Movement Disorders (revue)

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

Identifieur interne : 002205 ( PascalFrancis/Curation ); précédent : 002204; suivant : 002206

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 J. Lees [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.
pA  
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A08 01  1  ENG  @1 Safety and Efficacy of Perampanel in Advanced Parkinson's Disease: A Randomized, Placebo-Controlled Study
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A11 03  1    @1 BARONE (Paolo)
A11 04  1    @1 DODEL (Richard)
A11 05  1    @1 KATZENSCHLAGER (Regina)
A11 06  1    @1 EMRE (Murat)
A11 07  1    @1 LEES (Andrew J.)
A11 08  1    @1 RASCOL (Olivier)
A11 09  1    @1 POEWE (Werner)
A11 10  1    @1 TOLOSA (Eduardo)
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A11 17  1    @1 RUZICKA (Evzen)
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A14 02      @1 Eisai Global Clinical Development, Eisai Medical Research Inc., Woodcliff Lake @2 New Jersey @3 USA @Z 2 aut.
A14 03      @1 Department of Neurological Sciences, University of Naples Federico II-IDC Hermitage-Capodimonte @2 Naples @3 ITA @Z 3 aut.
A14 04      @1 Department of Neurology, Rheinische Friedrich-Wilhelms-University @2 Bonn @3 DEU @Z 4 aut.
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A14 07      @1 Reta Lila Weston Institute of Neurological Studies, University College London @2 London @3 GBR @Z 7 aut.
A14 08      @1 Clinical Investigation Center, INSERM CIC9302, University Hospital Toulouse @2 Toulouse @3 FRA @Z 8 aut.
A14 09      @1 Departments of Clinical Pharmacology and Neurosciences, INSERM UMR825, University Hospital Toulouse @2 Toulouse @3 FRA @Z 8 aut.
A14 10      @1 Department of Neurology, Medical University Innsbruck @2 Innsbruck @3 AUT @Z 9 aut.
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A14 13      @1 Clinica Neurologica, Università Chieti-Pescara @3 ITA @Z 12 aut.
A14 14      @1 Department of Neurology, IRCCS San Raffaele @2 Rome @3 ITA @Z 13 aut.
A14 15      @1 Chair of Neurology, University "La Sapienza @2 Rome @3 ITA @Z 14 aut.
A14 16      @1 IRCCS "C. Mondino Institute of Neurology" Foundation @2 Pavia @3 ITA @Z 14 aut.
A14 17      @1 Institute of Neurology, Clinical Centre of Serbia @2 Belgrade @3 SRB @Z 15 aut.
A14 18      @1 Clinic for Neurology and Psychiatry, Clinical Hospital Centre "Zvezdara @2 Belgrade @3 SRB @Z 16 aut.
A14 19      @1 Department of Neurology, Charles University in Prague, 1st Faculty of Medicine and General Teaching Hospital @2 Prague @3 CZE @Z 17 aut.
A17 01  1    @1 Cooperation with the German Competence Network on Parkinson's Disease @3 INC
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C01 01    ENG  @0 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="Oertel, Wolfgang" sort="Oertel, Wolfgang" uniqKey="Oertel W" first="Wolfgang" last="Oertel">Wolfgang Oertel</name>
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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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<title level="j" type="main">Movement disorders</title>
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<term>AMPA receptor</term>
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<term>Fluctuations</term>
<term>Nervous system diseases</term>
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<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>
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<fC03 i1="08" i2="X" l="FRE">
<s0>Fluctuation</s0>
<s5>13</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Fluctuations</s0>
<s5>13</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Fluctuación</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Récepteur AMPA</s0>
<s5>14</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>AMPA receptor</s0>
<s5>14</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Receptor AMPA</s0>
<s5>14</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Pathologie de l'encéphale</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Cerebral disorder</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Encéfalo patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Syndrome extrapyramidal</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Extrapyramidal syndrome</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Extrapiramidal síndrome</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Maladie dégénérative</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Degenerative disease</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Enfermedad degenerativa</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Pathologie du système nerveux central</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Central nervous system disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Sistema nervosio central patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Mouvement involontaire</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Involuntary movement</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Movimiento involuntario</s0>
<s5>42</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Trouble neurologique</s0>
<s5>43</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Neurological disorder</s0>
<s5>43</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Trastorno neurológico</s0>
<s5>43</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE">
<s0>Récepteur glutamate</s0>
<s5>44</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG">
<s0>Glutamate receptor</s0>
<s5>44</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA">
<s0>Receptor glutámato</s0>
<s5>44</s5>
</fC07>
<fN21>
<s1>186</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>

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