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NCT02207946

Botulinum Toxin A to Treat Arm Tremor

Completed Phase 2 Results posted Last updated 18 February 2021
What this trial tests

Phase 2 trial testing IncobotulinumtoxinA in Essential Tremor of the Upper Limbs in 30 participants. Completed in 26 September 2016.

Timeline
5 December 2014
Primary endpoint
9 May 2016
26 September 2016

Quick facts

Lead sponsorMerz Pharmaceuticals GmbH
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment30
Start date5 December 2014
Primary completion9 May 2016
Estimated completion26 September 2016
Sites6 locations across Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Merz Pharmaceuticals GmbH — full company profile →

Who can join

18 and older, any sex, with Essential Tremor of the Upper Limbs. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change From Baseline to Week 4 in Maximum Angular Tremor Amplitude of the Wrist (Injected Limb) Primary · Baseline up to Week 4

No primary efficacy variables are defined for this study. One of the secondary outcome measures is used for CTgov protocol registration and results reporting purposes only. TremorTek is a tremor kinematic analytics investigational device which is used to measure maximum angular tremor amplitude at wrist of the injected limb (unit: degrees). Angular tremor amplitude is the measure of tremor severity. Reduction of angular tremor amplitude at wrist of the injected limb represents tremor improvement.

GroupValue95% CI
IncobotulinumtoxinA 30 to 200 U-0.47± 0.63
Placebo0.07± 0.88
Change From Baseline to Week 4 in Maximum Log-transformed Accelerometric Tremor Amplitude at Wrist Level (Injected Limb) Secondary · Baseline up to Week 4

TremorTek is a tremor kinematic analytics investigational device which is used to measure maximum log-transformed accelerometric tremor amplitude at wrist level of the injected limb (unit: meter per square second \[m/s˄2\]). Log-transformed accelerometric tremor amplitude is a measure of tremor severity reflecting the non-vectoral intensity of tremor. Reduction of log-transformed accelerometric tremor amplitude at wrist level of the injected limb represents a tremor improvement.

GroupValue95% CI
IncobotulinumtoxinA 30 to 200 U-0.73± 0.63
Placebo0.05± 0.38
Change From Baseline to Week 4 in Fahn-Tolosa-Marin (FTM) Tremor Score in Injected Limb (Item 5 [Right Upper Extremity] or 6 [Left Upper Extremity]) Secondary · Baseline up to Week 4

The FTM tremor rating scale is used for evaluation of tremor severity and function and consists of three parts (A, B, C). For this outcome measure the score of FTM scale item 5 ("right upper extremity") or item 6 ("left upper extremity") is used (both items are from part A). The outcome values are calculated as the sum of the three functions "at rest", "with posture holding", and "with action and intention". The score for each item ranges from 0 (normal) to 4 (severe), that is, the possible values range from 0 to 12.

GroupValue95% CI
IncobotulinumtoxinA 30 to 200 U-1.9± 1.9
Placebo-0.5± 1.8
Change From Baseline to Week 4 in FTM Motor Performance Score (Items 11-15) Secondary · Baseline up to Week 4

The FTM tremor rating scale was used for evaluation of tremor severity and function. This investigator-assessed scale consists of 3 parts (A, B and C). Part A: Tremor location/Severity rating (items 1-10); Part B: Specific motor tasks / Function rating (items 11-15). Ratings for five motor tasks (handwriting, drawing \[large/small spiral, line\], and pouring); and Part C: Functional disabilities resulting from tremor/activities of daily living (items 16-23). For this outcome measure, the sum of the five FTM motor performance items (from Part B) were used: item 11 ('handwriting for dominant han

GroupValue95% CI
IncobotulinumtoxinA 30 to 200 U-2.8± 1.6
Placebo-0.8± 2.0
Participant's Global Impression of Change Scale (GICS) at Week 4 Secondary · Week 4

The GICS was used to measure the participant's impression of change due to treatment. The response option was a common 7-point Likert scale, with the following values: +3 (very much improved); +2 (much improved); +1 (minimally improved); 0 (no change); -1 (minimally worse); -2 (much worse); -3 (very much worse).

