Palmitoylethanolamide/Luteolin Supplementation in Older Adults Undergoing Cardiac Surgery
26. Juni 2026 aktualisiert von: Fondazione IRCCS San Gerardo dei Tintori
Palmitoylethanolamide/Luteolin for the Maintenance of Cognitive Performance in Older Adults Undergoing Cardiac Surgery
Postoperative Cognitive Dysfunction (POCD) is a common complication after surgery, particularly among older adults. It is characterized by cognitive impairment, reduced functional independence, and decreased quality of life. Growing evidence suggests that neuroinflammation plays a relevant role in POCD development and persistence.
Palmitoylethanolamide (PEA) is an endogenous lipid mediator involved in the regulation of neuroinflammatory processes through the modulation of non-neuronal cells, while luteolin is a flavonoid with well-known antioxidant properties. Under conditions of prolonged neuroinflammation, endogenous PEA levels may be insufficient to adequately counteract pro-inflammatory signaling, making exogenous administration necessary.
In this context, exogenous micronized and ultramicronized PEA (mPEA and umPEA) supplementation has been shown to modulate cognitive and executive functions, working memory, language, and activities of daily living. Moreover, the combination of umPEA and luteolin (PEALut) may produce synergistic effects by modulating neuroinflammation and supporting neuronal function.
This study aims to evaluate whether postoperative administration of co-ultramicronized PEA and luteolin (700 mg + 70 mg in 10 mL), added to standard of care, may contribute to the mitigation of POCD in older adults undergoing elective cardiac surgery, compared to standard care alone.
Studienübersicht
Status
Noch keine Rekrutierung
Bedingungen
Studientyp
Interventionell
Einschreibung (Geschätzt)
100
Phase
- Unzutreffend
Kontakte und Standorte
Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.
Studienkontakt
- Name: Giuseppe Bellelli
- Telefonnummer: +39 039 233 3472
- E-Mail: giuseppe.bellelli@unimib.it
Studienorte
-
-
-
Monza, Italien
- Fondazione IRCCS San Gerardo dei Tintori
-
Kontakt:
- Clinical Office
- E-Mail: ricerca.clinica@irccs-sangerardo.it
-
-
Teilnahmekriterien
Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.
Zulassungskriterien
Studienberechtigtes Alter
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Nein
Beschreibung
Inclusion Criteria:
- Age ≥ 65 years
- Both genders
- Undergoing elective aortic or mitral valve replacement/reconstruction with or without coronary artery bypass grafting (CABG), at the Cardiac Surgery Unit of IRCCS San Gerardo dei Tintori Foundation (Monza, Italy)
- Prognosis quoad vitam ≥ 3 months
- Availability of a formal or informal caregiver who can assist the participant in taking the prescribed dose and following the visit schedule
- Any concomitant therapy should be stable
- Written informed consent obtained prior to randomization (from the participant or caregiver if the participant is unable to sign but clearly expresses the will to participate)
Exclusion Criteria:
- Severe dementia diagnosis
- Preoperative clinical diagnosis of delirium
- Other treatments/medications that may improve cognition
- Current treatment with m/umPEA or PEALut (Glialia®), or its use within 90 days prior to enrollment
- Contraindications to the use of PEALut, including allergy to excipients contained in the supplement and previous adverse reactions to PEALut
- Other clinical conditions or situations that could interfere with the study or prevent optimal participation, as judged by the researchers
Studienplan
Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Unterstützende Pflege
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: PEALut® + Standard of Care
Participants receive co-ultramicronized Palmitoylethanolamide + Luteolin (700 mg + 70 mg in 10 ml) in addition to Standard of Care
|
Pflegestandard
Oral suspension, 10 ml twice daily (every 12 hours), starting within 24 hours post-surgery and for 3 months, in add-on to the Standard of Care
Andere Namen:
|
|
Aktiver Komparator: Standard of Care
Participants receive only the Standard of Care
|
Pflegestandard
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Change in cognitive performance
Zeitfenster: Baseline, hospital discharge (approximately postoperative day 7-10, depending on clinical course), 3 months after treatment, and 3 months after the end of treatment
|
Cognitive performance will be assessed using the Montreal Cognitive Assessment (MoCA), a 30-item screening tool that evaluates multiple cognitive domains, including memory, visuospatial ability, executive function, attention, language, and orientation.
