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Raloxifene for Women With Alzheimer's Disease

Primary Purpose

Alzheimer Disease

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
raloxifene
Placebo
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring raloxifene, women

Eligibility Criteria

60 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Female Post menopausal Age at least 60 years Eight or more years of education with a history of premorbid literacy By history, fluent speaker of English Dementia (DSM-IV-derived criteria) present for at least six months beginning at age 60 or older Mild or moderate dementia, defined by Mini-Mental State examination (MMSE) score between 12 and 26, inclusive National Institute of Neurological and Communicative Disease and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable Alzheimer's disease (AD) based on results of a neurologist's evaluation and laboratory tests Neurological history and examination within normal limits for age, except for changes consistent with AD or age Modified Ischemia Scale score of 4 or less Good physical health established by medical history, physical exam, and baseline laboratory tests Blood pressure < 180/100 at time of entry No history of, or examination evidence for, current insulin-dependent diabetes, stroke thought to impair cognition (e.g., cortical or thalamic infarct), or other focal brain lesion or neurological disorder likely to affect cognition, or other serious medical illness likely to limit participant's ability to complete study protocol No history of pulmonary embolism, deep vein thrombosis, or retinal vein occlusion No Diagnostic and Statistical Manual (DSM) IV criteria for Major Depressive Episode or other Axis I psychiatric disorder, other than AD, within the past year Effective dose of an FDA-approved cholinesterase inhibitor for at least 6 months prior to randomization (usually donepezil 5 or 10 mg/d, rivastigmine 6 to 12 mg/d, or galantamine 16 to 24 mg/d); stable effective dose for at least 2 months prior to randomization No psychotropic medication within 4 weeks of study entry or stable dose (for at least 4 weeks month) of psychotropic medications No experimental mediation for the treatment of cognitive impairment associated with dementia within 2 months of study entry No raloxifene within 6 months of study entry No systemic estrogen, progestin, testosterone, related gonadal hormone therapy within 2 months of study entry No other known contraindication to raloxifene or donepezil A primary caregiver who knows the participant well and who is able to accompany her for regular assessments during the course of the study Assent or consent of participant plus informed consent from participant's next of kin or legally authorized representative Exclusion Criteria: 1. Failure to meet inclusion criteria

Sites / Locations

  • Kaiser Permanente Santa Rosa
  • Stanford University School of Medicine
  • Southern Illinois University School of Medicine
  • Indiana University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

raloxifene

placebo

Arm Description

oral raloxifene 120 mg once daily

identical appearing oral placebo

Outcomes

Primary Outcome Measures

Alzheimer's Disease Assessment Scale, Cognitive Subscale (ADAS-cog)
ADAS-cog, change from baseline at 12 months, compared between treatment arms. The ADAS-cog is a neuropsychological battery commonly used in trials of AD patients. Error score range 0-70. For results below, positive change represents improvement/ better performance. For the primary outcome, as well as for secondary outcomes, the reported p-values reflect the calculated p-values.

Secondary Outcome Measures

Global Rating, Clinical Dementia Rating (CDR) Sum of Boxes
Global rating of dementia severity, change from baseline at 12 months. Range 0-5. For results below, positive change represents improvement/ better performance.
Function, Activities of Daily Living (ADL)
ADL scale from the Alzheimer's Disease Cooperative Study, change from baseline at 12 months. Range 0-78. For results below, positive change represents improvement/ better performance.
Behavior
Neuropsychiatric Inventory, change from baseline at 12 months. Range 0-120. For results below, positive change represents improvement/ better performance.
Cognitive (Neuropsychological)
Global composite calculated as a weighted average of standardized scores of neuropsychological tests (weighted by the inverse intertest correlation matrix), change from baseline at 12 months. There is no theoretical maximum or minimum for this cognitive composite, with a score of 0 standardized units representing no change. For results below, positive change represents improvement/ better performance.
ADAS-cog
Change from baseline at 6 months, compared between groups. Error score range 0-70. For results below, positive change represents improvement/ better performance.
Clinical Dementia Rating, Sum of Boxes
Change from baseline at 6 months, compared between groups. Range 0-5. For results below, positive change represents improvement/ better performance.
Function, Activities of Daily Living
Change from baseline at 6 months, compared between groups. Range 0-78. For results below, positive change represents improvement/ better performance.
Behavior
Neuropsychiatric Inventory, change from baseline at 6 months, compared between groups. Range 0-120. For results below, positive change represents improvement/ better performance.
Cognition (Neuropsychological)
Global composite calculated as a weighted average of standardized scores of neuropsychological tests (weighted by the inverse intertest correlation matrix), change from baseline at 6 months. There is no theoretical maximum or minimum for this cognitive composite, with a score of 0 standardized units representing no change. For results below, positive change represents improvement/ better performance.

