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Cerebrolysin Compared to Donepezil in Patients With Mild to Moderate Dementia of Alzheimer's Type (DAT) (DAT)

Primary Purpose

Alzheimer Disease

Status
Withdrawn
Phase
Phase 4
Locations
Austria
Study Type
Interventional
Intervention
Cerebrolysin
Donepezil
Sponsored by
Ever Neuro Pharma GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring DAT Study

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female patients ≥50 years of age
  • Diagnosis of probable mild to moderate Alzheimer's disease according to DSM-IV-TR and NINCDS-ADRDA criteria (see section 18.2.1)
  • Screening MMSE score between 15 and 24, both inclusive
  • Modified Hachinski Ischemic score of ≤4
  • Hamilton Depression Scale score ≤10
  • Brain computerized tomography (CT) or brain magnetic resonance imaging (MRI) scans within 12 months prior to screening without evidence of infection, infarction, or other focal lesions and without clinical symptoms suggestive of intervening neurological disease. If no brain CT or brain MRI is available, a brain MRI shall be performed to exclude other causes of dementia-like syndromes.
  • Sufficient language skills to complete all testing without assistance of a language interpreter
  • Ability to perform all sections of the ADAS-cog
  • Good general health without additional diseases expected to interfere with the study
  • Normal B12, folic acid, VDRL, and TSH or without any clinically significant laboratory abnormalities that would be expected to interfere with the study.
  • ECG and chest x-ray (if available) without clinically significant laboratory abnormalities that would be expected to interfere with the study.
  • Patient is not of childbearing potential (i.e., women must be two years post-menopausal or surgically sterile)
  • Responsible caregiver (individual who continuously attends to the needs of the person or dependent adult), who agrees to be present during study conduct.
  • Written informed consent obtained from the patient and caregiver (and legally authorized representative or guardian if different from caregiver) prior to entry into the study (Screening Visit)

Exclusion Criteria:

  • Any abnormalities associated with significant central nervous disease other than Alzheimer's Disease
  • Severe psychotic features, confusion, agitation or behavioral problems within the last three months that could lead to difficulties complying with the protocol
  • Delusional symptoms are often characteristic of Alzheimer's disease, but patients with symptoms so pronounced that they warrant an alternative psychiatric diagnosis are excluded
  • History of alcohol or substance abuse or dependence within the past two years (DSM-IV-TR criteria, see also sections 18.3.1 and 18.3.2)
  • History of schizophrenia, schizoaffective disorder, bipolar affective disorder (DSM-IV-TR criteria)
  • History of newly identified major depressive disorder within eight weeks before Screening Visit (DSM-IV-TR) (see also exclusion criteria 11 and inclusion criteria 5)
  • Any significant systemic illness or unstable medical condition that could lead to difficulties complying with the protocol. Patients with a history of systemic cancer within the past two years are excluded
  • History of myocardial infarction in the past year or unstable or severe cardiovascular disease, including uncontrolled hypertension
  • Any clinically significant laboratory abnormalities on the battery of screening tests (hematology, blood chemistry, urinalysis, ECG, chest x-ray (if available))
  • Uncontrolled insulin-requiring diabetes or non-insulin dependent diabetes mellitus (HbA1c >10.0)
  • Use of any concomitant medication that could affect functioning of the CNS or interfere with efficacy assessment.
  • Patients who in the Investigator's opinion would not comply with study procedures
  • Patients with fragile or thin veins who may not be able to receive many i.v. infusions
  • Patients who in the past have not tolerated treatment with 10 mg donepezil or treatment with a corresponding dose of another cholinesterase inhibitor
  • Patients with history of any epileptic seizure
  • Patients with known or suspected hypersensitivity to Cerebrolysin, donepezil hydrochloride, piperidine derivates or any of the IMPs' excipients

Sites / Locations

  • AKh Allgemeines Krankenhaus der Stadt Linz GmbH

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cerebrolysin Verum

Donepezil Verum

Arm Description

Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly). For the infusion 2x10 ml Cerebrolysin (215.2 mg/ml) is diluted with 80 ml 0.9% NaCl (saline) to a total volume of 100 ml, i.v. Placebo for donepezil: 1 tablet per day from TC 1 Day 1 on and 2 tablets per day from Visit 3 - Visit 5, p.o.

5-10 mg donepezil: 1x5 mg donepezil as 1 tablet per day from TC 1 Day 1 on and 2x5 mg donepezil as 2 tablets from Visit 3- Visit 5, p.o. Placebo for Cerebrolysin: 100 ml 0.9% NaCl (saline), i.v. infusion. Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly).

Outcomes

Primary Outcome Measures

Change from Baseline in ADAS-cog. and CIBIC+ score distribution
The ADAS-cog is a psychometric instrument that evaluates cognitive impairment in the assessment of Alzheimer's disease (memory, attention, reasoning, language, orientation and praxis). The CIBI+ is a global rating measure which covers the categories general, mental/cognitive state, behavior, and activities of daily living.

Secondary Outcome Measures

Adverse events
descriptive analysis of number, intensity, relation to study medication and action taken
Vital signs
descriptive analysis of baseline-changes of blood pressure, heart rate, respiration rate, body temperature and weight
Laboratory tests
descriptive analysis of baseline-changes of hematology (e.g. red blood cell count, hematocrit, hemoglobin levels, mean corpuscular volume, mean corpuscular hemoglobin), blood chemistry (e.g. glucose, total cholesterol, high density lipoprotein cholesterol) and urinalysis (glucose, bilirubin, ketones, density, blood, pH, protein, nitrites and leukocytes)

Full Information

First Posted
March 25, 2013
Last Updated
October 23, 2015
Sponsor
Ever Neuro Pharma GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT01822951
Brief Title
Cerebrolysin Compared to Donepezil in Patients With Mild to Moderate Dementia of Alzheimer's Type (DAT)
Acronym
DAT
Official Title
Comparison of Cerebrolysin and Donepezil: A Randomized, Double-blind, Controlled Trial on Efficacy and Safety in Patients With Mild to Moderate Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Withdrawn
Study Start Date
undefined (undefined)
Primary Completion Date
September 2016 (Anticipated)
Study Completion Date
December 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ever Neuro Pharma GmbH

