A Study to Evaluate the Efficacy and Safety of Brain Polypeptide Solution in Mild Alzheimer's Disease
Primary Purpose
Alzheimer Disease
Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
brain polypeptide solution
same package of placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease focused on measuring Alzheimer Disease, Brain polypeptide
Eligibility Criteria
Inclusion Criteria:
- Age range from 50 to 85 (including 50 and 85 years old), regardless of ethnic group or gender;
- The subjects should be able to complete the cognitive ability measurement and other tests specified in the protocol;
- meeting the criteria for likely Alzheimer's Disease (AD) dementia (2007) by National Institute of Neurological Disorders and Strokes - Alzheimer's Disease and Related Diseases Association(NINCDS-ADRDA);
- patients with mild dementia: the total score of Mini-Mental State Examination (MMSE) : illiteracy ≤17 points, primary school ≤20 points, secondary school ≤22 points, university ≤23 points; Clinical Dementia Rating scale (CDR) = 1 point;
- the total score of the Hachinski Ischemic Score (HIS )was < 4.
- Hamilton depression scale (17 items) total score ≤7 points;
- Brain MRI shows a high likelihood of AD;
- before enrollment, patients should take a stable dose of dementia drugs (such as donepezil 10mg) ≥8 weeks;
- the expected survival time is > 1 year;
- subjects should have a stable and reliable caregiver, or at least have frequent contact with the caregiver (at least 3 days per week and at least 2 hours per day), who will help patients participate in the whole study; Caregivers must accompany the subjects to the visit and assist in completing the relevant scale.
Exclusion Criteria:
- refuse to sign the inform consent form;
- other causes of dementia: known vascular, central nervous system infection ,Parkinson's disease, traumatic brain dementia, other physical and chemical factors; serious body disease , intracranial space-occupying lesions, endocrine system disease, such as thyroid disease, and a lack of vitamin B12, folic acid, or any other known causes of dementia.
- central nervous system diseases (including stroke, optic neuromyelitis, Parkinson's disease, epilepsy, etc.);
- obvious positive signs of nervous system examination;
- psychotic patients, including schizophrenia or other disorders with bipolar disorder, major depression or delirium;
- uncontrolled hypertension or hypotension during screening: systolic blood pressure ≥180(millimetres of mercury )mmHg or < 90mmhg, or diastolic blood pressure ≥120mmHg or < 60mmhg;
- unstable or severe diseases of the heart, lung, liver, kidney and hematopoietic system according to the judgment of the researchers;
- patients with incurable visual and auditory disorders that cannot complete neuropsychological tests and scales;
- female subjects who are positive in pregnancy test or breast-feeding and who cannot take effective contraceptive measures or have a birth plan;
- severe allergy, non-allergic drug reaction or multi-drug allergy history;
- participated in other clinical trials within 3 months before screening visit;
- taking any health care products related to brain and brain improvement currently and failing to keep the promise to stop using the above products;
- other conditions are unsuitable for participating in this study according to the judgement of researchers.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Intervention group
Control group
Arm Description
The experimental group will take the brain polypeptide solution .
The control group was treated with the same package of placebo .
Outcomes
Primary Outcome Measures
Changes of Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-cog) scores
ADAS-cog will be performed to test the cognition of patients at the enrollment and week 12.The score ranges from 0 to 75,and higher values represent a better outcome.
Secondary Outcome Measures
Changes of Alzheimer's Disease Collaborative research group-Activities of Daily Living(ADCS-ADL)scores
ADCS-ADL will be performed to test the activities of patients at the enrollment,week 6 and week12.The score ranges from 0 to 54,and higher values represent a better outcome.
Changes of Pittsburgh sleep quality index (PSQI) scores
PSQI will be performed to test the sleep quality of patients at the enrollment ,week 6 and week12.The score ranges from 0 to 21,and higher values represent a worse outcome.
