Trial Outcomes & Findings for Prazosin for Agitation in Alzheimer's Disease (NCT NCT03710642)
NCT ID: NCT03710642
Last Updated: 2023-02-06
Results Overview
The ADCS-CGIC-A is the primary outcome measure. It will be anchored to disruptive agitation, the target behaviors in this study. It measures whether the effects of active treatment are substantial enough to be detected by a skilled and experienced clinician on the basis of a direct examination of the participant and an interview of the participant's primary caregiver and other LTC facility staff. The baseline assessment is qualitative therefore there is no score at baseline; post-baseline scores represent a change score compared to baseline. The ADCS-CGIC-A is a 7-point scale that is structured as the clinician's assessment of change from baseline compared to the ADCS-CGIC-A Baseline Worksheet. There is no baseline score; post-baseline scores range from 1 (improvement) to 7 (worsening). A score of 1-2 indicates clinically meaningful improvement; a score of 3-5 indicates no clinically meaningful change; a score of 6-7 indicates clinically meaningful worsening.
COMPLETED
PHASE2
35 participants
From Baseline through Week 12.
2023-02-06
Participant Flow
Recruitment initiated September 2018: The research was initially approved for enrollment at Long Term Care facilities. Covid-19 impacted these facilities, and protocol amendments were approved to allow home-dwelling participants with full-time caregivers to enroll into the trial. Recruitment came from a blend of LTC facilities and institution/clinics.
Of the 54 participants consented and screened, 35 were eligible to participate in the trial and 19 were screening failures. Of the 35 participants randomized, 34 participants went on to receive study drug. One patient discontinued after randomization but prior to first dose administration.
Participant milestones
| Measure |
Treatment (Prazosin)
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Overall Study
STARTED
|
27
|
8
|
|
Overall Study
COMPLETED
|
17
|
3
|
|
Overall Study
NOT COMPLETED
|
10
|
5
|
Reasons for withdrawal
| Measure |
Treatment (Prazosin)
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Overall Study
Adverse Event
|
5
|
1
|
|
Overall Study
non-site physician recommendation
|
1
|
0
|
|
Overall Study
Participant unwilling or unable to participate
|
1
|
1
|
|
Overall Study
"other" is selected as the reason for study termination
|
1
|
3
|
|
Overall Study
NA-no code provided
|
1
|
0
|
|
Overall Study
Withdrawal by Subject
|
1
|
0
|
Baseline Characteristics
Prazosin for Agitation in Alzheimer's Disease
Baseline characteristics by cohort
| Measure |
Treatment (Prazosin)
n=26 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=8 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
Total
n=34 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
80.02 years
STANDARD_DEVIATION 11.27 • n=5 Participants
|
78.53 years
STANDARD_DEVIATION 8.0 • n=7 Participants
|
79.67 years
STANDARD_DEVIATION 10.5 • n=5 Participants
|
|
Sex: Female, Male
Female
|
19 Participants
n=5 Participants
|
6 Participants
n=7 Participants
|
25 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
7 Participants
n=5 Participants
|
2 Participants
n=7 Participants
|
9 Participants
n=5 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
4 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
4 Participants
n=5 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
21 Participants
n=5 Participants
|
8 Participants
n=7 Participants
|
29 Participants
n=5 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
1 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
1 Participants
n=5 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
1 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
1 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Asian
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Black or African American
|
1 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
1 Participants
n=5 Participants
|
|
Race (NIH/OMB)
White
|
24 Participants
n=5 Participants
|
8 Participants
n=7 Participants
|
32 Participants
n=5 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Region of Enrollment
United States
|
26 participants
n=5 Participants
|
8 participants
n=7 Participants
|
34 participants
n=5 Participants
|
PRIMARY outcome
Timeframe: From Baseline through Week 12.Population: The population analyzed for this outcome includes: 20 study completers, and 3 early terminations that completed their termination visit at or after the week 10 timepoint. Therefore, the N analyzed is higher than the numbers of completers listed in the participant flow section.
The ADCS-CGIC-A is the primary outcome measure. It will be anchored to disruptive agitation, the target behaviors in this study. It measures whether the effects of active treatment are substantial enough to be detected by a skilled and experienced clinician on the basis of a direct examination of the participant and an interview of the participant's primary caregiver and other LTC facility staff. The baseline assessment is qualitative therefore there is no score at baseline; post-baseline scores represent a change score compared to baseline. The ADCS-CGIC-A is a 7-point scale that is structured as the clinician's assessment of change from baseline compared to the ADCS-CGIC-A Baseline Worksheet. There is no baseline score; post-baseline scores range from 1 (improvement) to 7 (worsening). A score of 1-2 indicates clinically meaningful improvement; a score of 3-5 indicates no clinically meaningful change; a score of 6-7 indicates clinically meaningful worsening.
