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This trial will be a 2-part, adaptive, open label, single and/or multiple oral dose, safety, tolerability, food effect trial of CVL-751 in subjects with Parkinson's disease. Part 1 is a placebo-controlled, single dose cohort intended for assessment of safety and tolerability. In case of intolerable AEs, Part 2 would proceed as a multiple dose titration trial to achieve a 15 mg once daily dose while maintaining L-Dopa treatment (Part 2A). In case of a favorable tolerability profile in Part 1, Part 2B would proceed as a single dose trial (similar to Part 1), with discontinuation of L-Dopa for 24 hours (12 hours pre-Day 1 dose and 12 hours post-Day 1 dose).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part 1 | Placebo Comparator | Will include 4 subjects (3 active + 1 placebo) that will receive a single 15mg dose with approximately 48 hours of confinement and a follow-up after 7 days. |
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| Part 2 | Experimental | 2A: will include 14 subjects to complete 12 with 28 days of dosing with 7 days (+/-2) of follow-up, with at least 14 days of confinement. -or- 2B: will include 20 subjects to complete 12 with 2 dosing days and 5 days of washout with 7 days (+/-2) of follow-up, with 4 days of confinement (may be increased up to 12 days at the investigators discretion). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CVL-751 | Drug | Oral tablet |
|
| Measure | Description | Time Frame |
|---|---|---|
| Single Dose: Peak Plasma Concentration | Peak Plasma Concentration (Cmax) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions | Day 1 to 12 |
| Single Dose:Area under the plasma concentration-time curve | Area under the plasma concentration-time curve (AUC) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions | Day 1 to 12 |
| Single Dose: Area under the plasma concentration-time curve from time zero to infinity | Area under the plasma concentration-time curve from time zero to infinity (AUCinf) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions | Day 1 to 12 |
| Single Dose: Time to Maximum Concentration | Time to Maximum Concentration (Tmax) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions | Day 1 to 12 |
| Multiple Dose: Peak Plasma Concentration | Peak Plasma Concentration (Cmax) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions | Day 16 to 29 |
| Multiple Dose: Area under the plasma concentration-time curve | Area under the plasma concentration-time curve (AUCÏ„) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions | Day 16 to 29 |
| Multiple Dose: Time to Maximum Concentration |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary Outcome (AE) Number of subjects with reported Treatment Emergent Adverse Events (TEAEs) | Number of subjects with reported Treatment Emergent Adverse Events (TEAEs) | up to Day 35 |
| Secondary Outcome (Labs) Number of subjects with clinically significant changes in laboratory measures |
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Inclusion Criteria:
Exclusion Criteria:
Any significant Axis I psychiatric disease as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (American Psychiatric Association).
In the opinion of the investigator (or caregiver, as applicable), has signs/symptoms suggestive of clinically significant cognitive impairment that would interfere with the ability to comply with trial procedures.
Subjects with a Montreal Cognitive Assessment score <26.
History or clinical features consistent with an atypical parkinsonian syndrome (eg, ataxia, dystonia, clinically significant orthostatic hypotension).
Has a history of psychotic symptoms requiring treatment with an antipsychotic medication within the 12 months prior to signing ICF.
Subjects with epilepsy, or history of epilepsy, or conditions that lower seizure threshold, seizures of any etiology (including substance or drug withdrawal), or who have increased risk of seizures as evidenced by history of electroencephalogram with epileptiform activity.
Subjects with a history of febrile seizures only are allowed. Subjects with a history of head trauma with loss of consciousness requiring overnight hospitalization will be excluded as well.
Subjects with a current history of significant cardiovascular, pulmonary, gastrointestinal, renal, hepatic, metabolic, hematological, immunological, or neurological disease that, in the opinion of the investigator or medical monitor, could compromise either subject safety or the results of the trial.
Medical conditions that are minor or well-controlled may be considered acceptable if the condition does not expose the subject to an undue risk of a significant AE or interfere with the assessments of safety or efficacy during the course of the trial. The medical monitor should be contacted in any instance where the investigator is uncertain regarding the stability of a subject's medical conditions(s) and the potential impact of the condition(s) on trial participation.
History of substance or alcohol-use disorder (excluding nicotine; Diagnostic and Statistical Manual of Mental Disorders, 5th edition criteria) within 2 years prior to signing the ICF.
History of regular alcohol consumption exceeding 7 drinks/week for females or 14 drinks/week for males [1 drink = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of hard liquor] within 6 months prior to signing ICF.
If a current smoker, is unable to comply with the following guidelines: agrees not to smoke on the mornings of trial dosing days and for the entire trial dosing day until completion of all trial assessments for that day.
