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Efficacy Study of a ZT-1 Implant in Patients Suffering From Alzheimer's Disease (BRAINz)

Primary Purpose

Moderate Alzheimer's Disease

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
ZT-1
Donepezil
Sponsored by
Debiopharm International SA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Moderate Alzheimer's Disease focused on measuring Alzheimer's disease, cognitive impairment, cholinesterase inhibitors, sustained-release implants, long acting treatment

Eligibility Criteria

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

Inclusion Criteria:

  1. Presence of moderately severe probable AD, diagnosed according to the DSM-IV and the NINCDS-ADRDA criteria;
  2. MMSE score ≥ 14 and ≤ 22;
  3. Male/female patient aged > 50 years; female patients should be of no child-bearing potential or postmenopausal (at least one year after last menses);
  4. Body mass index (BMI) between 18 and 29 kg/m2 inclusive;
  5. Has a caregiver, is living at home or in an assisted living facility, is able to attend ambulatory study visits;
  6. Naïve to donepezil;
  7. Has discontinued another AChEI and/or memantine at least 3 months prior to study visit 2 (Day 1);
  8. Has a CT or MRI scan excluding another structural brain disease and supporting diagnosis of AD; CT or MRI scan must have been performed within 6 months prior to study visit 2 (Day 1, baseline);
  9. Fluent in English (mother tongue or working language);
  10. Able to communicate well with the Investigator;
  11. Physically able to carry out functional tasks;
  12. Has given written informed consent together with the caregiver.

Exclusion Criteria:

  1. Presence of any disabling, severe or life-threatening disease (cardiac, respiratory, gastro-intestinal, neurological, epileptic, psychiatric, infectious, bone, endocrinologic);
  2. Inability to discontinue at least 2 weeks prior to visit 2 (Day 1) (or within 5 drug half-lives, whichever is longer) any medication listed as prohibited;
  3. Proven or clinically suspected other type of dementia such as vascular dementia, post-traumatic dementia, fronto-temporal dementia, dementia associated with Parkinson's Disease, infectious disease HIV, syphilis), folate or vitamin B12 deficiency, hypothyroidism etc.;
  4. Significant liver impairment with ASAT, ALAT >=3x the upper normal limit at screening;
  5. Significant kidney impairment with serum creatinine >=2x the upper normal limit at screening;
  6. Presence of cardiac rhythm disorder, in particular bradycardia (< 60 bpm), conduction abnormalities such as AV block; presence of active ischaemia (such as unstable angina pectoris) or recent myocardial infarction, QT interval ≥ 450 msec at screening, QRS complex ≥ 110 msec at screening (ECG must be within normal limits at screening);
  7. Uncontrolled arterial hypertension i.e. patients with systolic blood pressure (BP) >=160 mmHg and/or diastolic >=100 mmHg, at screening despite regular medication;
  8. Uncontrolled arterial hypotension, i.e. patients with systolic BP ≤ 100 mmHg and/or presenting a fall of systolic BP ≥ 20 mmHg or a fall of diastolic BP >=10 mmHg after the 2 min Schellong test at screening;
  9. Any concomitant disorder or resultant therapy that is likely to interfere with patient compliance or his/her participation to the study;
  10. Participation in another study with an experimental drug within 3 months before study visit 2 (Day 1, baseline) or within 5 drug half-lives of the investigational drug (whichever is the longer);
  11. Known peripheral cholinergic intolerance, i.e. with previously prescribed AChEI(s);
  12. Known hypersensitivity to any of the test materials or related compounds, including lactose, present in the donepezil and placebo capsules;
  13. Known active use of recreational drug or alcohol dependence, current alcohol abuse;
  14. Inability to comply fully with the protocol;
  15. Patients who, in the opinion of the Investigator, are considered unsuitable for any other reason.

