WO2007117431A2 - Use of rasagiline for the treatment of restless legs syndrome - Google Patents

Use of rasagiline for the treatment of restless legs syndrome Download PDF

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Publication number
WO2007117431A2
WO2007117431A2 PCT/US2007/008261 US2007008261W WO2007117431A2 WO 2007117431 A2 WO2007117431 A2 WO 2007117431A2 US 2007008261 W US2007008261 W US 2007008261W WO 2007117431 A2 WO2007117431 A2 WO 2007117431A2
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Prior art keywords
propargyl
aminoindan
pharmaceutically acceptable
subject
acceptable salt
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PCT/US2007/008261
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English (en)
French (fr)
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WO2007117431A3 (en
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Eran Blaugrund
Ruth Levy
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Teva Pharmaceutical Industries Ltd
Teva Pharmaceuticals USA Inc
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Teva Pharmaceutical Industries Ltd
Teva Pharmaceuticals USA Inc
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Priority to MX2008012781A priority Critical patent/MX2008012781A/es
Priority to JP2009504260A priority patent/JP5769923B2/ja
Priority to EP07754738A priority patent/EP2007369A4/en
Priority to NZ571591A priority patent/NZ571591A/en
Priority to CN2007800117920A priority patent/CN101442997B/zh
Priority to AU2007235517A priority patent/AU2007235517B2/en
Priority to CA002646250A priority patent/CA2646250A1/en
Application filed by Teva Pharmaceutical Industries Ltd, Teva Pharmaceuticals USA Inc filed Critical Teva Pharmaceutical Industries Ltd
Publication of WO2007117431A2 publication Critical patent/WO2007117431A2/en
Priority to IL194328A priority patent/IL194328A/en
Priority to ZA2008/08409A priority patent/ZA200808409B/en
Anticipated expiration legal-status Critical
Publication of WO2007117431A3 publication Critical patent/WO2007117431A3/en
Priority to IL234749A priority patent/IL234749A0/en
Priority to IL247850A priority patent/IL247850A0/en
Priority to IL265866A priority patent/IL265866A/en
Priority to IL275890A priority patent/IL275890A/en
Ceased legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/13Amines
    • A61K31/135Amines having aromatic rings, e.g. ketamine, nortriptyline
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/16Amides, e.g. hydroxamic acids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/425Thiazoles
    • A61K31/428Thiazoles condensed with carbocyclic rings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00Drugs for disorders of the muscular or neuromuscular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/08Antiepileptics; Anticonvulsants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/14Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2300/00Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00

Definitions

  • Restless Legs Syndrome also known as Ekbom Syndrome
  • Ekbom Syndrome is a neurological condition that expresses itself as an overwhelming urge to move the legs, usually caused by uncomfortable or unpleasant sensations in the legs at rest. Movement of the legs temporarily alleviates the discomfort.
  • RLS The sensations occur during periods of inactivity, and are thus most intense in the evening and at night.
  • RLS often causes difficulty staying or falling asleep, which leads to feelings of daytime tiredness or fatigue.
  • RLS may cause involuntary jerking of the limbs during sleep and sometimes during wakefulness. Because of the nature of these symptoms, RLS is one of the most prevalent causes of sleep disorders such as sleep disturbance and insomnia.
  • sleep disorders such as sleep disturbance and insomnia.
  • RLS can occur at any age but increases in frequency as persons grow older.
  • Thorpy J. Michael- New Paradignms in the treatment of restless legs syndrome. Neurology 2005; 64: S28-S33 It afflicts about 8% of the general population. (see, rls.org/)
  • PLMs periodic leg movements
  • Both the sensations in the limbs and the PLMs can profoundly disrupt sleep (getting to sleep and staying asleep) • This can lead to excessive daytime sleepiness as well as depression and anxiety and may have a significant negative impact on quality of life.
  • RLS Treatment of RLS can be difficult and often requires trying different drugs and dosage regimes.
  • the Merck Manual, 17th Ed. 1999, 1416 The primary pharmacologic treatment of RLS is principally with two classes of medications: dopaminergic agents and opiate agents. (Restless Legs Syndrome Foundation, Inc. Medical Bulletin, April 2004, pg. 15)
  • L-dopa dopamine precursor levodopa
  • This initial response is not universally maintained.
