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Randomized Trial of a Nutritional Supplement in Alzheimer's Disease

Primary Purpose

Alzheimer's Disease

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Resveratrol with Glucose, and Malate
Placebo
Sponsored by
US Department of Veterans Affairs
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease focused on measuring Alzheimer's Disease, Dementia, Nutritional Supplement, Resveratrol

Eligibility Criteria

50 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Consenting individuals as defined by IRB guidelines
  2. NINCDS/ADRDA criteria for probable AD
  3. Community dwelling
  4. Age: greater than or equal to 50 years
  5. MMSE between 12 and 26, inclusive
  6. Stable medical condition for 3 months prior to screening visit
  7. Stable doses of (non excluded) medications with central nervous system activity for 4 weeks prior to the screening visit (For cholinesterase inhibitors there should be no plan of dose escalation)
  8. Physically acceptable for this study as confirmed by medical history, physical exam, neurologic exam and clinical laboratory tests
  9. Supervision available for administration of study medications
  10. Study partner to accompany subject to all scheduled visits and complete informant-based assessments.
  11. Fluent in English or Spanish
  12. Modified Hachinski < 4
  13. CT or MRI since onset of memory impairment demonstrating absence of clinically significant focal lesion (One lacune in a non-critical brain region is acceptable)
  14. Able to complete baseline assessments
  15. 6 years of education, or work history sufficient to exclude mental retardation
  16. Able to ingest oral medication

Exclusion Criteria:

  1. Active liver disease or persistent elevation in serum transaminase
  2. Severe renal disease
  3. - Hx of diabetes mellitus (both insulin-dependent and non-insulin-dependent) or blood glucose >150 mg/dl
  4. Active neoplastic disease (skin tumors other than melanoma are not exclusionary; subjects with stable prostate cancer or other stable cancers may be included at the discretion of the PI (Sano))
  5. Use of another investigational agent within 2 months of the screening visit
  6. History of clinically significant stroke
  7. Current evidence or history in the past 2 years of seizures, head injury with loss of consciousness and/or immediate confusion after the injury
  8. Current DSM-IV criteria-based diagnosis for major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse.
  9. Blindness, deafness, language difficulties or any other disability which may interfere with testing ability
  10. In female subjects, no history of menopause
  11. Use of medications containing aluminum hydroxide, including anti-ulcer antacids such as Alternagel, Amphojel, Alu-tab, Maalox and Mylanta

Sites / Locations

  • James J. Peters VA Medical Center, Bronx, NY

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Arm 1

Arm 2

Arm Description

Liquid placebo

Liquid Resveratrol with Glucose, and Malate

Outcomes

Primary Outcome Measures

Alzheimer Disease Assessment Scale (ADAScog)

Secondary Outcome Measures

CGIC

Full Information

First Posted
January 7, 2008
Last Updated
November 13, 2012
Sponsor
US Department of Veterans Affairs
Collaborators
Alzheimer's Association, Icahn School of Medicine at Mount Sinai
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1. Study Identification

Unique Protocol Identification Number
NCT00678431
Brief Title
Randomized Trial of a Nutritional Supplement in Alzheimer's Disease
Official Title
A Single Center, Multi-site, Randomized, Double-blind, Placebo-controlled Trial of Resveratrol With Glucose and Malate (RGM) to Slow the Progression of Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
January 2008 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
June 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
US Department of Veterans Affairs
Collaborators
Alzheimer's Association, Icahn School of Medicine at Mount Sinai

