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A Study of Donepezil Hydrochloride in Patients With Dementia Associated With Cerebrovascular Disease

Primary Purpose

Dementia Associated With Cerebrovascular Disease

Status
Completed
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Donepezil hydrochloride
Donepezil matching placebo
Donepezil hydrochloride
Sponsored by
Eisai Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dementia Associated With Cerebrovascular Disease

Eligibility Criteria

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

Inclusion Criteria:

Patients who meet all of the following criteria will be eligible for inclusion in the study:

  1. Male or female, age greater than or equal to (>=) 40 years at the time of informed consent.
  2. Possible or probable dementia associated with cerebrovascular disease as defined by National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN) criteria (NINDS-AIREN Criteria) with dementia of greater than 3 months duration.
  3. Radiological evidence of cerebrovascular disease.
  4. Mini-Mental Status Examination (MMSE) score is ≥ 10 and ≤ 24.
  5. Clinical Dementia Rating (CDR) ≥ 1.
  6. Outpatients who are physically healthy, and ambulatory or ambulatory-aided (i.e., walker, cane or wheelchair).
  7. Written informed consent (IC) is obtained from the patient (if possible) and from the patient's legal guardian prior to being exposed to any study-related procedures. The caregiver must separately provide IC for his/her own participation in the study.
  8. Patients having caregivers who submit written consent to cooperate with this study, have regular contact with the patient (i.e., an average of ≥ 4 hours/day and ≥ 3 days/week), provide patients' information necessary for this study, ensure the regular administration of assigned donepezil, as well as all concomitant therapies, at the correct dose, and escort the patients on required visits to study institution.
  9. Comorbid medical conditions are clinically stable prior to Baseline, unless otherwise specified.

Exclusion Criteria

Patients who meet any of the following criteria will be excluded:

  1. Anti-dementia drug therapy (cholinesterase inhibitors or memantine) within 12 weeks prior to Screening.
  2. Clinical and/or radiological evidence for other serious degenerative neurological disorders or neuropsychiatric disorders.
  3. Known human immunodeficiency virus disease, neurosyphilis, or a history of significant head trauma followed by persistent neurological deficits or known structural brain abnormalities.
  4. Hypothyroidism at Screening.
  5. Vitamin B12 or folate deficiency at Screening.
  6. Evidence of a new transient ischemic attack (TIA) or stroke that occurs within 12 weeks prior to Screening, even if the symptoms are minor and do not require hospitalization, are excluded.
  7. Supine diastolic blood pressure ≥ 95 mmHg.
  8. Complication of sick sinus syndrome, abnormal auricular and atrioventricular (AV) junction conductions (AV block, ≥ II ventricular block, etc.), or with a prolonged QT/QTc interval (> 450 ms) as demonstrated by a repeated electrocardiogram (ECG).
  9. A history of life-threatening arrhythmias.
  10. A history of malignant neoplasms treated within 5 years prior to study entry, current evidence of malignant neoplasm, recurrent, or metastatic disease.
  11. A known or suspected history of drug or alcohol dependency or abuse.
  12. Abnormal clinical laboratory values which are judged clinically significant by the investigator.
  13. Patients who cannot swallow or who have difficulty swallowing whole tablets, as tablets should not be broken or crushed.
  14. Known plan for elective surgery that would require general anesthesia and administration of neuromuscular blocking agents.
  15. Pregnant women, lactating women, or women of child-bearing potential who don't agree to practice effective contraception throughout the entire study period and for 30 days after donepezil discontinuation, or who don't have a negative serum â-Human chorionic gonadotropin (HCG) test result or a negative urine pregnancy test result.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Double Blind Phase: Placebo

Double Blind Phase: Donepezil

Open-Label Extension Phase: Donepezil

Arm Description

Participants will receive donepezil matching placebo, once daily in the evening during the double blind period.

Participants will receive donepezil 5 milligram (mg), once daily in the evening during the titration phase and then the dose will be increased to 10 mg at Week 4 during the double blind period. During the maintenance period, dose reduction to 5 mg/day will be permitted only when 10 mg/day is intolerable due to adverse events.

All participants who will complete the double-blind phase and want to continue the study participation, can be enrolled in the 24-week open-label extension phase. In this phase, treatment will be initiated at 5 mg/day, and the dose will be maintained until Week 6 (Day 28-42). After assessing clinical response during the period by examination, the dose can be increased to 10 mg/day. Dose reduction (from 10 mg/day to 5 mg/day) will be permitted when the investigator judges it difficult to continue the 10 mg/day administration. It will be possible to increase the dose to 10 mg/day again.

Outcomes

Primary Outcome Measures

Double Blind (DB) Phase: Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) Score (LOCF) at Week 24
The ADAS-Cog was a validated psychometric instrument that evaluates memory (word recall, word recognition), attention, reasoning (following commands), language (naming, comprehension), orientation, ideational praxis (placing letter in envelope) and constructional praxis (copying geometric designs). The ADAS-cog scores range from 0 to 70, with negative change from baseline indicating clinical improvement. LOCF=last observation carried forward.
Double Blind (DB) Phase: Clinicians Interview-based Impression of Change-plus Caregiver Input (CIBIC-plus) Score (LOCF)
The CIBIC-plus rates change in global functioning relative to baseline on a scale. The score ranges from 1 (Marked improvement) to 7 (Marked worsening). A score of "4" represents no change from baseline. LOCF=last observation carried forward.

Secondary Outcome Measures

Double Blind (DB) Phase: Change From Baseline in Mini-mental State Examination (MMSE) Score (LOCF) at Week 24
MMSE is a well-known, gold standard test for measuring the cognitive state of dementia participants. It includes items evaluating orientation to time and place, recall of objects, attention, language, and conversational abilities. The total score ranges from 0 (most impaired) to 30 (no impairment). The lower score means severe cognitive deficit. A positive change score indicated improvement from baseline. LOCF=last observation carried forward.
Double Blind (DB) Phase: Change From Baseline in Executive Function Test (Korean Trail Making Test Elderly [K-TMT-e]) Score (LOCF) at Week 24
The trail making test (TMT) was an evaluation tool used to assess the cognitive function, especially for executive function. The K-TMT-e has two parts that are referred to as part A (component: serial numbers) and part B (component: serial numbers and days). The K-TMT-e was a timed test and the goal was to complete the tests accurately and as quickly as possible. Higher scores reveal greater impairment. K-TMT-e Score was measured as time taken by participants to complete goal. LOCF=last observation carried forward.

Full Information

First Posted
January 18, 2016
Last Updated
December 20, 2019
Sponsor
Eisai Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02660983
Brief Title
A Study of Donepezil Hydrochloride in Patients With Dementia Associated With Cerebrovascular Disease
Official Title
A Multi-Center, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study of Donepezil Hydrochloride (E2020) in Patients With Dementia Associated With Cerebrovascular Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
August 5, 2013 (Actual)
Primary Completion Date
July 13, 2018 (Actual)
Study Completion Date
December 21, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eisai Co., Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objectives are to confirm that donepezil hydrochloride has superior efficacy compared with placebo in improving cognitive function, as measured by Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), and to demonstrate that donepezil hydrochloride has superior efficacy compared with placebo in improving global function, as measured by Clinician's Interview-Based Impression of Change-plus Caregiver Input (CIBIC-plus), in patients with dementia associated with cerebrovascular disease (VaD).
Detailed Description
This is a multi-center, randomized, double-blind, placebo-controlled, parallel-group study with an open-label extension. The study consists of 3 phases; screening phase (1 to 4 weeks), double-blind phase (24 weeks), and Open-label extension phase (24 weeks). Participants, who have completed the double-blind phase and want to continue the study participation, can be enrolled in the 24-week open-label extension phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dementia Associated With Cerebrovascular Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
302 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Double Blind Phase: Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive donepezil matching placebo, once daily in the evening during the double blind period.
Arm Title
Double Blind Phase: Donepezil
Arm Type
Experimental
Arm Description
Participants will receive donepezil 5 milligram (mg), once daily in the evening during the titration phase and then the dose will be increased to 10 mg at Week 4 during the double blind period. During the maintenance period, dose reduction to 5 mg/day will be permitted only when 10 mg/day is intolerable due to adverse events.
Arm Title
Open-Label Extension Phase: Donepezil
Arm Type
Experimental
Arm Description
All participants who will complete the double-blind phase and want to continue the study participation, can be enrolled in the 24-week open-label extension phase. In this phase, treatment will be initiated at 5 mg/day, and the dose will be maintained until Week 6 (Day 28-42). After assessing clinical response during the period by examination, the dose can be increased to 10 mg/day. Dose reduction (from 10 mg/day to 5 mg/day) will be permitted when the investigator judges it difficult to continue the 10 mg/day administration. It will be possible to increase the dose to 10 mg/day again.
Intervention Type
Drug
Intervention Name(s)
Donepezil hydrochloride
Other Intervention Name(s)
E2020, Aricept
Intervention Type
Drug
Intervention Name(s)
Donepezil matching placebo
Intervention Type
Drug
Intervention Name(s)
Donepezil hydrochloride
Other Intervention Name(s)
E2020, Aricept
Primary Outcome Measure Information:
Title
Double Blind (DB) Phase: Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) Score (LOCF) at Week 24
Description
The ADAS-Cog was a validated psychometric instrument that evaluates memory (word recall, word recognition), attention, reasoning (following commands), language (naming, comprehension), orientation, ideational praxis (placing letter in envelope) and constructional praxis (copying geometric designs). The ADAS-cog scores range from 0 to 70, with negative change from baseline indicating clinical improvement. LOCF=last observation carried forward.
Time Frame
Baseline and Week 24
Title
Double Blind (DB) Phase: Clinicians Interview-based Impression of Change-plus Caregiver Input (CIBIC-plus) Score (LOCF)
Description
The CIBIC-plus rates change in global functioning relative to baseline on a scale. The score ranges from 1 (Marked improvement) to 7 (Marked worsening). A score of "4" represents no change from baseline. LOCF=last observation carried forward.
Time Frame
Week 24
Secondary Outcome Measure Information:
Title
Double Blind (DB) Phase: Change From Baseline in Mini-mental State Examination (MMSE) Score (LOCF) at Week 24
Description
MMSE is a well-known, gold standard test for measuring the cognitive state of dementia participants. It includes items evaluating orientation to time and place, recall of objects, attention, language, and conversational abilities. The total score ranges from 0 (most impaired) to 30 (no impairment). The lower score means severe cognitive deficit. A positive change score indicated improvement from baseline. LOCF=last observation carried forward.
Time Frame
Baseline and Week 24
Title
Double Blind (DB) Phase: Change From Baseline in Executive Function Test (Korean Trail Making Test Elderly [K-TMT-e]) Score (LOCF) at Week 24
Description
The trail making test (TMT) was an evaluation tool used to assess the cognitive function, especially for executive function. The K-TMT-e has two parts that are referred to as part A (component: serial numbers) and part B (component: serial numbers and days). The K-TMT-e was a timed test and the goal was to complete the tests accurately and as quickly as possible. Higher scores reveal greater impairment. K-TMT-e Score was measured as time taken by participants to complete goal. LOCF=last observation carried forward.
Time Frame
Baseline and Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients who meet all of the following criteria will be eligible for inclusion in the study: Male or female, age greater than or equal to (>=) 40 years at the time of informed consent. Possible or probable dementia associated with cerebrovascular disease as defined by National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN) criteria (NINDS-AIREN Criteria) with dementia of greater than 3 months duration. Radiological evidence of cerebrovascular disease. Mini-Mental Status Examination (MMSE) score is ≥ 10 and ≤ 24. Clinical Dementia Rating (CDR) ≥ 1. Outpatients who are physically healthy, and ambulatory or ambulatory-aided (i.e., walker, cane or wheelchair). Written informed consent (IC) is obtained from the patient (if possible) and from the patient's legal guardian prior to being exposed to any study-related procedures. The caregiver must separately provide IC for his/her own participation in the study. Patients having caregivers who submit written consent to cooperate with this study, have regular contact with the patient (i.e., an average of ≥ 4 hours/day and ≥ 3 days/week), provide patients' information necessary for this study, ensure the regular administration of assigned donepezil, as well as all concomitant therapies, at the correct dose, and escort the patients on required visits to study institution. Comorbid medical conditions are clinically stable prior to Baseline, unless otherwise specified. Exclusion Criteria Patients who meet any of the following criteria will be excluded: Anti-dementia drug therapy (cholinesterase inhibitors or memantine) within 12 weeks prior to Screening. Clinical and/or radiological evidence for other serious degenerative neurological disorders or neuropsychiatric disorders. Known human immunodeficiency virus disease, neurosyphilis, or a history of significant head trauma followed by persistent neurological deficits or known structural brain abnormalities. Hypothyroidism at Screening. Vitamin B12 or folate deficiency at Screening. Evidence of a new transient ischemic attack (TIA) or stroke that occurs within 12 weeks prior to Screening, even if the symptoms are minor and do not require hospitalization, are excluded. Supine diastolic blood pressure ≥ 95 mmHg. Complication of sick sinus syndrome, abnormal auricular and atrioventricular (AV) junction conductions (AV block, ≥ II ventricular block, etc.), or with a prolonged QT/QTc interval (> 450 ms) as demonstrated by a repeated electrocardiogram (ECG). A history of life-threatening arrhythmias. A history of malignant neoplasms treated within 5 years prior to study entry, current evidence of malignant neoplasm, recurrent, or metastatic disease. A known or suspected history of drug or alcohol dependency or abuse. Abnormal clinical laboratory values which are judged clinically significant by the investigator. Patients who cannot swallow or who have difficulty swallowing whole tablets, as tablets should not be broken or crushed. Known plan for elective surgery that would require general anesthesia and administration of neuromuscular blocking agents. Pregnant women, lactating women, or women of child-bearing potential who don't agree to practice effective contraception throughout the entire study period and for 30 days after donepezil discontinuation, or who don't have a negative serum â-Human chorionic gonadotropin (HCG) test result or a negative urine pregnancy test result.
Facility Information:
City
Daegu-si
State/Province
Buk-gu
Country
Korea, Republic of
City
Seongnam-si
State/Province
Bundang-gu
Country
Korea, Republic of
City
Gwangju-si
State/Province
Dong-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Dongjak-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Gangdong-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Gangnam-gu
Country
Korea, Republic of
City
Chuncheon-si
State/Province
Gangwon-do
Country
Korea, Republic of
City
Seoul-si
State/Province
Gwangjin-gu
Country
Korea, Republic of
City
Anyang-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
City
Bucheon-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
City
Goyang-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
City
Seongnam-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
City
Suwon-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
City
Wonmi-Gu
State/Province
Gyeonggi-do
Country
Korea, Republic of
City
Changwon-si
State/Province
Gyeongsangnam-do
Country
Korea, Republic of
City
Yangsan-si
State/Province
Gyeongsangnam-do
Country
Korea, Republic of
City
Seoul-si
State/Province
Jongro-gu
Country
Korea, Republic of
City
Daegu-si
State/Province
Jung-gu
Country
Korea, Republic of
City
Incheon-si
State/Province
Jung-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Jungnang-Gu
Country
Korea, Republic of
City
Daegu-si
State/Province
Nam-gu
Country
Korea, Republic of
City
Incheon-si
State/Province
Namdong-gu
Country
Korea, Republic of
City
Busan-si
State/Province
Seo-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Seocho-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Seodaemun-Gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Seongbuk-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Seongdong-gu
Country
Korea, Republic of
City
Jongno-Gu
State/Province
Seoul
Country
Korea, Republic of
City
Seoul-si
State/Province
Songpa-Gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Yangcheon-gu
Country
Korea, Republic of
City
Seoul-si
State/Province
Yeongdeungpo-gu
Country
Korea, Republic of

12. IPD Sharing Statement

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A Study of Donepezil Hydrochloride in Patients With Dementia Associated With Cerebrovascular Disease

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