Alzheimer Disease Clinical Trial
Official title:
A Double-blind, Randomized Pilot Study to Evaluate the Effects of Galantamine and Donepezil on Sleep and Attention and Gastrointestinal (GI) Tolerance in Patients With Mild to Moderate Alzheimer's Disease (AD)
The purpose of this study is to evaluate the relative effects of galantamine compared to donepezil (both cholinesteraste inhibitors), on sleep, attention, and gastrointestinal tolerance in patients with Alzheimer's disease.
This is designed as a pilot (preliminary) study to evaluate the differences in effects on
attention, sleep problems and gastrointestinal tolerance associated with Alzheimer's Disease
with two different drugs at two different doses. Patients must have mild to moderate
Alzheimer's Disease based on the National Institute of Neurological and Communicative
Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA)
criteria and a Mini-Mental State Examination (MMSE) score of 10 to 24. The trial will
consist of a 2-week run-in phase, an 8-week assessment phase, and an extension phase of
variable length (6 weeks to 54 weeks). During the study, patients will be randomized
(assigned by chance) to receive either galantamine or donepezil. Galantamine will be given
by mouth 4mg twice daily for Weeks 1-4 and then 8mg twice daily for Weeks 5-8 and beyond
(for participants in the extension). The patients on donezepil will receive 5mg by mouth at
bedtime for Weeks 1-4 and then 10mg at bedtime for Weeks 5-8 and beyond. Placebo tablets
will be given so that each patient takes two capsules per dose in order to conceal the
identity of the drugs. Neither the patient nor the physician will know which drug the
patient is receiving. Drug effectiveness will be measured by change in overall functioning
of the patient shown by the Clinician's Interview-Based Impression of Change Plus Family
Input (CIBIC-Plus). Other tests to evaluate whether the drug is effective will include the
change in results of attention tests (Simple Reaction Time [SRT], Choice Reaction Time
[CRT], Verbal Series Attention Test [VSAT], and Stroop Test), and in sleep pattern tests
(tests that measure movements during sleep [Actiwatch] and patterns of sleep such as the
caregiver-completed Pittsburgh Sleep Quality Index [PSQI] and the Circadian Sleep Inventory
for Normal and Pathological States [CSINAPS]). Measures of quality of life will include the
Alzheimer's Disease Related Quality of Life Scale (ADRQL) and the caregiver-completed
Allocation of Caregiver Time Survey (ACTS) and SF-12 Quality of Life Survey. Safety
assessment and gastrointestinal tolerability will be based on recording the number and
severity of unexpected and undesirable events as well as physical examination and vital
signs. The exploratory study hypotheses are that galantamine will be superior to donezepil
in improving attention, sleep patterns, and quality of life in patients with
mild-to-moderate Alzheimer's disease and that it will be well tolerated by patients.
Patients will receive either galantamine 4mg twice daily by mouth or donepezil 5mg at
bedtime . Then, either galantamine 8mg twice daily by mouth or donezepil 10 mg at bedtime by
mouth (with placebo dose); the doses are continued into the double-blind extension phase (6
to 54 weeks).
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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