Effects of Sulforaphane in Patients With Prodromal to Mild Alzheimer's Disease
Primary Purpose
Alzheimer Disease
Status
Unknown status
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
sulforaphane
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease
Eligibility Criteria
Inclusion Criteria:
- 1. Age range from 50 to 75 (including 50 and 75 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 (2011) 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) : ≥22 points; Clinical Dementia Rating scale (CDR)score > or equal to 0.5 and < or equal to1;The MMSE score provides evidence of mild disease severity and the CDR-GS score indicates that the patients have noticeable amnestic (pAD) or cognitive and functional (mAD) deficits
- 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 (donepezil 5mg) ≥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
- Second Affiliated Hospital,Zhejiang University School of MedicineRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
sulforaphane group
Placebo group
Arm Description
The patients will take sulforaphane for 24 weeks, 2550mg once a day.
The patients will take placebo for 24 weeks, 2550mg once a day.
Outcomes
Primary Outcome Measures
The Alzheimer's Disease Assessment Scale
The Alzheimer's Disease Assessment Scale (ADAS-cog) will be performed to test the cognition of patients at the enrollment, week 12 and week 24. The score ranges from 0 to 75,and higher values represent a better outcome.
Secondary Outcome Measures
Alzheimer's Disease Collaborative research group-Activities of Daily Living scores.
Alzheimer's Disease Collaborative research group-Activities of Daily Living 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.
Neuropsychiatric Inventory scores
Neuropsychiatric Inventory 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.
Mini-Mental State Examination scores
Mini-Mental State Examination 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.
Montreal Cognitive Assessment scores
Montreal Cognitive Assessment 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.
Clinician Interview-Based Impression of Change plus caregiver input
Clinician Interview-Based Impression of Change plus caregiver input (CIBIC-plus) is widely used in antidementia drug trials. It comprises Likert scales for disease severity and changes, and written accounts summarizing semistructured interviews evaluating behavior, cognition, and function.
Full Information
NCT ID
NCT04213391
First Posted
November 13, 2019
Last Updated
May 9, 2020
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
1. Study Identification
Unique Protocol Identification Number
NCT04213391
Brief Title
Effects of Sulforaphane in Patients With Prodromal to Mild Alzheimer's Disease
Official Title
Randomized,Double-blind, Placebo-controlled, Efficacy and Safety Study of Sulforaphane in Patients With Prodromal to Mild Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
May 2019
Overall Recruitment Status
Unknown status
Study Start Date
May 10, 2020 (Anticipated)
Primary Completion Date
November 1, 2022 (Anticipated)
Study Completion Date
December 1, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
In this proposed study, the investigators will evaluate the efficacy, safety and related mechanism of sulforaphane in treatment of Alzheimer's disease (AD). The study will recruit 160 AD patients, and then these patients will be randomized to sulforaphane group or placebo group (80 patients per arm) for 24 weeks clinic trial. Clinical efficacy and safety assessment will be done at screen/baseline, 4 week, 12 week, and 24 week. The specific aims are to compare sulforaphane versus placebo on: clinical core symptoms; biological samples also will be collected, and stored to research related mechanisms. 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
In this proposed study, the investigators will evaluate the efficacy, safety and related mechanism of sulforaphane in treatment of AD. The study will recruit 160 AD patients, then these patients will be randomized to sulforaphane group or placebo group (80 patients per arm) for 24 weeks clinic trial. Clinical efficacy and safety assessment will be done at screen/baseline, 4 week, 12 week, 24 week. The specific aims are to compare sulforaphane versus placebo on: 1) clinical core symptoms; The investigators hypothesize that (1) sulforaphane is superior to placebo in the treatment of clinical symptoms in patients with AD, measured by the ADAS-cog, MMSE Scale, Moca; (2) Biological samples will be collected, and stored so that the hypothesis sulforaphane may alter oxidative stress indexes or inflammatory biomarkers, and influence histone deacetylase inhibitor mechanism or inflammatory mechanism et al that may be significantly correlated with clinical improvement. (3) Safety index including blood and urine routine, liver and kidney function, coagulation index and clinical effect index about neuropsychological scales will be recorded.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
160 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
sulforaphane group
Arm Type
Experimental
Arm Description
The patients will take sulforaphane for 24 weeks, 2550mg once a day.
Arm Title
Placebo group
Arm Type
Placebo Comparator
Arm Description
The patients will take placebo for 24 weeks, 2550mg once a day.
Intervention Type
Dietary Supplement
Intervention Name(s)
sulforaphane
Intervention Description
Sulforaphane take 2550mg once a day.
Intervention Type
Dietary Supplement
Intervention Name(s)
Placebo
Intervention Description
Placebo take 2550mg once a day.
Primary Outcome Measure Information:
Title
The Alzheimer's Disease Assessment Scale
Description
The Alzheimer's Disease Assessment Scale (ADAS-cog) will be performed to test the cognition of patients at the enrollment, week 12 and week 24. The score ranges from 0 to 75,and higher values represent a better outcome.
Time Frame
From baseline to 24 weeks
Secondary Outcome Measure Information:
Title
Alzheimer's Disease Collaborative research group-Activities of Daily Living scores.
Description
Alzheimer's Disease Collaborative research group-Activities of Daily Living 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.