Subjects who answer "Yes" on the Columbia-Suicide Severity Rating Scale (C-SSRS) Suicidal Ideation Item 4 (Active Suicidal Ideation with Some Intent to Act, Without Specific Plan) and whose most recent episode meeting criteria for this C-SSRS Item 4 occurred within the last 6 months, OR Subjects who answer "Yes" on the C-SSRS Suicidal Ideation Item 5 (Active Suicidal Ideation with Specific Plan and Intent) and whose most recent episode meeting criteria for this C-SSRS Item 5 occurred within the last 6 months OR Subjects who answer "Yes" on any of the 5 C-SSRS Suicidal Behavior Items (actual attempt, interrupted attempt, aborted attempt, preparatory acts, or behavior) and whose most recent episode meeting criteria for any of these 5 C-SSRS Suicidal Behavior Items occurred within the last 2 years, OR Subjects who, in the opinion of the investigator, present a serious risk of suicide.
Subjects who have attempted suicide in the past.
Human immunodeficiency virus seropositive status or acquired immunodeficiency syndrome, acute or chronic hepatitis B or C, with HbsAg, or hepatitis C virus antibodies at screening.
Subjects with a positive drug screen for illicit drugs are excluded and may not be retested or rescreened. Subjects with a positive urine drug screen resulting from use of marijuana (any cannabinoids), prescription medications, over-the-counter medications, or products that, in the investigator's documented opinion, do not signal a clinical condition that would impact the safety of the subject or interpretation of the trial results may continue evaluation for the trial following consultation and approval by the medical monitor.
Subjects with a 12-lead electrocardiogram (ECG) demonstrating the following:
• QT interval corrected for heart rate using Fridericia's formula (QTcF) >450 msec.
Subjects with any of the following abnormalities in clinical laboratory tests at the Screening Visit, as assessed by the central laboratory and confirmed by a single repeat measurement, if deemed necessary:
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| Name | Affiliation | Role |
|---|---|---|
| Matthew Leoni, MD | Cerevel Therapeutics, LLC | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CNS Network | Long Beach | California | 90806 | United States | ||
| Atlanta Center for Medical Research |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11775596 | Background | Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. 1967. Neurology. 2001 Nov;57(10 Suppl 3):S11-26. No abstract available. | |
| 15817019 | Background | Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x. |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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Time to Maximum Concentration (Tmax) for CVL-751 and its metabolite (PF-06752844) under fasted and fed conditions
| Day 16 to 29 |
Number of subjects with clinically significant changes in laboratory measures |
| up to Day 35 |
| Secondary Outcome (ECGs)Number of subjects with Clinically significant changes in Electrocardiogram | Number of subjects with Clinically significant changes in Electrocardiogram measures (PR,RR,QT and QTcF) | up to Day 35 |
| Secondary Outcome (Vital Signs) Number of subjects with Clinically meaningful changes in Vital signs | Number of subjects with Clinically meaningful changes in Vital signs | up to Day 35 |
| Secondary Outcome (C-SSRS) - Change from baseline of the Columbia-Suicide Severity Rating Scale(C-SSRS) | Change from baseline of the Columbia-Suicide Severity Rating Scale(C-SSRS) The C-SSRS rates an individual's degree of suicidal ideation (SI) on a scale, ranging from "wish to be dead" to "active suicidal ideation with specific plan and intent." The scale identifies SI severity and intensity, which may be indicative of an individual's intent to commit suicide. C-SSRS SI severity subscale ranges from 0 (no SI) to 5 (active SI with plan and intent). | up to Day 35 |
| Atlanta |
| Georgia |
| 30331 |
| United States |
| 22193671 | Background | Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011 Dec;168(12):1266-77. doi: 10.1176/appi.ajp.2011.10111704. |
| 12672864 | Result | Nussbaum RL, Ellis CE. Alzheimer's disease and Parkinson's disease. N Engl J Med. 2003 Apr 3;348(14):1356-64. doi: 10.1056/NEJM2003ra020003. No abstract available. |
| 10816186 | Result | Rascol O, Brooks DJ, Korczyn AD, De Deyn PP, Clarke CE, Lang AE. A five-year study of the incidence of dyskinesia in patients with early Parkinson's disease who were treated with ropinirole or levodopa. N Engl J Med. 2000 May 18;342(20):1484-91. doi: 10.1056/NEJM200005183422004. |
| 16941456 | Result | Schrag A, Banks P. Time of loss of employment in Parkinson's disease. Mov Disord. 2006 Nov;21(11):1839-43. doi: 10.1002/mds.21030. |
| 18416667 | Result | Yamamoto M, Schapira AH. Dopamine agonists in Parkinson's disease. Expert Rev Neurother. 2008 Apr;8(4):671-7. doi: 10.1586/14737175.8.4.671. |
| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |