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Huperzine A in Alzheimer's Disease

Primary Purpose

Alzheimer Disease

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Huperzine A
Sponsored by
National Institute on Aging (NIA)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring Alzheimer disease, Cholinesterase inhibitor

Eligibility Criteria

55 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

The selection process is designed to allow enrollment of all people with AD who are likely to be testable at the conclusion of the study period, and who do not have concurrent medical conditions or medications that might influence cognitive testing or that would increase the risk of treatment. Women and members of minority groups are encouraged to volunteer. Inclusion Criteria: NINDS/ADRDA criteria for probable AD. Mini Mental State Examination between 10 and 24, inclusive. Stable medical condition for 3 months prior to screening. Supervision available for administration of study medications. Study partner to accompany participant to all scheduled visits. Fluent in English or Spanish. Age 55 years or older. Modified Hachinski score equal to or less than 4. CT or MRI since onset of memory impairment demonstrating absence of clinically significant focal lesion. Able to complete baseline assessments. 6 years of education, or work history sufficient to exclude mental retardation. Able to ingest oral medication. Stable doses of medications for 4 weeks prior to screening. Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests. Exclusion Criteria: History of active peptic ulcer disease within 1 year of screening. Clinically significant cardiac arrhythmia. Resting pulse less than 50. Active neoplastic (cancer) disease (skin tumors other than melanoma are not excluded; participants with stable prostate cancer may be included at the discretion of the Project Director). Use of another investigational agent within 2 months of screening. History of clinically significant stroke. Current evidence or history in the past 2 years of epilepsy, focal brain lesion, head injury with loss of consciousness and/or immediate confusion after the injury, or DSM-IV criteria for any major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse. Blindness, deafness, language difficulties or any other disability which may prevent the participant from participating or cooperating in the protocol. Residence in a skilled nursing facility; but patients in an assisted living facility are acceptable. Excluded Medications: Use of cholinesterase inhibitors (galantamine, rivastigmine, donepezil, and tacrine) within 2 months of screening. Regular use of narcotic analgesics (>2 doses per week) within 4 weeks of screening. Use of medications with significant central nervous system anticholinergic activity within 2 months of screening (e.g. tricyclic antidepressants, diphenhydramine). Use of anti-Parkinsonian medications (including Sinemet, amantadine, bromocriptine, pergolide, selegiline) within 2 months of screening. Participation in any other investigational drug study within 2 months of screening (individuals may not participate in any other drug study while participating in this protocol). Use of estrogen is allowed if the dose has been stable for 3 months prior to screening. Use of vitamin E is allowed if the dose has been stable for 3 months prior to screening. Use of memantine is allowed if the dose has been stable for 3 months prior to screening.

Sites / Locations

  • University of Alabama
  • Banner Alzheimer's Institute
  • University of California, Irvine
  • University of California, San Diego, Alzheimer's Disease Research Center
  • University of Southern California
  • University of California, Davis
  • Howard University School of Medicine
  • Georgetown University Medical Center, Memory Disorders Program
  • MD Clinical
  • Roskamp Institute Memory Clinic
  • University of South Florida, Suncoast Alzheimer's and Gerontology Center
  • Premiere Research Institute
  • Emory University
  • Rush Alzheimer's Disease Center, Rush University Medical Center
  • ICPS Group
  • University of Nevada School of Medicine
  • Alzheimer's Research Corporation
  • University of Medicine and Dentistry of New Jersey
  • Albany Medical Center
  • New York University Medical Center
  • Mount Sinai School of Medicine
  • Nathan S. Kline Institute for Psychiatric Research
  • University of Rochester Medical Center
  • University of North Carolina
  • Oregon Health and Science University
  • University of Pittsburgh
  • Medical University of South Carolina
  • University of Texas Southwestern Medical Center
  • University of Vermont College of Medicine

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
May 26, 2004
Last Updated
February 19, 2008
Sponsor
National Institute on Aging (NIA)
Collaborators
Alzheimer's Disease Cooperative Study (ADCS), Neuro-Hitech
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1. Study Identification

Unique Protocol Identification Number
NCT00083590
Brief Title
Huperzine A in Alzheimer's Disease
Official Title
A Multi-Center, Double-Blind, Placebo-Controlled Therapeutic Trial to Determine Whether Natural Huperzine A Improves Cognitive Function
Study Type
Interventional

2. Study Status

Record Verification Date
February 2008
Overall Recruitment Status
Completed
Study Start Date
April 2004 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
November 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute on Aging (NIA)
Collaborators
Alzheimer's Disease Cooperative Study (ADCS), Neuro-Hitech

4. Oversight

5. Study Description

Brief Summary
The present study will evaluate the safety and efficacy of the Chinese herb huperzine A in the treatment of Alzheimer's disease (AD) in a randomized controlled trial of its effect on cognitive function.
Detailed Description
Huperzine A is a natural cholinesterase inhibitor derived from the Chinese herb Huperzia serrata. There is evidence that huperzine A may compare favorably in symptomatic efficacy to cholinesterase inhibitors currently in use. In addition, huperzine A has antioxidant and neuroprotective properties that suggest that it may be useful as a disease-modifying treatment for Alzheimer's disease (AD). The drug is currently available as a nutraceutical in this country, and is being used by some U.S. clinicians to treat AD. However, there have been no controlled clinical trials outside China assessing its toxicity and efficacy. The present study will evaluate huperzine A in the treatment of AD in a randomized controlled trial of its effect on cognitive function. The primary aim of this multicenter, double-blind, placebo-controlled therapeutic Phase II trial is to determine whether treatment with huperzine A 200µg twice a day improves cognitive function in individuals with AD. Secondary aims of this study are to: a) determine whether treatment with huperzine A 400µg twice a day improves cognitive function in individuals with AD; b) determine the effect of huperzine A treatment on global clinical status, activities of daily living, and behavior in AD; c) evaluate the tolerability of huperzine A treatment at dosages of 200µg twice a day and 400µg twice a day in AD; and d) determine the relationship between blood cholinesterase activity and cognitive function in individuals with AD treated with huperzine A. A total of 150 participants will be randomly assigned to three groups of equal size. This will allow a comparison of huperzine A 200µg twice a day, huperzine A 400µg twice a day, and placebo. The primary outcome measures will be the change in score on the ADAScog at the 16 week visit. Secondary outcome measures include the ADCS clinical global impression of change (CGIC) (Schneider et al 1997) and activities of daily living (ADL) (Galasko et al 1997) scales, and the Neuropsychiatric Inventory (Cummings 1997). Volunteers must be able to participate in the study for 24 weeks and make 9 visits to the trial site. At the end of the double-blind study, participants will be invited to continue huperzine A treatment for 6 months in an open-label extension phase. Participants will receive 200µg of huperzine A twice a day for six consecutive months, and will be assessed at 3-month intervals (months 6, 9, and 12, with month 6 assessments coinciding with the final visit of the double-blind phase).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
Keywords
Alzheimer disease, Cholinesterase inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Huperzine A

