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This is a randomized, double-blind, placebo-controlled, crossover, proof-of-concept Phase 2 study to test efficacy and safety of AV-101 (L-4-chlorokynurenine) in Parkinson's Disease subjects with levodopa-induced dyskinesia. The trial will be conducted in two treatment periods, in which each treatment period will consist of 14 days. The two treatment periods will be separated by a 1-week washout period. During the first treatment period, subjects meeting all eligibility criteria will be randomly assigned to receive either 1440 mg AV-101 or placebo in a 1:1 ratio. AV-101 or placebo will be administered BID for 14 days (every 12 hours). After the washout period, all subjects will be crossed over to receive the alternate treatment during the second treatment period (14-day period).
On the last day of each treatment period (Visit 4 [Day 14] and Visit 7 [Day35]), subjects will be assessed in clinic while in the practically "off" state and will receive the morning dose of the study drug at the clinic. This will be followed, within 25-30 minutes, by oral administration of a dose of levodopa that is 150% of the subject's normal dose. Assessments of dyskinesia and PD motor symptoms will be performed before and after levodopa/carbidopa administration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AV-101 | Experimental | 1440 mg of L-4-chlorokynurenine administered twice a day orally |
|
| Placebo | Placebo Comparator | Matching capsules of placebo |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AV-101 | Drug | Oral capsules taken twice daily for 14 days |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Unified Dyskinesia Rating Scale | (UDysRS) Part 3 AUC | 14 days |
| Unified Dyskinesia Rating Scale | (UDysRS) Part 3 Peak Score | 14 days |
| Measure | Description | Time Frame |
|---|---|---|
| Movement Disorder Society- Unified Parkinson's Disease Rating Scale | (MDS-UPDRS) part III (Parkinsonian disability) | 14 days |
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Inclusion Criteria:
Male or female adults, 30 to 80 years of age, inclusive.
Diagnosis of idiopathic PD meeting the United Kingdom Parkinson's disease Society Brain Bank criteria.
Levodopa-induced dyskinesia present greater than 25% of the day as per MDS-UPDRS.
Dyskinesia of at least moderate severity as per MDS-UPDRS
Subjects currently receiving anti-parkinsonian medications that contain levodopa and carbidopa are eligible provided they have been on a stable dose of these medications for at least 1 month prior to randomization.
Subjects currently receiving antidepressants such as selective serotonin reuptake inhibitors, provided the dose has been stable for at least 1 month prior to randomization.
If female, a status of non-childbearing potential or use of an acceptable form of birth control per the following specific criteria:
ii. Women who are willing and able to continuously use one of the following methods of birth control during the course of the study, defined as those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly: implants, injectable or patch hormonal contraception, oral contraceptives, intrauterine device, sexual abstinence. The form of birth control will be documented at screening.
iii. Male partner must use a condom.
Exclusion Criteria:
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| D004409 | Dyskinesia, Drug-Induced |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| Placebo | Drug | Oral capsules taken twice a day for 14 days |
|
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |
| D020820 | Dyskinesias |
| D009461 | Neurologic Manifestations |
| D020258 | Neurotoxicity Syndromes |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D064420 | Drug-Related Side Effects and Adverse Reactions |
| D064419 | Chemically-Induced Disorders |
| D011041 | Poisoning |