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Clinical Trial of Efficacy and Safety of MMH-MAP in the Treatment of Mild Cognitive Impairment in Early Recovery Stage After Ischemic Stroke

Primary Purpose

Mild Cognitive Impairment, Ischemic Stroke

Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
MMH-MAP
Placebo
Sponsored by
Materia Medica Holding
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mild Cognitive Impairment

Eligibility Criteria

45 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients of either sex, aged 45 to 80 years old inclusively.
  2. Patients with a history of one stroke sustained 3 to 6 months prior to study entry and confirmed by neuroimaging.
  3. Patients with cognitive impairment (MoCA score < 26).
  4. Patients with moderate performance in activities of daily living (Barthel score = 61-80).
  5. Agreement to use a reliable method of birth control for the duration of the study (men and women of reproductive potential).
  6. Availability of signed patient information sheet (Informed Consent form) for participation in the clinical trial.

Exclusion Criteria:

  1. Patients with a history of subarachnoid/parenchymatous/ventricular hemorrhage, brain neoplasm, or any other condition which has caused neurological dysfunction.
  2. History of central nervous system (CNS) disorders, including:

    • inflammatory diseases of the CNS (G00-G09)
    • systemic atrophies primarily affecting the CNS (G10-G13)
    • extrapyramidal and movement disorders (G20-G26)
    • other degenerative diseases of the nervous system (G30-G32)
    • demyelinating diseases of the CNS (G35-G37)
    • epilepsy (G40-41)
    • polyneuropathies and other disorders of the peripheral nervous system (G60-64), with marked movement and/or sensory impairments that cause movement disorders
    • diseases of neuromuscular junction and muscle (G70-73)
    • hydrocephalus (G91)
    • compression of brain (G93.5).
  3. Dementia (20 or less on the MMSE score).
  4. Speech disorders affecting investigator-patient communication.
  5. Prior diagnosis of heart failure defined by the New York Heart Association classification (1964) as IV Functional Classification or poorly treated hypothyroidism or diabetes mellitus.
  6. Patients having unstable angina or myocardial infarction in the past 6 months.
  7. History/suspicion of oncology of any location (except for benign neoplasms).
  8. Any other co-morbidity which, in the opinion of the investigator, may affect patient participation in the clinical trial.
  9. Patients allergic to/intolerant of any components of the study treatment.
  10. Patients with hereditary lactose intolerance.
  11. Malabsorption syndrome, including congenital or acquired lactase deficiency (or any other disaccharidase deficiency) and galactosemia.
  12. Pregnancy, breast-feeding or unwillingness to use birth control during the study.
  13. Patients who, from the investigator's point of view, will not comply with the observation requirements of the study or adhere to study drug dosing regimens.
  14. Patients with a history of non-adherence to medication; mental disorder (except for cognitive deficits); or alcoholism or abuse of psychoactive substances, which, in the investigator's opinion, will compromise compliance with study procedures.
  15. Patients who have used medications listed in 'Prohibited Concomitant Treatment' in the past week.
  16. Participation in other clinical trials in the previous 3 months.
  17. Patients who are related to any of the on-site research personnel directly involved in the conduct of the trial or are an immediate relative of the study investigator. 'Immediate relative' means husband, wife, parent, son, daughter, brother, or sister (regardless of whether they are natural or adopted).
  18. Patients who work for MATERIA MEDICA HOLDING (i.e. the company's employees, temporary contract workers, appointed officials responsible for carrying out the research or immediate relatives of the aforementioned).