  • L-dopa therapy lies in the fact that in many patients its effectiveness tapers off and/or the RLS problem is shifted toward the morning hours (rebound) or the disorder is aggravated with the problem occurring event during the day
  • Dopamine-receptor agonists such as pergolide and pramipexole, known by the trade name Mirapex [available from Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT], provide well-established and effective treatment for RLS. However, they have been reported to cause major side effects. (Dooley M. et al., Pramipexole: A Review of Its Use in the Management of Early and Advanced Parkinson's Disease, Drugs Aging, June 1998, 12 (6) : 495-514; and Silber M. H.
  • Opiates are effective against RLS as well, although often at relatively 'high doses.
  • alters, A. S. et al. Successful Treatment of the Idiopathic Restless Legs Syndrome in a Randomized Double-Blind Trial of Oxycodone Versus Placebo, Sleep, 1993, 16 (4) : 327-332
  • these substances are suitable for therapeutic application to a limited extent at best .
  • Benzodiazepines such as clonazepam and anticonvulsants such as gabapentin and carbamazepine have also been shown to alleviate the symptoms of RLS.
  • Medical Bulletin, infra at pg. 19 Medical Bulletin, infra at pg. 19
  • side effects similar to those associated with the treatments described above limit use.
  • Addiction and daytime sedation are problematic with benzodiapenes, which does not prevent movement but only prevents awakening.
  • High dosages are required in anticonvulsant treatments.
  • anticonvulsants fail to resolve the full spectrum of elements of RLS. (Telstad W. et al., Treatment of the Restless Legs Syndrome with Carbamazepine; A Double Blind Study, Br. Med. J. (Clin. Res. Ed.) , 1984, 288 (6415) : 444-446)
  • Valproate has also shown benefit for RLS, but the side effect of weight gain has limited its acceptance. (Dinesin H. et al., Weight Gain During Treatment With Valproate, Acta. Neurol. Scan. , 1984, 70(2):65-69)
  • Clonidine originally developed as an antihypertensive agent and miotic, has also been examined for its effectiveness in the treatment of RLS. While it was found that soporiferous latency was reduced, it had no effect on the quality of sleep, the frequency of waking up or periodic leg movement during sleep. Given that more efficacious substances are available for monotherapy, clonidine is not currently recommended as an alternative form of therapy except in limited situations. (U.S. Patent Publication No. 2001/0053777, published December 20, 2001)
  • This subject invention provides a method of treating a subject suffering from Restless Legs Syndrome which comprises administering to the subject an amount of R(+) -N-propargyl- 1-aminoindan or a pharmaceutically acceptably salt thereof, effective to treat the subject.
  • the subject invention also provides a method of alleviating a symptom of Restless Legs Syndrome in a subject afflicted with
  • Restless Legs Syndrome comprising administering to the subject an amount of R (+) -N-propargyl-1-aminoindan or a pharmaceutically acceptable salt thereof effective to alleviate the symptom of Restless Legs Syndrome in the subject.
  • the subject invention also provides a pharmaceutical composition
  • a pharmaceutical composition comprising in unit dosage form R ⁇ +) -N-propargyl- 1-aminoindan or a pharmaceutically acceptable salt thereof and at least one of pergolide, pramipexole, oxycodone, clonazepam, carbamazepine, gabapentin, valproate, ropinirole or clonidin.
  • the subject invention also provides a pharmaceutical composition for use in the treatment of, or alleviation of symptoms of, Restless Legs Syndrome, which comprises a therapeutically effective amount of R(+) -N-propargyl-1- aminoindan or a pharmaceutically acceptable salt thereof and a pharmaceutically acceptable carrier.
  • the subject invention also provides use of R ⁇ +) -N-propargyl- 1-aminoindan or a pharmaceutically acceptable salt thereof in the manufacture of a medicament for the treatment of, or alleviation of symptoms of, Restless Legs Syndrome.
  • the subject invention provides a method of treating a subject suffering from Restless Legs Syndrome which comprises administering to the subject an amount of R (+) -N-propargyl- 1-aminoindan or a pharmaceutically acceptably salt thereof, effective to treat the subject.
