Movement Disorders (revue)

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Safety and Efficacy of Perampanel in Advanced Parkinson's Disease: A Randomized, Placebo-Controlled Study

Identifieur interne : 002436 ( Main/Merge ); précédent : 002435; suivant : 002437

Safety and Efficacy of Perampanel in Advanced Parkinson's Disease: A Randomized, Placebo-Controlled Study

Auteurs : Karla Eggert [Allemagne] ; David Squillacote [États-Unis] ; Paolo Barone [Italie] ; Richard Dodel [Allemagne] ; Regina Katzenschlager [Autriche] ; Murat Emre [Turquie] ; Andrew Lees (neurologue) [Royaume-Uni] ; Olivier Rascol [France] ; Werner Poewe [Autriche] ; Eduardo Tolosa [Espagne] ; Claudia Trenkwalder [Allemagne] ; Marco Onofrj [Italie] ; Fabrizio Stocchi [Italie] ; Giuseppe Nappi [Italie] ; Vladimir Kostic [Serbie] ; Jagoda Potic [Serbie] ; Evzen Ruzicka [République tchèque] ; Wolfgang Oertel [Allemagne]

Source :

RBID : Pascal:10-0288342

Descripteurs français

English descriptors

Abstract

Perampanel, a novel, noncompetitive, selective AMPA-receptor antagonist demonstrated evidence of efficacy in reducing motor symptoms in animal models of Parkinson's disease (PD). We assessed the safety and efficacy of perampanel for treatment of "wearing off" motor fluctuations in patients with PD. Patients (N = 263) were randomly assigned to once-daily add-on 0.5, 1, or 2 mg of perampanel or placebo. The primary objective was to determine whether there was a dose-response relationship for efficacy among the 3 perampanel doses and placebo. The primary efficacy endpoint for each treatment was measured as the least-squares (LS) mean change from baseline to week 12 in percent "off' time reduction during the waking day, as recorded by patient diaries. The primary efficacy analysis was a 1-sided Williams test for dose-response trend at the 0.025 level of significance. At week 12, dose-response trends, as determined by the Williams test, were not statistically significant for LS mean reduction in percent "off" time during the waking day (P = 0.061, with significance defined as P ≤ 0.025). The 2 higher perampanel doses (ITT population; n = 258) produced non-significant reductions from baseline to week 12 in percent "off" time during the waking day versus placebo (7.59%, P = 0.421 [1 mg], 8.60%, P = 0.257 [2 mg] versus 5.05% [placebo]; significance for pairwise comparisons defined as P ≤ 0.05). There were no significant changes in dyskinesia or cognitive function in any perampanel group versus placebo. Adverse events were similar across treatment groups. Perampanel treatment was well tolerated and safe, but failed to achieve statistical significance in primary and secondary endpoints.

