RecruitingPhase 1Phase 2NCT04752774

A Study to Assess the Safety and Efficacy of IPN10200 in Adult Participants With Upper Limb Spasticity.

An Integrated Phase I/II, Multicentre, Double-blind, Randomised, Dysport and Placebo-controlled, Dose Escalation and Dose-finding Study to Evaluate the Safety and Efficacy of IPN10200 in the Treatment of Adult Upper Limb Spasticity.


Sponsor

Ipsen

Enrollment

240 participants

Start Date

Apr 29, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of the study is to assess the safety and efficacy of increasing doses of IPN10200 with the aim to evaluate the Pharmacodynamics (PD) profile of IPN10200 and to establish the total IPN10200 doses(s) that offer the best efficacy/safety profile when used for the treatment of Adult upper limb (AUL) spasticity.


Eligibility

Min Age: 18 YearsMax Age: 70 Years

Inclusion Criteria16

  • Participant must be 18 to 70 years of age inclusive (except for dose escalation must be 18 to 65 years of age) at the time of signing the informed consent.
  • Has spastic hemiparesis following stroke or Traumatic brain injury (TBI)
  • Is at least 6 months post-stroke or TBI
  • Has never received BoNT or if previously treated, should have received their last injection of any commercialized BoNT-A or B at least 4 months prior to study Baseline
  • Has a MAS score ≥2 in the (PTMG) to be injected
  • Is eligible to receive a total recommended dose 1000 U Dysport in the upper limb when applicable.
  • Has angle of spasticity ≥5° in the PTMG to be injected.
  • Does not have any fixed contractures as defined by:
  • Complete fingers extension with Angle of arrest at slow speed (Tardieu Scale) (XV1) ≥160°
  • Complete wrist extension with XV1 ≥90°
  • Complete elbow extension with XV1 ≥160°
  • Physiotherapy, occupational therapy, splinting, use of benzodiazepine, and muscle relaxants had to be stable from at least 30 days preceding the study Baseline up to the Month 3 visit, and whenever possible until the end of the study.
  • In good health (i.e. absence of any uncontrolled systemic disease or other significant medical condition) as determined by medical history, physical and neurological examinations, clinical laboratory studies, electrocardiograms (ECGs), vital signs, and Investigator's judgment prior to randomization
  • Male and female participants Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
  • Male participants must agree that, if their partner is at risk of becoming pregnant, they will use an effective method of contraception. The participants must agree to use the contraception during the whole period of the study.
  • A female participant is eligible to participate if she is not pregnant or breastfeeding, and one of the following conditions applies: Is a woman of non-childbearing potential (WONCBP) or is a woman of childbearing potential (WOCBP) and using an acceptable contraceptive method (until the end of the study). The investigator should evaluate the potential for contraceptive method failure in relationship to the first dose of study intervention. A WOCBP must have a negative highly sensitive pregnancy test.

Exclusion Criteria19

  • Any medical condition (including severe dysphagia or airway disease) that may increase, in the opinion of the investigator, the likelihood of adverse events (AEs) related to BoNT treatment.
  • Known disease of the neuromuscular junction (e.g. Lambert-Eaton myasthenic syndrome, myasthenia gravis or amyotrophic lateral sclerosis etc.).
  • Has a history of hypersensitivity to the investigational medicinal products (or other BoNTs) or any excipient used in their formulation.
  • Clinically diagnosed significant anxiety disorder, or any other significant psychiatric disorder (e.g. depression) that might interfere with the participant's participation in the study.
  • Likely treatment with any serotype of BoNT for any condition during the study.
  • Undergone previous surgery to treat spasticity in the affected upper limb.
  • Has initiated physiotherapy within 30 days prior to Baseline (if physiotherapy initiated more than 30 days prior to Baseline and ongoing, the therapy regimen should be maintained at the same frequency and intensity throughout the study if possible or at least up to 3-months post-injection).
  • Has received previous treatment with phenol and or alcohol in the targeted upper limb any time before the study.
  • Has been treated or is likely to be treated with intrathecal baclofen during the 30 days prior to study Baseline or during the course of the study.
  • Current or planned treatment with any medications that interfere either directly or indirectly with neuromuscular transmission, such as curare-like non depolarising agents, lincosamides, polymyxins, anticholinesterases and aminoglycoside antibiotics, within 30 days prior to Baseline.
  • Use of concomitant therapy which, in the investigator's opinion, would interfere with the evaluation of the safety or efficacy of the study intervention, including medications affecting bleeding disorders. For patients taking vitamin K antagonists, the INR values should be controlled (between 2 and 3)
  • Currently planned or a history of tendon lengthening surgery, significant contracture or muscle atrophy at target joint or muscle in the past 6 months prior to Screening.
  • Use of any experimental device within 30 days or use of any treatment with an experimental drug within five times the documented terminal half-life of the respective drug or its metabolites or if the half-life is unknown within 30 days prior to the start of the study (prior to Baseline) and during the conduct of the study.
  • Presence of any other condition (e.g. neuromuscular disorder, muscular dystrophies, cancer cachexia, sarcopenia or other disorder that could interfere with neuromuscular function), laboratory finding or circumstance that, in the judgment of the investigator, might increase the risk to the participant or decrease the chance of obtaining satisfactory data to achieve the objectives of the study.
  • Pregnant or lactating women, or women of childbearing potential not willing to practice a highly effective form of contraception method at the beginning of the study, for the duration of the study and for the duration of the study
  • Inability to understand protocol procedures and requirements
  • Infection at the injection site(s)
  • A history of drug or alcohol abuse
  • Male participants who are not vasectomised and who have female partners of childbearing potential and are not willing to use condoms with spermicide throughout study participation.

