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Phase 3 N=233 Randomized Double-blind Treatment

IncobotulinumtoxinA (Xeomin) Versus Placebo in the Treatment of Cervical Dystonia

Cervical Dystonia

Enrolled (actual)
233
Serious AEs
1.7%
Results posted
Dec 2010
Primary outcome: Primary: Change From Baseline in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) -Total Score at Week 4 After Injection of the Main Period - Xeomin (240 Units) Versus Placebo — -7.3; 1.6 points on a scale — p=<0.001

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
incobotulinumtoxinA (Xeomin) (240 Units) (Drug); incobotulinumtoxinA (Xeomin) (120 Units) (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Merz Pharmaceuticals GmbH
Primary completion
Jan 2008

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) -Total Score at Week 4 After Injection of the Main Period - Xeomin (240 Units) Versus Placebo
-7.3; 1.6 <0.001 sig
PRIMARY
Change From Baseline in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) -Total Score at Week 4 After Injection of the Main Period - Xeomin (120 Units) Versus Placebo
-10.8; -3.3 <0.001 sig
PRIMARY
Change From Baseline in the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) -Total Score at Week 4 After Injection of the Main Period - Xeomin (240 Units) Versus Xeomin (120 Units)
-10.5; -9.2 0.447
SECONDARY
Change From Baseline in the TWSTRS-Total Score
-8.2; -6.9; 0.4; -4.6; -3.6; 1.7
SECONDARY
Change From Baseline in the TWSTRS Disability Subscore
-3.0; -3.3; 0.0; -2.4; -2.1; 0.8
SECONDARY
Change From Baseline in the TWSTRS Severity Subscore
-5.5; -3.9; -1.9; -3.5; -3.1; -0.9
SECONDARY
Change From Baseline in the TWSTRS Pain Subscore
-2.4; -2.7; -0.3; -2.3; -1.8; 0.6
SECONDARY
Patient Evaluation of Global Response (PEGR) at Final Visit
1.3; 1.3; -0.2

Summary

At baseline patients received incobotulinumtoxinA (Xeomin) or placebo. Thereafter, all patients who entered the extension period were treated with up to five injection sessions of incobotulinumtoxinA (Xeomin) during the extension period.

Eligibility Criteria

Main Inclusion Criteria:

  • Male or female outpatients between ages 18 and 75 years inclusive)
  • A clinical diagnosis of cervical dystonia (i.e. spasmodic torticollis) with predominantly rotational form and a need for injection (determined by the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) -Total score)
  • TWSTRS-Total score >= 20
  • TWSTRS-Severity score >= 10
  • TWSTRS-Disability score >= 3
  • TWSTRS-Pain score >= 1
  • On a stable dose of medications (if any) used for focal dystonia treatment (e.g. anticholinergics and benzodiazepines) for at least 3 months prior to and expected throughout the Main Period
  • For pre-treated patients only: Source documentation of the last two consecutive injection sessions with Botulinum Toxin and stable therapeutic response directly prior to trial entry
  • For pre-treated patients only: At least 10 weeks must have been passed between the last injection with Botulinum Toxin for cervical dystonia and baseline
  • For pre-treated patients only: The most recent injection with Botulinum Toxin must have been maximal 300 Units of type A or 12,000 Units of type B

Main Exclusion Criteria:

  • Traumatic torticollis or tardive torticollis
  • TWSTRS-Severity score for anterocollis >= 2 points (pure anterocollis)
  • TWSTRS-Severity score for retrocollis >= 2 points (pure retrocollis)
  • Myotomy or denervation surgery in the affected muscles (e.g. peripheral denervation and/or spinal cord stimulation)
  • Hypersensitivity to human serum albumin, sucrose, or Botulinum Toxin Type A
  • Diagnosis of myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis, or any other significant neuromuscular disease which might interfere with the trial
  • Current swallowing disorder of any origin (dysphagia scale >= 3, i.e. severe, with swallowing difficulties and requiring a change in diet)
  • Marked limitation on passive range of motion that suggests contractures or other structural abnormality, e.g. cervical contractures or cervical spine syndrome
  • Treatment with Botulinum Toxins for any indication other than cervical dystonia within 4 months prior to baseline and during the trial
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00407030). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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