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this trial is the global risk-benefit assessment of Cerebrolysin as compared to donepezil in patients with mild to moderate dementia of Alzheimer's Type (DAT). In addition, a traditional approach will be taken based on the evaluation of the separate risk and benefit domains in comparison with donepezil. Global risk-benefit as compared to donepezil will be analyzed by determining whether the Cerebrolysin group shows a statistically significant non-inferiority with regard to the combined primary safety and efficacy endpoints (weighted multivariate ensemble). The endpoints will be combined by a global multivariate non-parametric procedure, weighting the safety and efficacy part 50:50.
Detailed Description
This phase IIIb/IV trial involves patients with mild to moderate Alzheimer's Disease in Europe, Canada and Latin America and is designed as a prospective, randomized, double-blind, active-controlled, parallel-group, multicenter, double-dummy trial. The study endpoint is after 24 weeks. In total, five visits are scheduled in this trial and a follow-up phone call is performed 4 weeks after Visit 5 (Week 24). The first visit (Screening Visit, Visit 1) identifies participants who are eligible for and interested in this trial.Efficacy and safety parameters are assessed at the Baseline Visit (Visit 2), in Week 6-7 (Visit 3), Week 14-15 (Visit 4) and Week 24 (Visit 5).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cerebrolysin Verum
Arm Type
Experimental
Arm Description
Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly). For the infusion 2x10 ml Cerebrolysin (215.2 mg/ml) is diluted with 80 ml 0.9% NaCl (saline) to a total volume of 100 ml, i.v. Placebo for donepezil: 1 tablet per day from TC 1 Day 1 on and 2 tablets per day from Visit 3 - Visit 5, p.o.
Arm Title
Donepezil Verum
Arm Type
Active Comparator
Arm Description
5-10 mg donepezil: 1x5 mg donepezil as 1 tablet per day from TC 1 Day 1 on and 2x5 mg donepezil as 2 tablets from Visit 3- Visit 5, p.o. Placebo for Cerebrolysin: 100 ml 0.9% NaCl (saline), i.v. infusion. Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly).
Intervention Type
Drug
Intervention Name(s)
Cerebrolysin
Other Intervention Name(s)
Cognicer, Renacenz
Intervention Description
Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly). The first treatment course (TC 1) will be in Week 1 and 2, second treatment course (TC 2) will be repeated during Week 9 and 10 and third treatment course (TC 3) during Week 19 and 20. Placebo for donepezil:1 tablet per day from TC 1 Day 1 on and 2 tablets per day from Visit 3 - Visit 5, p.o.
Intervention Type
Drug
Intervention Name(s)
Donepezil
Other Intervention Name(s)
Other names:, e.g. Aricept, Donesyn
Intervention Description
5-10 mg donepezil: 1x5 mg donepezil as 1 tablet per day from TC 1 Day 1 on and 2x5 mg donepezil as 2 tablets from Visit 3- Visit 5, p.o. Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly). The first treatment course (TC 1) will be in Week 1 and 2, second treatment course (TC 2) will be repeated during Week 9 and 10 and third treatment course (TC 3) during Week 19 and 20.
Primary Outcome Measure Information:
Title
Change from Baseline in ADAS-cog. and CIBIC+ score distribution
Description
The ADAS-cog is a psychometric instrument that evaluates cognitive impairment in the assessment of Alzheimer's disease (memory, attention, reasoning, language, orientation and praxis). The CIBI+ is a global rating measure which covers the categories general, mental/cognitive state, behavior, and activities of daily living.
Time Frame
at Week 24
Secondary Outcome Measure Information:
Title
Adverse events
Description
descriptive analysis of number, intensity, relation to study medication and action taken
Time Frame
at Week 24
Title
Vital signs
Description
descriptive analysis of baseline-changes of blood pressure, heart rate, respiration rate, body temperature and weight
Time Frame
at Week 24
Title
Laboratory tests
Description
descriptive analysis of baseline-changes of hematology (e.g. red blood cell count, hematocrit, hemoglobin levels, mean corpuscular volume, mean corpuscular hemoglobin), blood chemistry (e.g. glucose, total cholesterol, high density lipoprotein cholesterol) and urinalysis (glucose, bilirubin, ketones, density, blood, pH, protein, nitrites and leukocytes)
Time Frame
at Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients ≥50 years of age Diagnosis of probable mild to moderate Alzheimer's disease according to DSM-IV-TR and NINCDS-ADRDA criteria (see section 18.2.1) Screening MMSE score between 15 and 24, both inclusive Modified Hachinski Ischemic score of ≤4 Hamilton Depression Scale score ≤10 Brain computerized tomography (CT) or brain magnetic resonance imaging (MRI) scans within 12 months prior to screening without evidence of infection, infarction, or other focal lesions and without clinical symptoms suggestive of intervening neurological disease. If no brain CT or brain MRI is available, a brain MRI shall be performed to exclude other causes of dementia-like syndromes. Sufficient language skills to complete all testing without assistance of a language interpreter Ability to perform all sections of the ADAS-cog Good general health without additional diseases expected to interfere with the study Normal B12, folic acid, VDRL, and TSH or without any clinically significant laboratory abnormalities that would be expected to interfere with the study. ECG and chest x-ray (if available) without clinically significant laboratory abnormalities that would be expected to interfere with the study. Patient is not of childbearing potential (i.e., women must be two years post-menopausal or surgically sterile) Responsible caregiver (individual who continuously attends to the needs of the person or dependent adult), who agrees to be present during study conduct. Written informed consent obtained from the patient and caregiver (and legally authorized representative or guardian if different from caregiver) prior to entry into the study (Screening Visit) Exclusion Criteria: Any abnormalities associated with significant central nervous disease other than Alzheimer's Disease Severe psychotic features, confusion, agitation or behavioral problems within the last three months that could lead to difficulties complying with the protocol Delusional symptoms are often characteristic of Alzheimer's disease, but patients with symptoms so pronounced that they warrant an alternative psychiatric diagnosis are excluded History of alcohol or substance abuse or dependence within the past two years (DSM-IV-TR criteria, see also sections 18.3.1 and 18.3.2) History of schizophrenia, schizoaffective disorder, bipolar affective disorder (DSM-IV-TR criteria) History of newly identified major depressive disorder within eight weeks before Screening Visit (DSM-IV-TR) (see also exclusion criteria 11 and inclusion criteria 5) Any significant systemic illness or unstable medical condition that could lead to difficulties complying with the protocol. Patients with a history of systemic cancer within the past two years are excluded History of myocardial infarction in the past year or unstable or severe cardiovascular disease, including uncontrolled hypertension Any clinically significant laboratory abnormalities on the battery of screening tests (hematology, blood chemistry, urinalysis, ECG, chest x-ray (if available)) Uncontrolled insulin-requiring diabetes or non-insulin dependent diabetes mellitus (HbA1c >10.0) Use of any concomitant medication that could affect functioning of the CNS or interfere with efficacy assessment. Patients who in the Investigator's opinion would not comply with study procedures Patients with fragile or thin veins who may not be able to receive many i.v. infusions Patients who in the past have not tolerated treatment with 10 mg donepezil or treatment with a corresponding dose of another cholinesterase inhibitor Patients with history of any epileptic seizure Patients with known or suspected hypersensitivity to Cerebrolysin, donepezil hydrochloride, piperidine derivates or any of the IMPs' excipients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dieter Meier, MD
Organizational Affiliation
Ever Neuro Pharma GmbH
Official's Role
Study Director
Facility Information:
Facility Name
AKh Allgemeines Krankenhaus der Stadt Linz GmbH
City
Linz
ZIP/Postal Code
4021
Country
Austria