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Pascal:10-0288342

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<name sortKey="Kostic, Vladimir" sort="Kostic, Vladimir" uniqKey="Kostic V" first="Vladimir" last="Kostic">Vladimir Kostic</name>
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<s1>Department of Neurology, Charles University in Prague, 1st Faculty of Medicine and General Teaching Hospital</s1>
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<title xml:lang="en" level="a">Safety and Efficacy of Perampanel in Advanced Parkinson's Disease: A Randomized, Placebo-Controlled Study</title>
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<name sortKey="Katzenschlager, Regina" sort="Katzenschlager, Regina" uniqKey="Katzenschlager R" first="Regina" last="Katzenschlager">Regina Katzenschlager</name>
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<name sortKey="Emre, Murat" sort="Emre, Murat" uniqKey="Emre M" first="Murat" last="Emre">Murat Emre</name>
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<name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J." last="Lees">Andrew Lees (neurologue)</name>
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<settlement type="city">Londres</settlement>
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<name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name>
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<country>France</country>
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<settlement type="city">Toulouse</settlement>
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<settlement type="city">Toulouse</settlement>
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<orgName type="university" n="3">Université Toulouse III - Paul Sabatier</orgName>
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<s1>Departments of Clinical Pharmacology and Neurosciences, INSERM UMR825, University Hospital Toulouse</s1>
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<name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name>
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<s1>Department of Neurology, Medical University Innsbruck</s1>
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<country>Autriche</country>
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<settlement type="city">Innsbruck</settlement>
<region nuts="2" type="region">Tyrol (Land)</region>
</placeName>
<orgName type="university">Université de médecine d'Innsbruck</orgName>
</affiliation>
</author>
<author>
<name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name>
<affiliation wicri:level="3">
<inist:fA14 i1="11">
<s1>Neurology Service, Hospital Clinic, Universitat de Barcelona, CIBERNED</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
<placeName>
<settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Trenkwalder, Claudia" sort="Trenkwalder, Claudia" uniqKey="Trenkwalder C" first="Claudia" last="Trenkwalder">Claudia Trenkwalder</name>
<affiliation wicri:level="3">
<inist:fA14 i1="12">
<s1>Paracelsus-Elena Klinik</s1>
<s2>Kassel</s2>
<s3>DEU</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName>
<region type="land" nuts="1">Hesse (Land)</region>
<region type="district" nuts="2">District de Kassel</region>
<settlement type="city">Cassel (Hesse)</settlement>
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</affiliation>
</author>
<author>
<name sortKey="Onofrj, Marco" sort="Onofrj, Marco" uniqKey="Onofrj M" first="Marco" last="Onofrj">Marco Onofrj</name>
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<s1>Clinica Neurologica, Università Chieti-Pescara</s1>
<s3>ITA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<wicri:noRegion>Clinica Neurologica, Università Chieti-Pescara</wicri:noRegion>
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</author>
<author>
<name sortKey="Stocchi, Fabrizio" sort="Stocchi, Fabrizio" uniqKey="Stocchi F" first="Fabrizio" last="Stocchi">Fabrizio Stocchi</name>
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<s1>Department of Neurology, IRCCS San Raffaele</s1>
<s2>Rome</s2>
<s3>ITA</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<placeName>
<settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Nappi, Giuseppe" sort="Nappi, Giuseppe" uniqKey="Nappi G" first="Giuseppe" last="Nappi">Giuseppe Nappi</name>
<affiliation wicri:level="3">
<inist:fA14 i1="15">
<s1>Chair of Neurology, University "La Sapienza</s1>
<s2>Rome</s2>
<s3>ITA</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<placeName>