Full Information

First Posted
August 22, 2006
Last Updated
March 20, 2015
Sponsor
Stanford University
Collaborators
Kaiser Permanente, Indiana University, Southern Illinois University
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1. Study Identification

Unique Protocol Identification Number
NCT00368459
Brief Title
Raloxifene for Women With Alzheimer's Disease
Official Title
Raloxifene in Women With AD: Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
August 2006 (undefined)
Primary Completion Date
March 2011 (Actual)
Study Completion Date
January 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Stanford University
Collaborators
Kaiser Permanente, Indiana University, Southern Illinois University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multisite pilot randomized trial of raloxifene or placebo for the treatment of women with Alzheimer's disease.
Detailed Description
Raloxifene , a selective estrogen receptor modulator, has attracted attention as a potential treatment for Alzheimer's disease in women, but it has not been studied in this disorder. To assess feasibility of large-scale efficacy trials and to obtain an initial estimate of treatment effect, study investigators plan to conduct a pilot, randomized, double blind, placebo-controlled, clinical trial of high-dose (120 mg daily) raloxifene. Eligible participants are postmenopausal women with late-onset Alzheimer's disease of mild-to-moderate severity taking a stable dose of an approved cholinesterase inhibitor. This pilot study is not designed to have power to detect significant, modest between-group differences of the magnitude provided by current FDA-approved therapies. Study participants will be randomly allocated to oral raloxifene or identical placebo over a 12 month period. Outcomes of interest will be obtained at 6 and 12 months. The prespecified primary outcome is the change in the Alzheimer's Disease Assessment Scale, cognitive subscale (ADAS-cog), compared between groups at 12 months. Prespecified secondary outcomes include measures of global severity (Clinical Dementia Rating sum of boxes), function (Activities of Daily Living), behavior (Neuropsychiatric inventory), and other neuropsychological measures. Caregiver outcomes will be burden (Zarit burden inventory) and distress (from the Neuropsychiatric inventory).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
Keywords
raloxifene, women

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
42 (Actual)

