Characteristics of OFF-time Improvement in a Phase Two Study for Parkinson’s Disease (PD) with Solengepras, a Novel GPR6-inhibitor
Robert Hauser1, Stuart Isaacson2, Kelvin Chou3, Harini Sarva4, Rajesh Pahwa5, Shabbir Hussain Merchant6, Nicola Brice7, Michelle Charles7, Sagar Vaidya7, Xiao Xu7, Andrew McGarry8, Mika Leinonen8, Karl Kieburtz8, Aaron Ellenbogen9
1Parkinson’s Disease and Movement Disorders Center, Department of Neurology, University of South Florida, 2Parkinson's Dis & Mov Dis Ctr of Boca Raton, 3University of Michigan Health, Department of Neurology, 4Weill Cornell Medical Center, 5University of Kansas Medical Center, 6Beth Israel Deaconess Medical Center, 7Cerevance, 8Clintrex, 9Quest Research Institute
Objective:

To study the characteristics of OFF time and the impact of solengepras treatment on the patient experience in a Phase 2 study in Parkinson’s Disease (PD).

Background:

Solengepras is an oral, once-daily GPR6-inhibitor developed to release inhibition of the indirect (striatopallidal) pathway without directly affecting the dopamine pathway. In a prior study of PD with motor fluctuations, solengepras 150mg daily demonstrated a clinically meaningful -1.3-hour OFF-time reduction versus placebo.  Here, we examine additional characteristics of OFF-time to understand the impact of solengepras treatment on the patient experience.

Design/Methods:

In this Phase 2 randomized, double-blind, placebo-controlled study, PD patients with ≥2 hours of daily OFF-time based on patient motor diaries were randomized (1:1:1) to receive solengepras (50 mg or 150 mg) daily or placebo for 28 days (NCT04191577).  In this post-hoc exploratory analysis, motor diaries were normalized to a 16-hour day and limited to participants with ≥3 hours of OFF-time at baseline.  Characteristics of OFF-time were analyzed using mixed model for repeated measures (MMRM).  

Results:

110 participants (88%) met the criteria for inclusion.  Total daily OFF-time was improved by a mean of -1.78 hours from baseline in the solengepras 150mg group compared to placebo (p=0.0045), equivalent to a 34.7% reduction.  In addition, there was a reduction versus placebo in the mean number of OFF periods per day (-0.98, p=0.0021), mean duration of each OFF period (-26 min, p=0.0887), and mean duration of first morning OFF period (-26 min, p=0.1490).

Conclusions:

In this Phase 2 post-hoc analysis of patient motor diaries, solengepras reduced daily OFF-time in PD patients with ≥3 hours of OFF-time at baseline and reduced the mean number of OFF periods per day.  A non-significant reduction was also observed in the duration of OFF periods and morning OFF.  These results help describe the potential of solengepras to reduce patient burden and disability in PD.

10.1212/WNL.0000000000213105
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