Donepezil Versus Non-drug Treatment in Alzheimer's Disease. (CHOLINE-2)
Primary Purpose
Alzheimer Disease, Early Onset
Status
Recruiting
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
Donepezil
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease, Early Onset focused on measuring Alzheimer Disease, Donepezil
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of Alzheimer's disease according to the IWG-2 criteria.
- Age ≥ 50 years.
- Absence of legal protection measures (guardianship, curatorship).
- MMSE score ≥ 10 at inclusion.
- abnormal values for Aβ42 in the CSF or Aβ40 / Aβ42 ratio.
- abnormal values for phosphorylated Tau in CSF
- Presence of a family carer or a person at home who can ensure compliance with treatment if MMSE score <20.
- French native speaker.
Exclusion Criteria:
- Other cause of dementia.
- Previous use of symptomatic treatment for Alzheimer's disease.
- Hypersensitivity to donepezil hydrochloride or to any of the excipients listed in the SPC.
- Cardiological contraindication after possible opinion of a cardiologist, at the initiative of the investigator, in particular bradycardia, sinus disease or other supra-ventricular conduction abnormalities such as sinoatrial or atrioventricular block.
- Patients at particular risk of ulcer, known ulcer disease or receiving concomitant treatment with non-steroidal anti-inflammatory drugs.
- Patient at risk of urinary retention.
- History of epileptic disease.
- History of neuroleptic malignant syndrome.
- History of asthma or obstructive bronchopulmonary disease.
- Severe hepatic impairment.
Taking one of the following treatments:
- CYP3A4 inhibitors, such as ketonazole.
- 2D6 inhibitors, such as quinidine.
- CYP3A4 inhibitors, such as itraconazole and erythromycin.
- CYP2D6 inhibitors, such as fluoxetine.
- Enzyme inducers such as rifampicin, phenytoin, carbamazepine.
- Participation in another interventional study.
Sites / Locations
- Cognitive Neurology CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
Cognitive remediation
Cognitive remediation + Donepezil
Arm Description
Non-drug treatment, cognitive remediation, cognitive stimulation
Non-drug treatment, cognitive remediation, cognitive stimulation + Donepezil
Outcomes
Primary Outcome Measures
Difference of change in the MMSE score
Difference of change in the MMSE score between baseline and 26 weeks in the 2 ams (donepezil versus non-drug). MMSE is measured at baseline, 6 weeks, 13 weeks, and 26 weeks.
Secondary Outcome Measures
Difference of change in the ADAS-Cog scale
Difference of change in the ADAS-Cog scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
ADAS-Cog scale = Alzheimer's Disease Assessment Scale-Cognitive Subscale, scored from 0 to 70
Difference of change in the CDR scale
Difference of change in the CDR scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
CDR scale = Clinical Dementia Rating, scored from 0 to 3
Difference of change in the ADL scale
Difference of change in the ADL scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
ADL scale = Autonomy scale on daily activities, scored from 0 to 78
Difference of change in the quality of life scale
Difference of change in the quality of life scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
Difference of change in the ZARIT scale
Difference of change in the ZARIT scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
ZARIT scale = for assessing caregiver burden, scored from 0 to 88
Full Information
NCT ID
NCT04661280
First Posted
December 3, 2020
Last Updated
February 22, 2023
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
France Alzheimer
1. Study Identification
Unique Protocol Identification Number
NCT04661280
Brief Title
Donepezil Versus Non-drug Treatment in Alzheimer's Disease.
Acronym
CHOLINE-2
Official Title
Donepezil Use Versus Non-drug Approach in Treatment of Newly Diagnosed Alzheimer's Disease : a Multicentric, Randomized, Open Study : the CHOLINE-2 Study
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 10, 2022 (Actual)
Primary Completion Date
August 2024 (Anticipated)
Study Completion Date
August 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
France Alzheimer
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Donepezil, as well as the other symptomatic drugs of Alzheimer's disease, is not any more reimbursed by the French healthcare system, due to a controversy about its efficiency. French health authorities currently preconize a non-rug approach based on cognitive remediation or stimulation.
The aim of this study is to compare the efficiency of the 2 approaches (non-drug versus donepezil) on the symptoms of Alzheimer's disease after 6 months of treatment.
Detailed Description
Randomized multicentric open-label study, comparison of 2 therapeutic strategies.
2 arms:
Standard of care, non-drug approach: following the recommendations of the Alzheimer's disease care by the Frenchh Health Authority. The care is cognitive, psychic, functional or social and centered on the patient and his environment. This care is best carried out by the memory consultations participating in this study and having extensive experience in the care of Alzheimer patients. It is usually based in particular on the prescription of cognitive stimulation sessions by a speech therapist and a mobile Alzheimer specialist team at home for cognitive remediation sessions.
Donepezil group: Management similar to the previous arm plus addition of Donepezil 5 mg per os once a day for one month and then 10 mg per os once a day until the 6th month.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Early Onset
Keywords
Alzheimer Disease, Donepezil
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
240 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Cognitive remediation
Arm Type
No Intervention
Arm Description
Non-drug treatment, cognitive remediation, cognitive stimulation
Arm Title
Cognitive remediation + Donepezil
Arm Type
Experimental
Arm Description
Non-drug treatment, cognitive remediation, cognitive stimulation + Donepezil
Intervention Type
Drug
Intervention Name(s)
Donepezil
Other Intervention Name(s)
Aricept
Intervention Description
Donepezil 5 mg per day during one month, then 10 mg per day during 5 months.
Primary Outcome Measure Information:
Title
Difference of change in the MMSE score
Description
Difference of change in the MMSE score between baseline and 26 weeks in the 2 ams (donepezil versus non-drug). MMSE is measured at baseline, 6 weeks, 13 weeks, and 26 weeks.
Time Frame
26 weeks
Secondary Outcome Measure Information:
Title
Difference of change in the ADAS-Cog scale
Description
Difference of change in the ADAS-Cog scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
ADAS-Cog scale = Alzheimer's Disease Assessment Scale-Cognitive Subscale, scored from 0 to 70
Time Frame
26 weeks
Title
Difference of change in the CDR scale
Description
Difference of change in the CDR scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
CDR scale = Clinical Dementia Rating, scored from 0 to 3
Time Frame
26 weeks
Title
Difference of change in the ADL scale
Description
Difference of change in the ADL scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
ADL scale = Autonomy scale on daily activities, scored from 0 to 78
Time Frame
26 weeks
Title
Difference of change in the quality of life scale
Description
Difference of change in the quality of life scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
Time Frame
26 weeks
Title
Difference of change in the ZARIT scale
Description
Difference of change in the ZARIT scale between baseline and 26 weeks in the 2 ams (donepezil versus non-drug).
ZARIT scale = for assessing caregiver burden, scored from 0 to 88
Time Frame
26 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of Alzheimer's disease according to the IWG-2 criteria.
Age ≥ 50 years.
Absence of legal protection measures (guardianship, curatorship).
MMSE score ≥ 10 at inclusion.
abnormal values for Aβ42 in the CSF or Aβ40 / Aβ42 ratio.
abnormal values for phosphorylated Tau in CSF
Presence of a family carer or a person at home who can ensure compliance with treatment if MMSE score <20.
French native speaker.
Exclusion Criteria:
Other cause of dementia.
Previous use of symptomatic treatment for Alzheimer's disease.
Hypersensitivity to donepezil hydrochloride or to any of the excipients listed in the SPC.
Cardiological contraindication after possible opinion of a cardiologist, at the initiative of the investigator, in particular bradycardia, sinus disease or other supra-ventricular conduction abnormalities such as sinoatrial or atrioventricular block.
Patients at particular risk of ulcer, known ulcer disease or receiving concomitant treatment with non-steroidal anti-inflammatory drugs.
Patient at risk of urinary retention.
History of epileptic disease.
History of neuroleptic malignant syndrome.
History of asthma or obstructive bronchopulmonary disease.
Severe hepatic impairment.
Taking one of the following treatments:
CYP3A4 inhibitors, such as ketonazole.
2D6 inhibitors, such as quinidine.
CYP3A4 inhibitors, such as itraconazole and erythromycin.
CYP2D6 inhibitors, such as fluoxetine.
Enzyme inducers such as rifampicin, phenytoin, carbamazepine.
Participation in another interventional study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
DUMURGIER Julien, MD, PhD
Phone
+33140054313
Email
julien.dumurgier@aphp.fr
First Name & Middle Initial & Last Name or Official Title & Degree
PAQUET Claire, MD, PhD
Email
claire.paquet@inserm.fr
Facility Information:
Facility Name
Cognitive Neurology Center
City
Paris
ZIP/Postal Code
75010
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
DUMURGIER Julien, MD, PhD
Phone
+33140054313
Email
julien.dumurgier@aphp.fr
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Donepezil Versus Non-drug Treatment in Alzheimer's Disease.
We'll reach out to this number within 24 hrs