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Interventions

BIOLOGICALIPN10200

Powder and solvent for solution for injection

DRUGPlacebo

Powder and solvent for solution for injection

BIOLOGICALDysport

Powder for solution for injection


Locations(81)

Rancho Los Amigos National Rehab

Downey, California, United States

Kansas Institute of Research

Overland Park, Kansas, United States

Quest Research Institute

Farmington Hills, Michigan, United States

Einstein Physical Medicine and Rehabilitation at Elkins Park

Elkins Park, Pennsylvania, United States

The University of Texas Southwestern Medical Center

Dallas, Texas, United States

Medical University Innsbruck, Department of Neurology

Innsbruck, Austria

Kepler University Hospital GmbH, Department of Neurology and Psychiatry

Linz, Austria

Brothers of Charity Hospital Linz, Department of Neurology I

Linz, Austria

Medical University Vienna, Department of Neurology

Vienna, Austria

Multiprofile Hospital for Active Treatment "Heart and Brain"

Pleven, Bulgaria

Medical Center "Rusemed" EOOD

Rousse, Bulgaria

Multiprofile Hospital for Active Treatment of Neurology and Psychiatry "Sveti Naum", Sofia, Neurological Diseases Clinic for Neurodegenerative and Peripheral Neurological Diseases

Sofia, Bulgaria

Diagnostic Consulting Center - Convex EOOD

Sofia, Bulgaria

Medical Center Medica Plus Ltd

Veliko Tarnovo, Bulgaria

University Hospital Hradec Kralove, Clinic of Neurology

Hradec Králové, Czechia

Hospital Jihlava, Department of Neurology

Jihlava, Czechia

University Hospital Ostrava, Clinic of Neurology, Center for Demyelinating diseases

Ostrava, Czechia

Regional Hospital Pardubice, Clinic of Neurology

Pardubice, Czechia

University Hospital Kralovske Vinohrady, Clinic of Neurology

Prague, Czechia

General University Hospital in Prague, Clinic of Neurology

Prague, Czechia

Bastia Hospital Center

Bastia, France

Bordeaux University Hospital Center - Pellegrin Hospital Group

Bordeaux, France

Brest University Hospital Center - Morvan Hospital

Brest, France

Raymond-Poincare Hospital - APHP

Garches, France

University Hospital Bonn, Clinic and Policlinic for Neurology

Bonn, Germany

Heinrich Heine University Medical Center, Department of Neurology

Düsseldorf, Germany

University Medicine Goettingen, Department of Neurology

Goettigen, Germany

University Hospital Hamburg-Eppendorf, Clinic and Polyclinic of Neurology

Hamburg, Germany

University Hospital Johannes Gutenberg - University of Mainz, Clinic and Polyclinic of Neurology

Mainz, Germany

Ludwig Maximilians University Hospital, Campus Grosshadern, Department of Neurology

