Multiple Sclerosis Clinical Trial
Official title:
Ginkgo Biloba for Cognitive Impairment in Multiple Sclerosis
The purpose of this study is to see if treatment with Ginkgo improves cognitive function in people with multiple sclerosis who have cognitive problems.
Objectives:
Primary objective: Determine the difference between subjects treated with Ginkgo biloba (GB)
and subjects treated with placebo for 12 weeks on the performance of a battery of
neuropsychological tests that are frequently impaired in Multiple Sclerosis (MS): the Stroop
test, the Paced Auditory Serial Addition Test (PASAT), the California Verbal Learning Test
(CVLT-II), and the Controlled Oral Word Association Test (COWAT). Secondary objectives:
Determine the difference between the two groups after treatment in the following outcomes:
1) incidence of treatment related side effects, 2) cognitive performance as reported by the
subjects on the Perceived Deficits Questionnaire, 3) cognitive performance as reported by
the subject's family members or caregivers as measured on the Multiple Sclerosis
Neuropsychological Screening Questionnaire and 4) community integration as measured with the
Community Integration Questionnaire.
Research plan:
This will be a randomized double blind placebo controlled trial of GB 120 mg twice a day for
12 weeks.
Methods:
One hundred fifty-eight subjects (79 per group) will be randomly assigned to placebo or GB.
Subjects will be evaluated at baseline and exit with the cognitive test battery and the self
report measures detailed above.
For the primary outcome, multivariate analysis of covariance (MANCOVA) will be used to
analyze the changes in all the cognitive tests simultaneously. This analysis will be
followed by the analysis of covariance (ANCOVA) for each of the cognitive tests in the
battery. The sample size we selected has a power of 0.80 with an alpha level of 0.05 on the
overall MANCOVA and for each of the ANCOVA's after Bonferroni's correction.
The self report measures will be analyzed using ANCOVA with baseline responses as
covariates.
Safety evaluations will include complete blood count and metabolic panel as well as physical
exams at baseline and at exit. The physical exam will include the Expanded Disability Scale
(EDSS). Telephone follow-ups will be done monthly while on treatment and one month after
exiting the study to review study procedures and assess side effects. Adverse reactions will
be classified using the categories and grading in the Cancer Therapy Evaluation Program
(CTEP) Common Toxicity Criteria (CTC) Version 3.0 and reported to the Institutional Review
Board (IRB) following the institutions guidelines. A Data Safety Management Board (DSMB)
will oversee the study.
;
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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