Sites / Locations

  • Arkhangelsk Regional Clinical Hospital
  • Belgorod Regional Clinical Hospital of St. Joseph
  • Non-State Healthcare Institution "Divisional Hospital at the Bryansk-2 station of the open joint-stock company Russian Railways"
  • Bryansk Regional Hospital № 1
  • Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University" of the Ministry of Healthcare of the Russian Federation
  • Scientific-Research Institute - Regional Clinical Hospital №1 named after Professor S.V. Ochapovsky
  • The State Budget Health Care institution of Moscow the City "City clinical hospital No. 12 of the Administration of Health Care of Moscow City"
  • State Budgetary Institution of Healthcare of the City of Moscow City Clinical Hospital No. 1 named after. N.I. Pirogov Moscow Department of Health
  • City Clinical Hospital named after SI. Spasokokukotsky Department of Health of Moscow
  • City Clinical Hospital №5 of Nizhny Novgorod region of Nizhny Novgorod
  • Privolzhskiy Research Medical University
  • State budgetary institution of public health services of the Nizhniy Novgorod region "Nizhegorod Regional Clinical Hospital named after NA Semashko"
  • Pyatigorsk City Clinical Hospital № 2
  • Ryazan State Medical University named after academician I.P. Pavlov
  • St. Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine
  • Leningrad Regional Clinical Hospital
  • State budgetary institution of health care of the Samara region "Samara City Clinical Hospital № 1 named after NI Pirogov"
  • Republican Clinical Hospital №4
  • Saratov State Medical University named after V. I. Razumovsky
  • St. Petersburg State Budgetary Institution "City Hospital No. 40 in the Kurortny District"
  • Smolensk State Medical University
  • State budgetary institution of health care of the Tver region "Regional Clinical Treatment and Rehabilitation Center"
  • State Healthcare Institution Ulyanovsk Regional Clinical Hospital
  • State budgetary health care institution of the Vladimir region "Regional Clinical Hospital"
  • Volgograd State Medical University
  • Voronezh Regional Clinical Hospital № 1
  • Vsevolozhsk Clinical Interdistrict Hospital
  • State Institution of Health of the Yaroslavl Region Clinical Hospital No. 8

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

MMH-MAP

Placebo

Arm Description

Tablet for oral use. Dose per administration: 2 tablets. 2 tablets twice daily (4 tablets/day). The tablets should be held in mouth without chewing until complete dissolution. The duration of treatment will be 24 weeks.

Placebo for 24 weeks, according to the MMH-MAP dosing regimen.

Outcomes

Primary Outcome Measures

Percentage of Patients With Improved Cognitive Function (The Montreal Cognitive Assessment Test Total Score of the Baseline +1 or More)
MoCa is the test for assessment of cognitive impairment. The score ranges between 0 and 30. A score of 26-30 is normal. A score less than 26 is considered as mild cognitive impairment. Higher values represent a better outcome.

Secondary Outcome Measures

Full Information

First Posted
November 11, 2018
Last Updated
February 5, 2021
Sponsor
Materia Medica Holding
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1. Study Identification

Unique Protocol Identification Number
NCT03815292
Brief Title
Clinical Trial of Efficacy and Safety of MMH-MAP in the Treatment of Mild Cognitive Impairment in Early Recovery Stage After Ischemic Stroke
Official Title
Multicenter Double-blind Placebo-controlled Randomized Parallel-group Clinical Study of Efficacy and Safety of MMH-MAP in the Treatment of Mild Cognitive Impairment in Subjects in Early Rehabilitation Period of Ischemic Stroke
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
October 19, 2018 (Actual)
Primary Completion Date
January 27, 2020 (Actual)
Study Completion Date
January 27, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Materia Medica Holding

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is: to evaluate efficacy of MMH-MAP in the treatment of mild cognitive impairment in subjects in early rehabilitation period of ischemic stroke to evaluate safety of MMH-MAP in the treatment of mild cognitive impairment in subjects in early rehabilitation period of ischemic stroke
Detailed Description
A double-blind, placebo-controlled randomized clinical trial in parallel groups. The study patients are subjects of either gender, aged 45-80 years old, after an ischemic stroke within 3-6 months prior to enrollment and confirmed by neuroimaging, having mild cognitive impairment. After the patients provide signed Participant Information Sheet and Informed Consent, they will be interviewed for complaints and medical history and undergo physical examination and laboratory tests. The doctor will rate the severity of patients' cognitive impairments on the Mini Mental State Examination (MMSE) scale and Montreal Cognitive Assessment (MoCA) scale, assess their performance in activities of daily living on the Barthel Index scale [Collin C, Wade DT, Davies S, Horne V. "The Barthel ADL Index: a reliability study." Int Disability Study.1988;10:61-63.], and administer the Stroke Specific Quality of Life Scale (SS-QOL) questionnaire [Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke 1999 Jul;30(7):1362-9]. Eligible participants will have to have moderate cognitive impairments (MMSE score - at least 21 and MoCA - less than 26). Therapy received by patients for their co-morbidities and primary diagnosis will be recorded. All women of childbearing potential will be administered pregnancy tests. If a patient meets all inclusion criteria and does not have any exclusion criteria at Visit 1, he/she is randomized to one of the two groups: group 1 will receive MMH-MAP at 2 tablets twice daily; group 2 will receive Placebo using the study product dosing regimen. The total duration of follow-up and treatment will be 28 weeks, which will include 5 additional visits. At Visit 2 (Week 4±7 days), the doctor records patients' complaints and physical examination data, reviews the progress of study and basic and concomitant therapy, and assesses treatment safety and patient compliance with treatment. At Visit 3 (Week 8±7 days), Visit 4 (Week 16±7 days), and Visit 5 (Week 24±7 days), the doctor assesses patients' cognitive impairments (MoCA) and performance in activities of daily living (the Barthel Index). The patients complete the SS-QOL questionnaire. At Visit 5 (Week 24±7 days), the doctor will additionally complete the Clinical Global Impression Efficacy Index (CGI-EI) scale [Guy W, editor. ECDEU Assessment Manual for Psychopharmacology. 1976 Rockville, MD, U.S. Department of Health, Education, and Welfare] and collect samples for laboratory testing. The patient stops taking the study drug. After four weeks following the end of study therapy patients complete a follow-up visit -Visit 6 (Week 28±7 days). The patients are interviewed for complaints and undergo physical examination, with a check on their concomitant and primary therapies as well as on the safety of study treatment. The doctor assesses patients' cognitive impairments (MoCA) and performance in activities of daily living (the Barthel Index) and administers the SS-QOL questionnaire. The total length of the observation period will be 28 weeks. During the study, symptomatic therapy and therapy for underlying chronic conditions are allowed with the exception of the drugs indicated in the section "Prohibited Concomitant Treatment".