<settlement type="city">Rome</settlement>
<region nuts="2">Latium</region>
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<affiliation wicri:level="1">
<inist:fA14 i1="16">
<s1>IRCCS "C. Mondino Institute of Neurology" Foundation</s1>
<s2>Pavia</s2>
<s3>ITA</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<wicri:noRegion>IRCCS "C. Mondino Institute of Neurology" Foundation</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kostic, Vladimir" sort="Kostic, Vladimir" uniqKey="Kostic V" first="Vladimir" last="Kostic">Vladimir Kostic</name>
<affiliation wicri:level="1">
<inist:fA14 i1="17">
<s1>Institute of Neurology, Clinical Centre of Serbia</s1>
<s2>Belgrade</s2>
<s3>SRB</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Serbie</country>
<wicri:noRegion>Belgrade</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Potic, Jagoda" sort="Potic, Jagoda" uniqKey="Potic J" first="Jagoda" last="Potic">Jagoda Potic</name>
<affiliation wicri:level="1">
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<s1>Clinic for Neurology and Psychiatry, Clinical Hospital Centre "Zvezdara</s1>
<s2>Belgrade</s2>
<s3>SRB</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Serbie</country>
<wicri:noRegion>Belgrade</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ruzicka, Evzen" sort="Ruzicka, Evzen" uniqKey="Ruzicka E" first="Evzen" last="Ruzicka">Evzen Ruzicka</name>
<affiliation wicri:level="3">
<inist:fA14 i1="19">
<s1>Department of Neurology, Charles University in Prague, 1st Faculty of Medicine and General Teaching Hospital</s1>
<s2>Prague</s2>
<s3>CZE</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>République tchèque</country>
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<settlement type="city">Prague</settlement>
<region type="région" nuts="2">Bohême centrale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Oertel, Wolfgang" sort="Oertel, Wolfgang" uniqKey="Oertel W" first="Wolfgang" last="Oertel">Wolfgang Oertel</name>
<affiliation wicri:level="3">
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<s1>German Competence Network on Parkinson's Disease, Department of Neurology, Philipps-University Marburg</s1>
<s2>Marburg</s2>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName>
<region type="land" nuts="1">Hesse (Land)</region>
<region type="district" nuts="2">District de Giessen</region>
<settlement type="city">Marbourg</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">Movement disorders</title>
<title level="j" type="abbreviated">Mov. disord.</title>
<idno type="ISSN">0885-3185</idno>
<imprint>
<date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Movement disorders</title>
<title level="j" type="abbreviated">Mov. disord.</title>
<idno type="ISSN">0885-3185</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>AMPA receptor</term>
<term>Advanced stage</term>
<term>Dyskinesia</term>
<term>Fluctuations</term>
<term>Nervous system diseases</term>
<term>Parkinson disease</term>
<term>Perampanel</term>
<term>Placebo</term>
<term>Safety</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Maladie de Parkinson</term>
<term>Dyskinésie</term>
<term>Pathologie du système nerveux</term>
<term>Sécurité</term>
<term>Pérampanel</term>
<term>Stade avancé</term>
<term>Placebo</term>
<term>Fluctuation</term>
<term>Récepteur AMPA</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Perampanel, a novel, noncompetitive, selective AMPA-receptor antagonist demonstrated evidence of efficacy in reducing motor symptoms in animal models of Parkinson's disease (PD). We assessed the safety and efficacy of perampanel for treatment of "wearing off" motor fluctuations in patients with PD. Patients (N = 263) were randomly assigned to once-daily add-on 0.5, 1, or 2 mg of perampanel or placebo. The primary objective was to determine whether there was a dose-response relationship for efficacy among the 3 perampanel doses and placebo. The primary efficacy endpoint for each treatment was measured as the least-squares (LS) mean change from baseline to week 12 in percent "off' time reduction during the waking day, as recorded by patient diaries. The primary efficacy analysis was a 1-sided Williams test for dose-response trend at the 0.025 level of significance. At week 12, dose-response trends, as determined by the Williams test, were not statistically significant for LS mean reduction in percent "off" time during the waking day (P = 0.061, with significance defined as P ≤ 0.025). The 2 higher perampanel doses (ITT population; n = 258) produced non-significant reductions from baseline to week 12 in percent "off" time during the waking day versus placebo (7.59%, P = 0.421 [1 mg], 8.60%, P = 0.257 [2 mg] versus 5.05% [placebo]; significance for pairwise comparisons defined as P ≤ 0.05). There were no significant changes in dyskinesia or cognitive function in any perampanel group versus placebo. Adverse events were similar across treatment groups. Perampanel treatment was well tolerated and safe, but failed to achieve statistical significance in primary and secondary endpoints.