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Open Label Pilot Study of the Effects of Memantine on FDG-PET in Frontotemporal Dementia

Primary Purpose

Frontotemporal Dementia

Status
Completed
Phase
Phase 3
Locations
Canada
Study Type
Interventional
Intervention
memantine hydrochloride
Sponsored by
Tiffany Chow, MD
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Frontotemporal Dementia focused on measuring PET, frontotemporal dementia, memantine, Pick's disease

Eligibility Criteria

40 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Must meet criteria for frontotemporal lobar degeneration (FTD) by Neary et al. criteria. 28 Subjects may have either the behavioural or the aphasic variant of FTD.
  • Able to undergo psychometric testing.
  • Must have reliable informant with daily contact with patient
  • May be taking concurrent psychotropic medications, but must be on stable dosing regimen for 3 months prior to trial enrollment
  • On the basis of a physical examination, medical history (including psychiatric and neurological), and results of blood chemistry carried out at screening visit, the patient in the investigator's opinion is considered healthy.
  • Signed Informed Consent must be obtained from the patient or legally responsible representative and the informant prior to initiating any study specific procedures.

Exclusion Criteria:

  • Complaint of recurrent or persistent dizziness or constipation
  • Abnormal chemistry panel particular with respect to ruling out renal insufficiency or failure. We will exclude those patients with creatinine clearance (CLcr) < 50ml/min, per the Sakana equations for men and women.
  • Angina, myocardial infarction, severe hypertension, severe cardiac arrhythmia, unstable diabetes mellitus, or new abnormalities on EKG within the past year.
  • Any current malignancy, or any clinically significant hematological, endocrine, renal, hepatic, gastrointestinal or non-dementia neurological disease. If the condition has been stable for at least the past year and is judged by the investigators not to interfere with the patient's participation in the study, the patient may be included. Basal cell carcinoma is an exception.
  • Non-English speaking, as cognitive tests will be in English.
  • Evidence of other neurological or psychiatric disorders which preclude diagnosis of FTD (including, but not limited to, stroke, Parkinson's disease, any psychotic disorder, severe bipolar or unipolar depression) within the past year
  • Current or prior history of uncontrolled seizure disorder, due to seizures reported as adverse events with memantine.
  • Patients with suspected alcohol or substance abuse within last 1 year. If past history of abuse or dependence must have been abstinent for 1 year with continuing progression of dementia despite abstinence.
  • Patients with active delusions or hallucinations at the time of screening.
  • Female patients who are not at least two years post-menopausal or surgically sterile. Pre-menopausal women will be excluded; because almost all women are post-menopausal at the age of onset of FTD, we do not anticipate having to exclude more than one potential subject on the basis of this one exclusion criterion.
  • Use of investigational drugs or participation in another investigational drug study within 3 months of screening.
  • Patients who have previously been treated with memantine or have participated in an investigational study with memantine.
  • Patients with history of severe drug allergy or hypersensitivity or known hypersensitivity to amantadine or memantine.

Sites / Locations

  • Baycrest

Outcomes

Primary Outcome Measures

Metabolic activity in frontal and temporal lobes.

Secondary Outcome Measures

Behavioural inventories, UPDRS Motor scale.

Full Information

First Posted
January 7, 2008
Last Updated
June 1, 2012
Sponsor
Tiffany Chow, MD
Collaborators
H. Lundbeck A/S
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1. Study Identification

Unique Protocol Identification Number
NCT00594737
Brief Title
Open Label Pilot Study of the Effects of Memantine on FDG-PET in Frontotemporal Dementia
Official Title
An Open Label Pilot Study of the Effects of Memantine Administration on FDG-PET in Frontotemporal Dementia
Study Type
Interventional

2. Study Status

Record Verification Date
June 2012
Overall Recruitment Status
Completed
Study Start Date
October 2007 (undefined)
Primary Completion Date
June 2012 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Tiffany Chow, MD
Collaborators
H. Lundbeck A/S