Changes of Neuropsychiatric Inventory(NPI )scores
NPI will be performed to test the mental symptoms of patients at the enrollment and week12.The score ranges from 0 to 144,and higher values represent a worse outcome.
Changes of ( Mini-Mental State Examination )MMSE scores
MMSE will be performed to test the cognition of patients at the enrollment and week12.The score ranges from 0 to 30,and higher values represent a better outcome.
Changes of Montreal Cognitive Assessment (MoCA) scores
MoCA will be performed to test the cognition of patients at the enrollment and week12.The score ranges from 0 to 30,and higher values represent a better outcome.
Full Information
NCT ID
NCT03978338
First Posted
June 5, 2019
Last Updated
June 8, 2019
Sponsor
Peking Union Medical College Hospital
Collaborators
Zhitong Biopharma CO.,LTD
1. Study Identification
Unique Protocol Identification Number
NCT03978338
Brief Title
A Study to Evaluate the Efficacy and Safety of Brain Polypeptide Solution in Mild Alzheimer's Disease
Official Title
A Multi-center, Randomized, Double-blind, Controlled Study to Evaluate the Efficacy and Safety of Brain Polypeptide Solution in Improving Cognitive Function in Mild Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
June 2019
Overall Recruitment Status
Unknown status
Study Start Date
July 2019 (Anticipated)
Primary Completion Date
May 2020 (Anticipated)
Study Completion Date
September 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking Union Medical College Hospital
Collaborators
Zhitong Biopharma CO.,LTD
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
In recent years, reduced levels of brain-derived neurotrophic factor (BDNF) have been found in dementia patients. BDNF reduces amyloid precursor protein (APP) fragments via the Trk signaling pathway, and the expression of transgenic BDNF in animal models of Alzheimer's Disease(AD)shows a protective effect on neurodegeneration. A lot of researches have proved that brain hydrolysate injection can improve the level of BDNF in the brain. And oral brain peptide dietary supplements, which is also derived from brain proteolytic products, may also adjust and improve neuron metabolism, promote the formation of synapses, induce the differentiation of neurons, and protect nerve cells from ischemia and neurotoxin damage, reduce the risk of loss of cognitive function in the aging process. However, there are still no studies on dietary supplements derived from brain protein hydrolysates in China. Therefore, the investigators designed a randomized controlled double-blind study program to preliminarily evaluate the efficacy, safety and possible mechanism of brain polypeptide solution in improving the cognition of mild alzheimer's disease patients.
The research is a prospective, multicenter, cohort study. 200 patients with mild alzheimer's disease will be selected and randomly divided into experimental group and control group according to the numerical random table. The experimental group will take the brain polypeptide solution 60ml per day and the control group was treated with the same package of placebo 60ml per day. The treatment regimen remained unchanged during the observation period. During the study period, safety index including blood and urine routine, liver and kidney function, coagulation index and clinical effect index about neuropsychological scales will be recorded.
Detailed Description
The investigators design a prospective, multicenter, cohort study.200 patients with mild Alzheimer's disease will be selected and divided into brain polypeptide nutrient solution group (experimental group) and control group according to the numerical random table. The experimental group will take brain polypeptide solution 60ml per day, while the control group took placebo in the same package 60ml per day. The observation period is 84 days. And follow-up will take place at 42 and 84 days .The treatment regimen remained unchanged during the observation period. Safety indexes include blood and urine routine, liver and kidney function, coagulation index, etc. Screening indexes include syphilis antibody, HIV antibody, hepatitis b virus antibody, hepatitis c virus antibody, folic acid, vitamin B12, etc. Clinical outcome indicators include a number of scales to evaluate neurological and cognitive functions, such as the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog). Mechanism related indicators such as metabolomics was used to understand the possible differences in metabolic indicators. It is helpful to guide the use of brain polypeptide in Alzheimer's patients correctly .
