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NCT02342548

Open Label Extension Study To Investigate Long Term Safety, Tolerability And Efficacy Of Pf-02545920 In Subjects With Huntington's Disease Who Completed Study A8241021

Terminated Phase 2 Results posted Last updated 23 April 2018
What this trial tests

Phase 2 trial testing 20 mg BID of PF-02545920 in Huntington's Disease in 188 participants. Terminated before completion.

Timeline
25 February 2015
Primary endpoint
6 February 2017
6 February 2017

Quick facts

Lead sponsorPfizer
PhasePhase 2
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment188
Start date25 February 2015
Primary completion6 February 2017
Estimated completion6 February 2017
Sites50 locations across United Kingdom, Germany, Poland, Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Pfizer — full company profile →

Who can join

Adults 30 to 66, any sex, with Huntington's Disease. 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.

Number of Participants With Treatment-Emergent Adverse Events and Serious Adverse Events Primary · 1 year

An adverse event (AE) was any untoward medical occurrence in a clinical investigation participant administered a product or medical device, regardless of its causal relationship with study treatment. Serious adverse event (SAE) was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; was life-threatening (immediate risk of death); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs are events between first dose of study treatment and up to 28 calendar days afte

AEs
GroupValue95% CI
20 mg PF-0254592039
5 mg PF-02545920 Titration up to 20 mg63
Placebo and Titration up to 20 mg PF-0254592062
SAEs
GroupValue95% CI
20 mg PF-025459207
5 mg PF-02545920 Titration up to 20 mg9
Placebo and Titration up to 20 mg PF-025459205
Number of Participants With Laboratory Test Abnormalities (Without Regard to Baseline Abnormality) Primary · 1 year

The laboratory test included: hematology (hemoglobin, hematocrit, red blood cell count, platelet count, white blood cell count, absolute total neutrophils, eosinophils, monocytes, basophils, and lymphocytes), chemistry (blood urea nitrogen/urea, creatinine, glucose, glycosylated hemoglobin \[diabetics only\], calcium, phosphorus, magnesium, creatine kinase, sodium, potassium, chloride, total carbon dioxide, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, total bilirubin, alkaline phosphatase, uric acid, albumin, total protein), urinalysis (color, appearance, specif

GroupValue95% CI
20 mg PF-0254592019
5 mg PF-02545920 Titration up to 20 mg27
Placebo and Titration up to 20 mg PF-0254592028
Number of Participants With Vital Signs Data Meeting Categorical Summarization Criteria Primary · 1 year

Number of participants with vital signs data meeting the following criteria is presented: (1) supine systolic blood pressure (SBP) \<90 millimeters of mercury (mmHg); (2) standing SBP \<90 mmHg; (3) supine diastolic blood pressure (DBP) \<50 mmHg; (4) standing DBP \<50 mmHg; (5) supine pulse rate \<40 beats per minute (bpm); (6) supine pulse rate \>120 bpm; (7) standing pulse rate \<40 bpm; (8) standing pulse rate \>140 bpm; (9) maximum increase from baseline in supine SBP \>= 30 mmHg; (10) maximum increase from baseline in standing SBP \>= 30 mmHg; (11) maximum increase from baseline in supin

Supine SBP <90 mmHg
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Standing SBP <90 mmHg
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459200
Supine DBP <50 mmHg
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459200
Standing DBP <50 mmHg
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459200
Supine pulse rate <40 bpm
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Supine pulse rate >120 bpm
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Standing pulse rate <40 bpm
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Standing pulse rate >140 bpm
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Number of Participants With Electrocardiogram (ECG) Data Meeting Categorical Summarization Criteria Primary · 1 year

Maximum absolute values and increases from baseline were summarized for PR interval (interval between the start of the ECG P wave and the start of the QRS complex corresponding to the time between the onset of the atrial depolarization and onset of ventricular depolarization), QRS complex (time from Q wave to the end of the S wave corresponding to ventricular depolarization), and QTcF interval (time from ECG Q wave to the end of T wave corresponding to electrical systole, corrected for heart rate using Fridericia's formula). Number of participants with ECG data meeting the following criteria i

