- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00742417
Efficacy and Safety of Plasma Exchange With 5% Albumin in Beta-amyloid Peptide Clearance in Cerebral Spinal Fluid
Phase II Study to Evaluate the Efficacy and Safety of Plasma Exchange With 5% Albumin in Beta-amyloid Peptide Clearance in Cerebral Spinal Fluid, and Its Effects in Patients With Mild-moderate Alzheimer's Disease.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
A phase II study was conducted primarily to determine whether plasma exchange with 5% human albumin is able to modify the concentration of beta-amyloid peptide in cerebrospinal fluid (CSF) in patients with AD.
- There was two weeks for screening and randomization of both groups (treatment and control).
- The subjects were randomized in a 1:1 proportion.
After screening and randomization, treatment proceeded as follows:
- three weeks of intensive treatment with two plasma exchanges per week
- followed by a month and a half of maintenance treatment with one weekly plasma exchange, and
- finally, three months of treatment with one plasma exchange every two weeks.
The control group followed the same program, except for the plasma exchanges. After the treatment period ended, subjects followed-up for a 6-month period of time.
The trial comprises a global multicenter (Spain and US), blind, randomized, controlled design. The trials key coordination is based in Spain where Dr. Boada (see Study Officials/Investigators) is the main study official.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Madrid, Spain, 28007
- Hospital General Universitario Gregorio Maranon
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Catalunya
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Barcelona, Catalunya, Spain, 08028
- Fundacio ACE
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District of Columbia
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Washington, District of Columbia, United States, 20059
- Howard University
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New Jersey
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Manchester Township, New Jersey, United States, 08759
- Mid-Atlantic Geriatric/ARC
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- A diagnosis of AD ( National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association [NINCDS-ADRDA] criterion), and Mini-mental Status Examination (MMSE) score between ≥18 and ≤26.
- Current stable treatment with acetylcholine esterase inhibitors (AChEIs) for the previous three months.
- A stable care taker must be available, and must attend the patient study visits.
- The patient and a close relative or legal representative must read the patient information sheet, agree to participation in the trial, and then sign the informed consent document (the patient personally and the close relative/legal representative).
- The patient must be able to follow the study protocol, receive the treatment in the established time period, and continue during the follow-up interval.
- A brain Computed Axial Tomography (CAT) or Magnetic Resonance Imaging (MRI) study, obtained in the 12 months prior to recruitment, showing the absence of cerebrovascular disease, must be available.
Exclusion Criteria:
- Any contraindication for plasma exchange due to behavioral disorders or abnormal coagulation parameters
- A history of frequent adverse reactions (serious or otherwise) to blood products.
- Hypersensitivity to albumin or allergies to any of the components of Albutein 5% Human Albumin.
- Plasma creatinine > 2 mg/dL.
- Uncontrolled high blood pressure.
- Liver cirrhosis or any liver problem with alanine aminotransferase (GPT) > 2.5 x upper limit of normal (ULN), or bilirubin > 2 mg/dL.
- Heart diseases, including antecedents of coronary disease and heart failure.
- Difficult venous access precluding plasma exchange.
- Participation in other clinical trials, or the reception of any other investigational drug in the three months prior to the start of the study.
- Any condition complicating adherence to the study protocol (illness with less than one year of expected survival, toxic habits, etc.).
- Pregnant or nursing women or women not using effective contraceptive methods for at least one month after plasma exchange.
- Fewer than six years of education.
- Prior behavioral disorders requiring pharmacological treatment, including insomnia.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Sham Comparator: Control
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Control group followed the same schedule; however, they did not undergo plasma replacement (it was subjected to simulated plasma replacements)
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Experimental: Albutein 5%
Patients allocated to this arm underwent plasma exchange with Albutein 5%.
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18 Plasma Exchanges using Albutein 5%:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change From Baseline in Aβ1-42 Cerebrospinal Fluid (CSF) Levels.
Time Frame: Baseline and up to week 44
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Change in levels of Aβ1-42 in CSF in the period between baseline lumbar puncture (before the start of treatment) and lumbar puncture immediately after the end of the last plasma exchange (whenever this may be).
Separate assays of Aβ1-42 were performed with Innotest and The Genetics Company commercial kits.
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Baseline and up to week 44
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
P-Tau and Tau CSF Levels Throughout the Study.
Time Frame: Baseline, week 02, week 08, week 20, week 33 and week 44
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Levels of Tau and P-tau in CSF throughout the treatment phase and the follow-up phase (week 44).
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Baseline, week 02, week 08, week 20, week 33 and week 44
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Aβ1-40 Plasma Levels Before and After Each Study Period (The Genetics Company).
