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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
Peking Union Medical College Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring Alzheimer Disease, Brain polypeptide

Eligibility Criteria

50 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age range from 50 to 85 (including 50 and 85 years old), regardless of ethnic group or gender;
  2. The subjects should be able to complete the cognitive ability measurement and other tests specified in the protocol;
  3. 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);
  4. 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;
  5. the total score of the Hachinski Ischemic Score (HIS )was < 4.
  6. Hamilton depression scale (17 items) total score ≤7 points;
  7. Brain MRI shows a high likelihood of AD;
  8. before enrollment, patients should take a stable dose of dementia drugs (such as donepezil 10mg) ≥8 weeks;
  9. the expected survival time is > 1 year;
  10. 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:

  1. refuse to sign the inform consent form;
  2. 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.
  3. central nervous system diseases (including stroke, optic neuromyelitis, Parkinson's disease, epilepsy, etc.);
  4. obvious positive signs of nervous system examination;
  5. psychotic patients, including schizophrenia or other disorders with bipolar disorder, major depression or delirium;
  6. uncontrolled hypertension or hypotension during screening: systolic blood pressure ≥180(millimetres of mercury )mmHg or < 90mmhg, or diastolic blood pressure ≥120mmHg or < 60mmhg;
  7. unstable or severe diseases of the heart, lung, liver, kidney and hematopoietic system according to the judgment of the researchers;
  8. patients with incurable visual and auditory disorders that cannot complete neuropsychological tests and scales;
  9. female subjects who are positive in pregnancy test or breast-feeding and who cannot take effective contraceptive measures or have a birth plan;
  10. severe allergy, non-allergic drug reaction or multi-drug allergy history;
  11. participated in other clinical trials within 3 months before screening visit;
  12. taking any health care products related to brain and brain improvement currently and failing to keep the promise to stop using the above products;
  13. 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

    First Posted
    June 5, 2019
    Last Updated
    June 8, 2019
    Sponsor
    Peking Union Medical College Hospital
    Collaborators
    Zhitong Biopharma CO.,LTD
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    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
    background
    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
    background
    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
    18048059
    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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