Outcome measures
| Measure |
Treatment (Prazosin)
n=19 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=4 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
ADCS-Clinical Global Impression of Change in Agitation (ADCS-CGIC-A)
|
3.434 score on a scale
Standard Error 0.2833
|
3.442 score on a scale
Standard Error 0.6141
|
SECONDARY outcome
Timeframe: 12 weeksThe NPI was designed to characterize the neuropsychiatric symptoms and psychopathology of patients with AD and other dementias residing in the community about which information was obtained from family caregivers. The content of the questions and their scoring in the NPI-NH are identical to those of the NPI except for some slight rephrasing to be consistent with the LTC environment where information is gathered from professional caregivers. Assessment of the impact of behavioral disturbances on family and professional caregivers, is assessed by a caregiver distress scale in the NPI and an occupational disruptiveness scale in the NPI-NH; scoring of this component remains identical. Minimum score is 0 and highest score is 144. A higher score means a worse outcome. This outcome is the change from baseline to week 12.
Outcome measures
| Measure |
Treatment (Prazosin)
n=24 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=7 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Neuropsychiatric Inventory (NPI)/Neuropsychiatry Inventory-Nursing Home Version (NPI-NH)
|
-6.033 units on a scale
Standard Error 4.692
|
5.506 units on a scale
Standard Error 10.149
|
SECONDARY outcome
Timeframe: 12 weeksCumulative total dose of Lorazepam rescue medication administered during the trial. Information on the total mg rescue lorazepam administered will be collected as additional secondary outcome measures. If prazosin is more effective than placebo, it is predicted that participants randomized to prazosin will be prescribed lower cumulative mg of rescue lorazepam for management of persistent or worsening disruptive agitation.
Outcome measures
| Measure |
Treatment (Prazosin)
n=24 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=7 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Rescue Medication: Total mg Lorazepam Administered
|
0.25 mg
Standard Deviation 0.69
|
0.14 mg
Standard Deviation 0.24
|
SECONDARY outcome
Timeframe: 12 weeksCox proportional hazard modelling comparing the median time to drop out between treatment groups.
Outcome measures
| Measure |
Treatment (Prazosin)
n=27 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=8 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Study Discontinuations
|
65.63 days
Standard Deviation 32.63
|
54.62 days
Standard Deviation 33.29
|
SECONDARY outcome
Timeframe: 12 weeksComparison of proportions of responders versus non responders on the ADCS-CGIC-A. Responders are defined as those with moderate or marked improvement in agitation symptoms compared to baseline assessment.
Outcome measures
| Measure |
Treatment (Prazosin)
n=19 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=4 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Responder Analysis on CGIC-A
|
7 Participants
|
1 Participants
|
SECONDARY outcome
Timeframe: 12 weeksThe ADCS-ADL-Severe questionnaire is a secondary outcome measure aimed at detecting functional decline in people with severe AD. This scale is best suited for evaluating people with MMSE scores below 15/30, or equivalent. Questions are administered to a qualified caregiver informant about a set of 19 basic and instrumental ADL. Instrumental ADL are selected to be relevant to this level of severity of dementia, e.g., obtaining a beverage, turning lights on and off, turning a faucet on and off. Performance of each of these activities during the past 4 weeks, as well as the level of performance, are rated. A total score is derived by summing scores across items, and ranges from 0 (maximal impairment) to 54 (maximally independent function). This outcome is the change from baseline to week 12.
Outcome measures
| Measure |
Treatment (Prazosin)
n=19 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=4 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
ADCS-ADL-Severe
|
-1.47055 score on a scale
Standard Error 1.0062
|
-4.53993 score on a scale
Standard Error 2.1863
|
SECONDARY outcome
Timeframe: 12 weeksComparison of effects on caregiver distress/occupational disruptiveness scores on the NPI/NPI-NH. Minimum score is 0 and maximum score is 60. A higher score is a worse outcome. This outcome is the change from baseline to week 12.
Outcome measures
| Measure |
Treatment (Prazosin)
n=19 Participants
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=4 Participants
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Caregiver Distress on NPI/NPI-NH
|
-2.4438 score on a scale
Standard Error 2.332
|
0.9446 score on a scale
Standard Error 5.043
|
OTHER_PRE_SPECIFIED outcome
Timeframe: 12 weeksThe CMAI is an exploratory outcome measure for estimating frequency of agitated behaviors. The CMAI assesses the frequency of agitated behaviors in elderly persons and was developed for use in the LTC facility. The CMAI rates 29 agitated behaviors, each on a 7-point scale (1-7) of frequency ranging from never to several times per hour. Ratings pertain to the 2-week period preceding the rating. A higher score means a worse outcome.
Outcome measures
Outcome data not reported
OTHER_PRE_SPECIFIED outcome
Timeframe: 12 weeksThe Neuropsychiatric Inventory (NPI)/Neuropsychiatry Inventory-Nursing Home version (NPI-NH) subset score includes agitation/aggression, anxiety, disinhibition, irritability/lability and aberrant motor activity. Minimum and maximum values are 0 and 60 respectively. A higher score is a worse outcome.
