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Parkinson DiseasePhase 3NMS-Nab2NCT03773796

Nabilone for Non-motor Symptoms in Parkinson's Disease

A Phase 3 study testing Nabilone 0.25 mg in people with Parkinson Disease, run by Medical University Innsbruck at 1 site in Austria.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is an open-label extension study for participants of the randomized placebo-controlled, double-blind, parallel-group, enriched enrolment randomized withdrawal NMS-Nab Study, assessing the long-term safety and efficacy of nabilone for non-motor symptoms in patients with Parkinson´s Disease (PD). Read more about this study

Who is it for?
Ages 30 to 100 years
Conditions the study is for
Parkinson Disease
What is being tested?
Nabilone 0.25 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
22 participants
Where
1 siteAustria
Study dates
6 Aug 2018to 31 Jan 2020
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 30 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • In order to be eligible for participation in the study, subjects must meet all inclusion criteria:
  • In order to be eligible for the study, patients must have completed the double-blind phase of the NMS-Nab trial as responders within the last 2 months.
  • For patients that completed NMS-Nab Study over 2 months prior to the Screening / Baseline Visit, and meet all other inclusion criteria, eligibility should be discussed on a case-by-case basis.
  • Only patients without a drug-related serious adverse event (SAE) or (drug-related) moderate or severe AE during the NMS-Nab Study can be included in the study
  • Patients must be able and willing to provide written informed consent prior to any study related procedure being performed. Patients with a legal guardian should be consented according to local requirements.
  • Patients must be willing and able to take oral medication and able to comply with the study specific procedures.
  • The patient is in good health as determined by medical examination and based on the investigator's judgement

Who cannot join

  • Patients with any of the following characteristics will be excluded from entering the study:
  • Patients with PArkinson´s Disease (PD) who have not participated in the randomized double-blind phase of the previous NMS-Nab Study.
  • Patients that experienced a drug-related SAE or had a (drug-related) moderate or severe AE during the NMS-Nab Study will be excluded in the study.
  • Patients who are unable or unwilling to comply with the study procedures in the investigator´s opinion.
  • Patients with any clinically significant or unstable medical or surgical condition at the Screening / Baseline Visit that may preclude safety and the completion of the study participation (based on the investigator's judgement).

Trial locations and contacts

1 site in 1 country.

Austria1 site
  • Department of Neurology - Medical University Innsbruck

    Innsbruck, Tyrol, 6020

Other trials in Austria

About this study

Official title: Nabilone for Non-motor Symptoms in Parkinson's Disease: An Open-label Study to Evaluate Long-term Safety and Efficacy

This is an open-label extension study for participants of the randomized placebo-controlled, double-blind, parallel-group, enriched enrolment randomized withdrawal NMS-Nab Study, assessing the long-term safety and efficacy of nabilone for non-motor symptoms in patients with Parkinson´s Disease (PD). Nabilone is an analogue of tetrahydrocannabinol (THC), the psychoactive component of cannabis. Nabilone acts as a partial agonist on both Cannabinoid 1 (CB1) and Cannabinoid 2 (CB2) receptor in humans and therefore mimics the effect of THC but with more predictable side effects and less euphoria.

Eligible patients will be re-tapered in an open-label nabilone dose optimization phase followed by an open-label period of 6 months on a stable nabilone dose.

Read the detailed description

This is an open-label extension study for participants of the randomized placebo-controlled, double-blind, parallel-group, enriched enrolment randomized withdrawal NMS-Nab Study, assessing the long-term safety and efficacy of nabilone for non-motor symptoms in patients with Parkinson´s Disease. Nabilone is an analogue of tetrahydrocannabinol (THC), the psychoactive component of cannabis.

Eligible subjects will be re-tapered with open-label nabilone, optimally up to the dose the patient had in the NMS-Nab Trial. It is the investigator´s decision to modify this dose, if necessary. The re-tapering will be performed up to a maximum dose of 1 mg twice daily. Treatment responders will enter the open-label treatment period for 6 months with visits being performed every 3 months in the context of the patient´s regularly scheduled visits in the specialized outpatient department. The last visit will be the Termination Visit. Following this, nabilone will be tapered. During this period the patients will receive phone calls every other day. A Safety Follow-Up Visit will be performed.

