- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05004987
Aβ Dynamics in LLMD
October 31, 2023 updated by: NYU Langone Health
Depression Treatment and Aβ Dynamics: A Study of Alzheimer's Disease Risk (ABD Study)
This study will examine the biological factors that may modulate the relationship between depression and the development of Alzheimer's disease (AD).
Since the direction of causation between depression and the biological factors associated with AD is unknown, the only way to understand cause and associated risk is to treat the depressive symptoms and examine the effects on AD biomarkers.
The study involves an FDA-approved treatment for major depressive disorder.
It will compare the SSRI antidepressant escitalopram with placebo.
The hypothesis is that a reduction in depressive symptoms will be associated with a normalization of CSF AD biomarkers as well as peripheral inflammatory markers.
This research would contribute to fundamental knowledge about potentially modifiable risks of Alzheimer's disease (AD).
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
90
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Antero Sarreal, MD
- Phone Number: 845-398-6532
- Email: Antero.sarreal@nki.rfmh.org
Study Contact Backup
- Name: Chelsea Reichert Plaska, PhD
- Phone Number: 845-398-5583
- Email: Chelsea.reichert@nki.rfmh.org
Study Locations
-
-
New York
-
New York, New York, United States, 10016
- Recruiting
- NYU Langone Health
-
Principal Investigator:
- Nunzio Pomara, MD
-
Orangeburg, New York, United States, 10962
- Recruiting
- Nathan S. Kline Institute for Psychiatric Research
-
Contact:
- Antero Sarreal, MD
- Phone Number: 845-398-6532
- Email: Antero.sarreal@nki.rfmh.org
-
Principal Investigator:
- Nunzio Pomara, MD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
60 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Male and female subjects, age 60+ years inclusive, at the time of signing the informed consent.
- Meeting Structured Clinical Interview (SCID-5-RV) for DSM-5 criteria for Major depressive disorder.
- Montgomery-Åsberg Depression Rating Scale (MADRS) ≥18.
- Have results of a physical examination, neurological examination, vitals, and EKG within normal limits at screening.
- Cognitively unimpaired at screening visit as defined by Mini-Mental State Examination (MMSE) >27.
- Clinical Dementia Rating Scale (CDR) Global of 0.
- A score of 85 or greater on the RBANS delayed memory index score.
- Fluent in English, because some of the instruments used in this study have not been translated and validated in other languages, and are able to read at a 6th grade level or equivalent, as determined by the PI.
- Medically stable with no significant cerebrovascular, neurological, or systemic disease expected to interfere with the study.
- Adequate auditory acuity and normal-to-corrected vision.
- Willing to undergo brain MRI, urine drug screen and blood sampling for routine laboratory testing, lumbar puncture, APOE genotyping and plasma drug levels.
- Only individuals with normal hepatic and renal function including normal creatinine clearance will be included.
Exclusion Criteria:
- History of brain tumor, MRI evidence of brain damage or brain disease including significant trauma, hydrocephalus, seizures, or confluent (or more extensive) white matter hyperintensities.
- Mental retardation, or other serious neurological disorder (e.g. Parkinson's disease or other movement disorders).
- Subjects with a Fazekas scale >2.
- Significant history of alcoholism or drug abuse in the past 2 years. Fulfilling SCID-5-RV/DSM-5 criteria for current or past diagnosis of any psychiatric disorder (e.g., schizophrenia, bipolar disorder, or any psychotic disorder) other than recurrent MDD or anxiety disorders (e.g., panic disorder, agoraphobia, etc.).
- A current significant risk for suicidality based on the Columbia-Suicide-Severity Rating Scale (C-SSRS).
- Insulin dependent diabetes.
- Evidence of clinically relevant or unstable cardiac, pulmonary, endocrine or hematological conditions.
- Any prosthetic devices (e.g., pacemaker or surgical clips) that constitutes a hazard for MRI imaging.
- Positive urine drug screen for illicit drugs.
- History of poor tolerance to, poor response to, or ongoing treatment with escitalopram.
- If taking antidepressants, currently taking fluoxetine, due to the length of time required to washout.
