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Trial registered on ANZCTR
Registration number
ACTRN12614000355673
Ethics application status
Approved
Date submitted
25/03/2014
Date registered
2/04/2014
Date last updated
2/04/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Investigating the effect of Rasagiline on freezing of gait in Parkinson’s disease using accelerometry and functional MRI.
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Scientific title
Can Rasagiline alleviate symptoms of freezing of gait in patients with Parkinson's disease?
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Secondary ID [1]
284319
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Nil
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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:
Freezing of gait in Parkinson's disease
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Condition category
Condition code
Neurological
291835
291835
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0
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Parkinson's disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study is aimed to determine whether Rasagiline reduces the frequency and severity of freezing of gait (FOG) in Parkinson’s disease (PD). PD patients suffering from FOG will be randomized to either Rasagiline, 1mg once a day, orally ingested, or an oral placebo capsule for 12 consecutive weeks. After the 12 week intervention, the patients' gait variables will be evaluated and compared to their gait variables prior the treatment. To monitor adherence to treatment, participants must return their left over drug tablets at their last visit to enable pill count.
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Intervention code [1]
289038
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Treatment: Drugs
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Comparator / control treatment
Patients in the control group will receive oral placebos (capsules identical to those with medication in the intervention groups, containing glucose and lactose), once daily for 12 consecutive weeks.
All patients will continue their usual treatment.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Blinded assessment of time spend frozen during the Timed Up and Go assessment analyzed using accelerometry and video recordings at the end of the study compared to prior to treatment and to placebo.
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Assessment method [1]
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Timepoint [1]
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Assessed within the final 2 weeks of the treatment period and compared to the assessment prior to the investigation.
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Secondary outcome [1]
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Changes in the BOLD response on functional MRI at the end of the study compared to prior to treatment and to placebo.
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Assessment method [1]
307414
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Timepoint [1]
307414
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Assessed within the final 2 weeks of the treatment period and compared to the assessment prior to the investigation.
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Secondary outcome [2]
307415
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Changes in the performance on the Trail Making Test part A and B; clinician-administered tests of processing speed and flexible thinking
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Assessment method [2]
307415
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Timepoint [2]
307415
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Assessed within the final 2 weeks of the treatment period and compared to the assessment prior to the investigation.
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Eligibility
Key inclusion criteria
Patients diagnosed with PD according to the United Kingdom Brain Bank clinical criteria and confirmed by a trained neurologist.
Age over 18
Mini-Mental State Examination>/=24
Screening questionnaire criteria (FOG-Q) with a positive score on item 3.
FOG determined by the TUG prior to randomisation.
Stable medications for 1 month prior to randomisation.
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Minimum age
18
Years
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Maximum age
No limit
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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
Significant psychiatric disorder or cognitive impairment (MMSE< 24)
Current use of Rasagiline or medications that should be avoided with the concurrent use of Rasagiline, unless washout of more than four weeks.
Galactose intolerance, LAPP lactase deficiency or glucose-galactose malabsorption.
Any significant liver, kidney or autoimmune disease.
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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)
Participants will be approached via telephone based on previous medical and neuropsychological assessments at the PD Research Clinic to see if they are interested in taking part in the trial. Other participants may approach the clinic based on advertisement of the trial. Participants will then be sent out detailed information regarding the project in addition to consent forms. Participants will be allocated to groups using a blocked randomisation method conducted by a member of the clinical research team who is not in any way involved in the recruitment, assessment or training in the study.
