Parkinson DiseasePhase 1/2NCT03295786
Clinical Study to Test the Safety of CDNF by Brain Infusion in Patients With Parkinson's Disease
A Phase 1/2 study testing Cerebral Dopamine Neurotrophic Factor and Renishaw Drug Delivery System in people with Parkinson Disease and Movement Disorders, run by Herantis Pharma Plc. at 3 sites in 2 countries.
Trial summary
This study evaluates the safety and tolerability of CDNF in patients with Parkinson's disease, when dosed directly into the brain using an implanted investigational drug delivery system (DDS). Safety and accuracy of the DDS is also being evaluated. Read more about this study
- Who is it for?
- Ages 35 to 75 years
- Conditions the study is for
- Parkinson Disease, Movement Disorders, Neurodegenerative Diseases
- What is being tested?
- Cerebral Dopamine Neurotrophic Factor and Renishaw Drug Delivery System
- Type of treatment
- Injection or infusion, Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 17 participants
- Where
- 3 sitesin 2 countries
- Study dates
- 26 Sep 2017to 19 Dec 2019
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 35 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Idiopathic Parkinson's disease based on UK brain bank criteria
- Duration of PD motor symptoms 5-15 years (inclusive)
- Age 35-75 years (inclusive)
- Presence of motor fluctuations.
- At least 5 daily doses of levodopa
- Ability to reliably distinguish motor states and accurately complete fluctuation diaries
Show all 11Show fewer
- UPDRS motor score (part III) in a practically defined OFF-state between 25-50 (inclusive)
- Hoehn and Yahr ≤ stage III in the OFF-state
- Responsiveness to levodopa
- No change in anti-parkinsonian medication for 6 weeks before screening
- Provision of Informed Consent
Who cannot join
- Diagnosed with atypical parkinsonism or any known secondary parkinsonian syndrome.
- Signs or symptoms suggestive of atypical parkinsonian syndrome.
- Drug-resistant rest tremor.
- Prior neurosurgical treatment for PD, including lesioning or deep brain stimulation
- Significant neurological disorder other than PD including clinically significant head trauma, cerebrovascular disease, epilepsia, CSF shunt or other implanted CNS device
- Presence of significant depression as defined as a BDI score ≥ 20
Show all 18Show fewer
- Current psychosis requiring therapy.
- Presence of clinically significant impulse control disorder ((QUIP-RS) score > 20), or, presence of dopamine dysregulation syndrome.
- MoCA score < 24.
- Use within 3 months of planned catheter insertion of concomitant medications known to affect PD symptoms other than prescribed PD therapy.
- Any medical condition, which might impair outcome measure assessments or safety measures including ability to undergo MRI or DAT-PET.
- Hypersensitivity or allergy to gadolinium or to any of excipients of macrocyclic GBCA used for the surgical planning MRI.
- Screening and/or planning MRI demonstrating any abnormality, which would suggest an alternative cause for patient's parkinsonism or preclude neurosurgery.
- Any medical condition that would put the patient at undue risk from surgical treatment or chronic implants including but not limited to bleeding disorders, chronic infections, or immunosuppressive illness
- History within the last 5 years of cancer with the exception of basal cell carcinoma of the skin
- History of drug or alcohol abuse within 2 years of screening
- Use of any investigational drug or device within 90 days of screening
- Active breastfeeding
Trial locations and contacts
3 sites in 2 countries.
3 sites in 2 countries
Sweden2 sites
Skåne University Hospital
Lund, 221 85
Karolinska University Hospital, Huddinge
Stockholm, 141 86
About this study
Official title: Phase 1-2, Randomised, Double-Blind, Placebo Controlled, Safety and Tolerability Study of Intraputamenal Cerebral Dopamine Neurotrophic Factor (CDNF) Infusions Via an Investigational Drug Delivery System to Patients With Parkinson's Disease
This study evaluates the safety and tolerability of CDNF in patients with Parkinson's disease, when dosed directly into the brain using an implanted investigational drug delivery system (DDS). Safety and accuracy of the DDS is also being evaluated. One-third of the patients will receive monthly infusions with placebo and two-third of the patients will receive monthly infusions with either mid- or high-doses of CDNF for a period of 6 months.