Sites / Locations

  • Central Coast Neuroscience Research
  • Hornsby-Kuring-gai Health Service
  • Southern Neurology
  • The Prince Charles Hospital
  • Royal Adelaide Hospital
  • The Queen Elizabeth Hospital
  • St George's Hospital
  • Austin Health Repatriation Hospital
  • Hollywood Specialist Centre
  • Calgary West Medical Centre
  • Castledowns Medicentre
  • Saibal Nandy Professional Corporation
  • Parkwood Hospital
  • Toronto Memory Program
  • Gerontion Research Inc.
  • Neuro Rive-Sud
  • Jewish General Hospital
  • The Medical Arts Health Research Group
  • Douglas Hospital Research Center
  • The Medical Arts Health Research Group
  • OPMHS
  • Glasgow Memory Clinic
  • Llandough Hospital
  • Royal Blackburn Hospital
  • Camden and Islington Mental Health Trust
  • North Manchester General Hospital
  • New Castle General Hospital
  • MARC - Moorgreen Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

ZT-1

Donepezil

Arm Description

ZT-1 (investigational product)

Donepezil

Outcomes

Primary Outcome Measures

Change in the MMSE score from baseline to week 25

Secondary Outcome Measures

Responder rate as defined by at least 2 points improvement in the MMSE score;
Change on the ADAS-Cog 11 items subscale;
Change in the NPI-Q;
Change on the IADL scale;
Patient's convenience questionnaire.

Full Information

First Posted
January 17, 2007
Last Updated
January 13, 2015
Sponsor
Debiopharm International SA
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1. Study Identification

Unique Protocol Identification Number
NCT00423228
Brief Title
Efficacy Study of a ZT-1 Implant in Patients Suffering From Alzheimer's Disease
Acronym
BRAINz
Official Title
A Randomised, Double-blind, Double-dummy, Oral Donepezil Controlled Study on the Safety and Efficacy of Repeated Monthly Subcutaneous Injections of a Sustained-release Implant of ZT 1 in Patients With Moderate Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Completed
Study Start Date
February 2007 (undefined)
Primary Completion Date
April 2009 (Actual)
Study Completion Date
April 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Debiopharm International SA

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Alzheimer's disease is characterised by memory loss and difficulties with thinking. These problems may be due to a deficiency in a brain chemical called acetylcholine. Acetylcholine helps transmit messages between nerve cells. Acetylcholine is degraded by an enzyme called "acetylcholinesterase". ZT-1 is a new drug derived from a plant extract already used in China for memory disorders, which blocks the action of the enzyme and restores adequate levels of acetylcholine. This study will test the safety and efficacy of ZT-1 in the treatment of patients with Alzheimer's disease. BRAINz stands for Better Recollection for Alzheimer's patients with the Implant of ZT-1.
Detailed Description
This is a multicenter, randomised, double-blind, double-dummy, oral donepezil controlled study on the safety and efficacy of repeated monthly s.c. injections of a sustained-release implant of ZT 1 in patients with moderate Alzheimer's Disease. The study enrolls patients aged >50 years, with moderate AD with a MMSE score at study screening ≥14 and ≤22. The study aims to recruit 128 patients. The study is divided into 3 periods: A screening period A 6-month treatment period, consisting of one month of titration with an oral medication and 5 months of treatment with an implant administered under the skin every 4 weeks. Oral treatment will be maintained throughout the treatment phase A 2 week follow-up period. Patients will be randomized in a 1:1 ratio to one of 2 groups: the ZT-1 (investigational product) treatment group or the donepezil (active comparator) treatment group. The study comprises a total of 11 visits including screening and follow-up. An additional visit for PK/PD assessment is scheduled in about 10% of patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Moderate Alzheimer's Disease
Keywords
Alzheimer's disease, cognitive impairment, cholinesterase inhibitors, sustained-release implants, long acting treatment

