The investigational medicinal product (IMP) to be tested in the clinical trial (Rotigotine (ROT)-Transdermal System (TDS) (8 mg/24 h)), which is subject to this submission, was designed as a generic of Neupro® 8 mg/24 h, which is marketed in the European Union since 2006 (date of first authorisation is 2006, date of renewal of the authorisation is 2016) and serves as Reference product. It is the intention of this clinical trial to assess patch adhesion properties of the newly developed rotigotine patch and the marketed Reference product Neupro® 8 mg/24 h after multiple patch applications.
This multi-centre, open, randomized (order of treatments), multiple dose trial will be performed in a 4-period, 2-sequence-crossover design. A washout phase is not needed, i.e. the IMP application of the 2nd study period may take place the day of the IMP removal of the 1st study period (direct switch-over) and so forth. Patients with a diagnosis of idiopathic Parkinson's disease and a continuous and stable dose of rotigotine (at least 8 mg/24 h) including use of an 8 mg/24 hours patch will be randomized. In each of the 4 periods 1 patch, either of Test or Reference will be applied, with a release rate of 8 mg/24 h rotigotine each. Each patch will remain applied for 24 h. Assessment of patch adhesion will be performed 5 min after application of each patch as well as at the end of the application interval prior to removal of the patch. The clinical trial will be performed as a crossover investigation with intra-individual comparison, thus reducing variability of the patch adhesion parameters, which is supposed to be higher between patients than within an individual patient. The patients will continue their usual medications and will only replace one 8 mg/24 h rotigotine containing patch per day with the IMPs for the duration of treatment in the clinical trial. In case of prescribed doses above 8 mg/24 h rotigotine, the remaining dose will be provided by Non-Investigational Medicinal Pproducts (NIMPs). Thus, no interruption in the prescribed dose of rotigotine will occur.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
38
Once daily patch application of one Rotigotine 8Mg/24Hrs Patch (Test or Reference) over 4 days
Universitätsklinikum Ulm Neur. Studienzentrale im RKU
Ulm, Baden-Wurttemberg, Germany
Parkinson-Klinik Ortenau GmbH & Co. KG
Wolfach, Baden-Wurttemberg, Germany
Neuroakademie Alzenau GbR
Alzenau in Unterfranken, Bavaria, Germany
Curiositas ad Sanum Studien- und Beratungs GmbH Innklinikum Haag i.OB
Haag in Oberbayern, Bavaria, Germany
Curiositas ad Sanum Studien- und Beratungs GmbH
München, Bavaria, Germany
Neurologisches Fachkrankenhaus für Bewegungsstörungen/ Parkinson
Beelitz-Heilstätten, Brandenburg, Germany
Gertrudis-Klinik Parkinson-Zentrum GmbH
Leun, Hesse, Germany
Praxis für Neurologie Dr. med. Christian Oehlwein
Gera, Thuringia, Germany
Assessment of patch adhesion properties of the Test product in patients diagnosed with idiopathic Parkinson's disease at the end of the dosing interval
Patch adhesion will be assessed for Test/ Reference 5 min and 23 h 55 min after patch application by trained observers. Area(s) detached will be drawn on transparent films of identical size and shape as the patch in question by the trained observer. As suggested by the Guideline on the pharmacokinetic and clinical evaluation of modified release dosage forms (EMA/CPMP/EWP/280/96 Corr1), June 2015, patch adhesion will be measured by means of the percentage of area that remains adhered at the end of the dosing interval. Additionally, the patch adhesion will be documented by taking photos at the time point of intended patch adhesion assessment of the patch and surrounding area. The following scores and affiliated percentages for the relative area still in tight contact with the skin will be used in order to quantify the patch adhesion: 0 = ≥ 90% adhered 1. = ≥ 80% adhered 2. = ≥ 70% adhered 3. = ≥ 60% adhered 4. = ≥ 50% adhered 5. = \< 50% adhered or patch completely off the skin.
Time frame: 24 hours
Comparative assessment of patch adhesion properties of the Test vs. Reference product in patients diagnosed with idiopathic Parkinson's disease at the end of the dosing interval
Patch adhesion will be assessed for Test/ Reference 5 min and 23 h 55 min after patch application by trained observers. Area(s) detached will be drawn on transparent films of identical size and shape as the patch in question by the trained observer. As suggested by the Guideline on the pharmacokinetic and clinical evaluation of modified release dosage forms (EMA/CPMP/EWP/280/96 Corr1), June 2015, patch adhesion will be measured by means of the percentage of area that remains adhered at the end of the dosing interval. Additionally, the patch adhesion will be documented by taking photos at the time point of intended patch adhesion assessment of the patch and surrounding area. The following scores and affiliated percentages for the relative area still in tight contact with the skin will be used in order to quantify the patch adhesion: 0 = ≥ 90% adhered 1. = ≥ 80% adhered 2. = ≥ 70% adhered 3. = ≥ 60% adhered 4. = ≥ 50% adhered 5. = \< 50% adhered or patch completely off the skin.
Time frame: 24 hours
Skin tolerability of Test and Reference based on standardised assessment of Adverse Events of Special Interest
Skin irritation will be assessed for Test/ Reference 30 min after patch removal by trained observers. Skin will be visually checked and palpated. The investigator will decide based on own experience or given specifications, if a skin irritation is to be classified as Adverse Event. Additionally, photos of the skin area will be taken for documentation at all assessment time points. The following symptoms and severity grades will be used for assessment of tolerability at the site: Dermal response: symptom (severity); erythema (none/ minimal/ mild/ moderate/ severe); papules (none/ discrete/ pronounced); oedema (none/ minimal/ definite); vesicles (none/ non-confluent ≤ 5 mm/ confluent/ non-confluent ≥ 5 mm) Skin reaction spreading beyond site Other effects: none; slightly glazed appearance; markedly glazed appearance; glazing with peeling and cracking; glazing with fissures; film of dried serous exudates covering all or part of the site; small petechial erosions and/or scabs
Time frame: 24 hours
Descriptive characterisation of safety and tolerability of the investigational medicinal products (IMPs) in the trial population
Adverse Events (AEs) observed, mentioned upon general questioning, or spontaneously reported will be documented. Adverse Events of Special Interest (AESI): Skin irritation and sensitization symptoms at patch application site Adverse Events will be listed and evaluated descriptively with regard to action taken, frequency, seriousness, intensity, relationship to the IMP, and outcome, as well as period and treatment. Safety parameters vital signs (BP, pulse rate (PR)): Systolic and diastolic arterial blood pressure will be measured by oscillometry using an automatic non-invasive device. Abnormal findings during this safety measurements, assessed as clinically relevant by the investigator, will be reported as adverse events and will be followed up and/or treated as medically appropriate.
Time frame: 4 days
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