8. Arms, Groups, and Interventions

Arm Title
raloxifene
Arm Type
Experimental
Arm Description
oral raloxifene 120 mg once daily
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
identical appearing oral placebo
Intervention Type
Drug
Intervention Name(s)
raloxifene
Other Intervention Name(s)
Evista
Intervention Description
Raloxifene is a selective estrogen receptor modulator
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
There are no other names.
Intervention Description
Identical appearing placebo
Primary Outcome Measure Information:
Title
Alzheimer's Disease Assessment Scale, Cognitive Subscale (ADAS-cog)
Description
ADAS-cog, change from baseline at 12 months, compared between treatment arms. The ADAS-cog is a neuropsychological battery commonly used in trials of AD patients. Error score range 0-70. For results below, positive change represents improvement/ better performance. For the primary outcome, as well as for secondary outcomes, the reported p-values reflect the calculated p-values.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Global Rating, Clinical Dementia Rating (CDR) Sum of Boxes
Description
Global rating of dementia severity, change from baseline at 12 months. Range 0-5. For results below, positive change represents improvement/ better performance.
Time Frame
12 months
Title
Function, Activities of Daily Living (ADL)
Description
ADL scale from the Alzheimer's Disease Cooperative Study, change from baseline at 12 months. Range 0-78. For results below, positive change represents improvement/ better performance.
Time Frame
12 months
Title
Behavior
Description
Neuropsychiatric Inventory, change from baseline at 12 months. Range 0-120. For results below, positive change represents improvement/ better performance.
Time Frame
12 months
Title
Cognitive (Neuropsychological)
Description
Global composite calculated as a weighted average of standardized scores of neuropsychological tests (weighted by the inverse intertest correlation matrix), change from baseline at 12 months. There is no theoretical maximum or minimum for this cognitive composite, with a score of 0 standardized units representing no change. For results below, positive change represents improvement/ better performance.
Time Frame
12 months
Title
ADAS-cog
Description
Change from baseline at 6 months, compared between groups. Error score range 0-70. For results below, positive change represents improvement/ better performance.
Time Frame
6 months
Title
Clinical Dementia Rating, Sum of Boxes
Description
Change from baseline at 6 months, compared between groups. Range 0-5. For results below, positive change represents improvement/ better performance.
Time Frame
6 months
Title
Function, Activities of Daily Living
Description
Change from baseline at 6 months, compared between groups. Range 0-78. For results below, positive change represents improvement/ better performance.
Time Frame
6 months
Title
Behavior
Description
Neuropsychiatric Inventory, change from baseline at 6 months, compared between groups. Range 0-120. For results below, positive change represents improvement/ better performance.
Time Frame
6 months
Title
Cognition (Neuropsychological)
Description
Global composite calculated as a weighted average of standardized scores of neuropsychological tests (weighted by the inverse intertest correlation matrix), change from baseline at 6 months. There is no theoretical maximum or minimum for this cognitive composite, with a score of 0 standardized units representing no change. For results below, positive change represents improvement/ better performance.
Time Frame
6 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female Post menopausal Age at least 60 years Eight or more years of education with a history of premorbid literacy By history, fluent speaker of English Dementia (DSM-IV-derived criteria) present for at least six months beginning at age 60 or older Mild or moderate dementia, defined by Mini-Mental State examination (MMSE) score between 12 and 26, inclusive National Institute of Neurological and Communicative Disease and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable Alzheimer's disease (AD) based on results of a neurologist's evaluation and laboratory tests Neurological history and examination within normal limits for age, except for changes consistent with AD or age Modified Ischemia Scale score of 4 or less Good physical health established by medical history, physical exam, and baseline laboratory tests Blood pressure < 180/100 at time of entry No history of, or examination evidence for, current insulin-dependent diabetes, stroke thought to impair cognition (e.g., cortical or thalamic infarct), or other focal brain lesion or neurological disorder likely to affect cognition, or other serious medical illness likely to limit participant's ability to complete study protocol No history of pulmonary embolism, deep vein thrombosis, or retinal vein occlusion No Diagnostic and Statistical Manual (DSM) IV criteria for Major Depressive Episode or other Axis I psychiatric disorder, other than AD, within the past year Effective dose of an FDA-approved cholinesterase inhibitor for at least 6 months prior to randomization (usually donepezil 5 or 10 mg/d, rivastigmine 6 to 12 mg/d, or galantamine 16 to 24 mg/d); stable effective dose for at least 2 months prior to randomization No psychotropic medication within 4 weeks of study entry or stable dose (for at least 4 weeks month) of psychotropic medications No experimental mediation for the treatment of cognitive impairment associated with dementia within 2 months of study entry No raloxifene within 6 months of study entry No systemic estrogen, progestin, testosterone, related gonadal hormone therapy within 2 months of study entry No other known contraindication to raloxifene or donepezil A primary caregiver who knows the participant well and who is able to accompany her for regular assessments during the course of the study Assent or consent of participant plus informed consent from participant's next of kin or legally authorized representative Exclusion Criteria: 1. Failure to meet inclusion criteria
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr Victor Henderson
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kaiser Permanente Santa Rosa
City
Santa Rosa
State/Province
California
ZIP/Postal Code
95403
Country
United States
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Southern Illinois University School of Medicine
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62794
Country
United States
Facility Name
Indiana University Medical Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States

12. IPD Sharing Statement

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Raloxifene for Women With Alzheimer's Disease

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