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
228 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ZT-1
Arm Type
Experimental
Arm Description
ZT-1 (investigational product)
Arm Title
Donepezil
Arm Type
Active Comparator
Arm Description
Donepezil
Intervention Type
Drug
Intervention Name(s)
ZT-1
Intervention Description
Patients in the ZT-1 treatment group will receive ZT 1-1 mg capsules administered p.o. daily during the first month of treatment, followed by ZT-1 implants (9 mg) administered s.c. during the second month of treatment, followed by ZT-1 implants (12 mg) administered s.c. every 4 weeks during months 3 to 6 of treatment. Patients in the ZT-1 treatment group will receive dummy donepezil capsules during months 2 to 6 of the treatment period.
Intervention Type
Drug
Intervention Name(s)
Donepezil
Other Intervention Name(s)
Aricept
Intervention Description
Patients in the donepezil treatment group will receive donepezil 5 mg capsules administered p.o. during the first month of treatment, followed by donepezil 10 mg/day during months 2 to 6 of the treatment period. Patients in the donepezil treatment group will also receive s.c. injections of dummy ZT 1 implants every 4 weeks during months 2 to 6 of the treatment period.
Primary Outcome Measure Information:
Title
Change in the MMSE score from baseline to week 25
Time Frame
baseline to week 25
Secondary Outcome Measure Information:
Title
Responder rate as defined by at least 2 points improvement in the MMSE score;
Time Frame
baseline to week 25
Title
Change on the ADAS-Cog 11 items subscale;
Time Frame
baseline to week 25
Title
Change in the NPI-Q;
Time Frame
baseline to week 25
Title
Change on the IADL scale;
Time Frame
baseline to week 25
Title
Patient's convenience questionnaire.
Time Frame
baseline to week 25

