To evaluate the safety and tolerability of oral administration of PTL201 for relief of spasticity-related symptoms in 70 MS patients and to evaluate the efficacy of oral administration of PTL201 in relief of spasticity-related symptoms in MS patients. The pharmacokinetics of PTL201 in comparison to buccally administered Sativex will be evaluated in sub-study prior to the efficacy study.
The study will be comprised of the following parts: 1. Pharmacokinetics (PK) sub-study: A 7-day baseline observation period. Randomized cross-over treatments (Sativex, PTL201), performed at minimum 7-day washout. Follow up - one week after the last dosing session. 2. Efficacy study: A 7-day baseline observation period. Single-blind responder phase - 4 weeks. Randomized, double-blind, placebo-controlled treatment phase - 4 weeks Follow up - two weeks. Subjects participating in the pharmacokinetic sub-study will be allowed to participate in the efficacy study and will not be required to repeat the 7-day observation period of the efficacy study. Doses will be titrated over a one-week period until reaching maximum tolerated dose (MTD) for each participant The MTD will be self administered for three weeks thereafter. Participants demonstrating response to treatment will continue self administering daily PTL201 treatment or placebo, for an additional four weeks. Participants will keep a daily diary.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
70
Two piece acid resistance hard capsule filled with seamless gelatin matrix green beads containing tetrahydrocannabinol (THC) and cannabidiol (CBD). Each capsule contain 5 mg THC and 5 mg CBD
Placebo seamless gelatin matrix green beads containing excipients only
Sheba medical center
Tel Hashomer, Ramat Gan, Israel
Incidence of study treatment-related adverse events (AE)
Time frame: 10 weeks (70 days) from beginning of treatment to end of follow-up
Change in sNRS scores from randomization to end of placebo-controlled treatment phase
Time frame: during the 4 weeks (28 days) placebo-controlled treatment period
Incidence of all AEs
Time frame: during 10 week treatment plus follow up period
Percent change in walking velocity
Time frame: during 4 weeks placebo-controlled treatment period
Clinical Global Impression Improvement (CGI-I) assessment using a 7-point scale condition
Time frame: at randomization (day 29) and the end of placebo-controlled treatment phase (day 57)
Cadence (steps/min) assessment
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Stride length (cm) assessment
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
pNRS assessment
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Spasm frequency assessment
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
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Sleep disturbance assessment
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Assessment of clinical gait measures
Timed (sec) 25 foot walk test (T25FW)
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)
Assessment of clinical gait measures
Timed (sec) up and go test (TUG)
Time frame: at baseline (day 1) end of responder phase (day 29) and end of placebo-controlled treatment phase (day 57)