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mild Cognitive Impairment, Ischemic Stroke

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MMH-MAP
Arm Type
Experimental
Arm Description
Tablet for oral use. Dose per administration: 2 tablets. 2 tablets twice daily (4 tablets/day). The tablets should be held in mouth without chewing until complete dissolution. The duration of treatment will be 24 weeks.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo for 24 weeks, according to the MMH-MAP dosing regimen.
Intervention Type
Drug
Intervention Name(s)
MMH-MAP
Intervention Description
Oral administration
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Oral administration
Primary Outcome Measure Information:
Title
Percentage of Patients With Improved Cognitive Function (The Montreal Cognitive Assessment Test Total Score of the Baseline +1 or More)
Description
MoCa is the test for assessment of cognitive impairment. The score ranges between 0 and 30. A score of 26-30 is normal. A score less than 26 is considered as mild cognitive impairment. Higher values represent a better outcome.
Time Frame
24 weeks of the treatment as compared to the baseline
Other Pre-specified Outcome Measures:
Title
Change in MoCA (The Montreal Cognitive Assessment Test) Score
Description
MoCa is the test for assessment of cognitive impairment. The score ranges between 0 and 30. A score of 26-30 is normal. A score less than 26 is considered as mild cognitive impairment. Higher values represent a better outcome.
Time Frame
24 weeks of the treatment as compared to the baseline
Title
Percentage of Patients With Improved Performance in Activities of Daily Living (Barthel Index Score of the Baseline + 5 or More)
Description
Scale for measurement of performance in activities of daily living (ADL).The maximum score is 100. A score of 91-99 stands for mild dependence in ADL performance, 61-90 - for moderate dependence in ADL performance, 21-60 - for severe dependence in ADL performance, 0-20 - for complete dependence in ADL performance. Higher values represent a better outcome.
Time Frame
24 weeks of the treatment as compared to the baseline
Title
Change in Barthel Index Score
Description
Scale for measurement of performance in activities of daily living (ADL).The maximum score is 100. A score of 91-99 stands for mild dependence in ADL performance, 61-90 - for moderate dependence in ADL performance, 21-60 - for severe dependence in ADL performance, 0-20 - for complete dependence in ADL performance. Higher values represent a better outcome.
Time Frame
24 weeks of the treatment as compared to the baseline
Title
Change in SS-QOL (Stroke Specific Quality of Life Scale) Total Score
Description
Scale for assessment of health-related quality of life. The scale consists of 49 items in the 12 domains. Each domain consists of 3 to 10 items that are averaged to generate an overall score. Total score minimum value is 1 and maximum value is 245. Higher values represent a better outcome.
Time Frame
24 weeks of the treatment as compared to the baseline
Title
The CGI-EI (Clinical Global Impression Efficacy Index) Score
Description
Rating scale for assessment of the therapeutic effect of treatment and associated side effects. The scale consists of 2 items: therapeutic effect and side effects. Scores in therapeutic effect range from 1 (marked improvement) to 13 (unchanged or worse). Scores in side effects range from 0 (no side effects) to 3 (side effects outweigh therapeutic effects). Efficacy index ranges between 0 and 16. Higher values represent a worse result.
Time Frame
24 weeks of the treatment
Title
Change in MoCA (The Montreal Cognitive Assessment Test) Score During Follow-up
Description
Test for assessment of cognitive impairment. The score ranges between 0 and 30. A score of 26-30 is normal. A score less than 26 is considered as mild cognitive impairment. Higher values represent a better outcome.
Time Frame
24 and 28 weeks of the study
Title
Change in Barthel Index Score During Follow-up
Description
Scale for measurement of performance in activities of daily living (ADL). The maximum score is 100. A score of 91-99 stands for mild dependence in ADL performance, 61-90 - for moderate dependence in ADL performance, 21-60 - for severe dependence in ADL performance, 0-20 - for complete dependence in ADL performance. Higher values represent a better outcome.
