Efficacy and Safety of Yangxue Qingnao Pills in the Treatment of Mild to Moderate Alzheimer's Disease
Primary Purpose
Alzheimer Disease, Yangxue Qingnao Pills, Randomized
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Yangxue Qingnao pills
Yangxue Qingnao pills
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease
Eligibility Criteria
Inclusion Criteria:
Patients, Chinese speaking, in both gender are eligible to be included in the study only if they meet all of the following criteria:
- Meets NIA/AA core clinical criteria for probable AD;
- The body weight is between 45-90kg;
- Aged ≥ 65 and ≤ 85 years old;
- Mild to moderate stage of AD, defined as( MMSE score of 15 through 26) at baseline;
- Has had an MRI scan performed at baseline that has confirmed with a diagnosis of AD, Medial temporal atrophy scale (MTA) is used for routine assessment of the medial temporal lobe, and the MTA score need ≥1.5 (adjusted by age: 65-74 years ≥ 1.5 points, 75-84 years old ≥ 2.0 points);
- Has a PIB-PET scan or CSF result consistent with the presence of amyloid pathology at screening;
- And the patients must have adequate vision and hearing to participate in study assessments; has normal swallowing function, and can complete the medication;
- Have a stable caregiver;
- Can read simple articles and write simple sentences;
- Informed consent, signed informed consent by legal guardian.
Exclusion Criteria:
Patients who confirmed with any of the following excluding criteria conditions were not enrolled for the study:
- Early-onset Alzheimer disease (oneset at <65 years of age) and moderate to severe AD dementia (MMSE 14-0);
- Evidence of other reasons caused cognitive impairment, like vascular dementia, frontotemporal dementia, Parkinson's disease dementia, Lewy body dementia, Huntington's disease, subdural hematoma, communicating hydrocephalus, brain tumor, thyroid disease, vitamin deficiency Or other diseases that may cause cognitive impairment, or serious brain infections (including neurosyphilis, meningitis or encephalitis), etc.;
- There are unstable mental disorders, including major depression (HAMD≥17), severe anxiety disorder (HAMA≥12 points), bipolar disorder, schizophrenia, etc.;
- History of drug or alcohol abuse in the past 5 years;
- Other uncontrolled chronic illnesses, such as severe arrhythmia (ventricular rate <60 beats/min or >100 beats/min, or patients with myocardial infarction within 3 months before participating in the trial, or severe heart failure (NY classification III and IV), or severe abnormal blood pressure, systolic blood pressure ≤90mmHg or ≥180mmHg;
- Severe liver or kidney dysfunction (alanine aminotransferase or aspartate transaminase was more than 1.5 times the upper limit of normal, or serum creatinine was more than the upper limit of normal);
- A history of taking cholinesterase inhibitors, memantine, or proprietary Chinese medicines with clear nootropic effects within the past 1 month;
- Has received medications that affect the central nervous system (CNS), except treatments for AD for less than 4 weeks; that is, doses of chronic medications that affect the CNS should be stable for at least 4 weeks;
- One of the following manifestations on cranial MRI:> 4 cerebral microhemorrhages, evidence of a prior macrohemorrhage, > 3 lacunar infarcts over 10 mm each, any cortical infarct over 10 mm, or any other clinically significant finding (e.g., any lesion that may account for their cognitive impairment, including but not limited to brain tumor, severe white matter disease with a rating of 3 on the Fazekas scale for WM lesions ,arteriovenous malformation, cavernous hemangioma, or any infarct in a strategic subcortical location);
- History of hypersensitivity to the treatment drugs;
- Participate in other clinical study within the last 30 days;
- Has metal (ferromagnetic) implants, or a cardiac pacemaker and other conditions that could not undergo MRI scan;
- or other conditions that, in the investigator's opinion, could interfere with the analyses of safety and efficacy in this study.
Sites / Locations
- Dongzhimen Hospital ,Beijing University of Chinese MedicineRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Placebo Comparator
Arm Label
Yangxue Qingnao pills high dose group
Yangxue Qingnao pills lower dose group
Placebo group
Arm Description
Yangxue Qingnao pills 7.5 g per time,2 times per day.
Yangxue Qingnao pills 5 g per time,2 times per day, and placebo identified to Yangxue Qingnao pills 2.5 g per time, 2 times per day.
Placebo identified to Yangxue Qingnao pills 7.5 g per time,2 times per day
Outcomes
Primary Outcome Measures
Alzheimer's Disease Assessment Scale- Cognition Subscale (ADAS-cog)
The Alzheimer's Disease Assessment Scale-Cognitive Subscale test is one of the most frequently used tests to measure cognition in research studies and clinical trials for new drugs and other interventions.The ADAS-Cog consists of 11 parts and takes approximately 30 minutes to administer.The test administrator adds up points for the errors in each task of the ADAS-Cog for a total score ranging from 0 to 70. The greater the dysfunction, the greater the score. A score of 70 represents the most severe impairment and 0 represents the least impairment.