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Alzheimer's disease (AD), one of the leading causes of morbidity and mortality in the elderly is characterized by progressive cognitive decline and certain neuropathological features. Currently, there is great interest in the well-documented mitochondrial (oxidative) lesion in AD. Disturbed oxidative metabolism is a well described abnormality in AD. Several observational studies have shown that moderate consumption of wine is associated with a lower incidence of Alzheimer's disease (Truelsen et al., 2002; Luchsinger et al., 2004). Wine is enriched in antioxidant compounds with potential neuroprotective activities. In the early 1990s the presence of Resveratrol in red wine was detected where it is suspected to afford antioxidant and neuroprotective properties (Miller and Rice-Evans, 1995). Blass and Gordon (2004) have demonstrated positive effects in AD with an oral preparation of glucose, malate and resveratrol. Glucose is the physiological precursor of the substrates of oxidative metabolism in the brain, malate is a primer of the energy-providing Krebs-cycle. Glucose and malate therefore can provide reducing equivalents (electrons) to regenerate the reduced form of resveratrol, and do so under the normal regulation of brain cell metabolism. All three ingredients are classified by the FDA as Generally Recognized As Safe.
Detailed Description
Subjects will be assessed by their capacity to consent by a psychiatrist independent of this study. Subjects who are determined to have capacity will sign consent. For subjects determined to lack capacity consent will be obtained from their surrogate. Subjects lacking in capacity must nonetheless provide verbal assent to participation in this study. After informed consent is obtained, subjects will be screened for eligibility to participate in the study. Screening comprises of medical history, physical exam, neurological exam, and a MMSE. All of the above are performed for research purposes. Further evaluation of medical problems that are identified in the course of screening will be obtained as part of standard clinical care. For example, if an abnormality requiring further evaluation is detected on blood tests the subsequent evaluation will be conducted as standard clinical care. Subjects who meet eligibility criteria will be baseline within 4 weeks. Eligible subjects will not be asked to stop any medication they may currently be on before the study begins. Eligible subjects will be randomized to receive either a mixture of glucose, malate and resveratrol (RGM) or placebo. At baseline, medical history, physical exam, cognitive tests are obtained. An ECG and a panel consisting CBC, electrolytes, liver and renal function tests will be drawn at the screening visit. Clinical information is obtained from the identified caregiver. The study drug (RGM or placebo, depending on which group the subject is randomly assigned to) is dispensed at baseline. Follow up visits at months 3, 6, 9, and 12 months require physical exam and some cognitive measures. At Month 12 a neurological exam will be performed. Adverse events are collected at each visit. Medication compliance is assessed at months 3, 6, 9, and 12 months and unused study drug is retrieved. At Month 12 unused study drug is retrieved and no more study drug is dispensed. Clinical information is obtained from the caregiver at each visit. At the Month 12 visit, a questionnaire will be completed by the study staff, subject and study partner to assess the adequacy of medication blinding. As noted all of the above tests and procedures are part of the research protocol. At study termination the subject will be referred to ongoing clinical care as appropriate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease
Keywords
Alzheimer's Disease, Dementia, Nutritional Supplement, Resveratrol

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Placebo Comparator
Arm Description
Liquid placebo
Arm Title
Arm 2
Arm Type
Experimental
Arm Description
Liquid Resveratrol with Glucose, and Malate
Intervention Type
Dietary Supplement
Intervention Name(s)
Resveratrol with Glucose, and Malate
Intervention Description
Dietary supplement delivered in grape juice
Intervention Type
Dietary Supplement
Intervention Name(s)
Placebo
Intervention Description
Liquid placebo
Primary Outcome Measure Information:
Title
Alzheimer Disease Assessment Scale (ADAScog)
Time Frame
one year
Secondary Outcome Measure Information:
Title
CGIC
Time Frame
one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Consenting individuals as defined by IRB guidelines NINCDS/ADRDA criteria for probable AD Community dwelling Age: greater than or equal to 50 years MMSE between 12 and 26, inclusive Stable medical condition for 3 months prior to screening visit Stable doses of (non excluded) medications with central nervous system activity for 4 weeks prior to the screening visit (For cholinesterase inhibitors there should be no plan of dose escalation) Physically acceptable for this study as confirmed by medical history, physical exam, neurologic exam and clinical laboratory tests Supervision available for administration of study medications Study partner to accompany subject to all scheduled visits and complete informant-based assessments. Fluent in English or Spanish Modified Hachinski < 4 CT or MRI since onset of memory impairment demonstrating absence of clinically significant focal lesion (One lacune in a non-critical brain region is acceptable) Able to complete baseline assessments 6 years of education, or work history sufficient to exclude mental retardation Able to ingest oral medication Exclusion Criteria: Active liver disease or persistent elevation in serum transaminase Severe renal disease - Hx of diabetes mellitus (both insulin-dependent and non-insulin-dependent) or blood glucose >150 mg/dl Active neoplastic disease (skin tumors other than melanoma are not exclusionary; subjects with stable prostate cancer or other stable cancers may be included at the discretion of the PI (Sano)) Use of another investigational agent within 2 months of the screening visit History of clinically significant stroke Current evidence or history in the past 2 years of seizures, head injury with loss of consciousness and/or immediate confusion after the injury Current DSM-IV criteria-based diagnosis for major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse. Blindness, deafness, language difficulties or any other disability which may interfere with testing ability In female subjects, no history of menopause Use of medications containing aluminum hydroxide, including anti-ulcer antacids such as Alternagel, Amphojel, Alu-tab, Maalox and Mylanta
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mary Sano, PhD
Organizational Affiliation
James J. Peters Veterans Affairs Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
James J. Peters VA Medical Center, Bronx, NY
City
Bronx
State/Province
New York
ZIP/Postal Code
10468
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
30480082
Citation
Zhu CW, Grossman H, Neugroschl J, Parker S, Burden A, Luo X, Sano M. A randomized, double-blind, placebo-controlled trial of resveratrol with glucose and malate (RGM) to slow the progression of Alzheimer's disease: A pilot study. Alzheimers Dement (N Y). 2018 Nov 9;4:609-616. doi: 10.1016/j.trci.2018.09.009. eCollection 2018.
Results Reference
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Randomized Trial of a Nutritional Supplement in Alzheimer's Disease

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