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Anti-Oxidant Treatment of Alzheimer's Disease

Primary Purpose

Alzheimer's Disease

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Vitamin E, Vitamin C, and Alpha-lipoic Acid
Coenzyme Q
Placebo capsules
Placebo wafers
Sponsored by
National Institute on Aging (NIA)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease focused on measuring dementia, anti-oxidant, biomarkers, alpha-tocopherol, CoQ

Eligibility Criteria

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

Inclusion Criteria: Men or women aged 60-85, inclusive Diagnosis of probable Alzheimer's disease English-speaking; Spanish-speaking if individual site allows Study partner or caregiver to assure compliance Mini-Mental State Examination score at screening visit greater than 14 Female participants either surgically sterile or postmenopausal for over 1 year Stable medical condition for 3 months prior to screening, with no significant abnormal liver, kidney, or blood studies Stable medications for 4 weeks prior to screening Able to take oral medications Modified Hachinski Ischemic Index less than or equal to 4 CT or MRI since onset of memory impairment demonstrating the absence of a clinically significant focal lesion Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam, and clinical tests Exclusion Criteria: Significant neurologic disease such as Parkinson's disease, stroke, brain tumor, multiple sclerosis, or seizure disorder Major depression in the past 12 months, major mental illness such as schizophrenia, or recent (in past 12 months) alcohol or substance abuse History of invasive cancer within the past two years (excluding non-melanoma skin cancer) Contra-indications to lumbar puncture Use of any investigational agents within 30 days prior to screening Major surgery within 8 weeks prior to the Baseline Visit Uncontrolled cardiac conditions or severe unstable medical illnesses Antiretroviral therapy for human immunodeficiency virus (HIV) Conditions that will contribute to oxidative stress: current cigarette or cigar smokers (within past month), diabetics on insulin or poorly controlled on oral hypoglycemics Residence in skilled nursing facility Blindness, deafness, language difficulties or any other disability which may prevent the participant from participating or cooperating in the protocol Note: Exceptions to these criteria may be considered on a case-by-case basis, at the discretion of the Project Director. Excluded Medications: Experimental drugs Coumadin Insulin Immunosuppressive agents: prednisone and other corticosteroids (taken orally or by injection), methotrexate, cyclophosphamide, cyclosporin, tacrolimus, etc. HIV protease inhibitors Neuroleptics and lithium Anti-cancer agents (exception: stable doses of hormonal therapy, e.g. Lupron, estrogen, are permitted)

Sites / Locations

  • University of Arizona
  • University of California- Irvine
  • University of California, San Diego
  • University of California, Los Angeles
  • Wien Center, Mount Sinai Medical Center
  • University of Kentucky
  • University of Medicine and Dentistry of New Jersey
  • Neurological Care of CNY
  • Case Western Reserve University
  • Oregon Health Sciences University
  • University of Pennsylvania
  • Medical University of South Carolina
  • University of Washington

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

1

2

3

Arm Description

vitamin E 800 IU, vitamin C 200 mg, and alpha-lipoic acid 600 mg formulated into three capsules, one capsule given three times per day with meals, plus two placebo wafers three times per day with meals

CoQ 400 mg, compounded as a wafer, two wafers three times per day with meals, plus one placebo capsule three times per day with meals

two placebo wafers three times per day with meals, plus one placebo capsule three times per day with meals

Outcomes

Primary Outcome Measures

effect on cerebrospinal fluid (CSF) biomarkers related to oxidative damage

Secondary Outcome Measures

change in plasma and CSF concentrations of a-beta42 and a-beta40

Full Information

First Posted
June 30, 2005
Last Updated
April 1, 2009
Sponsor
National Institute on Aging (NIA)
Collaborators
Alzheimer's Disease Cooperative Study (ADCS)
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1. Study Identification