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
Keywords
Alzheimer Disease, Brain polypeptide
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
200 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Intervention group
Arm Type
Experimental
Arm Description
The experimental group will take the brain polypeptide solution .
Arm Title
Control group
Arm Type
Placebo Comparator
Arm Description
The control group was treated with the same package of placebo .
Intervention Type
Dietary Supplement
Intervention Name(s)
brain polypeptide solution
Intervention Description
The experimental group will take the brain polypeptide solution 60ml per day which contains nitrogen 90mg, soybean oil ,glycerin and soybean phospholipids in 84days.
Intervention Type
Other
Intervention Name(s)
same package of placebo
Intervention Description
The control group was treated with the same package of placebo 60ml per day which contains soybean oil ,glycerin and soybean phospholipids in 84 days.
Primary Outcome Measure Information:
Title
Changes of Alzheimer's Disease Assessment Scale-Cognitive Subscale(ADAS-cog) scores
Description
ADAS-cog will be performed to test the cognition of patients at the enrollment and week 12.The score ranges from 0 to 75,and higher values represent a better outcome.
Time Frame
baseline time,week 12.
Secondary Outcome Measure Information:
Title
Changes of Alzheimer's Disease Collaborative research group-Activities of Daily Living(ADCS-ADL)scores
Description
ADCS-ADL will be performed to test the activities of patients at the enrollment,week 6 and week12.The score ranges from 0 to 54,and higher values represent a better outcome.
Time Frame
baseline time,week6,week 12.
Title
Changes of Pittsburgh sleep quality index (PSQI) scores
Description
PSQI will be performed to test the sleep quality of patients at the enrollment ,week 6 and week12.The score ranges from 0 to 21,and higher values represent a worse outcome.
Time Frame
baseline time,week6,week 12.
Title
Changes of Neuropsychiatric Inventory(NPI )scores
Description
NPI will be performed to test the mental symptoms of patients at the enrollment and week12.The score ranges from 0 to 144,and higher values represent a worse outcome.
Time Frame
baseline time,week 12.
Title
Changes of ( Mini-Mental State Examination )MMSE scores
Description
MMSE will be performed to test the cognition of patients at the enrollment and week12.The score ranges from 0 to 30,and higher values represent a better outcome.
Time Frame
baseline time,week 12.
Title
Changes of Montreal Cognitive Assessment (MoCA) scores
Description
MoCA will be performed to test the cognition of patients at the enrollment and week12.The score ranges from 0 to 30,and higher values represent a better outcome.
Time Frame
baseline time,week 12.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age range from 50 to 85 (including 50 and 85 years old), regardless of ethnic group or gender;
The subjects should be able to complete the cognitive ability measurement and other tests specified in the protocol;
meeting the criteria for likely Alzheimer's Disease (AD) dementia (2007) by National Institute of Neurological Disorders and Strokes - Alzheimer's Disease and Related Diseases Association(NINCDS-ADRDA);
patients with mild dementia: the total score of Mini-Mental State Examination (MMSE) : illiteracy ≤17 points, primary school ≤20 points, secondary school ≤22 points, university ≤23 points; Clinical Dementia Rating scale (CDR) = 1 point;
the total score of the Hachinski Ischemic Score (HIS )was < 4.
Hamilton depression scale (17 items) total score ≤7 points;
Brain MRI shows a high likelihood of AD;
before enrollment, patients should take a stable dose of dementia drugs (such as donepezil 10mg) ≥8 weeks;
the expected survival time is > 1 year;
subjects should have a stable and reliable caregiver, or at least have frequent contact with the caregiver (at least 3 days per week and at least 2 hours per day), who will help patients participate in the whole study; Caregivers must accompany the subjects to the visit and assist in completing the relevant scale.