  • the subject invention also provides a method of alleviating a symptom of Restless Legs Syndrome in a subject afflicted with
  • Restless Legs Syndrome comprising .administering to the subject an amount of R (+ ⁇ ) -N-propargyl-1-aminoindan or a pharmaceutically acceptable salt thereof effective to alleviate the symptom of Restless Legs Syndrome in the subject.
  • the symptom may be any of tingling in the legs, cramps in the legs, pain in the legs or restlessness in the legs.
  • the IRLS Rating Scale score of the subject decreases compared to the baseline.
  • the decrease is a 20% decrease, preferably a 30% decrease, more preferably a 40% decrease, yet more preferably a 50% decrease of the IRLS Rating Scale Score.
  • the amount of R (+) -N-propargyl-1-aminoindan or of the pharmaceutically acceptable salt thereof may be from 0.01 mg to 20 mg per day.
  • 0.01 mg to 20 mg it is meant that all hundredth, tenth and integer unit amounts within the range are specifically disclosed as part of the invention.
  • 0.02, 0.03 ... 0.09; 0.1, 0.2 ...0.9; 1, 2 ...19 mg unit amounts are included as embodiments, of this invention.
  • the therapeutically effective amount of R ( + ) -N-propargyl-1-aminoindan or of the pharmaceutically acceptable salt thereof may be from 0.5 mg to 5 mg per day.
  • the amount may be 1.0 mg.
  • 0.5 mg to 5 mg it is meant that all tenth and integer unit amounts within the range are specifically disclosed as part of the invention.
  • 0.6, 0.7 ... 0.9; l f 2 ...4 mg unit amounts are included as embodiments of this invention.
  • a dose of R (+) -N-propargyl-1-aminoindan or of the pharmaceutically acceptable salt thereof may be administered 1 to 4 times a day.
  • a dose of R (+) -N-propargyl-1- aminoindan or of the pharmaceutically acceptable salt thereof may be administered once a day.
  • an evening dose of R (+) -N-propargyl-1-aminoindan or of the pharmaceutically acceptable salt thereof may be administered to a subject 1 to 3 hours before the subject goes to bed.
  • a second dose is administered to the subject 3 to 7 hours before the evening dose.
  • a dose of R (+) -N-propargyl-1- aminoindan or of the pharmaceutically acceptable salt thereof is administered to the subject at 3 to 7 hour intervals throughout the day.
  • the administration is of R (+) -N-propargyl- 1-aminoindan .
  • the administration is of the pharmaceutically acceptable salt of R (+) -N-propargyl-1- aminoindan .
  • the pharmaceutically acceptable salt of the methods may be esylate, mesylate, sulfate or tartrate.
  • the pharmaceutically acceptable salt may be mesylate.
  • the therapeutically effective amount of R (+) -N-propargyl-1-aminoindan mesylate may be 1.66 mg per day .
  • the administration may be oral, parenteral, rectal or transdermal administration.
  • the methods further comprise administration of carbidopa, levodopa, pergolide, pramipexole, oxycodone, clonazepam, carbamazepine, gabapentin, valproate, ropinirole or clonidin.
  • the administration of R (+) -N-propargyl-1- aminoindan or the salt substantially precedes the administration of any of carbidopa, levodopa, pergolide, pramipexole, oxycodone, clonazepam, carbamazepine, gabapentin, valproate, ropinirole or clonidin.
  • the administration of R(+)-N- propargyl-1-aminoindan or the salt is contemporaneous with the administration of any of carbidopa, levodopa, pergolide, pramipexole, oxycodone, clonazepam, carbamazepine, gabapentin, valproate, ropinirole or clonidin.
  • the R(+) -N-propargyl-1-aminoindan or the pharmaceutically acceptable salt thereof may be in a pharmaceutical composition when used in the methods.
  • the pharmaceutical composition is in tablet form.
  • the pharmaceutical composition is in a form suitable for transdermal administration.
  • the pharmaceutical composition is in a form suitable for sublingual administration.
  • the subject invention also provides a pharmaceutical composition
  • a pharmaceutical composition comprising in unit dosage form R (+) -N-propargyl- 1-aminoindan or a pharmaceutically acceptable salt thereof and at least one of pergolide, pramipexole, oxycodone, clonazepam, carbamazepine, gabapentin, valproate, ropinirole or clonidin.