Time Frame
From baseline to 24 weeks
Title
Neuropsychiatric Inventory scores
Description
Neuropsychiatric Inventory 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.
Time Frame
baseline time to 24 weeks
Title
Mini-Mental State Examination scores
Description
Mini-Mental State Examination 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.
Time Frame
baseline time to 24 weeks
Title
Montreal Cognitive Assessment scores
Description
Montreal Cognitive Assessment 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.
Time Frame
baseline time to 24 weeks
Title
Clinician Interview-Based Impression of Change plus caregiver input
Description
Clinician Interview-Based Impression of Change plus caregiver input (CIBIC-plus) is widely used in antidementia drug trials. It comprises Likert scales for disease severity and changes, and written accounts summarizing semistructured interviews evaluating behavior, cognition, and function.
Time Frame
baseline time to 24 weeks
Other Pre-specified Outcome Measures:
Title
Oxidative stress indexes
Description
The change of Oxidative stress indexes as tested by Oxidative stress indexes detection kit
Time Frame
At baseline and 24 week/endpoint
Title
Epigenetics indicators
Description
The change of Epigenetics indicators as tested by Epigenetics indicators
Time Frame
At baseline and 24 week/endpoint
Title
Cytokines & Chemokines
Description
The change of Cytokines & Chemokines as tested by Cytokines & Chemokines detection kit
Time Frame
At baseline and 24 week/endpoint
Title
Metabolites
Description
The change of Metabolites as tested by Metabolites detection kit
Time Frame
At baseline and 24 week/endpoint
Title
RNA expression
Description
The change of RNA expression as tested by RNA expression detection kit
Time Frame
At baseline and 24 week/endpoint
Title
Intestinal microflora
Description
The change of intestinal microflora as tested by Metagenomic technique
Time Frame
At baseline and 24 week/endpoint
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
1. Age range from 50 to 75 (including 50 and 75 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 (2011) 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) : ≥22 points; Clinical Dementia Rating scale (CDR)score > or equal to 0.5 and < or equal to1;The MMSE score provides evidence of mild disease severity and the CDR-GS score indicates that the patients have noticeable amnestic (pAD) or cognitive and functional (mAD) deficits
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 (donepezil 5mg) ≥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.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Qing-Qing tao, Ph.D
Phone
+08613777820430
Email
qingqingtao@zju.edu.cn
Facility Information:
Facility Name
Second Affiliated Hospital,Zhejiang University School of Medicine
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310009
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhi-Ying Wu, MD&PhD
Phone
+86-571-87783569
Email
zhiyingwu@zju.edu.cn
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
29714053
Citation
Lee S, Choi BR, Kim J, LaFerla FM, Park JHY, Han JS, Lee KW, Kim J. Sulforaphane Upregulates the Heat Shock Protein Co-Chaperone CHIP and Clears Amyloid-beta and Tau in a Mouse Model of Alzheimer's Disease. Mol Nutr Food Res. 2018 Jun;62(12):e1800240. doi: 10.1002/mnfr.201800240. Epub 2018 May 28.
Results Reference
background
PubMed Identifier
29614663
Citation
Hou TT, Yang HY, Wang W, Wu QQ, Tian YR, Jia JP. Sulforaphane Inhibits the Generation of Amyloid-beta Oligomer and Promotes Spatial Learning and Memory in Alzheimer's Disease (PS1V97L) Transgenic Mice. J Alzheimers Dis. 2018;62(4):1803-1813. doi: 10.3233/JAD-171110.
Results Reference
background
PubMed Identifier
29530050
Citation
Jhang KA, Park JS, Kim HS, Chong YH. Sulforaphane rescues amyloid-beta peptide-mediated decrease in MerTK expression through its anti-inflammatory effect in human THP-1 macrophages. J Neuroinflammation. 2018 Mar 12;15(1):75. doi: 10.1186/s12974-018-1112-x.
Results Reference
background
PubMed Identifier
27735126
Citation
Kim J, Lee S, Choi BR, Yang H, Hwang Y, Park JH, LaFerla FM, Han JS, Lee KW, Kim J. Sulforaphane epigenetically enhances neuronal BDNF expression and TrkB signaling pathways. Mol Nutr Food Res. 2017 Feb;61(2). doi: 10.1002/mnfr.201600194. Epub 2016 Nov 30.
Results Reference
background
PubMed Identifier
29382536
Citation
Zhao F, Zhang J, Chang N. Epigenetic modification of Nrf2 by sulforaphane increases the antioxidative and anti-inflammatory capacity in a cellular model of Alzheimer's disease. Eur J Pharmacol. 2018 Apr 5;824:1-10. doi: 10.1016/j.ejphar.2018.01.046. Epub 2018 Jan 31.
Results Reference
background
PubMed Identifier
25196440
Citation
Zhang R, Zhang J, Fang L, Li X, Zhao Y, Shi W, An L. Neuroprotective effects of sulforaphane on cholinergic neurons in mice with Alzheimer's disease-like lesions. Int J Mol Sci. 2014 Aug 18;15(8):14396-410. doi: 10.3390/ijms150814396.
Results Reference
background
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Effects of Sulforaphane in Patients With Prodromal to Mild Alzheimer's Disease
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