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Presence of moderately severe probable AD, diagnosed according to the DSM-IV and the NINCDS-ADRDA criteria; MMSE score ≥ 14 and ≤ 22; Male/female patient aged > 50 years; female patients should be of no child-bearing potential or postmenopausal (at least one year after last menses); Body mass index (BMI) between 18 and 29 kg/m2 inclusive; Has a caregiver, is living at home or in an assisted living facility, is able to attend ambulatory study visits; Naïve to donepezil; Has discontinued another AChEI and/or memantine at least 3 months prior to study visit 2 (Day 1); Has a CT or MRI scan excluding another structural brain disease and supporting diagnosis of AD; CT or MRI scan must have been performed within 6 months prior to study visit 2 (Day 1, baseline); Fluent in English (mother tongue or working language); Able to communicate well with the Investigator; Physically able to carry out functional tasks; Has given written informed consent together with the caregiver. Exclusion Criteria: Presence of any disabling, severe or life-threatening disease (cardiac, respiratory, gastro-intestinal, neurological, epileptic, psychiatric, infectious, bone, endocrinologic); Inability to discontinue at least 2 weeks prior to visit 2 (Day 1) (or within 5 drug half-lives, whichever is longer) any medication listed as prohibited; Proven or clinically suspected other type of dementia such as vascular dementia, post-traumatic dementia, fronto-temporal dementia, dementia associated with Parkinson's Disease, infectious disease HIV, syphilis), folate or vitamin B12 deficiency, hypothyroidism etc.; Significant liver impairment with ASAT, ALAT >=3x the upper normal limit at screening; Significant kidney impairment with serum creatinine >=2x the upper normal limit at screening; Presence of cardiac rhythm disorder, in particular bradycardia (< 60 bpm), conduction abnormalities such as AV block; presence of active ischaemia (such as unstable angina pectoris) or recent myocardial infarction, QT interval ≥ 450 msec at screening, QRS complex ≥ 110 msec at screening (ECG must be within normal limits at screening); Uncontrolled arterial hypertension i.e. patients with systolic blood pressure (BP) >=160 mmHg and/or diastolic >=100 mmHg, at screening despite regular medication; Uncontrolled arterial hypotension, i.e. patients with systolic BP ≤ 100 mmHg and/or presenting a fall of systolic BP ≥ 20 mmHg or a fall of diastolic BP >=10 mmHg after the 2 min Schellong test at screening; Any concomitant disorder or resultant therapy that is likely to interfere with patient compliance or his/her participation to the study; Participation in another study with an experimental drug within 3 months before study visit 2 (Day 1, baseline) or within 5 drug half-lives of the investigational drug (whichever is the longer); Known peripheral cholinergic intolerance, i.e. with previously prescribed AChEI(s); Known hypersensitivity to any of the test materials or related compounds, including lactose, present in the donepezil and placebo capsules; Known active use of recreational drug or alcohol dependence, current alcohol abuse; Inability to comply fully with the protocol; Patients who, in the opinion of the Investigator, are considered unsuitable for any other reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Emmanuel Tamches, MD
Organizational Affiliation
Debiopharm SA
Official's Role
Study Director
Facility Information:
Facility Name
Central Coast Neuroscience Research
City
East Gosford
State/Province
New South Wales
ZIP/Postal Code
2250
Country
Australia
Facility Name
Hornsby-Kuring-gai Health Service
City
Hornsby
State/Province
New South Wales
ZIP/Postal Code
2077
Country
Australia
Facility Name
Southern Neurology
City
Kogarah
State/Province
New South Wales
ZIP/Postal Code
2217
Country
Australia
Facility Name
The Prince Charles Hospital
City
Chermside
State/Province
Queensland
ZIP/Postal Code
4032
Country
Australia
Facility Name
Royal Adelaide Hospital
City
Adelaïde
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
The Queen Elizabeth Hospital
City
Woodville
State/Province
South Australia
ZIP/Postal Code
5011
Country
Australia
Facility Name
St George's Hospital
City
Kew
State/Province
Victoria
ZIP/Postal Code
3101
Country
Australia
Facility Name
Austin Health Repatriation Hospital
City
West Heidelberg
State/Province
Victoria
ZIP/Postal Code
3081
Country
Australia
Facility Name
Hollywood Specialist Centre
City
Nedlands (Perth)
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Facility Name
Calgary West Medical Centre
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3C 3P1
Country
Canada
Facility Name
Castledowns Medicentre
City
Edmonton
State/Province
Alberta
Country
Canada
Facility Name
Saibal Nandy Professional Corporation
City
Medicine Hat
State/Province
Alberta
ZIP/Postal Code
T1A 4C2
Country
Canada
Facility Name
Parkwood Hospital
City
London
State/Province
Ontario
ZIP/Postal Code
N6C 5J1
Country
Canada
Facility Name
Toronto Memory Program
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M3B 2W7
Country
Canada
Facility Name
Gerontion Research Inc.
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M6M 3Z5
Country
Canada
Facility Name
Neuro Rive-Sud
City
Montreal
State/Province
Quebec
ZIP/Postal Code
J4V 2J2
Country
Canada
Facility Name
Jewish General Hospital
City
Montreal
State/Province
Quebec
ZIP/Postal Code
P.Q. H3T 1E2
Country
Canada
Facility Name
The Medical Arts Health Research Group
City
Kelowna
ZIP/Postal Code
V1Y 3G8
Country
Canada
Facility Name
Douglas Hospital Research Center
City
Montréal
ZIP/Postal Code
H4H 1R3
Country
Canada
Facility Name
The Medical Arts Health Research Group
City
Penticton
ZIP/Postal Code
V2A 5C8
Country
Canada
Facility Name
OPMHS
City
Crowborough
State/Province
East Sussex
ZIP/Postal Code
TN61HB
Country
United Kingdom
Facility Name
Glasgow Memory Clinic
City
Glasgow
State/Province
Scotland
ZIP/Postal Code
G20 0XA
Country
United Kingdom
Facility Name
Llandough Hospital
City
Penarth
State/Province
Wales
ZIP/Postal Code
CF64 2XX
Country
United Kingdom
Facility Name
Royal Blackburn Hospital
City
Blackburn
ZIP/Postal Code
M8 5RB
Country
United Kingdom
Facility Name
Camden and Islington Mental Health Trust
City
London
ZIP/Postal Code
NW1 9DB
Country
United Kingdom
Facility Name
North Manchester General Hospital
City
Manchester
ZIP/Postal Code
M85RB
Country
United Kingdom
Facility Name
New Castle General Hospital
City
Newcastle upon Tyne
ZIP/Postal Code
NE4 6BE
Country
United Kingdom
Facility Name
MARC - Moorgreen Hospital
City
Southampton
ZIP/Postal Code
SO30 3JB
Country
United Kingdom

12. IPD Sharing Statement

Citations:
Citation
Wilkinson D, Roughan L. The BRAINz trial: a novel approach to acetylcholinesterase-inhibitor treatment for Alzheimer's disease. Future Neurol 2(4):379-382,2007.
Results Reference
background
Links:
URL
http://www.debiopharm.com
Description
Sponsor of the Study
URL
http://www.alzheimers.org
Description
Alzheimer's Disease Education and Referral (ADEAR) Center

Learn more about this trial

Efficacy Study of a ZT-1 Implant in Patients Suffering From Alzheimer's Disease

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