Outcome measures
Outcome data not reported
OTHER_PRE_SPECIFIED outcome
Timeframe: 12 weeksActigraphy measures of locomotor activity during the night will be compared between groups.
Outcome measures
Outcome data not reported
Adverse Events
Treatment (Prazosin)
Placebo Oral Capsule
Serious adverse events
| Measure |
Treatment (Prazosin)
n=26 participants at risk
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=8 participants at risk
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Nervous system disorders
Syncope
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Cardiac disorders
Syncope
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Infections and infestations
Pneumonia
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Injury, poisoning and procedural complications
Fall
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Dementia Alzheimer's type
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Vascular disorders
Syncope
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Injury, poisoning and procedural complications
Upper limb fracture
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
Other adverse events
| Measure |
Treatment (Prazosin)
n=26 participants at risk
Eligible participants will be randomized using a 2:1 schedule to prazosin or placebo and stratified by site and gender, and will follow a fixed titration scheme for the first 15 days, followed by a flexible does titration from days 15-29, then a maintenance phase stable dose from days 29 to the end of the 12 weeks study period.
Prazosin Fixed titration dose schedule for Days 1 to 14 1 mg QHS for Days 1 to 3
1 mg QAM and 1 mg QHS for days 4 to 7
1. mg QAM and 2 mg QHS for days 8 to 10
2. mg QAM and 2 mg QHS for days 11 to 14
Prazosin Flexible titration dose schedule for Days 15 to 29. 3 mg QAM and 3 mg QHS on day 15, 4 mg QAM and 4 mg QHS on day 22, 4 mg QAH and 6 mg QHS on day 29,
Dose increases will be allowed only during the fixed and flexible dosing periods.
Prazosin: Oral prazosin HCl capsules (or placebo) will be administered twice daily, with individualized doses up to a maximum of 4 mg QAM mid-morning and 6 mg at bedtime (QHS), or matching placebo capsules
|
Placebo Oral Capsule
n=8 participants at risk
Placebo medication will be administered in a titration schedule mimicking the active comparator treatment.
Placebo oral capsule: Placebo capsule matched to appearance of active drug.
|
|---|---|---|
|
Cardiac disorders
Bradycardia
|
7.7%
2/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Metabolism and nutrition disorders
Decreased appetite
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Musculoskeletal and connective tissue disorders
Back pain
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Skin and subcutaneous tissue disorders
Ecchymosis
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Cardiac disorders
Cardiac Failure
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Cardiac disorders
Palpitations
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Cardiac disorders
Syncope
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Cardiac disorders
Tachycardia
|
7.7%
2/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Gastrointestinal disorders
Anal incontinence
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Gastrointestinal disorders
Constipation
|
0.00%
0/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Gastrointestinal disorders
Diarrhoea
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Gastrointestinal disorders
Gastrooesophageal reflux disease
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Gastrointestinal disorders
Nausea
|
7.7%
2/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
General disorders
Asthenia
|
11.5%
3/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
25.0%
2/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
General disorders
Lethargy
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
General disorders
Oedema peripheral
|
15.4%
4/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
General disorders
Pyrexia
|
0.00%
0/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Infections and infestations
Bronchitis
|
0.00%
0/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Infections and infestations
Corona virus infection
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Infections and infestations
Pneumonia
|
7.7%
2/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Infections and infestations
Urinary tract infection
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Injury, poisoning and procedural complications
Ankle fracture
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Injury, poisoning and procedural complications
Fall
|
19.2%
5/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
25.0%
2/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Injury, poisoning and procedural complications
Facial bones fracture
|
0.00%
0/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Injury, poisoning and procedural complications
Upper limb fracture
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Altered state of consciousness
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Dementia Alzheimer's type
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Dizziness
|
19.2%
5/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Dizziness postural
|
7.7%
2/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Dysarthria
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Headache
|
7.7%
2/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Seizure
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Nervous system disorders
Syncope
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Psychiatric disorders
Anxiety
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Psychiatric disorders
Insomnia
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Psychiatric disorders
Restlessness
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Psychiatric disorders
Somnolence
|
11.5%
3/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Renal and urinary disorders
Incontinence
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Renal and urinary disorders
Urinary incontinence
|
0.00%
0/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Respiratory, thoracic and mediastinal disorders
Rhinitis allergic
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Respiratory, thoracic and mediastinal disorders
Tachypnoea
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Vascular disorders
Hypotension
|
19.2%
5/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
12.5%
1/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Vascular disorders
Orthostatic hypotension
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Vascular disorders
Syncope
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
|
Psychiatric disorders
Depression
|
3.8%
1/26 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
0.00%
0/8 • Adverse event data were collected from signed consent through the participant duration in the study. The specific time period is from consent through the end of the 12 week double-blind trial.
|
Additional Information
Clinical Operations
Alzheimer's Disease Cooperative Study (ADCS)
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place