Read the detailed description
A patient's participation in the study will last for ten months and will include sixteen to seventeen visits:
- Screening (2 visits)
- Planning of surgery - Surgery: implantation of drug delivery system - Post-surgery follow-up (3 visits)
- Test infusions with vehicle (1-2 visits)
- Positron emission tomography (PET) examinations before the first and after the last dose (2 visits)
- Baseline and randomisation to CDNF or placebo group (1 visit)
- Dosing visits: CDNF or placebo (6 visits)
- End-of-study visit (1 visit)
Study examinations and assessments
- Physical examination: pulse rate, blood pressure, temperature, body weight and height
- ECG (electrocardiography) and blood and urine tests
- HIV, hepatitis B and C blood tests (on first visit)
- Pregnancy tests for women of childbearing age
- Completion of a patient diary to record mobility and time asleep
- Parkinson's Kinetigraph (PKGTM) Data Logger: a watch-type device worn on the wrist for certain periods during the study to record movements
- Questionnaires, rating scales and forms: quality of life, mood, memory, impulse control, mental health
- Assessment of the port and the skin around the port
- Cerebrospinal fluid sampling by lumbar puncture
- Magnetic resonance imaging (MRI)
- Positron emission tomography scans (PET)
- Computed tomography (CT)
For more information: https://treater.eu/clinical-study/
- Conditions
- Parkinson Disease, Movement Disorders, Neurodegenerative Diseases, Nervous System Diseases, Brain Diseases
- Being tested
- Cerebral Dopamine Neurotrophic Factor, Renishaw Drug Delivery System
- Keywords
- Parkinson, CDNF, Drug Delivery System, Intracerebral
- Medical subject headings
- Parkinson Disease, Movement Disorders, Neurodegenerative Diseases, Nervous System Diseases, Brain Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cerebral Dopamine Neurotrophic FactorDrug
Also called CDNF
Repeated intracerebral infusions
Renishaw Drug Delivery SystemDevice
Also called DDS
Stereotactically implanted device
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Patients randomized to this group will receive 6 monthly infusions of placebo/vehicle Receives: Drug: Cerebral Dopamine Neurotrophic Factor; Device: Renishaw Drug Delivery System |
| CDNF mid-dose | Experimental | Patients randomized to this group will receive 6 doses of CDNF titrated to mid-dose Receives: Drug: Cerebral Dopamine Neurotrophic Factor; Device: Renishaw Drug Delivery System |
| CDNF high-dose | Experimental | Patients randomized to this group will receive 6 doses of CDNF titrated to high-dose Receives: Drug: Cerebral Dopamine Neurotrophic Factor; Device: Renishaw Drug Delivery System |
What is being measured
The primary outcome is the main question the study is designed to answer.
Adverse events (AEs)
Number and severity of adverse events
Measured: Week 15 to Week 40
Electrocardiogram (ECG)
Changes in electrical activity of heartbeat measured by electrocardiogram
Measured: Week 15 to Week 40
Beck Depression Inventory (BDI) score
Assessment of change in depression using Beck Depression Inventory (BDI) score
Measured: Week 15 to Week 40
Questionnaire for impulsive-compulsive disorder in Parkinson's disease rating scale (QUIP_RS)
Assessment of changes in impulsive-compulsive disorders using QUIP_RS
Measured: Week 15 to Week 40
Montreal cognitive assessment (MoCA)
Assessment of change in cognitive domains using MoCA test
Measured: Week 15 to Week 40
Physical examination
Changes in anatomic findings found in physical examination
Measured: Week 15 to Week 40
Vital signs
Changes in vital signs
Measured: Week 15 to Week 40
Clinical laboratory safety screen
Changes in clinical laboratory variables (chemistry, haematology, urinanalysis)
Measured: Week 15 to Week 40
Formation of anti-CDNF antibodies
Change in anti-CDNF antibody concentration
Measured: Week 15 to Week 40
Device related changes in safety measures
Occurrence of adverse device effects (ADE), for either the whole system or the individual sub systems (guide tubes/catheters, subcutaneous components, port), serious adverse device effect (SADE) including long term effects, neurological deficit (seizures), infection (local to components, in CNS), severe skin breakdown or necrosis requiring component removal life threatening or major (requiring intervention) intracerebral haemorrhage.
Measured: Week 8 to Week 40
Device related accuracy of implantation
The accuracy of implantation of the Drug Delivery System (DDS) will be measured comparing the tip of each individual catheters defined in the plan of the surgical procedure with the position of those measured by the post-operative CT scan.
Measured: Week 8
Secondary outcomes (8)
UPDRS (Unified Parkinson's Disease Rating Scale) Part III motor score
Changes in severity of PD (Parkinson's disease) motor symptoms assessed by UPDRS Part III motor scores
Measured: Week 15 to Week 40
TUG (Timed Up and Go) test
Changes in mobility assessed by TUG test
Measured: Week 15 to Week 40
UPDRS Total score (Part I-IV)
Change in severity of PD non-motor and motor symptoms assessed by UPDRS Part I-IV total scores (Parts I, II and IV in ON-state; Part III in OFF-state).
Measured: Week 15 to Week 40
Home diary score
Change in functional status assessed by home diary score
Measured: Week 16 to Week 24
PDQ-39 (Parkinson's Disease Questionnaire) score
Changes in health and daily activity assessed by PDQ-39 questionnaire score
Measured: Week 15 to Week 40
change in CGI (Clinical Global Impressions) scale
- Change from baseline until end of treatment evaluation in mental status as measured by CGI scale.
