Alzheimer's Disease Clinical Trial
Official title:
A Single Center, Multi-site, Randomized, Double-blind, Placebo-controlled Trial of Resveratrol With Glucose and Malate (RGM) to Slow the Progression of Alzheimer's Disease
Alzheimer's disease (AD), one of the leading causes of morbidity and mortality in the
elderly is characterized by progressive cognitive decline and certain neuropathological
features.
Currently, there is great interest in the well-documented mitochondrial (oxidative) lesion
in AD. Disturbed oxidative metabolism is a well described abnormality in AD. Several
observational studies have shown that moderate consumption of wine is associated with a
lower incidence of Alzheimer's disease (Truelsen et al., 2002; Luchsinger et al., 2004).
Wine is enriched in antioxidant compounds with potential neuroprotective activities. In the
early 1990s the presence of Resveratrol in red wine was detected where it is suspected to
afford antioxidant and neuroprotective properties (Miller and Rice-Evans, 1995).
Blass and Gordon (2004) have demonstrated positive effects in AD with an oral preparation of
glucose, malate and resveratrol. Glucose is the physiological precursor of the substrates of
oxidative metabolism in the brain, malate is a primer of the energy-providing Krebs-cycle.
Glucose and malate therefore can provide reducing equivalents (electrons) to regenerate the
reduced form of resveratrol, and do so under the normal regulation of brain cell metabolism.
All three ingredients are classified by the FDA as Generally Recognized As Safe.
Subjects will be assessed by their capacity to consent by a psychiatrist independent of this
study. Subjects who are determined to have capacity will sign consent. For subjects
determined to lack capacity consent will be obtained from their surrogate. Subjects lacking
in capacity must nonetheless provide verbal assent to participation in this study. After
informed consent is obtained, subjects will be screened for eligibility to participate in
the study. Screening comprises of medical history, physical exam, neurological exam, and a
MMSE.
All of the above are performed for research purposes. Further evaluation of medical problems
that are identified in the course of screening will be obtained as part of standard clinical
care. For example, if an abnormality requiring further evaluation is detected on blood tests
the subsequent evaluation will be conducted as standard clinical care.
Subjects who meet eligibility criteria will be baseline within 4 weeks. Eligible subjects
will not be asked to stop any medication they may currently be on before the study begins.
Eligible subjects will be randomized to receive either a mixture of glucose, malate and
resveratrol (RGM) or placebo. At baseline, medical history, physical exam, cognitive tests
are obtained. An ECG and a panel consisting CBC, electrolytes, liver and renal function
tests will be drawn at the screening visit. Clinical information is obtained from the
identified caregiver. The study drug (RGM or placebo, depending on which group the subject
is randomly assigned to) is dispensed at baseline. Follow up visits at months 3, 6, 9, and
12 months require physical exam and some cognitive measures. At Month 12 a neurological exam
will be performed. Adverse events are collected at each visit. Medication compliance is
assessed at months 3, 6, 9, and 12 months and unused study drug is retrieved. At Month 12
unused study drug is retrieved and no more study drug is dispensed. Clinical information is
obtained from the caregiver at each visit. At the Month 12 visit, a questionnaire will be
completed by the study staff, subject and study partner to assess the adequacy of medication
blinding. As noted all of the above tests and procedures are part of the research protocol.
At study termination the subject will be referred to ongoing clinical care as appropriate.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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