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Treatment of Periodontal Disease in Patients With Alzheimer's Disease

Primary Purpose

Periodontitis, Alzheimer Disease, Dementia

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
periodontal therapy
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Periodontitis

Eligibility Criteria

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

Inclusion Criteria:

  • Subject has primary school education or above.
  • Subject has probable AD dementia according to the NIA-AA criteria.
  • Subject has brain MRI scan consistent with the diagnosis of AD performed during the screening period. Computed Tomography scan can be used only if the subject has an absolute contraindication for MRI.
  • Subject has a Modified Hachinski score ≤4 at screening.
  • Subject has an MMSE score ≥15 at screening.
  • Subjects with background symptomatic therapy with acetylcholine esterase inhibitors, and/or memantine, are allowed as long as the dose has been stable for 90 days prior to screening and no changes are planned during the study.
  • Subject has a primary caregiver willing to accept responsibility for supervising the treatment (e.g., administering study drug) and assessing the condition of the subject throughout the study in accordance with all protocol requirements.
  • Subject has body mass index <38 kg/m2 at Screening

Exclusion Criteria:

  • Subject has imaging consistent with a dementia diagnosis other than AD.
  • Subject has had an increase or restoration of cognition based on medical history.
  • Subject with history or current evidence of major psychiatric illness such as schizophrenia, bipolar disorder, or major depressive disorder that may interfere with the patient's ability to perform the study and all assessments. NOTE: Mild depression or depressive mood arising in the context of AD are not criteria for exclusion. The use of anti-depressants or the use of anti epileptic medication for non seizure-related treatment is allowed if the dose has remained stable for at least 60 days prior to enrollment.
  • Subject is fitted with pacemakers (except for new compatible products), large ferromagnetic implants, or implanted electronic devices such as cochlear implants, magnetic metal drug infusion pumps, nerve stimulators, diaphragmatic stimulators and injection pumps, physiological stimulators, and cardiac mechanical valves.
  • Subject has magnetic metal foreign body or prosthesis in eye, magnetic metal joint or ferromagnetic foreign body in body.
  • Subject has epilepsy or claustrophobia.
  • Subject had received antibiotics or periodontal treatment within the last 6 months.
  • Subject had taken aspirin, warfarin and other anticoagulant drugs in the last 6 months.
  • Subject has any of the following laboratory findings at screening:

    1. Coagulation disorders.
    2. Hemoglobin ≤10 g/dl.
    3. Poorly controlled diabetes as defined by hemoglobin A1C (HbA1C) >8.
    4. Positive blood screen for Human Immunodeficiency Virus (HIV 1 and 2), Hepatitis B surface antigen (HBsAg), or Hepatitis C virus antibodies (HCV-Ab) at Screening.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    No Intervention

    Experimental

    Arm Label

    Control Group

    Periodontal therapy

    Arm Description

    Group will not receive treatment: periodontal therapy

    Group will receive treatment: periodontal therapy

    Outcomes

    Primary Outcome Measures

    Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog 11)
    Mean change in Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog 11) from baseline to the end of treatment period. ADAS-Cog 11 measures cognitive functions and non-cognitive functions such as mood and behavior. Total scores range from 0-70, with higher scores (≥ 18) indicating greater cognitive impairment. ADAS-Cog 11 score increases by 2-4 points per year on average in subjects with mild to moderate Alzheimer's Disease. A treatment period of 52 weeks was selected to allow sufficient time to demonstrate at least 2.5 points difference between active treatment and placebo on ADAS-Cog 11 at the end of the treatment period.
    ADCS-ADL
    Change in Alzheimer's Disease Cooperative Study Group-Activities of Daily Living (ADCS-ADL)

    Secondary Outcome Measures

    MMSE
    Change in Alzheimer's Disease Cooperative Study Group-Activities of Daily Living Change in Mini-Mental State Examination (MMSE).
    MoCA
    Change in Montreal Cognitive Assessment Scale

    Full Information

    First Posted
    December 26, 2021
    Last Updated
    February 15, 2022
    Sponsor
    Wuhan Union Hospital, China
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05183321
    Brief Title
    Treatment of Periodontal Disease in Patients With Alzheimer's Disease
    Official Title
    Treatment of Periodontal Disease in Patients With Alzheimer's Disease: Randomized Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    April 1, 2022 (Anticipated)
    Primary Completion Date
    December 31, 2026 (Anticipated)
    Study Completion Date
    December 31, 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Wuhan Union Hospital, China

    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.
    Yes

    5. Study Description

    Brief Summary
    The main objective of this study is to evaluate the effect of periodontal therapy in in subjects with a clinical diagnosis of mild to moderate AD dementia.
    Detailed Description
    This is a randomized, controlled study that will assess the effects of periodontal therapy in subjects with probable AD dementia according to the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria. The study will enroll approximately 190 generally healthy male and female subjects ≥55 and ≤80 years of age. Enrolled subjects must have a documented diagnosis of mild to moderate AD dementia. The subject should not have other conditions or brain imaging abnormalities that can explain the symptoms of dementia. All subjects will be encouraged to have LPs (during screening, week 28 and week 52) in the absence of medical conditions that can increase the risk of the procedure in the opinion of the Investigator. Cerebrospinal fluid (CSF) and blood will be analyzed for measurements of biomarkers of AD and neuroinflammation, PiB-PET will be done for assessment of AD. A subset of sites will monitor subjects for clinical evidence of periodontitis at baseline, 28 and 52 weeks. The study will consist of 3 phases: a screening phase of up to 8 weeks, a treatment phase of up to 52 weeks, and a safety follow-up phase of 8 weeks.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Periodontitis, Alzheimer Disease, Dementia

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    190 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Control Group
    Arm Type
    No Intervention
    Arm Description
    Group will not receive treatment: periodontal therapy
    Arm Title
    Periodontal therapy
    Arm Type
    Experimental
    Arm Description
    Group will receive treatment: periodontal therapy
    Intervention Type
    Procedure
    Intervention Name(s)
    periodontal therapy
    Intervention Description
    periodontal cleaning
    Primary Outcome Measure Information:
    Title
    Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog 11)
    Description
    Mean change in Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog 11) from baseline to the end of treatment period. ADAS-Cog 11 measures cognitive functions and non-cognitive functions such as mood and behavior. Total scores range from 0-70, with higher scores (≥ 18) indicating greater cognitive impairment. ADAS-Cog 11 score increases by 2-4 points per year on average in subjects with mild to moderate Alzheimer's Disease. A treatment period of 52 weeks was selected to allow sufficient time to demonstrate at least 2.5 points difference between active treatment and placebo on ADAS-Cog 11 at the end of the treatment period.
    Time Frame
    52 weeks
    Title
    ADCS-ADL
    Description
    Change in Alzheimer's Disease Cooperative Study Group-Activities of Daily Living (ADCS-ADL)
    Time Frame
    52 weeks
    Secondary Outcome Measure Information:
    Title
    MMSE
    Description
    Change in Alzheimer's Disease Cooperative Study Group-Activities of Daily Living Change in Mini-Mental State Examination (MMSE).
    Time Frame
    52 weeks
    Title
    MoCA
    Description
    Change in Montreal Cognitive Assessment Scale
    Time Frame
    52 weeks
    Other Pre-specified Outcome Measures:
    Title
    PiB-PET
    Description
    Change in PiB-PET
    Time Frame
    52 weeks
    Title
    Tau-PET
    Description
    Change in Tau-PET
    Time Frame
    52 weeks
    Title
    Tau levels in cerebrospinal fluid
    Description
    Change in Tau levels in cerebrospinal fluid
    Time Frame
    52 weeks
    Title
    Aβ levels in cerebrospinal fluid
    Description
    Change in Aβ levels in cerebrospinal fluid
    Time Frame
    52 weeks
    Title
    Magnetic resonance imaging
    Description
    Change in magnetic resonance imaging
    Time Frame
    52 weeks
    Title
    Periodontal (or gum) pocket depth
    Description
    Change in periodontal (or gum) pocket depth
    Time Frame
    52 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    55 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Subject has primary school education or above. Subject has probable AD dementia according to the NIA-AA criteria. Subject has brain MRI scan consistent with the diagnosis of AD performed during the screening period. Computed Tomography scan can be used only if the subject has an absolute contraindication for MRI. Subject has a Modified Hachinski score ≤4 at screening. Subject has an MMSE score ≥15 at screening. Subjects with background symptomatic therapy with acetylcholine esterase inhibitors, and/or memantine, are allowed as long as the dose has been stable for 90 days prior to screening and no changes are planned during the study. Subject has a primary caregiver willing to accept responsibility for supervising the treatment (e.g., administering study drug) and assessing the condition of the subject throughout the study in accordance with all protocol requirements. Subject has body mass index <38 kg/m2 at Screening Exclusion Criteria: Subject has imaging consistent with a dementia diagnosis other than AD. Subject has had an increase or restoration of cognition based on medical history. Subject with history or current evidence of major psychiatric illness such as schizophrenia, bipolar disorder, or major depressive disorder that may interfere with the patient's ability to perform the study and all assessments. NOTE: Mild depression or depressive mood arising in the context of AD are not criteria for exclusion. The use of anti-depressants or the use of anti epileptic medication for non seizure-related treatment is allowed if the dose has remained stable for at least 60 days prior to enrollment. Subject is fitted with pacemakers (except for new compatible products), large ferromagnetic implants, or implanted electronic devices such as cochlear implants, magnetic metal drug infusion pumps, nerve stimulators, diaphragmatic stimulators and injection pumps, physiological stimulators, and cardiac mechanical valves. Subject has magnetic metal foreign body or prosthesis in eye, magnetic metal joint or ferromagnetic foreign body in body. Subject has epilepsy or claustrophobia. Subject had received antibiotics or periodontal treatment within the last 6 months. Subject had taken aspirin, warfarin and other anticoagulant drugs in the last 6 months. Subject has any of the following laboratory findings at screening: Coagulation disorders. Hemoglobin ≤10 g/dl. Poorly controlled diabetes as defined by hemoglobin A1C (HbA1C) >8. Positive blood screen for Human Immunodeficiency Virus (HIV 1 and 2), Hepatitis B surface antigen (HBsAg), or Hepatitis C virus antibodies (HCV-Ab) at Screening.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Lili Chen, PhD
    Phone
    0086-027-85726480
    Email
    lily-c1030@163.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Mengru Xie
    Phone
    0086-027-85726480
    Email
    hbxiemengru@163.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Lili Chen
    Organizational Affiliation
    Wuhan Union Hospital, China
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Learn more about this trial

    Treatment of Periodontal Disease in Patients With Alzheimer's Disease

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