Alzheimer Disease Clinical Trial
Official title:
A Randomized, Double-Blind, Clinical Trial to Compare the Safety and Efficacy of Cerebrolysin and Aricept (Donepezil) and a Combination Therapy in Patients With Probable Alzheimer's Disease (AD)
The study was performed to compare the safety and efficacy of Cerebrolysin (10 mililiters
[ml]), Aricept (10 miligrams [mg]), and a combination of both treatments on cognitive
performance and global function in patients with probable Alzheimer's Disease (AD). It
should also be assessed if the treatments have a positive effect on activities of daily
living and neuropsychiatric symptoms.
Oral treatment with Aricept or Placebo was given once daily throughout the study.
Intravenous treatment with Cerebrolysin or Placebo was given once daily for 5 days per week
during week 1 to 4 and during week 13 to 16 of the study. During the study patients had six
visits at the hospital for evaluation.
Endogenous neurotrophic factors, also called neurotrophins, are signaling molecules in
various cellular pathways and allow proper neuronal function, survival and regeneration.
Sufficient supply is therefore regarded as a pre-requisite for neuronal maintenance but
sudden or chronic pathological changes result in an imbalance of this regulatory system.
Cerebrolysin is a peptide preparation acting in a similar way like endogenous neurotrophic
factors. Due to its pleiotropic effects - neuroprotection, neuronal survival,
neuroplasticity and neurogenesis -, Cerebrolysin is regarded as potential therapeutic tool
in complex diseases like stroke or dementia. In contrast to naturally occurring neurotrophic
factors, neuropeptides of Cerebrolysin enter the brain parenchyma by crossing the
blood-brain barrier after peripheral (intravenous [IV]) administration.
Another treatment approach for Alzheimer's disease targets the cholinergic system to
increase cortical acetylcholine. One of these drugs is the anticholinesterase donepezil
(Aricept). However, anticholinesterases seem to provide only symptomatic benefit for a
limited period and not to influence the progression of the disease. In view of the different
mechanisms of action and clinical profile of Cerebrolysin and Aricept, a combination therapy
of both may provide synergistic treatment effects. The combination of a treatment targeting
the neurotrophic axis (Cerebrolysin) with a treatment to improve cholinergic
neurotransmission (Aricept) can arguably be expected to provide additional benefits to AD
patients.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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