Measured: Week 16 to Week 40
Occurrence of blockage
Occurrence of blockage of implanted catheter preventing or limiting infusion assessed by measuring catheter pressure
Measured: Week 11 to Week 36
Cessation of infusions
Cessation of infusions in an individual patient
Measured: Week 11 to Week 36
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Sep 2017
- Study start26 Sep 2017
- Primary completion19 Dec 2019
- Study completion19 Dec 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Parkinson DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomised, Double-Blind, Placebo Controlled
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 17 participants (actual)
Sponsor and investigators
- Lead sponsor
- Herantis Pharma Plc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Renishaw plc.
- Responsible party
- Sponsor
- Investigators
- Per Svenningsson, MD, Principal investigator, Karolinska University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03295786
- Sponsor's protocol ID
- HP-CD-CL-2002
- Other IDs
- 2015-004175-73, 2015
- Status last verified
- Jan 2020
- First submitted
- 14 Sep 2017
- Last updated
- 13 Jan 2020
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Singh A, Panhelainen A, Reunanen S, Luk KC, Voutilainen MH. Combining fibril-induced alpha-synuclein aggregation and 6-hydroxydopamine in a mouse model of Parkinson's disease and the effect of cerebral dopamine neurotrophic factor on the induced neurodegeneration. Eur J Neurosci. 2024 Jan;59(1):132-153. doi: 10.1111/ejn.16196. Epub 2023 Dec 10.
PubMed 38072889
Study at a glance
From the registry record, last updated by the sponsor on 13 Jan 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase 1-2, Randomised, Double-Blind, Placebo Controlled, Safety and Tolerability Study of Intraputamenal Cerebral Dopamine Neurotrophic Factor (CDNF) Infusions Via an Investigational Drug Delivery System to Patients With Parkinson's Disease
- ClinicalTrials.gov ID
- NCT03295786
- Acronym / sponsor ID
- HP-CD-CL-2002
- Conditions
- Parkinson Disease, Movement Disorders, Neurodegenerative Diseases, Nervous System Diseases, Brain Diseases
- Keywords
- Parkinson, CDNF, Drug Delivery System, Intracerebral
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 17 participants (actual)
- Lead sponsor
- Herantis Pharma Plc.Industry (pharma, biotech, devices)
- Collaborators
- Renishaw plc.
- Study start
- 26 Sep 2017 (actual)
- Primary completion
- 19 Dec 2019 (actual)
- Study completion
- 19 Dec 2019 (actual)
- First posted
- 28 Sep 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluates the safety and tolerability of CDNF in patients with Parkinson's disease, when dosed directly into the brain using an implanted investigational drug delivery system (DDS). Safety and accuracy of the DDS is also being evaluated. One-third of the patients will receive monthly infusions with placebo and two-third of the patients will receive monthly infusions with either mid- or high-doses of CDNF for a period of 6 months.
Detailed description
A patient's participation in the study will last for ten months and will include sixteen to seventeen visits:
- Screening (2 visits)
- Planning of surgery - Surgery: implantation of drug delivery system - Post-surgery follow-up (3 visits)
- Test infusions with vehicle (1-2 visits)
- Positron emission tomography (PET) examinations before the first and after the last dose (2 visits)
- Baseline and randomisation to CDNF or placebo group (1 visit)
- Dosing visits: CDNF or placebo (6 visits)
- End-of-study visit (1 visit)
Study examinations and assessments
- Physical examination: pulse rate, blood pressure, temperature, body weight and height
- ECG (electrocardiography) and blood and urine tests
- HIV, hepatitis B and C blood tests (on first visit)
- Pregnancy tests for women of childbearing age
- Completion of a patient diary to record mobility and time asleep
- Parkinson's Kinetigraph (PKGTM) Data Logger: a watch-type device worn on the wrist for certain periods during the study to record movements
- Questionnaires, rating scales and forms: quality of life, mood, memory, impulse control, mental health
- Assessment of the port and the skin around the port
- Cerebrospinal fluid sampling by lumbar puncture
- Magnetic resonance imaging (MRI)
- Positron emission tomography scans (PET)
- Computed tomography (CT)
For more information: https://treater.eu/clinical-study/
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
- Model description
- Randomised, Double-Blind, Placebo Controlled
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: Cerebral Dopamine Neurotrophic Factor, Device: Renishaw Drug Delivery SystemPatients randomized to this group will receive 6 monthly infusions of placebo/vehicle |
| CDNF mid-dose | Experimental | Drug: Cerebral Dopamine Neurotrophic Factor, Device: Renishaw Drug Delivery SystemPatients randomized to this group will receive 6 doses of CDNF titrated to mid-dose |
| CDNF high-dose | Experimental | Drug: Cerebral Dopamine Neurotrophic Factor, Device: Renishaw Drug Delivery SystemPatients randomized to this group will receive 6 doses of CDNF titrated to high-dose |
Who may qualify
- Ages
- 35 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Idiopathic Parkinson's disease based on UK brain bank criteria
- Duration of PD motor symptoms 5-15 years (inclusive)
- Age 35-75 years (inclusive)
- Presence of motor fluctuations.
