14 research outputs found
Method of producing high T(subc) superconducting NBN films
Thin films of niobium nitride with high superconducting temperature (T sub c) of 15.7 K are deposited on substrates held at room temperature (approx 90 C) by heat sink throughout the sputtering process. Films deposited at P sub Ar 12.9 + or - 0.2 mTorr exhibit higher T sub c with increasing P sub N2,I with the highest T sub c achieved at P sub n2,I= 3.7 + or - 0.2 mTorr and total sputtering pressure P sub tot = 16.6 + or - 0.4. Further increase of N2 injection starts decreasing T sub c
Comparison of IPX066 with carbidopa–levodopa plus entacapone in advanced PD patients
AbstractBackgroundIPX066, an investigational extended-release carbidopa–levodopa (CD-LD) preparation, has demonstrated a rapid attainment and prolonged maintenance of therapeutic LD plasma concentrations in advanced Parkinson's disease (PD). This phase-3 crossover study assessed its efficacy and safety vs. CD-LD plus entacapone (CL + E).MethodsAt baseline, all patients had motor fluctuations despite a stable regimen of CL + E or CD-LD-entacapone combination tablets (CLE). The study included a 6-week conversion from CL + E or CLE to IPX066, followed by two 2-week, double-blind crossover treatment periods in randomized order, one on IPX066 (and placebo CL + E), the other on CL + E (and placebo IPX066), separated by 1-week open-label IPX066 treatment. The primary efficacy measure was mean percent daily “off” time during waking hours (from patient diaries).ResultsOf 91 randomized patients, 84 completed the study. Their median daily LD dosage was 1495 mg from IPX066 and 600 mg from CL + E, corresponding, after correction for bioavailability, to an approximately 22% higher LD exposure on IPX066. Compared with CL + E, IPX066 demonstrated a lower percent “off” time (24.0% vs. 32.5%; p < 0.0001), lower “off” time (3.8 vs. 5.2 h/day; p < 0.0001), and higher “on” time without troublesome dyskinesia (11.4 vs. 10.0 h/day; p < 0.0001). Other endpoints, including patient-reported treatment preference, also favored IPX066 (p < 0.05). During double-blind treatment, 20.2% and 13.6% of patients reported adverse events on IPX066 and CL + E, respectively. The most common were dyskinesia (4 patients), insomnia (3), and confusional state (3) for IPX066, and fall (2) for CL + E.ConclusionsIn advanced PD, IPX066 showed improved efficacy, compared with CL + E, and appeared to be well tolerated
Long-Term Treatment with Extended-Release Carbidopa– Levodopa (IPX066) in Early and Advanced Parkinson’s Disease: A 9-Month Open-Label Extension Trial
Background and Objective IPX066 is a multiparticulate
extended-release formulation of carbidopa–levodopa, designed
to produce prolonged therapeutic levodopa plasma
concentrations. This 9-month open-label extension study
assessed its long-term safety and clinical utility in early and
advanced Parkinson’s disease (PD).
Methods Participants were enrolled from two phase III
IPX066 studies and one open-label phase II study. Early
PD patients were titrated to an appropriate dosing regimen
while advanced patients started with regimens established
in the antecedent studies. Adjustment was allowed
throughout the extension. Clinical utility measures included
the Unified Parkinson’s Disease Rating Scale
(UPDRS) and Patient Global Impression (PGI) ratings.
Results Among 268 early PD patients, 53.4 % reported
adverse events (AEs) and 1.1 % (three patients)
discontinued due to AEs; the most frequent AEs were
nausea (5.6 %) and insomnia (5.6 %). Among 349
advanced patients, 60.2 % reported AEs and 3.7 % (13
patients) discontinued due to AEs; the most frequent AEs
were dyskinesia (6.9 %) and fall (6.6 %). At month 9 (or
early termination), 78.3 % of early patients were taking
IPX066 three times daily (median: 720 mg/day) and
87.7 % of advanced patients were taking IPX066 three or
four times daily (median: 1450 mg/day). Adjusting for
70 % bioavailability relative to immediate-release (IR)
carbidopa–levodopa, the median dosages correspond to
*500 and *1015 mg/day of IR levodopa in early and
advanced PD, respectively. Based on the plasma profiles
previously observed in PD patients, the IPX066 regimens
in the extension can be estimated to provide a levodopa
Cmax (maximum plasma drug concentration) similar to or
lower than that provided by IR regimens during the antecedent
trials. UPDRS and PGI findings showed sustained
treatment effects throughout the extension.
Conclusion During 9 months of extended use, IPX066
exhibited a safety/tolerability profile consistent with
dopaminergic PD therapy
Long-term treatment with extended-release carbidopa-levodopa (IPX066) in early and advanced Parkinson's Disease : a 9-month open-label extension trial
Background and Objective IPX066 is a multiparticulate
extended-release formulation of carbidopa–levodopa, designed to produce prolonged therapeutic levodopa plasma
concentrations. This 9-month open-label extension study
assessed its long-term safety and clinical utility in early and
advanced Parkinson’s disease (PD).
Methods Participants were enrolled from two phase III
IPX066 studies and one open-label phase II study. Early
PD patients were titrated to an appropriate dosing regimen
while advanced patients started with regimens established
in the antecedent studies. Adjustment was allowed
throughout the extension. Clinical utility measures included the Unified Parkinson’s Disease Rating Scale
(UPDRS) and Patient Global Impression (PGI) ratings.