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Autriche</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Royaume-Uni</li>
<li>République tchèque</li>
<li>Serbie</li>
<li>Turquie</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Bohême centrale</li>
<li>Catalogne</li>
<li>District de Cologne</li>
<li>District de Giessen</li>
<li>District de Kassel</li>
<li>Grand Londres</li>
<li>Hesse (Land)</li>
<li>Latium</li>
<li>Midi-Pyrénées</li>
<li>New Jersey</li>
<li>Rhénanie-du-Nord-Westphalie</li>
<li>Tyrol (Land)</li>
<li>Vienne (Autriche)</li>
</region>
<settlement>
<li>Barcelone</li>
<li>Bonn</li>
<li>Cassel (Hesse)</li>
<li>Innsbruck</li>
<li>Londres</li>
<li>Marbourg</li>
<li>Prague</li>
<li>Rome</li>
<li>Toulouse</li>
<li>Vienne (Autriche)</li>
</settlement>
<orgName>
<li>National Hospital for Neurology and Neurosurgery</li>
<li>Université Toulouse III - Paul Sabatier</li>
<li>Université de Toulouse</li>
<li>Université de médecine d'Innsbruck</li>
</orgName>
</list>
<tree>
<country name="Allemagne">
<region name="Hesse (Land)">
<name sortKey="Eggert, Karla" sort="Eggert, Karla" uniqKey="Eggert K" first="Karla" last="Eggert">Karla Eggert</name>
</region>
<name sortKey="Dodel, Richard" sort="Dodel, Richard" uniqKey="Dodel R" first="Richard" last="Dodel">Richard Dodel</name>
<name sortKey="Oertel, Wolfgang" sort="Oertel, Wolfgang" uniqKey="Oertel W" first="Wolfgang" last="Oertel">Wolfgang Oertel</name>
<name sortKey="Trenkwalder, Claudia" sort="Trenkwalder, Claudia" uniqKey="Trenkwalder C" first="Claudia" last="Trenkwalder">Claudia Trenkwalder</name>
</country>
<country name="États-Unis">
<region name="New Jersey">
<name sortKey="Squillacote, David" sort="Squillacote, David" uniqKey="Squillacote D" first="David" last="Squillacote">David Squillacote</name>
</region>
</country>
<country name="Italie">
<noRegion>
<name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name>
</noRegion>
<name sortKey="Nappi, Giuseppe" sort="Nappi, Giuseppe" uniqKey="Nappi G" first="Giuseppe" last="Nappi">Giuseppe Nappi</name>
<name sortKey="Nappi, Giuseppe" sort="Nappi, Giuseppe" uniqKey="Nappi G" first="Giuseppe" last="Nappi">Giuseppe Nappi</name>
<name sortKey="Onofrj, Marco" sort="Onofrj, Marco" uniqKey="Onofrj M" first="Marco" last="Onofrj">Marco Onofrj</name>
<name sortKey="Stocchi, Fabrizio" sort="Stocchi, Fabrizio" uniqKey="Stocchi F" first="Fabrizio" last="Stocchi">Fabrizio Stocchi</name>
</country>
<country name="Autriche">
<region name="Vienne (Autriche)">
<name sortKey="Katzenschlager, Regina" sort="Katzenschlager, Regina" uniqKey="Katzenschlager R" first="Regina" last="Katzenschlager">Regina Katzenschlager</name>
</region>
<name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name>
</country>
<country name="Turquie">
<noRegion>
<name sortKey="Emre, Murat" sort="Emre, Murat" uniqKey="Emre M" first="Murat" last="Emre">Murat Emre</name>
</noRegion>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J." last="Lees">Andrew Lees (neurologue)</name>
</region>
</country>
<country name="France">
<noRegion>
<name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name>
</noRegion>
<name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name>
</country>
<country name="Espagne">
<region name="Catalogne">
<name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name>
</region>
</country>
<country name="Serbie">
<noRegion>
<name sortKey="Kostic, Vladimir" sort="Kostic, Vladimir" uniqKey="Kostic V" first="Vladimir" last="Kostic">Vladimir Kostic</name>
</noRegion>
<name sortKey="Potic, Jagoda" sort="Potic, Jagoda" uniqKey="Potic J" first="Jagoda" last="Potic">Jagoda Potic</name>
</country>
<country name="République tchèque">
<region name="Bohême centrale">
<name sortKey="Ruzicka, Evzen" sort="Ruzicka, Evzen" uniqKey="Ruzicka E" first="Evzen" last="Ruzicka">Evzen Ruzicka</name>
</region>
</country>
</tree>
</affiliations>
</record>

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