Unique Protocol Identification Number
NCT00117403
Brief Title
Anti-Oxidant Treatment of Alzheimer's Disease
Official Title
Evaluation of the Safety, Tolerability and Impact on Biomarkers of Anti-Oxidant Treatment of Mild to Moderate Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
April 2008
Overall Recruitment Status
Completed
Study Start Date
January 2006 (undefined)
Primary Completion Date
September 2007 (Actual)
Study Completion Date
September 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Institute on Aging (NIA)
Collaborators
Alzheimer's Disease Cooperative Study (ADCS)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to examine the safety and effectiveness of two anti-oxidant treatment regimens in patients with mild to moderate Alzheimer's disease. The anti-oxidant treatments include vitamin E + C + alpha-lipoic acid, and Coenzyme Q (CoQ).
Detailed Description
Oxidative damage has been shown to be a factor in Alzheimer's disease (AD), and some studies have suggested that supplemental anti-oxidants can decrease the risk of AD or slow its progression. There are many candidate antioxidants, including combinations, which could be neuroprotective in established AD or could have efficacy in the prevention of AD. However, testing each of the possibilities in standard clinical trials is prohibitively expensive. This study will examine antioxidant supplements or vitamins which target specific cellular compartments, and look for evidence of biologically relevant effects in AD by measurement of biomarkers in CSF. Two general cellular compartments where antioxidant supplements may act are the cytosol and mitochondria. The study will examine a combination of antioxidants that act primarily at cytosolic sites (vitamin E + C + α-lipoic acid) and a single mitochondrial antioxidant, coenzyme Q10. This multicenter trial will recruit 75 participants who will be randomized into three groups: 25 participants will be given a combination of vitamin E 800 IU, vitamin C 200 mg, and alpha-lipoic acid 600 mg formulated into three capsules, one capsule given three times per day with meals, plus two placebo wafers three times per day with meals; 25 participants will be given CoQ 400 mg, compounded as a wafer, two wafers three times per day with meals, plus one placebo capsule three times per day with meals; 25 participants will be given both the placebo wafers, two wafers three times per day with meals, plus one placebo capsule three times per day with meals. The treatment period will last four months. The effects of the two anti-oxidant treatments will be evaluated by measuring biomarkers in blood and cerebrospinal fluid (CSF) at the beginning and end of the 4-month period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease
Keywords
dementia, anti-oxidant, biomarkers, alpha-tocopherol, CoQ

