The goal of this clinical trial is to learn if the drug BMS-986368 works to treat post stroke spasticity in adults who have had a stroke. BMS-986368 is a designed to increase natural compounds in the body that may help calm nerves that cause muscles to be tight or spasm. The study will also learn about the safety of drug BMS-986368
Post-stroke spasticity (PSS) is a common and disabling complication of stroke that can impair upper-limb function, limit activities of daily living, and negatively affect quality of life. Current treatment options, including oral antispasticity medications and botulinum toxin injections, may provide incomplete symptom control and are often associated with tolerability limitations. Therefore, there is a need for novel therapies that can improve both spasticity and functional recovery in individuals with PSS. Preclinical evidence and early clinical experience support evaluation of BMS-986368 as a treatment for post-stroke spasticity. The STIPS Study is a Phase 2, randomized, double-blind, placebo-controlled pilot trial designed to evaluate the efficacy, safety, and tolerability of BMS-986368 in adults with post-stroke spasticity. The study consists of: * A screening period of up to 4 weeks * An 8-week double-blind treatment period * An optional 8-week double-blind active treatment extension (DBATE) * A 4-week safety follow-up period The maximum study duration is approximately 24 weeks. During the double-blind treatment period, participants randomized to active treatment will receive oral BMS-986368 with dose escalation from 1 mg once daily, to 3 mg once daily and then 6 mg once daily. Participants randomized to placebo will receive matching placebo capsules. Participants who complete the double-blind treatment period may elect to enter the DBATE, during which all participants receive active treatment while maintaining study blinding. The study hypothesis is that BMS-986368 administered up to 6 mg once daily will result in greater improvement in spasticity and upper-extremity motor function compared with placebo, while demonstrating an acceptable safety and tolerability profile in participants with post-stroke spasticity
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Administration of BMS-986368. Specified dose on specified days
Interventions: Drug: Placebo
Jeffersi=on Moss Magee Rehabilitation
Elkins Park, Pennsylvania, United States
RECRUITINGTardieu Scale
Change from baseline in elbow and wrist Tardieu Scale. Clinical assessment with higher scores indicating greater spasticity.
Time frame: At Week 8
Upper Limb Fugl-Meyer Assessment (FMA-UE) Scale
Change from baseline, Clinical Assessment of upper-extremity motor function and sensorimotor recovery after stroke. Scores range from 0 to 66, with higher scores indicating better motor function.
Time frame: At Week 8
Tardieu Scale - DBATE
Change from baseline in in elbow and wrist Tardieu Scale for participants in the Optional Active Treatment Extension Phase (DBATE).
Time frame: At week 16
Upper Limb Fugl-Meyer Assessment (FMA-UE) Scale- DBATE
Change from baseline iat Week 16 for patients in the for patients in the Optional Active Treatment Extension Phase (DBATE)
Time frame: At week 16
Total Numeric-transformed Modified Ashworth Scale (TNmAS)
Change from baseline in Total Numeric-transformed Modified Ashworth Scale; Clinician-rated measure of muscle tone/spasticity.
Time frame: At week 8 for all participants. Additionally at Week 16 for participants in the Optional Active Treatment Extension phase
Numeric Rating Scale - Spasticity (NRS-S)
Change from baseline. Participant-rated severity of spasticity on a 0-10 scale
Time frame: At Week 8 for all participants. At Week 16 for participants in the Optional Active Treatment Extension Phase
Patient Health Questionnaire-9 (PHQ-9)
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Masking
QUADRUPLE
Enrollment
42
Change from baseline in PHQ-9 Depression Scale. .The PHQ-9 participant-reported questionnaire used to assess the severity of depressive symptoms/
Time frame: At Week 8 for all participants Additionally at Week 16 for participants in the Optional Active Treatment Extension Phase
Clinical Global Impression of Severity (CGI-S)
Change from baseline on the Clinical Global Impression of Severity (CGI-S) score. Clinician assessment of overall severity of spasticity-related impairment.
Time frame: At Week 8 for all participants. Additionally at Week 16 for participants in the Optional Active Treatment Extension Phase
Treatment-Emergent Adverse Events (TEAEs)
Number of participants with Treatment-Emergent Adverse Events (TEAEs)
Time frame: Up to week 16]
Serious adverse events (SAEs)
Serious adverse events (SAEs)
Time frame: Up to week 16
Adverse events (AEs) leading to treatment discontinuation
Adverse events (AEs) leading to treatment discontinuation
Time frame: Up to week 16]
AEs leading to death
AEs leading to death
Time frame: Up to week 16]
AEs leading to clinically significant lab abnormalities
AEs leading to clinically significant lab abnormalities
Time frame: [Time Frame: Up to week 16]
Suicidal Ideation and Behavior
Number of participants with suicidal ideation and behavior during trial as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS).
Time frame: Up to week 16]
Cannabis Withdrawal Symptoms
Number of participants with withdrawal symptoms following BMS-986368 administration as assessed by the Cannabis Withdrawal Scale (CWS).
Time frame: Up to week 24
Plasma concentrations of BMS-986368
Plasma concentrations of BMS-986368 at selected pre- and post-dose time points
Time frame: Up to Week 8