Munich, Germany

GFO Clinics Troisdorf, St. Johannes Sieglar

Troisdorf, Germany

University Hospital Tuebingen, Department of Neurology

Tübingen, Germany

Semmelweis University, Rehabilitation Clinic, Rehabilitation Department of Brain Injuries

Budapest, Hungary

University of Debrecen Clinical Center, Department of Medical Rehabilitation and Physical Medicine

Debrecen, Hungary

Petz Aladar University Teaching Hospital, Department of Neurology

Győr, Hungary

Szent Damjan Greek Catholic Hospital, Department of Neurology and Stroke

Kisvárda, Hungary

Borsod-Abauj-Zemplen County Central Hospital and University Educational Hospital, Department of Neurology

Miskolc, Hungary

ASST Spedali Civili Brescia

Brescia, Italy

University Hospital "Federico II"

Naples, Italy

University Polyclinic Foundation "Agostino Gemelli" - IRCCS

Rome, Italy

Clinical Research Center of Verona S.r.l. - CRC

Verona, Italy

Fukuoka Rehabilitation Hospital

Fukuoka, Japan

Chutoen General Medical Center, Department of Rehabilitation

Shizuoka, Japan

Tokushima University Hospital

Tokushima, Japan

NHO Murayama Medical Center, Department of Rehabilitation

Tokyo, Japan

St Wojciech - Adalbertus Hospital, Neurology Department

Gdansk, Poland

Specialist Doctor Practice

Katowice, Poland

Ma-Lek MS Therapy Centre

Katowice, Poland

Neuro-Medic

Katowice, Poland

Specialist Practises LLC

Krakow, Poland

Linden Medical Center

Krakow, Poland

Clinical Center for Neurology Sp. z o .o. (LLC)

Krakow, Poland

NeuroKlinika - Private Practice Prof. Andrzej Bogucki

Lodz, Poland

Health Institute Dr n. med. Magdalena Boczarska-Jedynak

Oświęcim, Poland

Clinical Research Center SP. ZOO MEDIC-R

Poznan, Poland

Neuro-Kard Ilkowski and Partners

Poznan, Poland

Holy Spirit Specialist Hospital in Sandomierz - Neurology Teaching Hospital, Neurology Department

Sandomierz, Poland

Wolski Hospital, Neurological Department

Warsaw, Poland

NeuroProtect Medical Center

Warsaw, Poland

EuroMediCare Specialist Outpatient Clinics in Wroclaw

Wroclaw, Poland

Alto Ave Central Hospital

Guimarães, Portugal

Local Health Unit Loures-Odivelas E.P.E.

Loures, Portugal

Local Health Unit of Matosinhos (ULSM), EPE - Pedro Hispano Hospital

Matosinhos Municipality, Portugal

Local Unit of Health in Alto Minho, EPE

Viana do Castelo, Portugal

Federal Siberian Research and Clinical Center, Department of Nervous Diseases, Traditional Medicine with Course in Postgraduate Education

Krasnoyarsk, Russia

National Medical Research Center Treatment and Rehabilitation Center, Department of Neurology

Moscow, Russia

"Praximed" - Diagnostic and Rehabilitation Center, Rehalibitation Department

Saint Petersburg, Russia

N.P. Bekhtereva Research Institute of Human Brain

Saint Petersburg, Russia

Astarta, LLC, Department of Neurology

Saint Petersburg, Russia

Medical and Sanitary Unit #70 of "Passazhiravtotrans"

Saint Petersburg, Russia

Dongguk University Ilsan Hospital

Goyang-si, South Korea

The Catholic University of Korea - Incheon St. Mary's Hospital

Incheon, South Korea

Seoul National University Bundang Hospital

Seongnam-si, South Korea

Severance Hospital, Yonsei University Health System

Seoul, South Korea

Hospital Maritimo de Oza

A Coruña, Spain

University Hospital Vall d'Hebron

Barcelona, Spain

Juan Ramon Jimenez Hospital

Huelva, Spain

University Hospital de La Princesa, Physical Medicine and Rehabilitation

Madrid, Spain

Santiago de Compostela Clinical Hospital, Physical Medicine and Rehabilitation

Santiago de Compostela, Spain

University Hospital Virgen Macarena, Physical Medicine and Rehabilitation

Seville, Spain

Meixoeiro Hospital at Vigo University Hospital Complex

Vigo, Spain

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NCT04752774


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