  • the subject invention also provides a pharmaceutical composition for use in the treatment of, or alleviation of symptoms of, Restless Legs Syndrome, which comprises a therapeutically effective amount of R (+) -N-propargyl-1- aminoindan or a pharmaceutically acceptable salt thereof and a pharmaceutically acceptable carrier.
  • the subject invention also provides use of R (+) -N-propargyl- 1-aminoindan or a pharmaceutically -acceptable salt thereof in the manufacture of a medicament for the treatment of, or alleviation of symptoms of, Restless Legs Syndrome.
  • Such use can have the same embodiments as those specifically disclosed herein in the context of a method.
  • the present invention thus provides the R- (+) -enantiomer of N-propargyl-1-aminoindan ["R(+)PAI"] of the formula (I):
  • the present invention also provides pharmaceutical compositions comprising the compound R(+)PAI, their preparations and methods of treatment of RLS with the pharmaceutical compositions.
  • the subject invention also provides a method for the treatment of RLS with rasagiline, wherein, the patient has previously been diagnosed and treated for RLS and developed symptoms of augmentation, i.e. a common consequence of long term treatment in which the symptoms of RLS become more severe, occur earlier in the evening, and spread to other parts of the body.
  • Rasagiline is the INN (International Nonproprietary Name) and USAN (United States Adopted Name) of the chemical substance R- (+) -N-propargyl-1-aminoindan.
  • R(+)PAI may be obtained by optical resolution of racemic mixtures of R and S-enantiomer of N-propargyl-1-aininoindan
  • Such a resolution can be accomplished by any conventional resolution method, well known to a person skilled in the art, such as those described in "Enantiomers, Racemates and Resolutions" by J. Jacques, A. Collet and S. Wilen, Pub. John Wiley & Sons, N. Y., 1981.
  • the resolution may be carried out by preparative chromatography on a chiral column.
  • Another example of a suitable resolution method is the formation of diastereomeric salts with a chiral acid such as tartaric, malic, mandelic acid or N-acetyl derivatives of amino acids, such as N-acetyl leucine, followed by recrystallisation to isolate the diastereomeric salt of the desired R enantiomer.
  • the racemic mixture of R and S enantiomers of PAI may be prepared, e.g. as described in WO95/11016.
  • the racemic mixture of PAI can also be prepared by reacting 1-chloroindan or 1-bromoindan with propargylamine .
  • this racemate may be prepared by reacting propargylamine with 1- indanone to form the corresponding imine, followed by reduction of the carbon-nitrogen double bond of the imine with a suitable agent, such as sodium borohydride.
  • R(+)PAI can also be prepared directly from the optically active R-enantiomer of 1-aminoindan by reaction with propargyl bromide or propargyl chloride in the presence of an organic or inorganic base and optionally in the presence of a suitable solvent.
  • a preferred method of preparation of the aforementioned compound is the reaction between R-1-aminoindan with propargyl chloride using potassium bicarbonate as a base and acetonitrile as solvent.
  • the compound R(+)PAI may be prepared as pharmaceutical compositions particularly useful for the treatment of RLS.
  • Such compositions may comprise the compound of R(+)PAI or pharmaceutically acceptable acid addition salts thereof, together with pharmaceutically acceptable carriers and/or excipients .
  • pharmaceutically acceptable salts include, but are not limited to, the mesylate, maleate, fumarate, tartrate, hydrochloride, hydrobromide, esylate, p-tolunesulfonate, benzoate, acetate, phosphate and sulfate salts.
  • compositions may be prepared as medicaments to be administered orally, parenterally, rectally or transdermally .
  • suitable forms for oral administration include tablets, compressed or coated pills, dragees, sachets, hard or soft gelatin capsules, sublingual tablets, syrups and suspensions; for parenteral administration the invention provides ampoules or vials that include an aqueous or non-aqueous solution or emulsion; for rectal administration there are provided suppositories with hydrophilic or hydrophobic vehicles; and for topical application as ointments and transdermal delivery there are provided suitable delivery systems as known • in the art-
  • Tablets may contain suitable binders, lubricants, disintegrating agents, coloring agents, flavoring agents, flow-inducing agents, and melting agents.