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Memantine has been approved for use in Alzheimer's disease. Its mechanism of action raises questions of whether it can also be effective for non-Alzheimer's dementias such as frontotemporal dementia (FTD), which currently has no disease-modifying treatment. This is an open-label study to probe the effects of memantine in 15 outpatients diagnosed with FTD, as shown objectively by comparing PET scans performed before and after use of the medication. The specific type of PET scan, FDG-PET, allows the investigators to gauge the effects of memantine on cortical activity levels. The investigators hypothesize that subjects on memantine will show normalization of cortical metabolic activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Frontotemporal Dementia
Keywords
PET, frontotemporal dementia, memantine, Pick's disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
memantine hydrochloride
Other Intervention Name(s)
Ebixa, Namenda
Intervention Description
memantine hydrochloride oral tablets, 10mg po bid
Primary Outcome Measure Information:
Title
Metabolic activity in frontal and temporal lobes.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Behavioural inventories, UPDRS Motor scale.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must meet criteria for frontotemporal lobar degeneration (FTD) by Neary et al. criteria. 28 Subjects may have either the behavioural or the aphasic variant of FTD. Able to undergo psychometric testing. Must have reliable informant with daily contact with patient May be taking concurrent psychotropic medications, but must be on stable dosing regimen for 3 months prior to trial enrollment On the basis of a physical examination, medical history (including psychiatric and neurological), and results of blood chemistry carried out at screening visit, the patient in the investigator's opinion is considered healthy. Signed Informed Consent must be obtained from the patient or legally responsible representative and the informant prior to initiating any study specific procedures. Exclusion Criteria: Complaint of recurrent or persistent dizziness or constipation Abnormal chemistry panel particular with respect to ruling out renal insufficiency or failure. We will exclude those patients with creatinine clearance (CLcr) < 50ml/min, per the Sakana equations for men and women. Angina, myocardial infarction, severe hypertension, severe cardiac arrhythmia, unstable diabetes mellitus, or new abnormalities on EKG within the past year. Any current malignancy, or any clinically significant hematological, endocrine, renal, hepatic, gastrointestinal or non-dementia neurological disease. If the condition has been stable for at least the past year and is judged by the investigators not to interfere with the patient's participation in the study, the patient may be included. Basal cell carcinoma is an exception. Non-English speaking, as cognitive tests will be in English. Evidence of other neurological or psychiatric disorders which preclude diagnosis of FTD (including, but not limited to, stroke, Parkinson's disease, any psychotic disorder, severe bipolar or unipolar depression) within the past year Current or prior history of uncontrolled seizure disorder, due to seizures reported as adverse events with memantine. Patients with suspected alcohol or substance abuse within last 1 year. If past history of abuse or dependence must have been abstinent for 1 year with continuing progression of dementia despite abstinence. Patients with active delusions or hallucinations at the time of screening. Female patients who are not at least two years post-menopausal or surgically sterile. Pre-menopausal women will be excluded; because almost all women are post-menopausal at the age of onset of FTD, we do not anticipate having to exclude more than one potential subject on the basis of this one exclusion criterion. Use of investigational drugs or participation in another investigational drug study within 3 months of screening. Patients who have previously been treated with memantine or have participated in an investigational study with memantine. Patients with history of severe drug allergy or hypersensitivity or known hypersensitivity to amantadine or memantine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tiffany W Chow, MD
Organizational Affiliation
Rotman Research Institute at Baycrest, University of Toronto
Official's Role
Principal Investigator
Facility Information:
Facility Name
Baycrest
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M6A 2E1
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
17545743
Citation
Swanberg MM. Memantine for behavioral disturbances in frontotemporal dementia: a case series. Alzheimer Dis Assoc Disord. 2007 Apr-Jun;21(2):164-6. doi: 10.1097/WAD.0b013e318047df5d.
Results Reference
background
Citation
Chow TW, Binns MA, Freedman M, Pollock BG, Verhoeff NPG, Graff-Guerrero A. Pre- and post-memantine FDG-PET imaging in frontotemporal dementia. Am J Geriatr Psychiatry 2009;17(3 Supp 1): A73.
Results Reference
result
PubMed Identifier
21792308
Citation
Chow TW, Graff-Guerrero A, Verhoeff NP, Binns MA, Tang-Wai DF, Freedman M, Masellis M, Black SE, Wilson AA, Houle S, Pollock BG. Open-label study of the short-term effects of memantine on FDG-PET in frontotemporal dementia. Neuropsychiatr Dis Treat. 2011;7:415-24. doi: 10.2147/NDT.S22635. Epub 2011 Jul 13.
Results Reference
result
PubMed Identifier
22674572
Citation
Chow TW, Fam D, Graff-Guerrero A, Verhoeff NP, Tang-Wai DF, Masellis M, Black SE, Wilson AA, Houle S, Pollock BG. Fluorodeoxyglucose positron emission tomography in semantic dementia after 6 months of memantine: an open-label pilot study. Int J Geriatr Psychiatry. 2013 Mar;28(3):319-25. doi: 10.1002/gps.3832. Epub 2012 Jun 4.
Results Reference
result
Links:
URL
http://www.camhpet.ca/
Description
PET Imaging Centre website
URL
http://www.theaftd.org
Description
Association for Frontotemporal Dementias

Learn more about this trial

Open Label Pilot Study of the Effects of Memantine on FDG-PET in Frontotemporal Dementia

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