Trial Outcomes & Findings for Endothelial Facilitation in Alzheimer's Disease (NCT NCT01439555)

NCT ID: NCT01439555

Last Updated: 2019-07-30

Results Overview

Measurement of changes to cerebral blood flow (ml/110g/min) in regions of interest as measured using Magnetic Resonance Imaging (MRI)

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

11 participants

Primary outcome timeframe

Baseline to 16 weeks

Results posted on

2019-07-30

Participant Flow

Participant milestones

Participant milestones
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Overall Study
STARTED
11
Overall Study
COMPLETED
10
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Overall Study
Protocol Violation
1

Baseline Characteristics

Endothelial Facilitation in Alzheimer's Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=10 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Age, Categorical
<=18 years
0 Participants
n=93 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
n=93 Participants
Age, Categorical
>=65 years
9 Participants
n=93 Participants
Age, Continuous
67.1 Years of Age
STANDARD_DEVIATION 6.84 • n=93 Participants
Sex: Female, Male
Female
6 Participants
n=93 Participants
Sex: Female, Male
Male
4 Participants
n=93 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=93 Participants
Race (NIH/OMB)
White
10 Participants
n=93 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
Region of Enrollment
United States
10 participants
n=93 Participants

PRIMARY outcome

Timeframe: Baseline to 16 weeks

Population: Data for 6 participants available. Data file for remaining participants corrupted and could not be retrieved for analysis/reporting.

Measurement of changes to cerebral blood flow (ml/110g/min) in regions of interest as measured using Magnetic Resonance Imaging (MRI)

Outcome measures

Outcome measures
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=6 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Mean Change in Cerebral Blood Flow as Measured by Magnetic Resonance Imaging (MRI)
Baseline
0.621528 ml/110g/min
Standard Deviation 0.116513988
Mean Change in Cerebral Blood Flow as Measured by Magnetic Resonance Imaging (MRI)
Week 4
0.6447692 ml/110g/min
Standard Deviation 0.070388324
Mean Change in Cerebral Blood Flow as Measured by Magnetic Resonance Imaging (MRI)
Week 8
0.654822667 ml/110g/min
Standard Deviation 0.024032403
Mean Change in Cerebral Blood Flow as Measured by Magnetic Resonance Imaging (MRI)
Week 16
0.579838667 ml/110g/min
Standard Deviation 0.091658076

PRIMARY outcome

Timeframe: Baseline to week 16

Population: Data files corrupted, analysis not possible

Data not available as files corrupted and could not be analyzed

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline to 4 weeks, 8 weeks and 16 weeks post-baseline

Population: Patients were sequentially treated with the HMC-CoA reductase synthesis inhibitor simvastatin (weeks 0-16); L-Arginine (weeks 4-16); and tetrahydrobiopterin (weeks 8-16). The investigators assessed cognitive function with a psychometric battery including the MMSE at each time point.

Change in mental state as reflected by changes to mean Mini Mental State Examination (MMSE) score as measured 4 weeks, 8 weeks and 16 weeks post-baseline. The MMSE uses a 30 point questionnaire to measure cognitive impairment. The MMSE is scored from 0 to 30,with a score equal to or greater than 24 points indicating normal cognition, a score of 19-23 points indicating mild cognitive impairment, 10-18 points indicating moderate impairment and a score equal to or below 9 indicating severe impairment.

Outcome measures

Outcome measures
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=10 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Mini Mental State Examination (MMSE) Scores
Baseline
24.2 score on a scale
Standard Deviation 3.155
Mini Mental State Examination (MMSE) Scores
Week 4
25.33 score on a scale
Standard Deviation 2.21
Mini Mental State Examination (MMSE) Scores
Week 8
26 score on a scale
Standard Deviation 3.13
Mini Mental State Examination (MMSE) Scores
Week 16
25.55 score on a scale
Standard Deviation 2.51

SECONDARY outcome

Timeframe: Baseline to 16 weeks post-baseline

This outcome measured the change in average Cognitive Assessment Screening Test (CAST) scores for the participant group. The CAST is scored from 0 to 40. A higher score indicates better performance, and a lower score indicates worse performance. The participants were given the CAST at baseline, 4 weeks, 8 weeks and 16 weeks post-baseline. The outcome reports on the averaged change for the averaged CAST scores from baseline to 16 weeks.

Outcome measures

Outcome measures
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=10 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Cognitive Assessment Screening Test (CAST)
31.4 score on a scale
Standard Deviation 5.46

SECONDARY outcome

Timeframe: Baseline to 16 weeks post-baseline

This outcome measures Clinical Dementia Rating Scale (CDR) scores at baseline (enrollment) and 16 weeks post-enrollment. The Clinical Dementia Rating Scale is scored with a composite scale of 0 to 3, with higher scores indicating lower functional status and lower scores indicating better functional status.

Outcome measures

Outcome measures
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=10 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Clinical Dementia Rating Scale (CDR)
CDR Score at Baseline
0.9 score on a scale
Standard Deviation .47
Clinical Dementia Rating Scale (CDR)
CDR Score at 16 weeks
0.9 score on a scale
Standard Deviation .47

SECONDARY outcome

Timeframe: Baseline to 16 weeks post-baseline

Mean Alzheimer's Disease Assessment Scale: Cognitive Subscale (ADAS-COG) score at baseline and at 16 weeks post-enrollment. The ADAS-COG consists of 11 tasks measuring disturbances of memory, language, praxis, attention and other cognitive abilities. Total scores range from 0 to 70, with higher scores (18 and above) indicating greater cognitive impairment.

Outcome measures

Outcome measures
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=10 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Alzheimer's Disease Assessment Scale: Cognitive and Modified Version (ADAS-COG)
ADAS-COG Baseline
21.6 score on a scale
Standard Deviation 5.65
Alzheimer's Disease Assessment Scale: Cognitive and Modified Version (ADAS-COG)
ADAS-COG 16 weeks
21.9 score on a scale
Standard Deviation 8.9

SECONDARY outcome

Timeframe: Baseline to 4 weeks, 8 weeks and 16 weeks post-baseline

The Clinical Interview Based Impression of Change + Caregiver Input (CIBIC Plus) is a semi-structured instrument to examine four major areas of patient function: General, Cognitive, Behavioral and Activities of Daily Living. It is scored from 1 to 7. A score of 1 indicates marked improvement, 4 indicates no change and 7 indicates marked worsening.

Outcome measures

Outcome measures
Measure
Simvastatin + L-Arginine + Tetrahydrobiopterin
n=10 Participants
Simvastatin, 40 mg per day orally; L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin 20 mg/kg/day orally Simvastatin: Simvastatin, 40 mg per day orally L-Arginine: L-Arginine, 2 Gm four times per day orally; Tetrahydrobiopterin: Tetrahydrobiopterin 20 mg/kg/day orally
Clinical Interview Based Impression of Change + Caregiver Input (CIBIC Plus)
Change in CIBIC score from baseline to 4 weeks
-.1 score on a scale
Standard Deviation 0.32
Clinical Interview Based Impression of Change + Caregiver Input (CIBIC Plus)
Change in CIBIC Score from 4 weeks to 8 weeks
.6 score on a scale
Standard Deviation .84
Clinical Interview Based Impression of Change + Caregiver Input (CIBIC Plus)
Change in CIBIC Score from 8 weeks to 16 weeks
-.1 score on a scale
Standard Deviation 1.29

Adverse Events

Simvastatin + L-Arginine + Tetrahydrobiopterin

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Elizabeth DeGrush, DO

UMass Medical School

Phone: 508-334-1000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place