Being tested
Nabilone 0.25 mg
Keywords
Parkinson´s Disease, cannabinoids, non-motor symptoms
Medical subject headings
Parkinson Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nabilone 0.25 mgDrug

    Also called Canemes

    capsules, 0.25 mg up to 2 mg of nabilone taken orally on a daily basis

Study groups in NCT03773796
Study groupRoleWhat they receive
Treatment GroupOtherAssessment of long-term efficacy and safety of nabilone 0.25 mg - 2 mg
Receives: Drug: Nabilone 0.25 mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. AEs in PD Patients Taking Nabilone, Between V 1 and V 3

    Safety and tolerability will be evaluated with reference to the following:

    Adverse Events (AE)

    Measured: 6 months

  2. Number of Subjects (%) Who Discontinue the Study Due to an AE Between V 1 and V 3

    Safety and tolerability will be evaluated with reference to the following:

    Number of subjects (%) who discontinue the study due to an AE The reasons for discontinuation will be grouped in "discontinuation due to an AE" and "discontinuation due to other reasons". Both results will be provided separately.

    Measured: 6 months

  3. Number of Subjects (%) Who Discontinue the Study Due to Other Reasons Than an AE Between V 1 and V 3

    Safety and tolerability will be evaluated with reference to the following:

    Number of subjects (%) who discontinue the study due to other reasons than an AE The reasons for discontinuation will be grouped in "discontinuation due to an AE" and "discontinuation due to other reasons". Both results will be provided separately.

    Measured: 6 months

  4. Suicidality in PD Patients Taking Nabilone Between V 1 and V 3 Using the Columbia-Suicide Severity Rating Scale

    Change in aggregated data of the Columbia-Suicide Severity Rating Scale (C-SSRS).

    Different questions for suicidality with the possible answers yes or no. Yes represents a worse outcome. Count of participants with new suicidality is given.

    Measured: between V 1 and V 3 (6 months)

  5. Hallucinations in PD Patients Taking Nabilone Between V 1 and V 3

    Changes in points of the:

    Hallucination item (1.2) of Movement Disorders Society - Unified Parkinson´s Disease Rating Scale (MDS-UPDRS) Each item has a minimum of 0 and a maximum of 4 points with higher score values representing a worse outcome.

    Participant count with a change in the hallucination item is reported.

    Measured: between V 1 and V 3 (6 months)

  6. Day-time Sleepiness in PD Patients Taking Nabilone Between V 1 and V 3

    Changes in points of the:

    Day-time sleepiness item (1.8) of Movement Disorders Society - Unified Parkinson´s Disease Rating Scale (MDS-UPDRS) Each item has a minimum of 0 and a maximum of 4 points with higher score values representing a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  7. Orthostatic Hypotension in PD Patients Taking Nabilone Between V 1 and V 3

    Changes in points of the:

    Orthostatic hypotension item (1.12) of Movement Disorders Society - Unified Parkinson´s Disease Rating Scale (MDS-UPDRS)

    Each item has a minimum of 0 and a maximum of 4 points with higher score values representing a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  8. Subject Compliance in PD Patients Taking Nabilone.

    subject incompliance as per drug accountability (%)

    Measured: between V 1 and V 3 (6 months)

  9. Changes in Supine and Standing Blood Pressure Measurements (mmHg) in PD Patients Taking Nabilone Between V 1 and V 3

    changes in supine and standing blood pressure measurements (mmHg)

    Row titles:

    1. Mean Change of systolic blood pressure readings (SBP) from supine to standing position for 3 min at V 1
    2. Mean Change of systolic blood pressure readings (SBP) from supine to standing position for 3 min at V 3
    3. Mean Change of diastolic blood pressure readings (DBP) from supine to standing position for 3 min at V 1
    4. Mean Change of diastolic blood pressure readings (DBP) from supine to standing position for 3 min at V 3

    Measured: between V 1 and V 3 (6 months)

Secondary outcomes (11)
  1. Changes in Motor and Non-motor Symptoms in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Total and different parts of Movement Disorders Society - Unified Parkinson´s Disease Rating Scale (MDS-UPDRS) Part I: minimum points: 0, maximum points: 52, higher score values indicate a worse outcome.