Time Frame
24 and 28 weeks of the study
Title
Change in Total SS-QOL (Stroke Specific Quality of Life Scale) Score During Follow-up
Description
Scale for assessment of health-related quality of life. The scale consists of 49 items in the 12 domains.Each domain consists of 3 to 10 items that are averaged to generate an overall score.Total score minimum value is 1 and maximum value is 245.Higher values represent a better outcome.
Time Frame
24 and 28 weeks of the study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients of either sex, aged 45 to 80 years old inclusively. Patients with a history of one stroke sustained 3 to 6 months prior to study entry and confirmed by neuroimaging. Patients with cognitive impairment (MoCA score < 26). Patients with moderate performance in activities of daily living (Barthel score = 61-80). Agreement to use a reliable method of birth control for the duration of the study (men and women of reproductive potential). Availability of signed patient information sheet (Informed Consent form) for participation in the clinical trial. Exclusion Criteria: Patients with a history of subarachnoid/parenchymatous/ventricular hemorrhage, brain neoplasm, or any other condition which has caused neurological dysfunction. History of central nervous system (CNS) disorders, including: inflammatory diseases of the CNS (G00-G09) systemic atrophies primarily affecting the CNS (G10-G13) extrapyramidal and movement disorders (G20-G26) other degenerative diseases of the nervous system (G30-G32) demyelinating diseases of the CNS (G35-G37) epilepsy (G40-41) polyneuropathies and other disorders of the peripheral nervous system (G60-64), with marked movement and/or sensory impairments that cause movement disorders diseases of neuromuscular junction and muscle (G70-73) hydrocephalus (G91) compression of brain (G93.5). Dementia (20 or less on the MMSE score). Speech disorders affecting investigator-patient communication. Prior diagnosis of heart failure defined by the New York Heart Association classification (1964) as IV Functional Classification or poorly treated hypothyroidism or diabetes mellitus. Patients having unstable angina or myocardial infarction in the past 6 months. History/suspicion of oncology of any location (except for benign neoplasms). Any other co-morbidity which, in the opinion of the investigator, may affect patient participation in the clinical trial. Patients allergic to/intolerant of any components of the study treatment. Patients with hereditary lactose intolerance. Malabsorption syndrome, including congenital or acquired lactase deficiency (or any other disaccharidase deficiency) and galactosemia. Pregnancy, breast-feeding or unwillingness to use birth control during the study. Patients who, from the investigator's point of view, will not comply with the observation requirements of the study or adhere to study drug dosing regimens. Patients with a history of non-adherence to medication; mental disorder (except for cognitive deficits); or alcoholism or abuse of psychoactive substances, which, in the investigator's opinion, will compromise compliance with study procedures. Patients who have used medications listed in 'Prohibited Concomitant Treatment' in the past week. Participation in other clinical trials in the previous 3 months. Patients who are related to any of the on-site research personnel directly involved in the conduct of the trial or are an immediate relative of the study investigator. 'Immediate relative' means husband, wife, parent, son, daughter, brother, or sister (regardless of whether they are natural or adopted). Patients who work for MATERIA MEDICA HOLDING (i.e. the company's employees, temporary contract workers, appointed officials responsible for carrying out the research or immediate relatives of the aforementioned).
Facility Information:
Facility Name
Arkhangelsk Regional Clinical Hospital
City
Arkhangel'sk
ZIP/Postal Code
163045
Country
Russian Federation
Facility Name
Belgorod Regional Clinical Hospital of St. Joseph
City
Belgorod
ZIP/Postal Code
308007
Country
Russian Federation
Facility Name