Exclusion Criteria:
refuse to sign the inform consent form;
other causes of dementia: known vascular, central nervous system infection ,Parkinson's disease, traumatic brain dementia, other physical and chemical factors; serious body disease , intracranial space-occupying lesions, endocrine system disease, such as thyroid disease, and a lack of vitamin B12, folic acid, or any other known causes of dementia.
central nervous system diseases (including stroke, optic neuromyelitis, Parkinson's disease, epilepsy, etc.);
obvious positive signs of nervous system examination;
psychotic patients, including schizophrenia or other disorders with bipolar disorder, major depression or delirium;
uncontrolled hypertension or hypotension during screening: systolic blood pressure ≥180(millimetres of mercury )mmHg or < 90mmhg, or diastolic blood pressure ≥120mmHg or < 60mmhg;
unstable or severe diseases of the heart, lung, liver, kidney and hematopoietic system according to the judgment of the researchers;
patients with incurable visual and auditory disorders that cannot complete neuropsychological tests and scales;
female subjects who are positive in pregnancy test or breast-feeding and who cannot take effective contraceptive measures or have a birth plan;
severe allergy, non-allergic drug reaction or multi-drug allergy history;
participated in other clinical trials within 3 months before screening visit;
taking any health care products related to brain and brain improvement currently and failing to keep the promise to stop using the above products;
other conditions are unsuitable for participating in this study according to the judgement of researchers.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wei Chen
Phone
010-69154095
Email
chenw@pumch.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Xiaodong Shi
Phone
17888811579
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wei Chen, M.D.
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
The following data will be shared at the end of the study: demographic data, current medical history, past history,physical examination data and date of neuropsychological evaluation collected at this research.
IPD Sharing Time Frame
The data is expected to be available after,September, 2020 and can be used forever.
IPD Sharing Access Criteria
The information should be used for academic research, medical communication, etc., and is prohibited from being used for commercial gain.
Citations:
PubMed Identifier
28440854
Citation
McEvoy CT, Guyer H, Langa KM, Yaffe K. Neuroprotective Diets Are Associated with Better Cognitive Function: The Health and Retirement Study. J Am Geriatr Soc. 2017 Aug;65(8):1857-1862. doi: 10.1111/jgs.14922. Epub 2017 Apr 25.
Results Reference
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PubMed Identifier
26493230
Citation
Kmietowicz Z. Mediterranean diet is associated with reduced brain shrinkage in older people, study finds. BMJ. 2015 Oct 21;351:h5556. doi: 10.1136/bmj.h5556. No abstract available.
Results Reference
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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
25832905
Citation
Gauthier S, Proano JV, Jia J, Froelich L, Vester JC, Doppler E. Cerebrolysin in mild-to-moderate Alzheimer's disease: a meta-analysis of randomized controlled clinical trials. Dement Geriatr Cogn Disord. 2015;39(5-6):332-47. doi: 10.1159/000377672. Epub 2015 Mar 26.
Results Reference
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PubMed Identifier
21679156
Citation
Alvarez XA, Cacabelos R, Sampedro C, Couceiro V, Aleixandre M, Vargas M, Linares C, Granizo E, Garcia-Fantini M, Baurecht W, Doppler E, Moessler H. Combination treatment in Alzheimer's disease: results of a randomized, controlled trial with cerebrolysin and donepezil. Curr Alzheimer Res. 2011 Aug;8(5):583-91. doi: 10.2174/156720511796391863.
Results Reference
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PubMed Identifier
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Citation
Muresanu DF, Alvarez XA, Moessler H, Buia M, Stan A, Pintea D, Moldovan F, Popescu BO. A pilot study to evaluate the effects of Cerebrolysin on cognition and qEEG in vascular dementia: cognitive improvement correlates with qEEG acceleration. J Neurol Sci. 2008 Apr 15;267(1-2):112-9. doi: 10.1016/j.jns.2007.10.016. Epub 2007 Nov 28.
Results Reference
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A Study to Evaluate the Efficacy and Safety of Brain Polypeptide Solution in Mild Alzheimer's Disease
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