Scores range from 0 to 30, with higher scores indicating better cognitive performance.
|
Baseline, hospital discharge (approximately postoperative day 7-10, depending on clinical course), 3 months after treatment, and 3 months after the end of treatment
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Incidence of Postoperative Cognitive Dysfunction (POCD)
Zeitfenster: Hospital discharge (approximately postoperative day 7-10, depending on clinical course), and 3 months after treatment
|
Incidence of POCD will be defined as a decrease of at least 1 standard deviation from baseline MoCA score.
|
Hospital discharge (approximately postoperative day 7-10, depending on clinical course), and 3 months after treatment
|
|
Incidence, subtype and duration of postoperative delirium (POD)
Zeitfenster: Daily, from 24 hours after the intervention until hospital discharge (approximately postoperative day 7-10, depending on clinical course)
|
Postoperative delirium will be assessed using the 4AT screening tool.
A score of ≥4 suggests possible delirium (with or without cognitive impairment), with higher scores indicating greater severity of cognitive disturbance.
Positive screenings will be confirmed using DSM-5 criteria.
Delirium subtype will be classified using the Delirium Motor Subtyping Scale-4 (DMSS-4), and duration will be recorded in days from onset to resolution.
|
Daily, from 24 hours after the intervention until hospital discharge (approximately postoperative day 7-10, depending on clinical course)
|
|
Change in Activities of Daily Living (ADL)
Zeitfenster: Baseline, 3 months after treatment, and 3 months after the end of treatment
|
Activities of daily living will be assessed using the six-item Katz Activities of Daily Living (ADL) Index.
Scores range from 0 to 6, with higher values indicating greater function.
|
Baseline, 3 months after treatment, and 3 months after the end of treatment
|
|
Change in Instrumental Activities of Daily Living (IADL)
Zeitfenster: Baseline, 3 months after treatment, and 3 months after the end of treatment
|
Functional status will be assessed using the Instrumental Activities of Daily Living (IADL) scale.
Scores range from 0 to 8, with higher scores indicating better functional ability.
|
Baseline, 3 months after treatment, and 3 months after the end of treatment
|
|
Change in Short Physical Performance Battery (SPPB)
Zeitfenster: Baseline, 3 months after treatment, and 3 months after the end of treatment
|
Physical performance will be assessed using the Short Physical Performance Battery (SPPB), which evaluates balance, gait speed, and chair stand performance.
Scores range from 0 to 12, with higher scores indicating better physical performance.
|
Baseline, 3 months after treatment, and 3 months after the end of treatment
|
|
Change in Handgrip Strength
Zeitfenster: Baseline, 3 months after treatment, and 3 months after the end of treatment
|
Muscle strength will be assessed using a handgrip dynamometer.
Handgrip strength will be recorded in kilograms (kg), with higher values indicating greater muscle strength.
|
Baseline, 3 months after treatment, and 3 months after the end of treatment
|
|
Rehospitalization
Zeitfenster: From 24 hours after the intervention to 6 months after randomization
|
Incidence of rehospitalization
|
From 24 hours after the intervention to 6 months after randomization
|
|
Mortality
Zeitfenster: From 24 hours after the intervention to 6 months after randomization
|
Incidence of mortality
|
From 24 hours after the intervention to 6 months after randomization
|
|
Incidence of Treatment-Related Adverse Events
Zeitfenster: From first treatment administration up to 3 months after the end of treatment
|
Safety and Adherence assessment will be assessed by monitoring the incidence and severity of adverse events occurring during the study period.
|
From first treatment administration up to 3 months after the end of treatment
|
|
Plasma p-tau217 levels
Zeitfenster: Baseline
|
Plasma levels of phosphorylated tau (p-tau217) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline
|
|
Plasma Aβ42 levels
Zeitfenster: Baseline
|
Plasma levels of Amyloid beta 42 (Aβ42) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline
|
|
Change in plasma IL-6 levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Interleukin-6 (IL-6) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma s-RAGE levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of soluble Receptor for Advanced Glycation End-products (s-RAGE) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma GDF-15 levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Growth Differentiation Factor-15 (GDF-15) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma GFAP levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Glial Fibrillary Acidic Protein (GFAP) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma NSE levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Neuron-Specific Enolase (NSE) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma NfL levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Neurofilament Light Chain (NfL) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma FGF-1 levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Fibroblast Growth Factor-1 (FGF-1) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
|
Change in plasma BDNF levels
Zeitfenster: Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Plasma levels of Brain-Derived Neurotrophic Factor (BDNF) will be measured in blood samples using standard clinical laboratory assays.
|
Baseline, Immediately after surgery (within 24 hours, before PEALut administration), and 3 months after treatment
|
Mitarbeiter und Ermittler
Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.
Ermittler
- Hauptermittler: Giuseppe Bellelli, School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
Publikationen und hilfreiche Links
Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.