Non-State Healthcare Institution "Divisional Hospital at the Bryansk-2 station of the open joint-stock company Russian Railways"
City
Bryansk
ZIP/Postal Code
241004
Country
Russian Federation
Facility Name
Bryansk Regional Hospital № 1
City
Bryansk
ZIP/Postal Code
241033
Country
Russian Federation
Facility Name
Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University" of the Ministry of Healthcare of the Russian Federation
City
Kazan
ZIP/Postal Code
420012
Country
Russian Federation
Facility Name
Scientific-Research Institute - Regional Clinical Hospital №1 named after Professor S.V. Ochapovsky
City
Krasnodar
ZIP/Postal Code
350086
Country
Russian Federation
Facility Name
The State Budget Health Care institution of Moscow the City "City clinical hospital No. 12 of the Administration of Health Care of Moscow City"
City
Moscow
ZIP/Postal Code
115516
Country
Russian Federation
Facility Name
State Budgetary Institution of Healthcare of the City of Moscow City Clinical Hospital No. 1 named after. N.I. Pirogov Moscow Department of Health
City
Moscow
ZIP/Postal Code
119049
Country
Russian Federation
Facility Name
City Clinical Hospital named after SI. Spasokokukotsky Department of Health of Moscow
City
Moscow
ZIP/Postal Code
127206
Country
Russian Federation
Facility Name
City Clinical Hospital №5 of Nizhny Novgorod region of Nizhny Novgorod
City
Nizhny Novgorod
ZIP/Postal Code
603005
Country
Russian Federation
Facility Name
Privolzhskiy Research Medical University
City
Nizhny Novgorod
ZIP/Postal Code
603005
Country
Russian Federation
Facility Name
State budgetary institution of public health services of the Nizhniy Novgorod region "Nizhegorod Regional Clinical Hospital named after NA Semashko"
City
Nizhny Novgorod
ZIP/Postal Code
603126
Country
Russian Federation
Facility Name
Pyatigorsk City Clinical Hospital № 2
City
Pyatigorsk
ZIP/Postal Code
357538
Country
Russian Federation
Facility Name
Ryazan State Medical University named after academician I.P. Pavlov
City
Ryazan'
ZIP/Postal Code
390026
Country
Russian Federation
Facility Name
St. Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine
City
Saint Petersburg
ZIP/Postal Code
192242
Country
Russian Federation
Facility Name
Leningrad Regional Clinical Hospital
City
Saint Petersburg
ZIP/Postal Code
194291
Country
Russian Federation
Facility Name
State budgetary institution of health care of the Samara region "Samara City Clinical Hospital № 1 named after NI Pirogov"
City
Samara
ZIP/Postal Code
443096
Country
Russian Federation
Facility Name
Republican Clinical Hospital №4
City
Saransk
ZIP/Postal Code
430032
Country
Russian Federation
Facility Name
Saratov State Medical University named after V. I. Razumovsky
City
Saratov
ZIP/Postal Code
410012
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Institution "City Hospital No. 40 in the Kurortny District"
City
Sestroretsk
ZIP/Postal Code
197706
Country
Russian Federation
Facility Name
Smolensk State Medical University
City
Smolensk
ZIP/Postal Code
214018
Country
Russian Federation
Facility Name
State budgetary institution of health care of the Tver region "Regional Clinical Treatment and Rehabilitation Center"
City
Tver
ZIP/Postal Code
170026
Country
Russian Federation
Facility Name
State Healthcare Institution Ulyanovsk Regional Clinical Hospital
City
Ulyanovsk
ZIP/Postal Code
432063
Country
Russian Federation
Facility Name
State budgetary health care institution of the Vladimir region "Regional Clinical Hospital"
City
Vladimir
ZIP/Postal Code
600023
Country
Russian Federation
Facility Name
Volgograd State Medical University
City
Volgograd
ZIP/Postal Code
400131
Country
Russian Federation
Facility Name
Voronezh Regional Clinical Hospital № 1
City
Voronezh
ZIP/Postal Code
394066
Country
Russian Federation
Facility Name
Vsevolozhsk Clinical Interdistrict Hospital
City
Vsevolozhsk
ZIP/Postal Code
188643
Country
Russian Federation
Facility Name
State Institution of Health of the Yaroslavl Region Clinical Hospital No. 8
City
Yaroslavl
ZIP/Postal Code
150030
Country
Russian Federation

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Clinical Trial of Efficacy and Safety of MMH-MAP in the Treatment of Mild Cognitive Impairment in Early Recovery Stage After Ischemic Stroke

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