Clinical dementia rating scale-sum box(CDR-SB)
The Clinical Dementia Rating Scale (CDR) is a global assessment instrument that yields global and Sum of Boxes (CDR-SB) scores, with the global score regularly used in clinical and research settings to stage dementia severity. The CDR-SB score is obtained by summing each of the domain box scores, with scores ranging from 0 to 18. Higher score means severe global cognition impairment.
Secondary Outcome Measures
Mini-Mental State Examination(MMSE)
TThe Mini-Mental Status Examination offers a quick and simple way to quantify cognitive function and screen for cognitive loss. It tests the individual's orientation, attention, calculation, recall, language and motor skills. It takes ~ 5-10 minutes to administer The range for the total MMSE score is 0 to 30, higher score means better cognition.
Neuropsychiatric Inventory(NPI)
The NPI is a semistructured clinician interview of caretakers in which the severity and frequency of disturbance in 12 symptom domains is rated
Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL/23)
The Alzheimer's Disease Cooperative Study (ADCS) tested 23-item version (ADCS-ADL/23) includes more complex ADL for the assessment of mild to moderate AD, such as reading books or magazines, pastime activities, or household chores. Ratings take about 20 minutes and are based on information obtained from the patient and caregiver. The scores range from 0 to 78, higher scores indicating less functional impairment.
Full Information
NCT ID
NCT04780399
First Posted
February 28, 2021
Last Updated
February 18, 2023
Sponsor
Dongzhimen Hospital, Beijing
1. Study Identification
Unique Protocol Identification Number
NCT04780399
Brief Title
Efficacy and Safety of Yangxue Qingnao Pills in the Treatment of Mild to Moderate Alzheimer's Disease
Official Title
Efficacy and Safety of Yangxue Qingnao Pills in the Treatment of Mild to Moderate Alzheimer's Disease:a Multicenter, Randomized, Double-blind, Placebo-controlled, Phase II Clicnial Trial
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 9, 2021 (Actual)
Primary Completion Date
March 1, 2024 (Anticipated)
Study Completion Date
December 30, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dongzhimen Hospital, Beijing
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
As a traditional Chinese medicine compound, Yangxue Qingnao Pills is proven to have beneficial effects on learning and memory ability in animal models of Alzheimer's disease(AD). The purpose of the study is to evaluate the efficacy and safety of Yangxue Qingnao Pills on patients with mild to moderate AD. This phase II randomized, double-blind, parallel controlled trial include a 2 weeks run-in period, and a 48 weeks double-blind treatment period of after randomization. Participants will be randomly allocated to Yangxue Qingnao pills high dose group (7.5 g per time,2 times per day) ; and Yangxue Qingnao pills low dose group (5 g per time,2 times per day), or placebo group. The outcome measures include general cognitive function, ability of daily living, and behavioural and psychological symptoms in AD patients.
Detailed Description
Yangxue Qingnao pills is a traditional Chinese herbal medicine, which is composed of Angelicae Sinensis Radix , Chuanxiong Rhizoma , Paeoniae Radix Alba, Rehmannia glutinosa, Uncaria macrophylla Wall, Caulis spatholobi, Spica Prunellae, Catsia tora Linn , Mater Margarita, Corydalis ambigua and Asarum sieboldii. The function of Yangxue Qingnao pills is nourishing blood and calming liver, promoting blood circulation and dredging collaterals in Chinese traditional medicine theory. This study is a 48-weeks, multicenter, randomized, double-blind, parallel controlled phase II trial being carried out in China. The study population includes mild to moderate Alzheimer's disease (planned a total of 216) aged 65-85 in both gender. Participants will be randomly allocated to Yangxue Qingnao pills high dose group (7.5 g per time,2 times per day) ; and Yangxue Qingnao pills low dose group (5 g per time,2 times per day), or placebo group for a 48-weeks double-blind treatment period. The primary outcome measure is change from baseline in the Alzheimer's Disease Assessment Scale- Cognition Subscale (ADAS-cog) and the clinical dementia rating scale. The secondary outcomes are changes from baseline in the Mini-Mental State Examination(MMSE), Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL/24) and Neuropsychiatric Inventory. Besides, the blood biomarkers including Aβ42, Aβ40, T-tau, P-tau181, NfL, TOM1, IL-1R1,IL-1b, IL-6, IL-8, TNF-a, FB, FH, sCR1, MCP-1, eotaxin-1, Ach, ChEI and the hippocampal volume on MRI. Safety is being assessed by observing side effects and adverse reaction during the entire treatment period. Statistical analysis will be conducted according to per-protocol population and intend-to-treat population and the safety will be analyzed in safety set.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Yangxue Qingnao Pills, Randomized
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
216 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Yangxue Qingnao pills high dose group
Arm Type
Experimental
Arm Description
Yangxue Qingnao pills 7.5 g per time,2 times per day.
Arm Title
Yangxue Qingnao pills lower dose group
Arm Type
Experimental
Arm Description
Yangxue Qingnao pills 5 g per time,2 times per day, and placebo identified to Yangxue Qingnao pills 2.5 g per time, 2 times per day.
Arm Title
Placebo group
Arm Type
Placebo Comparator
Arm Description
Placebo identified to Yangxue Qingnao pills 7.5 g per time,2 times per day
Intervention Type
Drug
Intervention Name(s)
Yangxue Qingnao pills
Intervention Description
72 subjects in the Yangxue Qingnao pills group take 7.5g of Yangxue Qingnao pills each time, twice a day, 0.5 hours after breakfast and dinner, taking with warm water.
Intervention Type
Drug
Intervention Name(s)
Yangxue Qingnao pills
Intervention Description
72 subjects in the Yangxue Qingnao pills group take 5g of Yangxue Qingnao pills and 2.5g placebo identified to Yangxue Qingnao pills each time, twice a day, 0.5 hours after breakfast and dinner, taking with warm water.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
72 subjects in the placebo group take 7.5g placebo identified to Yangxue Qingnao pills each time, twice a day, 0.5 hours after breakfast and dinner, taking with warm water.
Primary Outcome Measure Information:
Title
Alzheimer's Disease Assessment Scale- Cognition Subscale (ADAS-cog)
Description
The Alzheimer's Disease Assessment Scale-Cognitive Subscale test is one of the most frequently used tests to measure cognition in research studies and clinical trials for new drugs and other interventions.The ADAS-Cog consists of 11 parts and takes approximately 30 minutes to administer.The test administrator adds up points for the errors in each task of the ADAS-Cog for a total score ranging from 0 to 70. The greater the dysfunction, the greater the score. A score of 70 represents the most severe impairment and 0 represents the least impairment.
Time Frame
Change from baseline ADAS-cog score at Week 48
Title
Clinical dementia rating scale-sum box(CDR-SB)
Description
The Clinical Dementia Rating Scale (CDR) is a global assessment instrument that yields global and Sum of Boxes (CDR-SB) scores, with the global score regularly used in clinical and research settings to stage dementia severity. The CDR-SB score is obtained by summing each of the domain box scores, with scores ranging from 0 to 18. Higher score means severe global cognition impairment.
Time Frame
Change from baseline CDR-SB score at Week 48
Secondary Outcome Measure Information:
Title
Mini-Mental State Examination(MMSE)
Description
TThe Mini-Mental Status Examination offers a quick and simple way to quantify cognitive function and screen for cognitive loss. It tests the individual's orientation, attention, calculation, recall, language and motor skills. It takes ~ 5-10 minutes to administer The range for the total MMSE score is 0 to 30, higher score means better cognition.
Time Frame
Change from baseline MMSE score at Week 48
Title
Neuropsychiatric Inventory(NPI)
Description
The NPI is a semistructured clinician interview of caretakers in which the severity and frequency of disturbance in 12 symptom domains is rated
Time Frame
Change from baseline NPI score at Week 48
Title
Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL/23)
Description
The Alzheimer's Disease Cooperative Study (ADCS) tested 23-item version (ADCS-ADL/23) includes more complex ADL for the assessment of mild to moderate AD, such as reading books or magazines, pastime activities, or household chores. Ratings take about 20 minutes and are based on information obtained from the patient and caregiver. The scores range from 0 to 78, higher scores indicating less functional impairment.
