Status:

COMPLETED

Efficacy of Transdermal Nicotine, on Motor Symptoms in Advanced Parkinson's Disease

Lead Sponsor:

Assistance Publique - Hôpitaux de Paris

Conditions:

Idiopathic Parkinson's Disease

Eligibility:

All Genders

35-70 years

Phase:

PHASE2

Brief Summary

Medical treatment of idiopathic Parkinson disease motor symptoms requires dopaminergic drugs, with long term disabling side effects. (fluctuations, dyskinesia, ON/OFF phenomena). Use of nicotine in Pa...

Detailed Description

Experimental plan Phase II controled study, in 40 patients, randomised in single blind, and in 2 groups: * One group treated by transdermal nicotine-therapy (N= 20), * One group without additional t...

Eligibility Criteria

Inclusion

  • Patients with idiopathic Parkinson's disease according to the United Kingdom Parkinson's Disease Society Brain Bank (UKPDSBB), since at least three years,or treated by L-dopa for 2 years minimum with motor fluctuations (amendment 12/10/2010)
  • Patients aged between 35 and 70 years inclusive,
  • L-Dopa responders: L-Dopa test with an improvement of over 30 % of UPDRS-III motor score,
  • L-Dopa treatment since at least three years,
  • Patients with Parkinson's disease stage maximum IV ("OFF" state) according to the modified Hoehn and Yahr classification (without treatment since at least 12 hours), and III maximum in "ON" state,
  • Non smoker,
  • Signed Informed Consent

Exclusion

  • Previous neurosurgery for Parkinson's disease,
  • Weight \< 45 kg or \> 100 kg,
  • Previous Parkinson's disease treatment by transdermal nicotine-therapy discontinued less than 6 months before inclusion,
  • History of allergy to Nicotine,
  • History of allergy to transdermal device,
  • Cutaneous disorders wich could disturb use of transdermal device,
  • Cognitive disorders, (Mattis score \< 125)
  • History or detection at inclusion of cardiac arrhythmia,
  • History of coronary failure,
  • History of cardiac failure, (NYHA from II to IV \& ejection fraction (EF) \< 40%)
  • Severe arterial hypertension (diastolic \> 100 mmHg) or uncontrolled,
  • Symptomatic orthostatic hypotension, (2 points of differential in standing position and systolic \<100mm Hg or clinical evidence)
  • History of stroke or occlusive peripheral vascular disease,
  • History of hyperthyroid,
  • History or detection at inclusion of type I or II diabetes, (HbA1c \< 11%)
  • History of pulmonary disease: asthma, chronic obstructive pulmonary disease (COPD),
  • History of auto-immune disease,
  • Progressive depression, suicide attack, acute psychosis, invasive hallucinations, psychiatrist opinion harmful for a correct compliance to experimentation,
  • History or recent gastroduodenal ulcer, (\< 3 months)
  • History or detection at inclusion of hepatobiliary or renal failure, (clearance\< 60 mL/min)
  • Pregnancy, breast-feeding,
  • Absence of effective contraception in women in childbearing potential,
  • Treatment by nifedipine, beta-blockers, diuretics, insulin and H2 antihistaminics for potential side effects in combination with nicotine,
  • Patients unlikely to be compliant or to fully cooperate during the study.

Key Trial Info

Start Date :

February 1 2009

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

May 1 2013

Estimated Enrollment :

40 Patients enrolled

Trial Details

Trial ID

NCT00873392

Start Date

February 1 2009

End Date

May 1 2013

Last Update

December 31 2013

Active Locations (1)

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1

Groupe Hospitalier Albert Chenevier Henri Mondor

Créteil, France, 94000