Cerebrolysin Compared to Donepezil in Patients With Mild to Moderate Dementia of Alzheimer's Type (DAT) (DAT)
Alzheimer Disease
About this trial
This is an interventional treatment trial for Alzheimer Disease focused on measuring DAT Study
Eligibility Criteria
Inclusion Criteria:
- Male and female patients ≥50 years of age
- Diagnosis of probable mild to moderate Alzheimer's disease according to DSM-IV-TR and NINCDS-ADRDA criteria (see section 18.2.1)
- Screening MMSE score between 15 and 24, both inclusive
- Modified Hachinski Ischemic score of ≤4
- Hamilton Depression Scale score ≤10
- Brain computerized tomography (CT) or brain magnetic resonance imaging (MRI) scans within 12 months prior to screening without evidence of infection, infarction, or other focal lesions and without clinical symptoms suggestive of intervening neurological disease. If no brain CT or brain MRI is available, a brain MRI shall be performed to exclude other causes of dementia-like syndromes.
- Sufficient language skills to complete all testing without assistance of a language interpreter
- Ability to perform all sections of the ADAS-cog
- Good general health without additional diseases expected to interfere with the study
- Normal B12, folic acid, VDRL, and TSH or without any clinically significant laboratory abnormalities that would be expected to interfere with the study.
- ECG and chest x-ray (if available) without clinically significant laboratory abnormalities that would be expected to interfere with the study.
- Patient is not of childbearing potential (i.e., women must be two years post-menopausal or surgically sterile)
- Responsible caregiver (individual who continuously attends to the needs of the person or dependent adult), who agrees to be present during study conduct.
- Written informed consent obtained from the patient and caregiver (and legally authorized representative or guardian if different from caregiver) prior to entry into the study (Screening Visit)
Exclusion Criteria:
- Any abnormalities associated with significant central nervous disease other than Alzheimer's Disease
- Severe psychotic features, confusion, agitation or behavioral problems within the last three months that could lead to difficulties complying with the protocol
- Delusional symptoms are often characteristic of Alzheimer's disease, but patients with symptoms so pronounced that they warrant an alternative psychiatric diagnosis are excluded
- History of alcohol or substance abuse or dependence within the past two years (DSM-IV-TR criteria, see also sections 18.3.1 and 18.3.2)
- History of schizophrenia, schizoaffective disorder, bipolar affective disorder (DSM-IV-TR criteria)
- History of newly identified major depressive disorder within eight weeks before Screening Visit (DSM-IV-TR) (see also exclusion criteria 11 and inclusion criteria 5)
- Any significant systemic illness or unstable medical condition that could lead to difficulties complying with the protocol. Patients with a history of systemic cancer within the past two years are excluded
- History of myocardial infarction in the past year or unstable or severe cardiovascular disease, including uncontrolled hypertension
- Any clinically significant laboratory abnormalities on the battery of screening tests (hematology, blood chemistry, urinalysis, ECG, chest x-ray (if available))
- Uncontrolled insulin-requiring diabetes or non-insulin dependent diabetes mellitus (HbA1c >10.0)
- Use of any concomitant medication that could affect functioning of the CNS or interfere with efficacy assessment.
- Patients who in the Investigator's opinion would not comply with study procedures
- Patients with fragile or thin veins who may not be able to receive many i.v. infusions
- Patients who in the past have not tolerated treatment with 10 mg donepezil or treatment with a corresponding dose of another cholinesterase inhibitor
- Patients with history of any epileptic seizure
- Patients with known or suspected hypersensitivity to Cerebrolysin, donepezil hydrochloride, piperidine derivates or any of the IMPs' excipients
Sites / Locations
- AKh Allgemeines Krankenhaus der Stadt Linz GmbH
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Cerebrolysin Verum
Donepezil Verum
Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly). For the infusion 2x10 ml Cerebrolysin (215.2 mg/ml) is diluted with 80 ml 0.9% NaCl (saline) to a total volume of 100 ml, i.v. Placebo for donepezil: 1 tablet per day from TC 1 Day 1 on and 2 tablets per day from Visit 3 - Visit 5, p.o.
5-10 mg donepezil: 1x5 mg donepezil as 1 tablet per day from TC 1 Day 1 on and 2x5 mg donepezil as 2 tablets from Visit 3- Visit 5, p.o. Placebo for Cerebrolysin: 100 ml 0.9% NaCl (saline), i.v. infusion. Intravenous medication is given in three treatment courses (TC). Each treatment course lasts for two weeks and consists of 10 infusions (5 infusions weekly).