Time Frame
Change from baseline ADCS-ADL/23 score at Week 48
Other Pre-specified Outcome Measures:
Title
Blood biomarkers including Aβ42, Aβ40, T-tau, P-tau181, NfL, TOM1, IL-1R1,IL-1b, IL-6, IL-8, TNF-a, FB, FH, sCR1, MCP-1, eotaxin-1, Ach, ChEI
Time Frame
Change from baseline of Aβ42, Aβ40, T-tau, P-tau181, NfL, TOM1, IL-1R1,IL-1b, IL-6, IL-8, TNF-a, FB, FH, sCR1, MCP-1, eotaxin-1, Ach, ChEI at Week 48
Title
Hippocampus volume with MRI
Time Frame
Change of hippocampus volume with MRI after 48 weeks'treatment from baseline
10. Eligibility
Sex
All
Minimum Age & Unit of Time
65 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients, Chinese speaking, in both gender are eligible to be included in the study only if they meet all of the following criteria:
Meets NIA/AA core clinical criteria for probable AD;
The body weight is between 45-90kg;
Aged ≥ 65 and ≤ 85 years old;
Mild to moderate stage of AD, defined as( MMSE score of 15 through 26) at baseline;
Has had an MRI scan performed at baseline that has confirmed with a diagnosis of AD, Medial temporal atrophy scale (MTA) is used for routine assessment of the medial temporal lobe, and the MTA score need ≥1.5 (adjusted by age: 65-74 years ≥ 1.5 points, 75-84 years old ≥ 2.0 points);
Has a PIB-PET scan or CSF result consistent with the presence of amyloid pathology at screening;
And the patients must have adequate vision and hearing to participate in study assessments; has normal swallowing function, and can complete the medication;
Have a stable caregiver;
Can read simple articles and write simple sentences;
Informed consent, signed informed consent by legal guardian.
Exclusion Criteria:
Patients who confirmed with any of the following excluding criteria conditions were not enrolled for the study:
Early-onset Alzheimer disease (oneset at <65 years of age) and moderate to severe AD dementia (MMSE 14-0);
Evidence of other reasons caused cognitive impairment, like vascular dementia, frontotemporal dementia, Parkinson's disease dementia, Lewy body dementia, Huntington's disease, subdural hematoma, communicating hydrocephalus, brain tumor, thyroid disease, vitamin deficiency Or other diseases that may cause cognitive impairment, or serious brain infections (including neurosyphilis, meningitis or encephalitis), etc.;
There are unstable mental disorders, including major depression (HAMD≥17), severe anxiety disorder (HAMA≥12 points), bipolar disorder, schizophrenia, etc.;
History of drug or alcohol abuse in the past 5 years;
Other uncontrolled chronic illnesses, such as severe arrhythmia (ventricular rate <60 beats/min or >100 beats/min, or patients with myocardial infarction within 3 months before participating in the trial, or severe heart failure (NY classification III and IV), or severe abnormal blood pressure, systolic blood pressure ≤90mmHg or ≥180mmHg;
Severe liver or kidney dysfunction (alanine aminotransferase or aspartate transaminase was more than 1.5 times the upper limit of normal, or serum creatinine was more than the upper limit of normal);
A history of taking cholinesterase inhibitors, memantine, or proprietary Chinese medicines with clear nootropic effects within the past 1 month;
Has received medications that affect the central nervous system (CNS), except treatments for AD for less than 4 weeks; that is, doses of chronic medications that affect the CNS should be stable for at least 4 weeks;
One of the following manifestations on cranial MRI:> 4 cerebral microhemorrhages, evidence of a prior macrohemorrhage, > 3 lacunar infarcts over 10 mm each, any cortical infarct over 10 mm, or any other clinically significant finding (e.g., any lesion that may account for their cognitive impairment, including but not limited to brain tumor, severe white matter disease with a rating of 3 on the Fazekas scale for WM lesions ,arteriovenous malformation, cavernous hemangioma, or any infarct in a strategic subcortical location);
History of hypersensitivity to the treatment drugs;
Participate in other clinical study within the last 30 days;
Has metal (ferromagnetic) implants, or a cardiac pacemaker and other conditions that could not undergo MRI scan;
or other conditions that, in the investigator's opinion, could interfere with the analyses of safety and efficacy in this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jinzhou Tian, MD.PhD
Phone
+861084013380
Email
jztian@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jing Shi, MD
Phone
86-10-84011920
Email
shijing87@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jinzhou Tian, MD,PhD
Organizational Affiliation
Dongzhimen Hospital, Beijing University of Chinese Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dongzhimen Hospital ,Beijing University of Chinese Medicine
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100700
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jinzhou Tian, Ph.D,M.D
Phone
86-10-84013380
Email
jztian@hotmail.com
First Name & Middle Initial & Last Name & Degree
Jing Shi, M.D
Phone
86-10-84013380
Email
shijing87@hotmail.com
First Name & Middle Initial & Last Name & Degree
Jinzhou Tian, Ph.D,M.D
First Name & Middle Initial & Last Name & Degree
Jing Shi, M.D
First Name & Middle Initial & Last Name & Degree
Mingqing Wei, M.D
12. IPD Sharing Statement
Learn more about this trial
Efficacy and Safety of Yangxue Qingnao Pills in the Treatment of Mild to Moderate Alzheimer's Disease
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