Treatment with following medications will not be permitted. In some cases, medications will be allowed if medically prescribed and dose regimen stable. Note: Some medications (e.g., amphetamines, opiates) may appear on the routine urine drug test in the screening period but can be allowed as per protocol.
- For subjects taking prescribed psychoactive medications and supplements (i.e., opioids, amphetamines, amphetamine-like substances, and cannabinoids), must be on a stable dose for 1 month prior to randomization.
- Anti-Parkinsonian medications (carbidopa/levodopa, amantadine, bromocriptine, pergolide, selegiline).
- Cholinesterase inhibitors and memantine
- Continuous aspirin (any dosage) use which can affect platelet function is prohibited. Exception: If participant is on low dose aspirin for prophylaxis and is willing to temporarily discontinue prior to research blood draw (i.e., 2 days before).
- Continuous use of other medications which are also known to affect platelet function, including nonsteroidal anti-inflammatory drugs (NSAIDs), anti-histamines. Exception: If participant is taking medication continuously and is willing to temporarily discontinue prior to research blood draw (i.e., 2 days before)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo (PBO)
|
Daily dose of placebo will mimic that of ESC.
Other Names:
|
Active Comparator: Escitalopram (ESC)
|
The daily dose of ESC/PBO will be 10 mg for the first 2 weeks, then increase to 20 mg as tolerated, with an option to reduce back to 10 mg if necessary.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Cerebrospinal Fluid (CSF) Aβ40 Biomarker Levels
Time Frame: Baseline, Week 8
|
Baseline, Week 8
|
|
Change in Cerebrospinal Fluid (CSF) Aβ42 Biomarker Levels
Time Frame: Baseline, Week 8
|
Baseline, Week 8
|
|
Change in Vascular Dysfunction (VD) Biomarker Levels
Time Frame: Baseline, Week 8
|
Baseline, Week 8
|
|
Change in Scores on Montgomery-Asberg Depression Ration Scale (MADRS)
Time Frame: Baseline, Week 8
|
MADRS consists of 10 items evaluating core symptoms of depression (e.g, apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thought, and suicidal thoughts).
Each symptom is rated on a 0-6 scale (0=no abnormality, 6=severe).
The total score ranges from 0 to 60; the higher the score, the more severe the symptoms.
|
Baseline, Week 8
|
Other Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change in Plasma Aβ Biomarker Levels
Time Frame: Baseline, Week 8
|
Baseline, Week 8
|
Change in Cerebrospinal Fluid (CSF) P-tau Biomarker Levels
Time Frame: Baseline, Week 8
|
Baseline, Week 8
|
Change in Cerebrospinal Fluid (CSF) T-tau Biomarker Levels
Time Frame: Baseline, Week 8
|
Baseline, Week 8
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Nunzio Pomara, MD, NYU Langone Health
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 4, 2022
Primary Completion (Estimated)
April 1, 2026
Study Completion (Estimated)
June 1, 2026
Study Registration Dates
First Submitted
August 12, 2021
First Submitted That Met QC Criteria
August 12, 2021
First Posted (Actual)
August 13, 2021
Study Record Updates
Last Update Posted (Actual)
November 1, 2023
Last Update Submitted That Met QC Criteria
October 31, 2023
Last Verified
October 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Mood Disorders
- Neurocognitive Disorders
- Neurodegenerative Diseases
- Dementia
- Tauopathies
- Depressive Disorder
- Alzheimer Disease
- Depressive Disorder, Major
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Parasympatholytics
- Autonomic Agents
- Peripheral Nervous System Agents
- Muscarinic Antagonists
- Cholinergic Antagonists
- Cholinergic Agents
- Psychotropic Drugs
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Serotonin Agents
- Antidepressive Agents
- Antidepressive Agents, Second-Generation
- Antiparkinson Agents
- Anti-Dyskinesia Agents
- Selective Serotonin Reuptake Inhibitors
- Citalopram
- Dexetimide
- Escitalopram
Other Study ID Numbers
- 21-00535
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices) will be shared upon reasonable request.
IPD Sharing Time Frame
Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.
IPD Sharing Access Criteria
The investigator who proposed to use the data will have access to the data upon reasonable request.
Requests should be directed to nunzio.pomara@nki.rfmh.org.
To gain access, data requestors will need to sign a data access agreement.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
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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