After baseline assessments, participants will receive the tablets (either Rasagiline or placebo) prepared by a person who is not involved in the assessment or training in the study.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomized at the time of the baseline assessment using a simple randomization table created by computer software and allocated by a blinded researcher not involved in trial recruitment, data gathering, assessments or training. Randomization will occur in 1:1 ratio in random blocks. Patients will be allocated a unique ID code in sequential, ascending chronological order.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A mixed model design will be used. The trial will be analysed on an intention-to-treat basis (Placebo or 1mg Rasagiline). Drug randomisation and time will be the fixed factors. Event rates from the first week prior treatment and week 12 after treatment will be used in the mixed model analysis of variance to help characterise individual patients variability (individual patients will be random factors). For the primary test of efficacy in the model we will test whether Rasagiline causes a reduction in time spend frozen than placebo over the last 12 weeks of the treatment period. Twenty patients will be randomised in each strata to have sufficient completers in this efficacy trial assuming a dropout rate of 10% to detect a reduction in the average amount spend frozen of 30%. With 18 completers in each strata, we will have 90% power with alpha set at 5% to detect this 30% relative improvement.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/05/2014
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Actual
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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
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
288957
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Commercial sector/Industry
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Name [1]
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Lundbeck Australia
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Address [1]
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1 Innovation Road
North Ryde, Sydney,
New South Wales, 2113
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Country [1]
288957
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Simon Lewis
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Address
Brain & Mind Research Institute,
100 Mallett Street,
Camperdown, Sydney,
New South Wales, 2050
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Country
Australia
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Secondary sponsor category [1]
287636
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None
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Name [1]
287636
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Address [1]
287636
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Country [1]
287636
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Human Research Ethics Committee, University of Sydney
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Ethics committee address [1]
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Level 6 Jane Foss Russell Building G02 University of Sydney, New South Wales, 2006
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
290768
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Approval date [1]
290768
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Ethics approval number [1]
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2013/1030
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Summary
Brief summary
We will evaluate whether Rasagiline is an effective treatment to alleviate symptoms of freezing of gait (FOG) in Parkinson’s disease. 40 patients with FOG will be randomised to either Rasagiline or placebo arms. Treatment response will be assessed by video recordings and accelerometry of specific walking tasks (Timed up and Go test), taken before and after the intervention. In addition, functional brain imaging whilst patients perform a validated virtual reality gait paradigm will be used to determine the brain activation patterns associated with improvements in FOG. The use of brain imaging will also allow us to see why patients might have differential responses to therapy. Identifying the nature of these relationships will hopefully advance our understanding of freezing.
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Trial website
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Trial related presentations / publications
Chen, J. J. & Ly, A-V. Rasagiline: A second-generation monoamine oxidase type B-inhibitor for the treatment of Parkinson's disease. Am J Health-Syst Pharm. 2006; 63: 915-928. Parkinson Study Group. A controlled trial of rasagiline in early Parkinson disease: the TEMPO Study. Arch Neurol. 2002; 59:1937-43. Parkinson Study Group. A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease. Arch Neurol. 2004; 61:561-6. Rascol O, Brooks DJ, Melamed E et al. Rasagiline as an adjunct to levodopa in patients with Parkinson’s disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial. Lancet. 2005; 365:947-54. Parkinson Study Group. A randomized placebo-controlled trial of rasagiline in levodopa-treated patients with Parkinson disease and motor fluctuations. The PRESTO Study. Arch Neurol. 2005; 62:241-8. Lewis, S. J. G. & Barker, R. A. A pathophysiological model of freezing of gait in Parkinson's disease. Parkinsonism Rel Disord. 2009; 15(5): 333-8 Shine, J. M., Matar, E., Ward, P. B., et al. Exploring the cortical and subcortical functional magnetic resonance imaging changes associated with freezing in Parkinson’s disease. Brain. 2013; 136(4): 1204-1215
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Simon Lewis
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Address
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Brain & Mind Research Institute
100 Mallett Street,
Camperdown, Sydney,
New South Wales, 2050
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Country
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Australia
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Phone
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+61 2 9351 0702
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Simon Lewis
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Address
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Brain & Mind Research Institute
100 Mallett Street,
Camperdown, Sydney,
New South Wales, 2050
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Country
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Australia
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Phone
47195
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+61 2 9351 0702
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Simon Lewis
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Address
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Brain & Mind Research Institute
100 Mallett Street,
Camperdown, Sydney,
New South Wales, 2050
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Country
47196
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Australia
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Phone
47196
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+61 2 9351 0702
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Fax
47196
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Email
47196
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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