PR interval >=300 msec
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
QRS complex >=140 msec
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
QTcF interval: 450 to <480 msec
GroupValue95% CI
20 mg PF-025459202
5 mg PF-02545920 Titration up to 20 mg2
Placebo and Titration up to 20 mg PF-025459202
QTcF interval: 480 to <500 msec
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459201
QTcF interval >=500 msec
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
PR interval increase from baseline >=25/50 percent
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
QRS complex increase from baseline >=50 percent
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
QTcF increase from baseline: 30 to <60 msec
GroupValue95% CI
20 mg PF-025459203
5 mg PF-02545920 Titration up to 20 mg5
Placebo and Titration up to 20 mg PF-025459204
Number of Participants With Abnormal White Blood Cell Count and Absolute Neutrophil Count (Without Regard to Baseline Abnormality) Primary · 1 year

Number of participants with white blood cell (WBC) count and absolute neutrophil count (ANC) meeting the following criteria is presented: (1) WBC count \<0.6 \*the lower limit of normal (LLN); (2) WBC count \>1.5 times the upper limit of normal (ULN); (3) ANC \<0.8\*LLN; and (4) ANC \>1.2\*ULN.

WBC < 0.6*LLN
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
WBC > 1.5*ULN
GroupValue95% CI
20 mg PF-025459201
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459201
ANC < 0.8*LLN
GroupValue95% CI
20 mg PF-025459201
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
ANC > 1.2*ULN
GroupValue95% CI
20 mg PF-025459203
5 mg PF-02545920 Titration up to 20 mg4
Placebo and Titration up to 20 mg PF-025459207
Number of Participants With Laboratory Test Abnormalities (Normal Baseline) Primary · 1 year

The laboratory test included: hematology (hemoglobin, hematocrit, red blood cell count, platelet count, white blood cell count, absolute total neutrophils, eosinophils, monocytes, basophils, and lymphocytes), chemistry (blood urea nitrogen/urea, creatinine, glucose, glycosylated hemoglobin \[diabetics only\], calcium, phosphorus, magnesium, creatine kinase, sodium, potassium, chloride, total carbon dioxide, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, total bilirubin, alkaline phosphatase, uric acid, albumin, total protein), urinalysis (color, appearance, specif

GroupValue95% CI
20 mg PF-0254592013
5 mg PF-02545920 Titration up to 20 mg22
Placebo and Titration up to 20 mg PF-0254592023
Number of Participants With Adverse Events Related to Extrapyramidal Symptoms by Severity Primary · 1 year

Adverse events related to extrapyramidal symptoms included dystonia, akathisia, tardive dyskinesia). Severity was assessed by the investigator. Mild means the AE didn't interfere with the participant's usual function. Moderate means the AE interfered to some extent the participant's usual function. Severe means the AE interfered significantly with the participant's usual function.

Mild dystonia
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459200
Moderate dystonia
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459201
Severe dystonia
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Mild akathisia
GroupValue95% CI
20 mg PF-025459201
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459200
Moderate akathisia
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459203
Severe akathisia
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459201
Mild dyskinesia
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg2
Placebo and Titration up to 20 mg PF-025459204
Moderate dyskinesia
GroupValue95% CI
20 mg PF-025459201
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459202
Number of Participants in Each Columbia Classification Algorithm of Suicide Assessment (C-CASA) Category Primary · Baseline (Day 1), Weeks 2 and 4, Months 3, 6, 9 and 12, follow-up visit (7-14 days after the last dose of Month 12)

Columbia Suicide Severity Rating Scale (C-SSRS) was an interview-based rating scale to systematically assess suicidal ideation and suicidal behavior, and was used in this study. C-SSRS responses were mapped onto the Columbia Classification Algorithm of Suicide Assessment (C-CASA). Number of participants with any of the following behaviors occurring since last visit was summarized: completed suicide; suicide attempt; preparatory acts towards suicide; suicidal ideation; self-injurious behavior (no suicidal intent).

Day 1: completed suicide
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Day 1: suicide attempt
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Day 1: preparatory acts towards suicide
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Day 1: suicidal ideation
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg1
Placebo and Titration up to 20 mg PF-025459201
Day 1: self-injurious behavior
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Week 2: completed suicide
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Week 2: suicide attempt
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Week 2: preparatory acts towards suicide
GroupValue95% CI
20 mg PF-025459200
5 mg PF-02545920 Titration up to 20 mg0
Placebo and Titration up to 20 mg PF-025459200
Change From Baseline in Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score Secondary · Baseline (Day 1), Month 6, and Month 12

The UHDRS is a clinical rating scale developed to provide a uniform assessment of the clinical features and course of Huntington's disease (HD). The components of the full UHDRS assess motor function, cognition, behavior and functional abilities. Total Motor Score (TMS) assesses motor features of HD with standardized ratings of oculomotor function, dysarthria, chorea, dystonia, gait, and postural ability. The total motor impairment scores was the sum of all the individual 31 motor sub-items (each rated from 0 to 4), with higher scores indicating more severe motor impairment than lower scores.

