SNIFF 120: Study of Nasal Insulin to Fight Forgetfulness (120 Days)

NCT ID: NCT00438568

Last Updated: 2012-09-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

173 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-06-30

Study Completion Date

2011-12-31

Brief Summary

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The purpose of this study is to find out if insulin, when administered as a "nasal spray" into the nasal passages, improves memory in adults with mild cognitive impairment (MCI) or Alzheimer's disease.

Detailed Description

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A growing body of evidence suggests that insulin plays a role in normal memory processes and that insulin abnormalities may contribute to cognitive and brain changes associated with Alzheimer's disease (AD). Interestingly, insulin administered to the nasal cavity is transported within a few minutes into the brain, but does not affect blood sugar or insulin levels.

This study will consist of a randomized double-blind, placebo-controlled parallel group trial in which 90 participants with AD or MCI receive daily intranasal administrations of either insulin (10 or 20 IU twice a day for a total dose of 20 or 40 IU per day) or placebo (saline twice a day) for 4 months. The study will examine the effects of intranasal insulin administration on cognition, cerebral glucose metabolism, and β-amyloid (Aβ) in cerebrospinal fluid (CSF) and plasma, testing the hypothesis that daily intranasal insulin administration for 4 months will facilitate memory for adults with AD, and adults with mild cognitive impairment (MCI). A subset of participants will have the option to participate in 2 sub-studies: PET scans (prior to and at the end of treatment) to determine whether intranasal insulin increases cerebral glucose metabolism; lumbar punctures (LPs) before and at the end of treatment to determine effects of intranasal insulin administration on CSF Aβ levels.

Conditions

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Mild Cognitive Impairment Alzheimer's Disease

Keywords

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amyloid protein brain metabolism glucose metabolism insulin sensitivity /resistance cognition disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

saline

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

administered intra-nasally twice a day for 16 weeks

2

10 Units

Group Type EXPERIMENTAL

Regular Insulin

Intervention Type DRUG

administered intra-nasally twice a day for 16 weeks

3

20 Units

Group Type EXPERIMENTAL

Regular Insulin

Intervention Type DRUG

administered intra-nasally twice a day for 16 weeks

Interventions

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Regular Insulin

administered intra-nasally twice a day for 16 weeks

Intervention Type DRUG

Placebo

administered intra-nasally twice a day for 16 weeks

Intervention Type DRUG

Other Intervention Names

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Novolin U-100 saline

Eligibility Criteria

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Inclusion Criteria

* Age 55 or greater
* Good physical health
* Memory impairment with a diagnosis of mild cognitive impairment (MCI) or Alzheimer's disease (AD)
* Participants on stable doses of Memantine (Namenda) or cholinesterase inhibitors will be eligible

Exclusion Criteria

* Chronic sinus problems/allergies with chronic use of nasal decongestants or antihistamines
* Significant neurologic disease that might affect cognition (other than AD), such as stroke, Parkinson's disease, multiple sclerosis, severe head injury with loss of consciousness for more than 30 minutes or with permanent neurologic symptoms
* Significant medical illness or organ failure, such as uncontrolled hypertension or cardiovascular disease, chronic obstructive pulmonary disease, liver disease, or kidney disease
* Preexisting diabetes or current or previous use of hypoglycemic agents or insulin; participants will be excluded if they have a fasting blood sugar greater than 165 on baseline OGTT
* Clinically significant elevations in liver function tests, cholesterol, or triglycerides
* Major psychiatric disorders (e.g., untreated major depression and schizophrenia)
* Chronic use of the following types of medications: anti-psychotic, anxiolytic, and opiates
Minimum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Suzanne Craft, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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Veterans Administration Puget Sound Health Care System

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Reger MA, Watson GS, Frey WH 2nd, Baker LD, Cholerton B, Keeling ML, Belongia DA, Fishel MA, Plymate SR, Schellenberg GD, Cherrier MM, Craft S. Effects of intranasal insulin on cognition in memory-impaired older adults: modulation by APOE genotype. Neurobiol Aging. 2006 Mar;27(3):451-8. doi: 10.1016/j.neurobiolaging.2005.03.016. Epub 2005 Jun 16.

Reference Type BACKGROUND
PMID: 15964100 (View on PubMed)

Reger MA, Craft S. Intranasal insulin administration: a method for dissociating central and peripheral effects of insulin. Drugs Today (Barc). 2006 Nov;42(11):729-39. doi: 10.1358/dot.2006.42.11.1007675.

Reference Type BACKGROUND
PMID: 17171192 (View on PubMed)

Fishel MA, Watson GS, Montine TJ, Wang Q, Green PS, Kulstad JJ, Cook DG, Peskind ER, Baker LD, Goldgaber D, Nie W, Asthana S, Plymate SR, Schwartz MW, Craft S. Hyperinsulinemia provokes synchronous increases in central inflammation and beta-amyloid in normal adults. Arch Neurol. 2005 Oct;62(10):1539-44. doi: 10.1001/archneur.62.10.noc50112.

Reference Type BACKGROUND
PMID: 16216936 (View on PubMed)

Craft S, Baker LD, Montine TJ, Minoshima S, Watson GS, Claxton A, Arbuckle M, Callaghan M, Tsai E, Plymate SR, Green PS, Leverenz J, Cross D, Gerton B. Intranasal insulin therapy for Alzheimer disease and amnestic mild cognitive impairment: a pilot clinical trial. Arch Neurol. 2012 Jan;69(1):29-38. doi: 10.1001/archneurol.2011.233. Epub 2011 Sep 12.

Reference Type DERIVED
PMID: 21911655 (View on PubMed)

Other Identifiers

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5R01AG027415

Identifier Type: NIH

Identifier Source: secondary_id

View Link

1R01AG027415-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

30579-B

Identifier Type: -

Identifier Source: org_study_id