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
The selection process is designed to allow enrollment of all people with AD who are likely to be testable at the conclusion of the study period, and who do not have concurrent medical conditions or medications that might influence cognitive testing or that would increase the risk of treatment. Women and members of minority groups are encouraged to volunteer. Inclusion Criteria: NINDS/ADRDA criteria for probable AD. Mini Mental State Examination between 10 and 24, inclusive. Stable medical condition for 3 months prior to screening. Supervision available for administration of study medications. Study partner to accompany participant to all scheduled visits. Fluent in English or Spanish. Age 55 years or older. Modified Hachinski score equal to or less than 4. CT or MRI since onset of memory impairment demonstrating absence of clinically significant focal lesion. Able to complete baseline assessments. 6 years of education, or work history sufficient to exclude mental retardation. Able to ingest oral medication. Stable doses of medications for 4 weeks prior to screening. Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests. Exclusion Criteria: History of active peptic ulcer disease within 1 year of screening. Clinically significant cardiac arrhythmia. Resting pulse less than 50. Active neoplastic (cancer) disease (skin tumors other than melanoma are not excluded; participants with stable prostate cancer may be included at the discretion of the Project Director). Use of another investigational agent within 2 months of screening. History of clinically significant stroke. Current evidence or history in the past 2 years of epilepsy, focal brain lesion, head injury with loss of consciousness and/or immediate confusion after the injury, or DSM-IV criteria for any major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse. Blindness, deafness, language difficulties or any other disability which may prevent the participant from participating or cooperating in the protocol. Residence in a skilled nursing facility; but patients in an assisted living facility are acceptable. Excluded Medications: Use of cholinesterase inhibitors (galantamine, rivastigmine, donepezil, and tacrine) within 2 months of screening. Regular use of narcotic analgesics (>2 doses per week) within 4 weeks of screening. Use of medications with significant central nervous system anticholinergic activity within 2 months of screening (e.g. tricyclic antidepressants, diphenhydramine). Use of anti-Parkinsonian medications (including Sinemet, amantadine, bromocriptine, pergolide, selegiline) within 2 months of screening. Participation in any other investigational drug study within 2 months of screening (individuals may not participate in any other drug study while participating in this protocol). Use of estrogen is allowed if the dose has been stable for 3 months prior to screening. Use of vitamin E is allowed if the dose has been stable for 3 months prior to screening. Use of memantine is allowed if the dose has been stable for 3 months prior to screening.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul S. Aisen, MD
Organizational Affiliation
Georgetown University Medical Center, Memory Disorders Program
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Banner Alzheimer's Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
University of California, Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
University of California, San Diego, Alzheimer's Disease Research Center
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
University of California, Davis
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Howard University School of Medicine
City
Washington, DC
State/Province
District of Columbia
ZIP/Postal Code
20060
Country
United States
Facility Name
Georgetown University Medical Center, Memory Disorders Program
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20057
Country
United States
Facility Name
MD Clinical
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33321
Country
United States
Facility Name
Roskamp Institute Memory Clinic
City
Tampa
State/Province
Florida
ZIP/Postal Code
33617
Country
United States
Facility Name
University of South Florida, Suncoast Alzheimer's and Gerontology Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33617
Country
United States
Facility Name
Premiere Research Institute
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33407
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Rush Alzheimer's Disease Center, Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
ICPS Group
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02131
Country
United States
Facility Name
University of Nevada School of Medicine
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89102
Country
United States
Facility Name
Alzheimer's Research Corporation
City
Manchester
State/Province
New Jersey
ZIP/Postal Code
08759
Country
United States
Facility Name
University of Medicine and Dentistry of New Jersey
City
Piscataway
State/Province
New Jersey
ZIP/Postal Code
08855
Country
United States
Facility Name
Albany Medical Center
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
New York University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Mount Sinai School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Nathan S. Kline Institute for Psychiatric Research
City
Orangeburg
State/Province
New York
ZIP/Postal Code
10962
Country
United States
Facility Name
University of Rochester Medical Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14620
Country
United States
Facility Name
University of North Carolina
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97201
Country
United States
Facility Name
University of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Medical University of South Carolina
City
North Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
University of Vermont College of Medicine
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
10637369
Citation
Bai DL, Tang XC, He XC. Huperzine A, a potential therapeutic agent for treatment of Alzheimer's disease. Curr Med Chem. 2000 Mar;7(3):355-74. doi: 10.2174/0929867003375281.
Results Reference
background
PubMed Identifier
9141073
Citation
Ved HS, Koenig ML, Dave JR, Doctor BP. Huperzine A, a potential therapeutic agent for dementia, reduces neuronal cell death caused by glutamate. Neuroreport. 1997 Mar 3;8(4):963-8. doi: 10.1097/00001756-199703030-00029.
Results Reference
background
Citation
Mazurek A: An open-label trial of huperzine A in the treatment of Alzheimer's disease. Alternative Therapies 5(2): 97-98, March 16, 2000.
Results Reference
background

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Huperzine A in Alzheimer's Disease

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