Month 6
GroupValue95% CI
20 mg PF-025459202.4± 7.21
5 mg PF-02545920 Titration up to 20 mg3.5± 7.61
Placebo and Titration up to 20 mg PF-025459200.7± 7.43
Month 12
GroupValue95% CI
20 mg PF-025459204.9± 10.17
5 mg PF-02545920 Titration up to 20 mg3.3± 6.71
Placebo and Titration up to 20 mg PF-025459200.6± 8.24
Change From Baseline in Unified Huntington's Disease Rating Scale (UHDRS) Total Maximum Chorea (TMC) Score Secondary · Baseline (Day 1), Month 6, and Month 12

The UHDRS is a clinical rating scale developed to provide a uniform assessment of the clinical features and course of Huntington's disease (HD). The components of the full UHDRS assess motor function, cognition, behavior and functional abilities. Total Maximum Chorea (TMC) is a subset of the TMS assessment, and composed of the scoring of 7 chorea assessments (face, orobuccolingual, trunk, right and left upper extremities, right and left lower extremities). Each assessment is rated from 0 to 4 (absent to prolonged). TMC is obtained by adding up each of the separate scores, leading to max score

Month 6
GroupValue95% CI
20 mg PF-025459200.1± 3.12
5 mg PF-02545920 Titration up to 20 mg1.3± 3.97
Placebo and Titration up to 20 mg PF-025459201.4± 4.14
Month 12
GroupValue95% CI
20 mg PF-025459200.1± 4.92
5 mg PF-02545920 Titration up to 20 mg0.8± 1.64
Placebo and Titration up to 20 mg PF-025459200.7± 3.51
Absolute Value in Clinical Global Impression of Improvement (CGI-I) Score Secondary · Month 6 and Month 12

The Clinical Global Impression of Improvement (CGI-I) is a global measure of improvement or change based on the clinician's assessment of all available clinical data obtained from interviewing the participant. The CGI-I consists of a single 7-point rating of total improvement or change from baseline severity, regardless of whether or not the change is due entirely to drug treatment. Raters select 1 response based on the following question, "Compared to your participant's condition at the beginning of treatment, how much has he/she changed?" Scores are: 1: Very much improved; 2: Much improved;

Month 6
GroupValue95% CI
20 mg PF-025459203.9± 1.04
5 mg PF-02545920 Titration up to 20 mg4.2± 1.03
Placebo and Titration up to 20 mg PF-025459203.7± 1.19
Month 12
GroupValue95% CI
20 mg PF-025459203.5± 1.30
5 mg PF-02545920 Titration up to 20 mg4.6± 1.13
Placebo and Titration up to 20 mg PF-025459204.0± 1.21

Adverse events — posted to ClinicalTrials.gov

Time frame: 1 year. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

20 mg PF-02545920
Serious: 7/51 (14%)
Deaths: 0/51
5 mg PF-02545920 Titration up to 20 mg
Serious: 9/71 (13%)
Deaths: 0/71
Placebo and Titration up to 20 mg PF-02545920
Serious: 5/66 (8%)
Deaths: 0/66

Serious adverse events (24 terms)

ReactionSystem20 mg PF-025459205 mg PF-02545920 Titration…Placebo and Titration up t…
HyperkinesiaNervous system disorders
Huntington's diseaseCongenital, familial and genetic disorders
DysphagiaGastrointestinal disorders
PancreatitisGastrointestinal disorders
Complication associated with deviceGeneral disorders
CholelithiasisHepatobiliary disorders
Cervical vertebral fractureInjury, poisoning and procedural complications
FallInjury, poisoning and procedural complications
Blood creatine phosphokinase increasedInvestigations
Weight decreasedInvestigations
DehydrationMetabolism and nutrition disorders
Back painMusculoskeletal and connective tissue disorders
Intervertebral disc protrusionMusculoskeletal and connective tissue disorders
OsteoarthritisMusculoskeletal and connective tissue disorders
ChoreaNervous system disorders
SyncopeNervous system disorders
Transient ischaemic attackNervous system disorders
AgitationPsychiatric disorders
DepressionPsychiatric disorders
Panic attackPsychiatric disorders
Suicide attemptPsychiatric disorders
Urinary tract disorderRenal and urinary disorders
ProstatomegalyReproductive system and breast disorders
CoughRespiratory, thoracic and mediastinal disorders
Other adverse events (23 terms — click to expand)