Time Frame: Baseline, pre-plasma exchange 1 (PRE-PE1), post-plasma exchange 6 (POST-PE6), pre-plasma exchange 7 (PRE-PE7), post-plasma exchange 12 (POST-PE12), pre-plasma exchange 13 (PRE-PE13), post-plasma exchange 18 (POST-PE18), week 33 and week 44.
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Plasma levels of Aβ1-40 before and after the Intensive period, Maintenance period I, Maintenance period II and the Follow-up phase (using The Genetics Company commercial kits).
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Baseline, pre-plasma exchange 1 (PRE-PE1), post-plasma exchange 6 (POST-PE6), pre-plasma exchange 7 (PRE-PE7), post-plasma exchange 12 (POST-PE12), pre-plasma exchange 13 (PRE-PE13), post-plasma exchange 18 (POST-PE18), week 33 and week 44.
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Aβ1-42 Plasma Levels Before and After Each Study Period (The Genetics Company).
Time Frame: Baseline, pre-plasma exchange 1 (PRE-PE1), post-plasma exchange 6 (POST-PE6), pre-plasma exchange 7 (PRE-PE7), post-plasma exchange 12 (POST-PE12), pre-plasma exchange 13 (PRE-PE13), post-plasma exchange 18 (POST-PE18), week 33 and week 44
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Plasma levels of Aβ1-42 before and after the Intensive period, Maintenance period I, Maintenance period II and the Follow-up phase (using The Genetics Company commercial kits).
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Baseline, pre-plasma exchange 1 (PRE-PE1), post-plasma exchange 6 (POST-PE6), pre-plasma exchange 7 (PRE-PE7), post-plasma exchange 12 (POST-PE12), pre-plasma exchange 13 (PRE-PE13), post-plasma exchange 18 (POST-PE18), week 33 and week 44
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Aβ1-42 Plasma Levels Before and After Each Study Period (Innotest).
Time Frame: Baseline, pre-plasma exchange 1 (PRE-PE1), post-plasma exchange 6 (POST-PE6), pre-plasma exchange 7 (PRE-PE7), post-plasma exchange 12 (POST-PE12), pre-plasma exchange 13 (PRE-PE13), post-plasma exchange 18 (POST-PE18), week 33 and week 44.
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Plasma levels of Aβ1-42 before and after the Intensive period, Maintenance period I, Maintenance period II and the Follow-up phase (using Innotest commercial kits).
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Baseline, pre-plasma exchange 1 (PRE-PE1), post-plasma exchange 6 (POST-PE6), pre-plasma exchange 7 (PRE-PE7), post-plasma exchange 12 (POST-PE12), pre-plasma exchange 13 (PRE-PE13), post-plasma exchange 18 (POST-PE18), week 33 and week 44.
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Change From Baseline to Week 44 in Cognitive, Functional and Neuropsychiatric Scores (MMSE, ADAS-Cog, NPS Battery and CSDD)
Time Frame: Change from baseline at week 44
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Change in the cognitive, functional and neuropsychiatric scores and overall development.
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Change from baseline at week 44
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Change From Baseline to Week 44 in Cognitive, Functional and Neuropsychiatric Scores (ADCS-ADL, NPI, CDR-Sb and ADCS-CGIC).
Time Frame: Change from baseline at week 44
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Change in the cognitive, functional and neuropsychiatric scores and overall development.
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Change from baseline at week 44
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Magnetic Resonance Imaging (MRI) Structural Changes Variations Versus Baseline.
Time Frame: Week 00 (baseline), week 20 and week 44
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Structural changes in volume of the hippocampus, posterior cingular area, and other associated areas by Magnetic Resonance Imaging (MRI).
Three measurements were made (week -2 or -1, 20 and 44).
It was measured the variations versus the baseline.
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Week 00 (baseline), week 20 and week 44
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Variations in Hypoperfusion Based on Single Photon Emission Computed Tomography (SPECT)
Time Frame: End of study
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Percentage of patients with improved perfusion at the end of the study compared to their initial perfusion.
Frontal, parietal and temporal lobes were evaluated from the quantified NeuroGam images.
This rendered parametric images showed brain alterations with more than 2 standard deviations with respect to a normal data base.
Initial parametric images were compared to the final ones and it was considered perfusion improvement those patients that showed less stretch and/or defect intensity.
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End of study
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Merce Boada, MD, Fundacio ACE
- Study Director: Laura Núñez, Grifols Biologicals, LLC
- Study Chair: Antonio Paez, Grifols Biologicals, LLC
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IG0602
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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