The purpose of this study is to assess the efficacy, the safety, and the effect on biomarkers of 2 dose levels of oral GT-02287 over placebo after 48 weeks of treatment in treated and untreated participants with early PD.
This is a 48-week, double-blind, randomized, placebo-controlled Phase 2a study testing two doses of oral GT-02287 in people with early Parkinson's disease (PD), both treated and untreated. The study has three parts: * Screening Period lasting up to 45 days * Treatment Period lasting about 341 days * Follow-up Period lasting up to 33 days Participants will have 7 onsite visits for efficacy, safety, tolerability, and biomarker assessments (Week 4, Week 8, Week 12, Week 24, Week 36, Week 48, and a Follow-Up Visit at Week 52). In addition, there will be 5 additional visits for laboratory blood tests (Weeks 2, 16, 20, 30, and 42). Approximately 111 participants will be randomized into three groups (high dose, low dose, placebo). Participants can have idiopathic PD or be heterozygous for a pathogenic variant in the GBA1 gene. Participants who have other PD-associated genetic variants (e.g., leucine rich repeat kinase 2 \[LRRK2\]) are ineligible. All participants will be genotyped to determine their PD-associated genetic status before enrollment. At the start, participants undergo screening and baseline tests, including motor assessments, quality of life, sensor measurements, and collection of fluid and blood samples for biomarkers. Some baseline tests may be done just before dosing. The study will measure efficacy through various motor, quality of life, disease progression, non-motor and other symptoms of PD, and cognitive tests, along with wearable sensor data. Safety will be assessed by recording adverse events, lab tests, vital signs, body weight, heart monitoring, and questionnaires. The study will also analyze GT-02287 levels in blood and spinal fluid, and its effects on biomarkers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
111
Sachets containing 400 mg/day or 600 mg/day of active (GT-02287), depending on the participant's body weight. Each daily dose will be prepared as an oral suspension by mixing the content of 1 sachet with the vehicle (supplied in an amber glass bottle) and the requisite volume of tap water.
Sachets containing 800 mg/day or 1000 mg/day of active (GT-02287), depending on the participant's body weight. Each daily dose will be prepared as an oral suspension by mixing the content of 1 sachet with the vehicle (supplied in an amber glass bottle) and the requisite volume of tap water.
Sachets containing 420 to 1200 mg of MAS indistinguishable from the active sachets. Each daily dose will be prepared as an oral suspension by mixing the content of 1 sachet with the vehicle (supplied in an amber glass bottle) and the requisite volume of tap water.
Change from Baseline to Week 48 in the sum of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II score and Part III score [Efficacy]
Change from Baseline to Week 48 in the sum of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II score and Part III score assessed in the practically defined OFF state. MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of four parts. Part II assesses motor experiences of daily living (Range 0-52). It contains 13 questions which are to be rated by the patient and/or caregiver. Part III assesses the motor signs of PD and is rated by the investigator (Range 0-132). Part III contains 33 scores based on 18 items. For each question a numeric score is assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. A higher score indicates more severe symptoms of PD.
Time frame: From baseline to Week 48
Incidence of Treatment-Emergent Adverse Events [Safety and tolerability]
Incidence, nature, relationship to investigational product (IP), and severity of adverse events (AEs); Incidence of clinically significant findings for clinical laboratory evaluations, physical and neurological examinations, body weight , vital signs measurements, 12-lead o 12-lead electrocardiograms (ECGs), Columbia Suicide Severity Rating Scale (C-SSRS)
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the MDS-UPDRS Part II score [Effect on motor function]
Change from Baseline to Week 48 in the MDS-UPDRS Part II score. MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of four parts. Part II assesses motor experiences of daily living (Range 0-52). It contains 13 questions which are to be rated by the patient and/or caregiver. A higher score indicates more severe symptoms of PD.
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the MDS-UPDRS Part III score [Effect on motor function]
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Change from Baseline to Week 48 in the MDS-UPDRS Part III score assessed in the practically defined OFF state. MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of four parts. Part III assesses the motor signs of PD and is rated by the investigator (Range 0-132). Part III contains 33 scores based on 18 items. For each question a numeric score is assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. A higher score indicates more severe symptoms of PD.
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the Timed Up and Go (TUG) test [Effect on motor function]
Change from Baseline to Week 48 in the Timed Up and Go (TUG) test performed in the practically defined OFF state. The TUG is a clinical test for assessing functional mobility and balance, where a person times how long it takes to stand up from a chair, walk 3 meters, turn 180 degrees, walk back, and sit down again. A time of less than 14 to 15 seconds indicates good mobility, while longer times suggest an increased risk of falling, poor physical performance, and potentially neurological issues.
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the Parkinson's Disease Questionnaire 39 (PDQ-39) score [Effect on quality of life]
Change from Baseline to Week 48 in the Parkinson's Disease Questionnaire 39 (PDQ-39) score. The PDQ-39 is a 39-item self-report questionnaire, which assesses PD-specific health-related quality over the last month. The questionnaire measures 39 items, which assess 8 domains of health: mobility (10 items), activities of daily living (6 items), emotional well being (6 items), stigma (4 items), social support (3 items), cognitions (4 items), communication (3 items), and bodily discomfort (3 items). Each item is scored on the following scale: 0 = never, 1 = occasionally, 2 = sometimes, 3 = often, and 4 = always. Items in each subscale and the total scale can be summarized into an index and transformed linearly to a scale from 0 (perfect health as assessed by the measure) to 100 (worst health as assessed by the measure).
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the Schwab and England Activities of Daily Living (SEADL) scale [Effect on activities of daily living]
Change from Baseline to Week 48 in the Schwab and England Activities of Daily Living (SEADL) scale. The SEADL Scale assesses the capabilities of people with impaired mobility in a range of life activities. The scale uses a percentage score to rate a person's abilities, with 100% indicating complete independence (able to do all chores without slowness, difficulty, or impairment) and 0% indicating full dependence (bedridden and almost completely comatose).
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the Patient Global Impression Scale - Severity (PGI-S)
Change from Baseline to Week 48 in the Patient Global Impression Scale - Severity (PGI-S). The PGI-S is a simple, direct, easy to use scales used to rate the response of a condition to a therapy. It is a transition scale for the participant to rate their condition now as compared with how it was prior to before starting the treatment on a scale from 1 "Very much better" to 7 "Very much worse" with lower scores indicating greater improvement.
Time frame: From baseline to Week 48
Change from Baseline to Week 48 in the Clinical Global Impressions Scale - Severity (CGI-S)
Change from Baseline to Week 48 in the Clinical Global Impressions Scale - Severity (CGI-S). The CGI-C scale is a clinician-rated measures of severity of a symptom or condition, using a single item, 6-point-scale. The CGI-S scale ranges from 1 ("None") to 6 ("Very Severe") with lower scores indicating lower severity.
Time frame: From baseline to Week 48