- At least 5 daily doses of levodopa
Key exclusion criteria (18 listed)
- Diagnosed with atypical parkinsonism or any known secondary parkinsonian syndrome.
- Signs or symptoms suggestive of atypical parkinsonian syndrome.
- Drug-resistant rest tremor.
- Prior neurosurgical treatment for PD, including lesioning or deep brain stimulation
- Significant neurological disorder other than PD including clinically significant head trauma, cerebrovascular disease, epilepsia, CSF shunt or other implanted CNS device
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Cerebral Dopamine Neurotrophic FactorAlso: CDNFRepeated intracerebral infusions | Drug | CDNF high-dose, CDNF mid-dose, Placebo |
| Renishaw Drug Delivery SystemAlso: DDSStereotactically implanted device | Device | CDNF high-dose, CDNF mid-dose, Placebo |
Primary outcome
Adverse events (AEs)
Time frame: Week 15 to Week 40
Number and severity of adverse events
Electrocardiogram (ECG)
Time frame: Week 15 to Week 40
Changes in electrical activity of heartbeat measured by electrocardiogram
Beck Depression Inventory (BDI) score
Time frame: Week 15 to Week 40
Assessment of change in depression using Beck Depression Inventory (BDI) score
Questionnaire for impulsive-compulsive disorder in Parkinson's disease rating scale (QUIP_RS)
Time frame: Week 15 to Week 40
Assessment of changes in impulsive-compulsive disorders using QUIP_RS
Montreal cognitive assessment (MoCA)
Time frame: Week 15 to Week 40
Assessment of change in cognitive domains using MoCA test
Physical examination
Time frame: Week 15 to Week 40
Changes in anatomic findings found in physical examination
Vital signs
Time frame: Week 15 to Week 40
Changes in vital signs
Clinical laboratory safety screen
Time frame: Week 15 to Week 40
Changes in clinical laboratory variables (chemistry, haematology, urinanalysis)
Formation of anti-CDNF antibodies
Time frame: Week 15 to Week 40
Change in anti-CDNF antibody concentration
Device related changes in safety measures
Time frame: Week 8 to Week 40
Occurrence of adverse device effects (ADE), for either the whole system or the individual sub systems (guide tubes/catheters, subcutaneous components, port), serious adverse device effect (SADE) including long term effects, neurological deficit (seizures), infection (local to components, in CNS), severe skin breakdown or necrosis requiring component removal life threatening or major (requiring intervention) intracerebral haemorrhage.
Device related accuracy of implantation
Time frame: Week 8
The accuracy of implantation of the Drug Delivery System (DDS) will be measured comparing the tip of each individual catheters defined in the plan of the surgical procedure with the position of those measured by the post-operative CT scan.
8 secondary outcomes
UPDRS (Unified Parkinson's Disease Rating Scale) Part III motor score
Time frame: Week 15 to Week 40
TUG (Timed Up and Go) test
Time frame: Week 15 to Week 40
UPDRS Total score (Part I-IV)
Time frame: Week 15 to Week 40
Home diary score
Time frame: Week 16 to Week 24
PDQ-39 (Parkinson's Disease Questionnaire) score
Time frame: Week 15 to Week 40
change in CGI (Clinical Global Impressions) scale
Time frame: Week 16 to Week 40
Occurrence of blockage
Time frame: Week 11 to Week 36
Cessation of infusions
Time frame: Week 11 to Week 36
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jan 2020.
- Derived from this study: PubMed 38072889Singh A, Panhelainen A, Reunanen S, Luk KC, Voutilainen MH. Combining fibril-induced alpha-synuclein aggregation and 6-hydroxydopamine in a mouse model of Parkinson's disease and the effect of cerebral dopamine neurotrophic factor on the induced neurodegeneration. Eur J Neurosci. 2024 Jan;59(1):132-153. doi: 10.1111/ejn.16196. Epub 2023 Dec 10.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Per Svenningsson, MD principal investigator
Karolinska University Hospital
3 sites in 2 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Cerebral Dopamine Neurotrophic Factor and Renishaw Drug Delivery System in people with Parkinson Disease and Movement Disorders, run by Herantis Pharma Plc. at 3 sites in 2 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Sweden, Finland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Adverse events (AEs) (time frame: Week 15 to Week 40). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03295786, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2020.