    Part II: minimum points: 0, maximum points: 52, higher score values indicate a worse outcome.

    Part III: minimum points: 0, maximum points: 132, higher score values indicate a worse outcome.

    Part IV: minimum points: 0, maximum points: 24, higher score values indicate a worse outcome.

    Total Score: minimum points: 0, maximum points: 272, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  2. Changes in Non-motor Symptoms (NMSS) in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Non Motor Symptoms Scale (NMSS) Minimum: 0, maximum: 360, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  3. Changes in Non-motor Symptoms (HADS) in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Hospital anxiety and depression scale (HADS), HADS-A assesses anxiety, HADS-D depression.

    Total scale: minimum: 0, maximum: 42, separate HADS-A/-D score: minimum: 0, maximum: 21.

    Higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  4. Changes in Quality of Life in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Parkinson´s Disease Questionnaire - 8 (PDQ-8). Minimum: 0, maximum: 42, higher score values indicate a worse outcome.

    PDQ-8 was standardized, therefore the score ranges from 0 to 100 (= PDQ-8 Summary Index).

    Measured: between V 1 and V 3 (6 months)

  5. Changes in Sleepiness in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Epworth Sleepiness Scale (ESS) Minimum: 0, maximum: 24, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  6. Changes in Fatigue in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Fatigue Severity Scale (FSS). Minimum: 9, maximum: 63, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  7. Changes in Pain in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    King's Parkinson's disease pain scale (KPPS) Minimum: 0, maximum: 168, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  8. Changes in Impulsive-compulsive Behaviour in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) Minimum: 0, maximum: 112, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  9. Changes in Overall Symptoms in Patients With PD Taking Nabilone Between V 1 and V 3

    Long-term efficacy evaluations are the secondary objective of this study. Efficacy endpoints include changes in points from V 1 to the termination visit in the following questionnaires:

    Clinical Global Impression - Global Improvement (CGI-I) Minimum: 1, maximum: 7, higher score values indicate a worse outcome.

    Measured: between V 1 and V 3 (6 months)

  10. Changes in Cognitive Function (MoCA) in Patients With PD Taking Nabilone Between V 1 and V 3

    The change of Montreal Cognitive Assessment (MoCA, minimum 0 points, maximum 30 points, higher score values indicate better outcome) score values between the Screening Visit of the NMS-Nab Study (before the first intake of nabilone medication) and the termination visit of this study will be assessed as secondary efficacy endpoints.

    Measured: from Screening of the preceding study (NCT03769896) to V 3 of this study (a maximum of 2 years, at study completion)

  11. Changes in Cognitive Function (MMSE) in Patients With PD Taking Nabilone

    The change of Mini Mental State Exam (MMSE, minimum 0 points, maximum 30 points, higher score values indicate better outcome) between the Screening Visit of the NMS-Nab Study (before the first intake of nabilone medication) and the termination visit of this study will be assessed as secondary efficacy endpoints.

    Measured: from screening of the preceding study (NCT03769896) to V 3 of this study (a maximum of 2 years, at study completion)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Dec 2018
  2. Study start6 Aug 2018
  3. Primary completion31 Jan 2020
  4. Study completion31 Jan 2020

Resources

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 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
open-label
Masking
None (open label)
Enrolment
22 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03773796
Sponsor's protocol ID
1.3
Acronym
NMS-Nab2
Status last verified
Feb 2021
First submitted
19 Jul 2018
Last updated
2 Mar 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The results of this study will be published according to the principles of publication policy. There are no arrangements on publication issues with subsiding parties.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Nabilone 0.25 mg in people with Parkinson Disease, run by Medical University Innsbruck at 1 site in Austria.

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 7 inclusion and 5 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 2 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Austria. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Mar 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

AEs in PD Patients Taking Nabilone, Between V 1 and V 3 (time frame: 6 months). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 2 Mar 2021.

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