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
vitamin E 800 IU, vitamin C 200 mg, and alpha-lipoic acid 600 mg formulated into three capsules, one capsule given three times per day with meals, plus two placebo wafers three times per day with meals
Arm Title
2
Arm Type
Experimental
Arm Description
CoQ 400 mg, compounded as a wafer, two wafers three times per day with meals, plus one placebo capsule three times per day with meals
Arm Title
3
Arm Type
Placebo Comparator
Arm Description
two placebo wafers three times per day with meals, plus one placebo capsule three times per day with meals
Intervention Type
Drug
Intervention Name(s)
Vitamin E, Vitamin C, and Alpha-lipoic Acid
Intervention Description
vitamin E 800 IU, vitamin C 200 mg, and alpha-lipoic acid 600 mg formulated into three capsules, one capsule given three times per day with meals
Intervention Type
Drug
Intervention Name(s)
Coenzyme Q
Intervention Description
400 mg, compounded as a wafer, two wafers three times per day with meals
Intervention Type
Drug
Intervention Name(s)
Placebo capsules
Intervention Description
one placebo capsule three times per day with meals
Intervention Type
Drug
Intervention Name(s)
Placebo wafers
Intervention Description
two placebo wafers three times per day with meals
Primary Outcome Measure Information:
Title
effect on cerebrospinal fluid (CSF) biomarkers related to oxidative damage
Time Frame
baseline and 4 months
Secondary Outcome Measure Information:
Title
change in plasma and CSF concentrations of a-beta42 and a-beta40
Time Frame
baseline and 4 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men or women aged 60-85, inclusive Diagnosis of probable Alzheimer's disease English-speaking; Spanish-speaking if individual site allows Study partner or caregiver to assure compliance Mini-Mental State Examination score at screening visit greater than 14 Female participants either surgically sterile or postmenopausal for over 1 year Stable medical condition for 3 months prior to screening, with no significant abnormal liver, kidney, or blood studies Stable medications for 4 weeks prior to screening Able to take oral medications Modified Hachinski Ischemic Index less than or equal to 4 CT or MRI since onset of memory impairment demonstrating the absence of a clinically significant focal lesion Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam, and clinical tests Exclusion Criteria: Significant neurologic disease such as Parkinson's disease, stroke, brain tumor, multiple sclerosis, or seizure disorder Major depression in the past 12 months, major mental illness such as schizophrenia, or recent (in past 12 months) alcohol or substance abuse History of invasive cancer within the past two years (excluding non-melanoma skin cancer) Contra-indications to lumbar puncture Use of any investigational agents within 30 days prior to screening Major surgery within 8 weeks prior to the Baseline Visit Uncontrolled cardiac conditions or severe unstable medical illnesses Antiretroviral therapy for human immunodeficiency virus (HIV) Conditions that will contribute to oxidative stress: current cigarette or cigar smokers (within past month), diabetics on insulin or poorly controlled on oral hypoglycemics Residence in skilled nursing facility Blindness, deafness, language difficulties or any other disability which may prevent the participant from participating or cooperating in the protocol Note: Exceptions to these criteria may be considered on a case-by-case basis, at the discretion of the Project Director. Excluded Medications: Experimental drugs Coumadin Insulin Immunosuppressive agents: prednisone and other corticosteroids (taken orally or by injection), methotrexate, cyclophosphamide, cyclosporin, tacrolimus, etc. HIV protease inhibitors Neuroleptics and lithium Anti-cancer agents (exception: stable doses of hormonal therapy, e.g. Lupron, estrogen, are permitted)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Douglas Galasko, MD
Organizational Affiliation
University of California, San Diego
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Arizona
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
University of California- Irvine
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
University of California, San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
University of California, Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Wien Center, Mount Sinai Medical Center
City
Miami Beach
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
University of Kentucky
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States
Facility Name
University of Medicine and Dentistry of New Jersey
City
Piscataway
State/Province
New Jersey
ZIP/Postal Code
08855
Country
United States
Facility Name
Neurological Care of CNY
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
Facility Name
Case Western Reserve University
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44120
Country
United States
Facility Name
Oregon Health Sciences University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Medical University of South Carolina
City
North Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98108
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
9110909
Citation
Sano M, Ernesto C, Thomas RG, Klauber MR, Schafer K, Grundman M, Woodbury P, Growdon J, Cotman CW, Pfeiffer E, Schneider LS, Thal LJ. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med. 1997 Apr 24;336(17):1216-22. doi: 10.1056/NEJM199704243361704.
Results Reference
background
PubMed Identifier
10096843
Citation
Behl C. Alzheimer's disease and oxidative stress: implications for novel therapeutic approaches. Prog Neurobiol. 1999 Feb;57(3):301-23. doi: 10.1016/s0301-0082(98)00055-0.
Results Reference
background
PubMed Identifier
14732624
Citation
Zandi PP, Anthony JC, Khachaturian AS, Stone SV, Gustafson D, Tschanz JT, Norton MC, Welsh-Bohmer KA, Breitner JC; Cache County Study Group. Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. Arch Neurol. 2004 Jan;61(1):82-8. doi: 10.1001/archneur.61.1.82.
Results Reference
background
PubMed Identifier
22431837
Citation
Galasko DR, Peskind E, Clark CM, Quinn JF, Ringman JM, Jicha GA, Cotman C, Cottrell B, Montine TJ, Thomas RG, Aisen P; Alzheimer's Disease Cooperative Study. Antioxidants for Alzheimer disease: a randomized clinical trial with cerebrospinal fluid biomarker measures. Arch Neurol. 2012 Jul;69(7):836-41. doi: 10.1001/archneurol.2012.85.
Results Reference
derived

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Anti-Oxidant Treatment of Alzheimer's Disease

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