12. IPD Sharing Statement

Citations:
PubMed Identifier
16420392
Citation
Alvarez XA, Cacabelos R, Laredo M, Couceiro V, Sampedro C, Varela M, Corzo L, Fernandez-Novoa L, Vargas M, Aleixandre M, Linares C, Granizo E, Muresanu D, Moessler H. A 24-week, double-blind, placebo-controlled study of three dosages of Cerebrolysin in patients with mild to moderate Alzheimer's disease. Eur J Neurol. 2006 Jan;13(1):43-54. doi: 10.1111/j.1468-1331.2006.01222.x.
Results Reference
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PubMed Identifier
12111446
Citation
Panisset M, Gauthier S, Moessler H, Windisch M; Cerebrolysin Study Group. Cerebrolysin in Alzheimer's disease: a randomized, double-blind, placebo-controlled trial with a neurotrophic agent. J Neural Transm (Vienna). 2002 Jul;109(7-8):1089-104. doi: 10.1007/s007020200092.
Results Reference
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PubMed Identifier
11552768
Citation
Ruether E, Husmann R, Kinzler E, Diabl E, Klingler D, Spatt J, Ritter R, Schmidt R, Taneri Z, Winterer W, Koper D, Kasper S, Rainer M, Moessler H. A 28-week, double-blind, placebo-controlled study with Cerebrolysin in patients with mild to moderate Alzheimer's disease. Int Clin Psychopharmacol. 2001 Sep;16(5):253-63. doi: 10.1097/00004850-200109000-00002. Erratum In: Int Clin Psychopharmacol 2001 Nov;16(6):372.
Results Reference
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PubMed Identifier
11129744
Citation
Bae CY, Cho CY, Cho K, Hoon Oh B, Choi KG, Lee HS, Jung SP, Kim DH, Lee S, Choi GD, Cho H, Lee H. A double-blind, placebo-controlled, multicenter study of Cerebrolysin for Alzheimer's disease. J Am Geriatr Soc. 2000 Dec;48(12):1566-71. doi: 10.1111/j.1532-5415.2000.tb03865.x.
Results Reference
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PubMed Identifier
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Citation
Alvarez XA, Cacabelos R, Sampedro C, Aleixandre M, Linares C, Granizo E, Doppler E, Moessler H. Efficacy and safety of Cerebrolysin in moderate to moderately severe Alzheimer's disease: results of a randomized, double-blind, controlled trial investigating three dosages of Cerebrolysin. Eur J Neurol. 2011 Jan;18(1):59-68. doi: 10.1111/j.1468-1331.2010.03092.x.
Results Reference
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Xiao S, Yan H, Yao P. Efficacy of Cerebrolysin in patients with Alzheimer's disease. Clin. Drug Invest. 2000; 19:43-53.
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Ruther E, Ritter R, Apecechea M, Freytag S, Windisch M. Efficacy of the peptidergic nootropic drug cerebrolysin in patients with senile dementia of the Alzheimer type (SDAT). Pharmacopsychiatry. 1994 Jan;27(1):32-40. doi: 10.1055/s-2007-1014271.
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Cerebrolysin Compared to Donepezil in Patients With Mild to Moderate Dementia of Alzheimer's Type (DAT)

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