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A randomized double blind placebo controlled study to evaluate the modulation of cognitive functions in Parkinson's subjects by sildenafil
ISRCTN ISRCTN18044132
ClinicalTrials.gov identifier
Public title A randomized double blind placebo controlled study to evaluate the modulation of cognitive functions in Parkinson's subjects by sildenafil
Scientific title
Acronym SCOPE
Serial number at source A1481189
Study hypothesis That 48 weeks of sildenafil therapy will stabilize or slow down the progression of cognitive impairment in Parkinson's disease subjects with mild cognitive impairment when compared with untreated Parkinson's disease controls. The study will also assess the effects of sildenafil upon motor state and olfaction in Parkinson's disease since these parameters may also be improved by sildenafil.
Lay summary
Ethics approval Not provided at time of registration
Study design Randomised controlled trial
Countries of recruitment United Kingdom
Disease/condition/study domain Parkinson's disease (PD)
Participants - inclusion criteria 1. Male or female subjects (excluding women of child bearing potential) between the ages of 50 and 80 years, inclusive
2. Diagnosis of Parkinson's disease according to UK Parkinson's Disease Society Brain Bank Criteria
3. Diagnosis of Parkinson's disease >12 months
4. Mild cognitive impairment insufficient to fulfill Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for dementia, with MMSE score 18-27
5. University of Pennsylvania Smell Identification Test (UPSIT) test score of <30
6. Subjects must be willing and able to provide written informed consent
Participants - exclusion criteria 1. Subjects with evidence of severe or unstable concomitant medical illness
2. Known hypersensitivity to, or current use of sildenafil, or other PDE5 inhibitors
3. Clinically significant orthostatic hypotension (defined as disabling postural light-headedness or syncopal episodes associated with a fall in systolic blood pressure on standing of over 30 mmHg)
4. Patient taking anti-psychotic or cholinesterase inhibitor medication
5. Patient taking dopamine agonists
6. Major depressive disorder
7. Anosmia secondary to head injury/non-PD related cause
8. Exclusion of patients with Multiple Systems Atrophy
9. Exclusion of patients with colour-blindness
10. Subjects who were prescribed and/or are taking nitrates or nitric oxide donors in any form (oral, sub-lingual, tansdermal, inhalation,aerosols), alpha blockers and/or class IA or III anti-arrhythmic medication
11. Use of medication known or suspected to be potent or moderate inhibitors of cytochrome P4503A4 (excluding ketoconazole, itraconazole, cimetidine, ritonavir)
12. Subjects with congenital QT prolongation
13. Electrocardiogram (ECG) evidence of severe life-threatening rhythm or ischaemic disturbances including acute myocardial infarction (within last year), left bundle branch block, or ventricular tachycardia
14. QTcF prolongation >500 msecs
15. Sustained hypertension >170 mmHg systolic or >110 mmHg diastolic; sustained hypotension <90 mmHg systolic or <50 mmHg diastolic
16. History of regular alcohol abuse within 6 months of screening
17. Treatment with investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of study medication
Anticipated start date 14/12/2004
Anticipated end date 30/09/2006
Status of trial Completed
Patient information material
Target number of participants 100 subjects, 50 randomised to both sildenafil and placebo group
Interventions Sildenafil dosing in the treatment group will start at 50 mg once daily for 4 weeks. Dosing is then increased to 100 mg daily for a further 44 weeks. The control group will receive matching placebo teatment for 48 weeks.
Primary outcome measure(s) 1. To test if 48 weeks of sildenafil therapy will result in improved cognitive functions in Parkinson's disease subjects as measured by the paired association learning (PAL) test
2. To test if 48 weeks of sildenafil therapy will result in improved olfaction in Parkinson's disease subjects as measured by the UPSIT test
Secondary outcome measure(s) To test if 48 weeks of sildenafil therapy will result in improved motor and cognitive function in Parkinson's disease subjects as measured by the Unified Parkinson's Disease Rating Scale (UPDRS), Dyskinesia Rating Scale, Spatial Working Memory Test and Reaction Time Test.
Sources of funding Study is fully funded by Pfizer Inc. (USA)
Trial website
Publications
Contact name Dr  David  Burn
  Address Regional Neurosciences Centre
Newcastle General Hospital
Westgate Road
  City/town Newcastle
  Zip/Postcode NE46BE
  Country United Kingdom
  Tel +44 (0)1912563425
  Fax +44 (0)1912727242
  Email d.j.burn@ncl.ac.uk
Sponsor Pfizer Inc. (USA)
  Address Groton Laboratories
Clinical Sciences Dept.
445 Eastern Point Road
  City/town Groton
  Zip/Postcode CT06340
  Country United States of America
Date applied 30/08/2005
Last edited 14/09/2009
Date ISRCTN assigned 26/09/2005
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