ReactionSystem20 mg PF-025459205 mg PF-02545920 Titration…Placebo and Titration up t…
FallInjury, poisoning and procedural complications
ChoreaNervous system disorders
Weight decreasedInvestigations
NauseaGastrointestinal disorders
FatigueGeneral disorders
DizzinessNervous system disorders
SomnolenceNervous system disorders
InsomniaPsychiatric disorders
Viral upper respiratory tract infectionInfections and infestations
HyperkinesiaNervous system disorders
AnxietyPsychiatric disorders
DiarrhoeaGastrointestinal disorders
Back painMusculoskeletal and connective tissue disorders
DyskinesiaNervous system disorders
VomitingGastrointestinal disorders
HeadacheNervous system disorders
SedationNervous system disorders
DepressionPsychiatric disorders
RestlessnessPsychiatric disorders
DysphagiaGastrointestinal disorders
AkathisiaNervous system disorders
Muscle spasmsMusculoskeletal and connective tissue disorders
Sleep disorderPsychiatric disorders

Most-reported serious reactions: Hyperkinesia, Huntington's disease, Dysphagia, Pancreatitis, Complication associated with device, Cholelithiasis, Cervical vertebral fracture, Fall.

Data from ClinicalTrials.gov NCT02342548 adverse events section.

Sponsor's own description

This study is a 12 month open label extension study of PF-02545920 20 mg dosed BID following study A8241021 in subjects with HD. Primary endpoints will be to assess long-term safety and tolerability of 20 mg BID of PF-02545920. Secondary endpoints will be the change from baseline in the Total Motor Score (TMS)assessment, and/ior the Total maximum Chorea (TMC) assessment of the Unified Huntington Disease Rating Scale (UHDRS) after 6 and 12 months of treatment, and Clinical Global Impression-Improvement score after 6 and 12 months of treatment. Subjects, who were assigned to the 20 mg PF-02545920 dose group in the preceding A8241021 study, will receive 20 mg PF-02545920 without any titration. All other subjects will be titrated to the 20 mg BID dose as follows: 5 mg BID for 7 days, 10 mg BID for 7 days, 15 mg BID for 7 days, then 20 mg BID for the remainder of the treatment phase. Up to 260 subjects may take part in this open label extension

Publications & conference data

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

  1. Therapeutic targeting of 3',5'-cyclic nucleotide phosphodiesterases: inhibition and beyond.
    Baillie GS, Tejeda GS, Kelly MP. · · 2019 · cited 263× · PMID 31388135 · DOI 10.1038/s41573-019-0033-4
  2. From Pathogenesis to Therapeutics: A Review of 150 Years of Huntington's Disease Research.
    Jiang A, Handley RR, Lehnert K, Snell RG. · · 2023 · cited 88× · PMID 37629202 · DOI 10.3390/ijms241613021
  3. Clinical Trials Corner: September 2017.
    Rodrigues FB, Wild EJ. · · 2017 · cited 33× · PMID 28968245 · DOI 10.3233/jhd-170262
  4. Chorea-related mutations in PDE10A result in aberrant compartmentalization and functionality of the enzyme.
    Tejeda GS, Whiteley EL, Deeb TZ, Bürli RW, et al · · 2020 · cited 10× · PMID 31871190 · DOI 10.1073/pnas.1916398117
  5. Inhibition of Phosphodiesterase 10A by MP-10 Rescues Behavioral Deficits and Normalizes Microglial Morphology and Synaptic Pruning in A Mouse Model of FOXP1 Syndrome.
    Fröhlich H, Wang J, Althammer F, Schubert T, et al · · 2025 · cited 1× · PMID 40568906 · DOI 10.1002/advs.202500623

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