  • the active drug component can be combined with an oral, non-toxic, pharmaceutically acceptable, inert carrier such as lactose, gelatin, agar, starch, sucrose, glucose, methyl cellulose, dicalcium phosphate, calcium sulfate, mannitol, sorbitol, microcrystalline cellulose and the like.
  • Suitable binders include starch, gelatin, natural sugars such as glucose or beta-lactose, corn starch, natural and synthetic gums such as acacia, tragacanth, or sodium alginate, povidone, carboxymethylcellulose, polyethylene glycol, waxes, and the like.
  • Lubricants used in these dosage forms include sodium oleate, sodium stearate, sodium benzoate, sodium acetate, sodium chloride, stearic acid, sodium stearyl fumarate, talc and the like.
  • Disintegrators include, without limitation, starch, methyl cellulose, agar, bentonite, xanthan gum, croscarmellose sodium, sodium starch glycolate and the like.
  • Rasagiline mesylate in a 1 mg tablet is commercially available for use in Parkinson' s disease treatment as Azilect® from Teva Pharmaceutical Industries, Ltd. (Petach
  • R(+)PAI compositions may be used alone to treat RLS, or alternatively, they may be used as an adjunct to existing RLS treatments.
  • R(+)PAI may be administered at different times and separate from other RLS treatments, or as a combined pharmaceutical composition of R(+)PAI with at least one of carbidopa, levodopa, pergolide, pramipexole, oxycodone, clonazepam, carbamazepine, gabapentin, valproate, ropinirole or clonidin.
  • a pharmaceutical composition for oral use in the form of tablets or capsules may comprise R (+) -N-propargyl-1-aminoindan, Levodopa, and a decarboxylase inhibitor.
  • Such a composition may comprise 0.01-20 mg of R ⁇ +) -N-propargyl-1-aminoindan, 50-100 mg of Levodopa, and 12.5-50 mg of benserazide.
  • the preferred dosages of R(+)P2 ⁇ I in any of the disclosed compositions may be within the following ranges: for oral or suppository formulations 0.01-20. mg per dosage unit to be taken daily and more preferably 0.5-5 mg per dosage unit to be taken daily may be used; and for injectable formulations
  • 0.05-10 mg/ml per dosage unit to be taken daily and more preferably 0.5-3 mg/ml per dosage unit to be taken daily may be used.
  • 0.01-20 mg it is meant that all hundredth, tenth and integer unit amounts within the range are specifically disclosed as part of the invention. Thus, 0.02, 0.03 ... 0.09; 0.1, 0.2 ... 0.9; and 1, 2 ... 19 mg unit amounts are included as embodiments of this invention.
  • R(+)PAI is effective and suitable for use in the treatment of RLS, both alone and in combination with other RLS treatments.
  • Pregelatinized starch 10.0 mg/tablet Colloidal silicon dioxide 0.6 mg/tablet Talc 2.0 mg/tablet Stearic acid 2.0 mg/tablet
  • 6-hydroxydopamine is an agent that selectively disrupts or destroys catecholaminergic systems.
  • stereotaxic bilateral 6-hydroxydopamine lesions into the nucleus of dopaminergic diencephalic spinal neurons are performed to effect behavior consistent, although not specific, with what would be expected in a rat model of RLS.
  • epochs demonstrate an increased average number of standing episodes and increased total standing time but similar total sleep time in lesioned rats when compared with control rats.
  • treatment of the lesioned rats with R(+)PAI mesylate results in fewer standing episodes and less total standing time when compared with untreated lesioned rats.
  • Periodic limb movements in sleep are often associated with RLS.
  • sleep-wake behavior is recorded and hindlimb movements are detected by means of a magneto-inductive device during two 12-h light periods (Baier P. C. et al., Assessment of spontaneously occurring periodic limb movements in sleep in the rat, J. Neurol. Sci. 2002; 198(1-2): 71-77).
  • Periodic hindlimb movements (PHLM) during nonrapid eye movement sleep (NREM) are identified according to modified human criteria in some of the rats, which are then selected for the rasagiline study.
  • Half the rats are treated daily with rasagiline while the other half receive vehicle. Incidence of PHLM is determined for 3 consecutive nights, beginning 7 days after onset of treatment. It is demonstrated that rasagiline- treated rats have significantly fewer PHLM than vehicle- treated rats.