Results Among 268 early PD patients, 53.4 % reported
adverse events (AEs) and 1.1 % (three patients)
discontinued due to AEs; the most frequent AEs were
nausea (5.6 %) and insomnia (5.6 %). Among 349
advanced patients, 60.2 % reported AEs and 3.7 % (13
patients) discontinued due to AEs; the most frequent AEs
were dyskinesia (6.9 %) and fall (6.6 %). At month 9 (or
early termination), 78.3 % of early patients were taking
IPX066 three times daily (median: 720 mg/day) and
87.7 % of advanced patients were taking IPX066 three or
four times daily (median: 1450 mg/day). Adjusting for
70 % bioavailability relative to immediate-release (IR)
carbidopa–levodopa, the median dosages correspond to
*500 and *1015 mg/day of IR levodopa in early and
advanced PD, respectively. Based on the plasma profiles
previously observed in PD patients, the IPX066 regimens
in the extension can be estimated to provide a levodopa
Cmax (maximum plasma drug concentration) similar to or
lower than that provided by IR regimens during the antecedent trials. UPDRS and PGI findings showed sustained
treatment effects throughout the extension.
Conclusion During 9 months of extended use, IPX066
exhibited a safety/tolerability profile consistent with
dopaminergic PD therapy
Dosing Patterns during Conversion to IPX066, Extended-Release Carbidopa-Levodopa (ER CD-LD), in Parkinson’s Disease with Motor Fluctuations
Background. IPX066 is an extended-release (ER) oral formulation of carbidopa-levodopa (CD-LD). Following an initial peak at about one hour, plasma LD concentrations are maintained for about 4-5 hours. Objective. To present dosing factors that may affect the successful conversion to ER CD-LD from other LD formulations. Methods. Two-phase 3 studies of ER CD-LD vs. immediate-release (IR) CD-LD (ADVANCE-PD) and vs. CD-LD + entacapone (CLE; ASCEND-PD) in subjects with advanced PD included a 6-week, open-label conversion to ER CD-LD prior to treatment randomization. The “converted” daily LD dose ratio and dose frequency for ER CD-LD were compared to the prior LD treatment regimens at study entry. Results. The average daily LD dose ratio at the end of dose conversion to ER CD-LD was approximately 2.1 for IR CD-LD and 2.8 for CLE. The final dose ratios tended to be slightly higher for participants taking lower LD doses at study entry but independent of dose frequency. ER CD-LD dose frequency increased with increasing LD dose and dose frequency at study entry. Participants on higher baseline LD doses ≥800 mg and dose frequencies ≥6 tended to have higher rates of discontinuation during conversion to ER CD-LD. Conclusions. Converting participants from other LD formulations to ER CD-LD is based on their current LD regimen. For the most common daily doses (≤1250 mg) and dose frequencies (<7) of LD, final mean dose ratios were within tight ranges of 2.1 to 2.4 for IR CD-LD (ADVANCE-PD) and 2.4 to 2.8 for CLE (ASCEND-PD) and were generally independent of the LD dosing frequency at study entry. These trials are registered with NCT00974974, NCT01130493
Effect of Concomitant Medications on the Safety and Efficacy of Extended-Release Carbidopa-Levodopa (IPX066) in Patients With Advanced Parkinson Disease: A Post Hoc Analysis
OBJECTIVES: Extended-release (ER) carbidopa-levodopa (CD-LD) (IPX066/RYTARY/NUMIENT) produces improvements in off time, on time without troublesome dyskinesia, and Unified Parkinson Disease Rating Scale scores compared with immediate-release (IR) CD-LD or IR CD-LD plus entacapone (CLE). Post hoc analyses of 2 ER CD-LD phase 3 trials evaluated whether the efficacy and safety of ER CD-LD relative to the respective active comparators were altered by concomitant medications (dopaminergic agonists, monoamine oxidase B [MAO-B] inhibitors, or amantadine).
METHODS: ADVANCE-PD (n = 393) assessed safety and efficacy of ER CD-LD versus IR CD-LD. ASCEND-PD (n = 91) evaluated ER CD-LD versus CLE. In both studies, IR- and CLE-experienced patients underwent a 6-week, open-label dose-conversion period to ER CD-LD prior to randomization. For analysis, the randomized population was divided into 3 subgroups: dopaminergic agonists, rasagiline or selegiline, and amantadine. For each subgroup, changes from baseline in PD diary measures ( off time and on time with and without troublesome dyskinesia), Unified Parkinson Disease Rating Scale Parts II + III scores, and adverse events were analyzed, comparing ER CD-LD with the active comparator.
RESULTS AND CONCLUSIONS: Concomitant dopaminergic agonist or MAO-B inhibitor use did not diminish the efficacy (improvement in off time and on time without troublesome dyskinesia) of ER CD-LD compared with IR CD-LD or CLE, whereas the improvement with concomitant amantadine failed to reach significance. Safety and tolerability were similar among the subgroups, and ER CD-LD did not increase troublesome dyskinesia. For patients on oral LD regimens and taking a dopaminergic agonist, and/or a MAO-B inhibitor, changing from an IR to an ER CD-LD formulation provides approximately an additional hour of good on time