease (PD) based on the United Kingdom (UK) Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria 2. Hoehn and Yahr stage ≥ 1 (symptoms on only 1 side of the body) with treatment and ≤ 3 (mild-to-moderate bilateral disease; some postural instability; physically independent) 3. Mild cognitive impairment in Parkinson's disease based on the Movement Disorder Society (MDS) Task Force Diagnostic Criteria and the Montreal Cognitive Assessment (MoCA) rating scale (range, 20-25, inclusive) 4. Medically stable outpatient, based on the investigator's judgment 5. The patient is on a stable dopaminergic medication regimen for ≥ 30 days before entering the study (Screening/Baseline Visit) 6. Other inclusion criteria apply; please contact the site for more information Exclusion Criteria:

1. Clinically relevant history of vascular disease (eg, stroke) 2. History of melanoma 3. History of deep brain stimulation (DBS) 4. Impaired hepatic function, based on the investigator's judgment 5. Psychosis or is receiving antipsychotic treatment 6. Clinically significant or unstable medical or surgical condition that may preclude safe and complete study participation, based on the investigator's judgment 7. Other exclusion criteria apply; please contact the site for more information

Gender Eligibility: All

Minimum Age: 45 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Teva Branded Pharmaceutical Products R&D, Inc.
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Teva Medical Expert, Study Director, Teva Branded Pharmaceutical Products R&D, Inc.

References

Hanagasi HA, Gurvit H, Unsalan P, Horozoglu H, Tuncer N, Feyzioglu A, Gunal DI, Yener GG, Cakmur R, Sahin HA, Emre M. The effects of rasagiline on cognitive deficits in Parkinson's disease patients without dementia: a randomized, double-blind, placebo-controlled, multicenter study. Mov Disord. 2011 Aug 15;26(10):1851-8. doi: 10.1002/mds.23738. Epub 2011 Apr 15.

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