GroupValue95% CI
IncobotulinumtoxinA 30 to 200 U0.6± 0.6
Placebo0.3± 0.6
Investigator's Global Impression of Change Scale (GICS) at Week 4 Secondary · Week 4

The GICS was used to measure the investigator's impression of change due to treatment. The response option was a common 7-point Likert scale, with the following values: +3 (very much improved); +2 (much improved); +1 (minimally improved); 0 (no change); -1 (minimally worse); -2 (much worse); -3 (very much worse).

GroupValue95% CI
IncobotulinumtoxinA 30 to 200 U0.8± 0.7
Placebo0.1± 0.7

Adverse events — posted to ClinicalTrials.gov

Time frame: From screening up to Week 24. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

IncobotulinumtoxinA 30 to 200 U
Serious: 0/19 (0%)
Deaths: 0/19
Placebo
Serious: 2/11 (18%)
Deaths: 0/11

Serious adverse events (2 terms)

ReactionSystemIncobotulinumtoxinA 30 to …Placebo
Influenza like illnessGeneral disorders
Chest discomfortGastrointestinal disorders
Other adverse events (31 terms — click to expand)

ReactionSystemIncobotulinumtoxinA 30 to …Placebo
Upper respiratory tract infectionInfections and infestations
Muscular weaknessMusculoskeletal and connective tissue disorders
CystitisInfections and infestations
Eyelid infectionInfections and infestations
Genital infectionInfections and infestations
Nail infectionInfections and infestations
SinusitisInfections and infestations
Tooth infectionInfections and infestations
AppendicitisInfections and infestations
Back painMusculoskeletal and connective tissue disorders
ExostosisMusculoskeletal and connective tissue disorders
ArthritisMusculoskeletal and connective tissue disorders
Muscle spasmsMusculoskeletal and connective tissue disorders
OsteoarthritisMusculoskeletal and connective tissue disorders
Ankle fractureInjury, poisoning and procedural complications
Head injuryInjury, poisoning and procedural complications
Joint injuryInjury, poisoning and procedural complications
ContusionInjury, poisoning and procedural complications
DiarrhoeaGastrointestinal disorders
Dry mouthGastrointestinal disorders
DysphagiaGastrointestinal disorders
GlaucomaEye disorders
Injection site bruisingGeneral disorders
Injection site painGeneral disorders
AstheniaGeneral disorders
Blood cholesterol increasedInvestigations
Diabetes mellitusMetabolism and nutrition disorders
DysphoniaRespiratory, thoracic and mediastinal disorders
HypoaesthesiaNervous system disorders
ParaesthesiaNervous system disorders
Breast massReproductive system and breast disorders

Most-reported serious reactions: Influenza like illness, Chest discomfort.

Data from ClinicalTrials.gov NCT02207946 adverse events section.

Sponsor's own description

The objective of this study is to assess the efficacy and safety of a single, kinematic-analysis-based intramuscular injection of NT 201, compared with placebo, in moderate to marked essential tremor of the upper limb.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Tolerability and Efficacy of Customized IncobotulinumtoxinA Injections for Essential Tremor: A Randomized, Double-Blind, Placebo-Controlled Study.
    Jog M, Lee J, Scheschonka A, Chen R, et al · · 2020 · cited 21× · PMID 33419261 · DOI 10.3390/toxins12120807
  2. Clinical and pharmacological properties of incobotulinumtoxinA and its use in neurological disorders.
    Jost WH, Benecke R, Hauschke D, Jankovic J, et al · · 2015 · cited 17× · PMID 25897202 · DOI 10.2147/dddt.s79193
  3. Pooled Safety Analysis of IncobotulinumtoxinA in the Treatment of Neurological Disorders in Adults.
    Jost WH, Kaňovský P, Hast MA, Hanschmann A, et al · · 2023 · cited 2× · PMID 37368654 · DOI 10.3390/toxins15060353
  4. Editorial on the Special Issue "Botulinum Toxin for the Treatment of Neurological Disorders: Where We Are and Where We Need to Go".
    Jog M, Fasano A. · · 2022 · PMID 35051018 · DOI 10.3390/toxins14010041

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02207946.

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