Phase 4
N=71
Effect of Safinamide on Parkinson's Disease Related Chronic Pain
Idiopathic Parkinson Disease
Bottom Line
View on ClinicalTrials.gov: NCT03841604 ↗Enrolled (actual)
71
Serious AEs
2.8%
Results posted
May 2023
Primary outcome: Primary: Change From Baseline to Week 16 in Pain Severity (NRS-11 Scale) - Full Analysis Set — -1.6; -0.8 score on a scale — p=0.1695
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- Safinamide Methanesulfonate (Drug); Safinamide methanesulfonate matching placebo (Other)
- Age
- Adult, Older Adult · 30+ yrs
- Sex
- All
- Sponsor
- Zambon SpA
- Primary completion
- Apr 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline to Week 16 in Pain Severity (NRS-11 Scale) - Full Analysis Set |
-1.6; -0.8 | 0.1695 |
| PRIMARY Change From Baseline to Week 16 in Pain Severity (NRS-11 Scale) - Per Protocol Set |
-1.6; -0.8 | 0.0784 |
| SECONDARY Number of Subjects With a Reduction of ≥2 Points in Pain Severity at Week 16, Compared to Baseline |
15; 3 | 0.0744 |
| SECONDARY The Change From Baseline to Week 16 in the Clinical Global Impression of Change (CGI-C) Score for Pain |
3.4; 3.5 | 0.7247 |
| SECONDARY The Global Impression of Severity (CGI-S) Score for Pain at Week 16 |
3.8; 3.8; 3.4; 3.5 | 0.9052 |
| SECONDARY The Change From Baseline to Week 16 in the Patient Global Impression of Change (PGI-C) Score for Pain |
2.7; 2.5 | 0.7115 |
| SECONDARY Number of Subjects With Concomitant Use of Pain Drugs at Different Timepoints |
0; 0; 0; 1; 0; 0 | 0.1967 |
| SECONDARY Amount of PRN PD Pain Medication: Count of Subjects Who Used PRN PD Pain Medication in the 7 Days Preceding Visits |
12; 7; 8; 5; 5; 4 | 0.5122 |
| SECONDARY Amount of PRN PD Pain Medication: Number of Days on Which PRN PD Pain Medication Was Taken at Different Timepoints |
3.2; 4.1; 4.8; 4.3; 6.0; 4.5 | — |
| SECONDARY Change From Baseline to Week 16 in the Hospital Anxiety and Depression Scale (HADS) Score |
-1.5; -2.0 | 0.7376 |
| SECONDARY The Change From Baseline to Week 16 in MDS-UPDRS |
-6.8; -4.8 | 0.5349 |
Summary
Primary objective:
• To evaluate the potential efficacy of safinamide 100 mg once daily (OD), compared with placebo, as add-on therapy for PD-related chronic pain
Secondary objectives:
* Percentage of pain responders
* Clinical Global Impression for pain
* Patient Global Impression for pain
* Reduction in use of pain drugs
* Mood
* Motor and non-motor symptoms
Safety Objectives:
• Safety and tolerability
Eligibility Criteria
Inclusion Criteria
- Participant must be 30 years of age or older, at the time of signing the informed consent.
- Diagnosed with IPD by using the United Kingdom Parkinson's Disease Society Brain Bank criteria for more than 5 years duration.
- Receiving treatment with a stable dose of oral L-Dopa (including controlled release [CR], immediate release [IR] or a combination of CR/IR), with and without benserazide/carbidopa, with or without addition of a catechol O-methyltransferase (COMT) inhibitor and may be receiving concomitant treatment with stable doses of a dopamine agonist, an anticholinergic and/or amantadine for at least 4 weeks prior to the randomisation (baseline visit).
- Hoehn and Yahr stage between 2-3 (inclusive) during the "ON" phase at the screening visit.
- Experiencing motor fluctuations following optimum titration of treatment medications and within the 4 weeks immediately prior to randomisation.
- Experiencing chronic pain (i.e. ongoing for ≥3 months prior to screening visit); the Investigator must consider chronic pain directly related to PD and not explained by any other health problem (e.g. peripheral neuropathy, organ disease or arthritis pain) OR consider the intensity of chronic pain specifically aggravated by PD.
- If taking regular analgesics, the treatment regimen should be stable in the 4 weeks prior to the randomisation visit.
- Able to maintain an accurate and complete electronic diary with the help of a caregiver.
- Male or female
•A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: i.Not a woman of childbearing potential (WOCBP) OR ii.A WOCBP who agrees to follow the contraceptive guidance
- Capable of giving signed informed consent
Exclusion Criteria
- Any form of Parkinsonism other than IPD.
- Diagnosis of chronic migraine (>15 days per month) or cancer pain.
- History of bipolar disorder, depression, schizophrenia or other psychotic disorder requiring treatment with neuroleptics.
- History of dementia or cognitive dysfunction.
- Severe, peak dose or biphasic dyskinesia.
- Unpredictable or widely swinging fluctuations.
- Ophthalmologic history including any of the following conditions: albinism, uveitis, retinitis pigmentosa, retinal degeneration, active retinopathy, severe progressive diabetic retinopathy, inherited retinopathy or family history of hereditary retinal disease.
- Moderate or severe liver failure using the Child-Pugh classification score.
- History of drug and/or alcohol abuse within 12 months prior to screening as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders.
- Allergy/sensitivity, intolerance or contraindications to Safinamide.
- Treatment with monoamine oxidase inhibitors (MAOIs), levodopa infusion, pethidine, fluoxetine, fluvoxamine less than 4 weeks prior to the randomisation visit
- Use of any investigational drug or device within 30 days prior to screening or 5 half-lives, whichever is the longest
- Previous treatment with Safinamide in the 9 months before the screening visit
- Mini-Mental State Exam (MMSE) total score <24 at screening.
- NRS score ≤ 4 points at randomization visit.
- Any clinically significant condition which, in the opinion of the Investigator, would not be compatible with study participation or represent a risk for participants while in the study
Data sourced from ClinicalTrials.gov (NCT03841604). 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.