Ambroxol to Slow Progression in Parkinson Disease

• Status: Not yet recruiting
• Trial end date: 2028-09-01
• Target enrollment: 0
• Participant gender: All

Summary

This is a clinical trial in patients with Parkinson's disease (PD) of a drug called ambroxol hydrochloride, which is an already licensed drug for the treatment of respiratory conditions (such as a common cold) in many European countries. The aim of this trial is to find out whether ambroxol hydrochloride can slow down the progression of Parkinson's disease and to evaluate it's safety and tolerability.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University College, London
• Treatments: Ambroxol

Criteria

Inclusion Criteria:

1. Adults aged ≥ 40 and ≤ 75 years.

2. Hoehn and Yahr stage between 1-2.5, inclusive (in ON stage) at screening visit.

3. Known glucocerebrosidase gene (GBA) status (status to be confirmed prior to screening).

4. If on levodopa or any other PD medication (such as a dopamine agonist), the medication regimen must be stable for at least 30 days (at least 60 days for rasagiline) prior to randomisation (Stable is defined as no change in PD medication dose in the previous 30 days).

5. Able and willing to provide informed consent prior to any study related assessments and/or procedures.

6. Able and willing to attend trial visits and comply with all study procedures for the duration of the trial.

7. Willing and able to self-administer oral ambroxol medication or placebo.

8. For women of childbearing potential (WOCBP), a negative serum pregnancy test result at the screening visit and a negative urine pregnancy test at the baseline visit, prior to randomisation.

9. Only applicable for those patients consenting to the optional CSF sub-study: willing to comply with a 4 hour fast and lumbar puncture.

Exclusion Criteria:

1. Diagnosis of PD >7 years ago. PD is a clinical diagnosis and is based on the opinion of the PI or delegate on site after review of the clinical history, examination findings and response to PD medication (The MDS diagnostic criteria for PD may be used to help assist in the diagnosis).

2. Participation in another interventional clinical trial of an Investigational Medicinal Product (IMP) and use of an Investigational Medicinal Product (IMP) within 90 days prior to the first dose of trial treatment, or in the case of an Investigational New Drug being tested for PD disease modifying potential this should be 12 months.

3. Past surgical history of deep brain stimulation.

4. Use of ambroxol in the past 12 months.

5. Exposure to more than three Parkinson's Disease (PD) investigational medicinal products within 12 months prior to the first dose in this current trial, or any within the last 3 months.

6. Exposure to Exenatide within 12 months prior to the first dose in this current trial.

7. Concomitant medications that in the opinion of the Investigator would preclude participation in the study e.g., exenatide or other GLP1 agonist for diabetes.

8. Confirmed dysphagia that would preclude self-administration of ambroxol.

9. History of known sensitivity to the study medication, ambroxol or its excipients (lactose monohydrate, granulated microcrystalline cellulose, copovidone and magnesium stearate) in the opinion of the investigator that contraindicates their participation.

10. History of known rare hereditary disorders of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.

11. Presence of the LRRK2 G2019S mutation (status to be confirmed prior to screening).

12. History of drug abuse or alcoholism in the opinion of the Investigator that would preclude participation in the trial.

13. Pregnant (or planned pregnancy during the trial) and/or breastfeeding.

14. Women of childbearing potential (WOCBP) and male participants with a partner of childbearing potential not willing to use highly effective contraception or abstinence for the duration of the trial treatment and for 2 weeks following the last dose of the study drug.

15. Any clinically significant or unstable medical or surgical condition that in the opinion of the Investigator may; put the participant at risk when participating in the study, influence the results of the study or affect the participants ability to take part in the study, as determined by medical history, physical examinations, electrocardiogram (ECG) or laboratory tests. Such conditions may include:

I. Impaired renal function function with creatinine clearance <50ml/min.

II. Moderate/Severe hepatic impairment.

III. A major cardiovascular event (e.g., myocardial infarction, acute coronary syndrome compensated congestive heart failure, pulmonary embolism, coronary revascularisation) that occurred within 6 months prior to the screening visit.

16. Severe depression defined by a score >20 on the Beck Depression Inventory-II (BDI-II).

17. Significant cognitive impairment defined by a score <20 on the Montreal Cognitive Assessment (MoCA).

18. Only applicable for those patients consenting to the optional CSF sub-study: Evidence or history of hypersensitivity to lidocaine or its derivatives.

19. Only applicable for those patients consenting to the optional CSF sub-study: current treatment with anti-coagulants (e.g., warfarin) that might preclude safe completion of the lumbar puncture in the opinion of the Investigator. Aspirin will be permitted.

20. Only applicable for those patients consenting to the optional CSF sub-study:

Significant known lower spinal malformations or other spinal abnormalities that would preclude a lumbar puncture.