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Management of Parkinson's disease if levodopa is broken down prematurely
EU CTIS ID: 2024-510629-24-00
What this study is testing
Can symptom management of persons with Parkinson's disease who have increased activity of the levodopa-metabolizing enzyme aromatic L-amino acid decarboxylase (AADC), or who have increased abundance of bacteria that produce the levodopa-metabolizing enzymes tyrosine decarboxylase (TDC), aromatic amino acid aminotransferase (AAT) or aromatic amino acid lactate dehydrogenase (ALDH), be improved by either circumventing the enzymatic mechanisms (using the dopamine receptor agonist apomorphine), or an antibiotic intervention against enzyme-producing bacteria (rifaximin), or both?
- Therapeutic exploratory (Phase II)
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- Subject is an adult, at least 25 years of age, of either sex
- Subject lives in the Netherlands
- Subject can read and understand Dutch
- Subject has completed the ethics board-approved Informed Consent
- Subject is willing, competent, and able to comply with all aspects of the protocol, including multiple occasions of not taking their PD medication during a 12-hour period, and biospecimen collection
- Diagnosis of Parkinson’s disease (idiopathic parkinsonism) by a neurologist, according to accepted clinical criteria
You likely can't join if
- Significant doubt over the correctness of the diagnosis idiopathic Parkinson’s disease
- Atypical or genetic parkinsonism, or parkinsonism caused by a structural laesion of the brain
- Levodopa-resistant tremor, unless the subtotal of the ‘OFF’ MDS-UPDRS III tremor scores (item 3.15-3.18) makes up less than 15% of the ‘OFF’ MDS-UPDRS III total sum score
- Presence of dementia
- Current presence of hallucinations or delusions, or history of developing hallucinations or delusions under dopaminergic therapy. Exception: hallucinations or delusions not currently present AND currently adequately treated with a cholinesterase inhibitor to prevent recurrence.
- Fear of needles/injection
See the full eligibility criteria
- Subject is an adult, at least 25 years of age, of either sex
- Subject lives in the Netherlands
- Subject can read and understand Dutch
- Subject has completed the ethics board-approved Informed Consent
- Subject is willing, competent, and able to comply with all aspects of the protocol, including multiple occasions of not taking their PD medication during a 12-hour period, and biospecimen collection
- Diagnosis of Parkinson’s disease (idiopathic parkinsonism) by a neurologist, according to accepted clinical criteria
- Documented peripheral levodopa resistance
- Serum AADC enzyme activity of >144 mU/L (in sample taken in medicated condition) AND/OR faecal abundance of levodopa-metabolizing bacteria of >90,000 fragments per million
- Significant doubt over the correctness of the diagnosis idiopathic Parkinson’s disease
- Atypical or genetic parkinsonism, or parkinsonism caused by a structural laesion of the brain
- Levodopa-resistant tremor, unless the subtotal of the ‘OFF’ MDS-UPDRS III tremor scores (item 3.15-3.18) makes up less than 15% of the ‘OFF’ MDS-UPDRS III total sum score
- Presence of dementia
- Current presence of hallucinations or delusions, or history of developing hallucinations or delusions under dopaminergic therapy. Exception: hallucinations or delusions not currently present AND currently adequately treated with a cholinesterase inhibitor to prevent recurrence.
- Fear of needles/injection
- Co-morbidities that would hamper interpretation of parkinsonian disability, such as coincident musculoskeletal abnormalities
- Not able to stand or walk without the assistance of another person (walking aids are not an exclusion criterion)
- Presence of gastrointestinal disease associated with impaired drug absorption (e.g. coeliac disease)
- Pregnancy or breastfeeding
- Allergies to any of the investigational and non-investigational medications or constituents thereof
- Documented severe and debilitating dyskinesias on levodopa, to such an extent that levodopa treatment was terminated
- Contraindications to levodopa/benserazide
- Present use of, or planned initiation during the study period of, advanced therapies (AT) for Parkinson’s disease including deep brain stimulation (DBS), continuous jejunal levodopa infusion (CJLI), continuous subcutaneous (fos)levodopa infusion (CSLI), apomorphine pen injections or continuous subcutaneous apomorphine infusion (CSAI)
- Any antibiotic therapy during the study period and in the 12 months preceding it, unless participant only participates in apomorphine substudy and is selected for inclusion based solely upon AADC activity, not bacterial abundance
- Present, or in the past 14 days, use of non-selective monoamine oxidase (MAO) inhibitors (including tranylcypromine) or dual use of a selective MAO-B inhibitor (including rasagiline, safinamide) and a selective MAO-A inhibitor (including moclobemide)
- Present, or in the past 4 weeks, use of any probiotic preparations, unless participant only participates in apomorphine substudy and is selected for inclusion based solely upon AADC activity, not bacterial abundance
The study team makes the final eligibility decision.
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 18-64 years, 65+ years. The study team makes the final eligibility decision.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.