  • the 1 mg tablet of R(+)PAI mesylate is investigated in placebo-controlled, double-blind, randomized clinical tests covering in a study adult patients who are suffering from moderate to severe primary Restless Legs Syndrome.
  • Randomization in terms of gender, age and severity of prior illnesses is reasonably balanced. Patients with RLS secondary to other conditions (e.g., pregnancy, renal failure, and anemia) are excluded.
  • the patients of one group are treated with a 0.5 mg dosage and the patients of another group are treated with 1 mg.
  • the patients in the placebo group are treated with a placebo-
  • IRLSSG International Restless Legs Syndrome Study Group
  • an initial starting value is determined for each patient participating in the study. This is done by adding up the individual IRLSSG parameter values as of Day 0, i.e. before treatment. Over the course of treatment the IRLSSG values are compared with the starting value and any changes from that starting value are recorded. Finally, the average improvement of the IRLSSG value over the starting value is determined by calculating the average of all test subjects. The resulting value is called CAS-- (complete analysis set) randomized average change from the starting value of the overall IRLSSG rating.
  • CAS-- complete analysis set
  • R(+)PAI is well tolerated and safe and leads to a distinct clinical improvement in patients in a moderate to severe stage of RLS.
  • the maximal interval between the screening and baseline visits should be 14 days. If, however, results from screening procedures are still pending after 14 days from the screening visit and the investigator has to wait until all results are available before determining a subject's eligibility, the interval between the screening and baseline visits may extend up to 21 days.
  • Procedures during an unscheduled visit are optional, except vital signs.
  • Pregnancy test relevant to women of childbearing potential only d) Including weight and height at screening and weight at Visit Week 8/EarIy Termination
  • the primary efficacy endpoint was based on the change from baseline to weeks 2, 4, and 8 in IRLS scores.
  • CGI-I Clinical Global Impression-Global Improvement
  • the CGI-I scale is a single item scale on which the investigator rated a subject's symptoms as very much improved, much improved, minimally improved, not changed, minimally worse, much worse, or very much worse. Subjects were scored on this scale at weeks 2, 4, and 8. The mean score at each of these time points was calculated as a secondary efficacy endpoint . Table 2 shows the results of the CGI-I Rating Scale. Subjects are scored on a scale of 1-7, where 1 indicates the subject's symptoms are very much improved and 7 indicates the subject's symptoms are very much worse.
  • RLS QoL Restless Leg Syndrome Quality of Life questionnaire
  • the RLS QoL questionnaire was completed by the investigator at the baseline and Week 4, and 8 visits.
  • the change from baseline to each post-baseline study visit was calculated as an additional efficacy endpoint .
  • the Sleep Scale is a 12- item scale that provides a comprehensive view across almost all dimensions of sleep including daytime somnolence, sleep disturbance, sleep adequacy and sleep quantity.
  • the investigator scored subjects on this scale at the baseline and Week 4, and 8 visits. The change from baseline to each post- baseline study visit was calculated as a secondary efficacy endpoint.
  • Sleep measures In A. L. Stewart & J. E. Ware (eds. ) , Measuring functioning and well-being: The Medical Outcomes Study approach (pp.235-259) , Durham, NC: Duke University Press.
  • Tables 4-12 show the results of the Sleep Rating Scale and change from baseline over time for each of the 9 dimensions scored by the Sleep Rating Scale.
  • N is the number of participants in the study. A low score indicates the absence of problems and a high score indicates a very severe problem.
  • this subject had an improvement of 37% in the IRLS Quality of Life Questionnaire compared to baseline. In addition, by eight weeks, this subject had an improvement of 58% in the Sleep Problems Index II statistic measured as part of the Sleep Scale.
  • rasagiline has been shown to have a clinically significant effect on the symptoms of RLS.

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PCT/US2007/008261 2006-04-03 2007-03-30 Use of rasagiline for the treatment of restless legs syndrome Ceased WO2007117431A2 (en)

Priority Applications (13)

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MX2008012781A MX2008012781A (es) 2006-04-03 2007-03-30 Uso de rasagilina para el tratamiento de sindrome de piernas inquietas.
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US12310929B2 (en) 2006-04-03 2025-05-27 Teva Pharmaceutical Industries, Ltd. Use of rasagiline for the treatment of restless legs syndrome
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