Allgemeine Veröffentlichungen
- Clayton P, Hill M, Bogoda N, Subah S, Venkatesh R. Palmitoylethanolamide: A Natural Compound for Health Management. Int J Mol Sci. 2021 May 18;22(10):5305. doi: 10.3390/ijms22105305.
- Suraarunsumrit P, Srinonprasert V, Kongmalai T, Suratewat S, Chaikledkaew U, Rattanasiri S, McKay G, Attia J, Thakkinstian A. Outcomes associated with postoperative cognitive dysfunction: a systematic review and meta-analysis. Age Ageing. 2024 Jul 2;53(7):afae160. doi: 10.1093/ageing/afae160.
- Moller JT, Cluitmans P, Rasmussen LS, Houx P, Rasmussen H, Canet J, Rabbitt P, Jolles J, Larsen K, Hanning CD, Langeron O, Johnson T, Lauven PM, Kristensen PA, Biedler A, van Beem H, Fraidakis O, Silverstein JH, Beneken JE, Gravenstein JS. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998 Mar 21;351(9106):857-61. doi: 10.1016/s0140-6736(97)07382-0.
- Savageau JA, Stanton BA, Jenkins CD, Frater RW. Neuropsychological dysfunction following elective cardiac operation. II. A six-month reassessment. J Thorac Cardiovasc Surg. 1982 Oct;84(4):595-600.
- Zhang L, Qiu Y, Zhang ZF, Zhao YF, Ding YM. Current perspectives on postoperative cognitive dysfunction in geriatric patients: insights from clinical practice. Front Med (Lausanne). 2024 Sep 27;11:1466681. doi: 10.3389/fmed.2024.1466681. eCollection 2024.
- Nobili S, Micheli L, Lucarini E, Toti A, Ghelardini C, Di Cesare Mannelli L. Ultramicronized N-palmitoylethanolamine associated with analgesics: Effects against persistent pain. Pharmacol Ther. 2024 Jun;258:108649. doi: 10.1016/j.pharmthera.2024.108649. Epub 2024 Apr 12.
- Colizzi M, Bortoletto R, Colli C, Bonomo E, Pagliaro D, Maso E, Di Gennaro G, Balestrieri M. Therapeutic effect of palmitoylethanolamide in cognitive decline: A systematic review and preliminary meta-analysis of preclinical and clinical evidence. Front Psychiatry. 2022 Oct 28;13:1038122. doi: 10.3389/fpsyt.2022.1038122. eCollection 2022.
- Caltagirone C, Cisari C, Schievano C, Di Paola R, Cordaro M, Bruschetta G, Esposito E, Cuzzocrea S; Stroke Study Group. Co-ultramicronized Palmitoylethanolamide/Luteolin in the Treatment of Cerebral Ischemia: from Rodent to Man. Transl Stroke Res. 2016 Feb;7(1):54-69. doi: 10.1007/s12975-015-0440-8. Epub 2015 Dec 26.
Studienaufzeichnungsdaten
Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.
Haupttermine studieren
Studienbeginn (Geschätzt)
1. Juni 2026
Primärer Abschluss (Geschätzt)
1. Juni 2027
Studienabschluss (Geschätzt)
1. Juni 2028
Studienanmeldedaten
Zuerst eingereicht
11. Juni 2026
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
26. Juni 2026
Zuerst gepostet (Tatsächlich)
2. Juli 2026
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
2. Juli 2026
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
26. Juni 2026
Zuletzt verifiziert
1. Mai 2026
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen des Nervensystems
- Psychische Störungen
- Postoperative Komplikationen
- Pathologische Prozesse
- Neurokognitive Störungen
- Entzündung
- Kognitionsstörungen
- Pathologische Zustände, Anzeichen und Symptome
- Postoperative kognitive Komplikationen
- Neuroinflammatorische Erkrankungen
- Kognitive Dysfunktion
- Verwaltung des Gesundheitswesens
- Qualität, Zugang und Bewertung im Gesundheitswesen
- Heterocyclische Verbindungen, 1-Ring
- Heterocyclische Verbindungen
- Heterocyclische Verbindungen, 2-Ring
- Heterocyclische Verbindungen, Fusionsring
- Pyraner
- Qualität der Gesundheitsversorgung
- Qualitätsindikatoren, Gesundheitsversorgung
- Benzopyrans
- Flavonoide
- Chromone
- Flavone
- Sorgfalt
- Luteolin
Andere Studien-ID-Nummern
- PEGASUS COG
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
NEIN
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Nein
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Nein
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .