Alzheimer's Disease or Vascular Dementia
Conditions
Brief summary
A Randomized, Double-Blind, Vehicle-Controlled, Parallel, Phase II Study to Evaluate Efficacy and Safety of BAC in Patient with Alzheimer's Disease or Vascular Dementia
Detailed description
This study was designed as a randomized, double-blind, vehicle-controlled and parallel trial to evaluate the efficacy and safety of BAC in patients with Alzheimer's disease or vascular dementia. The investigation product, BAC, is a potential anti-inflammatory agent consisted of Multi-Glycan Complex (MGC) from the Soybean extract. It aims to reduce the neruoinflammation in the Alzhemimer's disease and vascular dementia. In each study site, eligible patients were randomized and stratified to 1 of 2 dementia types (Alzheimer's disease and non-Alzheimer's disease) in 3:1 ratio to receive either one of topical application of BAC or BAC matched vehicle, topical application on external nasal skin, scalp, and neck, 2 times daily, 30 g/day. The treatment duration for each patient was 12 weeks, which consisted of 6 visits located at Screening (within 2 weeks before Baseline visit), Baseline (Week 0), Weeks 2, 4, 8, and Week 12 (Final). During the treatment period, patients may continue to receive medications or treatments routinely used for Alzheimer's disease or vascular dementia except those prohibited under this protocol.
Interventions
DRUGBAC treatment
BAC, topical application on external nasal skin, scalp, and neck, 2 times daily, 30 g/day for 12 weeks
DRUGMatched vehicle
BAC matched vehicle, topical application on external nasal skin, scalp, and neck, 2 times daily, 30 g/day for 12 weeks
Sponsors
Charsire Biotechnology Corp.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. With either gender aged at least 40 years old 2. With a diagnosis of one of the following disease i. Vascular dementia according to the NINDS-AIREN International Workshop criteria or ii. Alzheimer's disease according to the NIAAA criteria iii. Mixed dementia (possible Alzheimer's disease with cerebrovascular disease) according to the NIAAA criteria Note: 1. NINDS-AIREN: National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences 2. NIAAA: National Institute on Aging-Alzheimer's Association 3. With mild-to-moderate dementia (score of the Mini-Mental State Examination (MMSE) defined as between 10 to 24 and score of ADAS-Cog as at least 12) 4. Able to read, write, communicate, and understand cognitive testing instructions 5. Having a responsible caregiver who spends at least 4 hours daily with the patient. The caregiver will accompany the patient to all study visits, , supervise administration of study drug, and be able to assess the patient's condition 6. Patients and the responsible caregiver willing and able to provide written informed consent form
Exclusion criteria
1. With large vessel thrombosis (thrombotic stroke occurring in large arteries) 2. With radiological evidence of other brain disorders (subdural hematoma, post-traumatic / post-surgery) 3. With dementia caused by other brain diseases except Alzheimer's disease and vascular dementia (e.g. Parkinson's disease, demyelinated disease of the central nervous system, tumor, hydrocephalus, head injury, central nervous system infection including syphilis, acquired immune deficiency syndrome, etc.) 4. With clinical evidence of pulmonary, hepatic, gastrointestinal, metabolic, endocrine or other life threatening diseases judged by investigators not suitable to enter the study 5. With clinically unstable hypertension, diabetes mellitus, and cardiac disease for the last 3 months 6. Ever hospitalized for stroke or with acute coronary syndrome in the previous 3 months prior to screening 7. Drug or alcohol abuse within the previous 12 months of screening. 8. With one of the following abnormal laboratory parameters: hemoglobin \< 10 mg/dL or platelet \< 100\*109/L; creatinine or total bilirubin more than 1.5 times the upper limit value; alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT) more than 2 times the upper limit of normal, or thyroid-stimulating hormone (TSH) more than 2.5 times the upper limit value or less than the lower limit value of normal 9. With severe depression graded by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and Cornell Scale for Depression in Dementia (CSDD) 10. With any uncontrolled illness (including, but not limited to, any of the following: ongoing or active infection including hepatitis B, C, and HIV, active bleeding, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris or, cardiac arrhythmia) judged by the investigator that entering the trial may be detrimental to the patient 11. With known or suspected hypersensitivity to any ingredients of study product and vehicle 12. Pregnant or lactating or premenopausal with childbearing potential but not taking reliable contraceptive method(s) during the study period Note: Reliable contraceptive methods will consider as below: 1. Established use of oral, injected or implanted hormonal methods of contraception \> 3 months prior to baseline. 2. Placement of an intrauterine device (IUD) or intrauterine system (IUS) \> 3 months prior to baseline. 3. Barrier methods of contraception: Condom or Occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository 4. Partner male sterilization (i.e., vasectomy) \> 1 month of screening 13. Enrollment in any investigational drug trial within 4 weeks of screening visit 14. Experienced dosage increment of routinely use in drugs listed as follows within past three months before Screening visit 1. medications/treatments for Alzheimer's disease or vascular dementia 2. antipsychotic medications including but not limited to selective serotonin reuptake inhibitors (SSRIs), benzodiazepine (BZD) 3. Vitamin B12 4. drugs for thyroid disease 15. Current antiplatelet drug (antiaggregant) except dosage including but not limited to aspirin \<= 100mg/day, clopidogrel \<= 75mg/day, ticagrelor \<= 180mg/day, dipyridamole \<= 400mg/day 16. Caregivers who have psychotic symptoms, are imminently suicidal, have an unstable medical condition (e.g. recent heart attack, recent stroke, episodes of dizziness, fainting attacks) or significant orthopaedic problems.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Alzheimer Disease Assessment Scale-cognitive (ADAS-cog) Score at Week 12 Visit Compared to Baseline | Week 12 | The Alzheimer's Disease Assessment Scale- Cognitive (ADAS-Cog) Subscale test is the standard assessment tool and one of the most popular cognitive testing instrument in clinical trials. It is designed to assess various cognitive abilities such as those associated with memory, language and praxis. It consists of 11 parts: 1. Word Recall Task; 2. Naming Task; 3: Commands; 4: Constructional Praxis; 5. Ideational Praxis; 6. Orientation; 7. Word Recognition Task; 8. Language; 9. Comprehension of Spoken Language; 10. Word Finding Difficulty; and 11. Remembering Test Instructions. Scores range from 0 to 70 with lower scores indicating lesser severity. ADAS-Cog was measured at Screening, Randomization/Baseline, Week 4, Week 8 and Week 12. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4, 8, 12 | This is a global measure of detectable change in cognition, function and behavior. The format for CIBIS/CIBIC-Plus consists of the assessment of an independent clinician based on observation of the patient at an interview, and information provided by the caregiver. The clinician's assessing severity at baseline and overall impression for assessing severity of the global change in disease severity, compared with baseline, is rated. The CIBIS/CIBIC plus examined general, cognitive, and behavioral function and activities of daily living on a 7-point categorical rating scale, ranging from a score of 0 indicating Not assessed, to a score of 7 indicating Among the most extremely ill patients for CIBIS and ranging from 1 indicating Very much improved, to a score of 7 indicating Marked worsening, and with a score of 4 indicating no change for CIBIC-Plus. CIBIS was measured at Randomization visit and CIBIC-Plus was measured at Week 4, Week 8, and Week 12. |
| Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 4, 8, 12 | An inventory of informant based items to assess activities of daily living and instrumental activities of daily living, i.e. functional performance, of Alzheimer's disease (AD). It consists of 23-item inventory of ADL, rated based on extent of assistance the patient requires (independently, with supervision, with physical help): 0 (total independence in performing an activity) to 4 (total inability to act independently). Each question varies in the number of options to choose. Total score range: 0 to 78; higher scores indicate less functional impairment. ADL will be measured at Randomization/Baseline, Week 4, Week 8, and Week 12. |
| Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 4, 8, 12 | This is a multi-item instrument that examines orientation, registration, attention, calculation, recall, visuospatial abilities and language. The score ranges from 0 to 30, with higher scores indicating better cognitive function. MMSE was measured at Screening, Randomization/Baseline, Week 4, Week 8, and Week 12. |
| Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 4, 8, 12 | The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 10 behavioral domains (10-item NPI, section A\ J) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. Frequency is scored from 1 (occasionally) to 4 (very frequently) and severity is rated from 1 (mild) to 3 (severe). The score for each domain is frequency multiplied by severity. Therefore, the score ranges from 1 to 12 with higher scores indicate worse condition. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12. |
| Change in ADAS-cog Score at All Post Treatment Visits (Except Week 12 Visit) Compared to Baseline | Week 4, 8 | The Alzheimer's Disease Assessment Scale- Cognitive (ADAS-Cog) Subscale test is the standard assessment tool and one of the most popular cognitive testing instrument in clinical trials. It is designed to assess various cognitive abilities such as those associated with memory, language and praxis. It consists of 11 parts: 1. Word Recall Task; 2. Naming Task; 3: Commands; 4: Constructional Praxis; 5. Ideational Praxis; 6. Orientation; 7. Word Recognition Task; 8. Language; 9. Comprehension of Spoken Language; 10. Word Finding Difficulty; and 11. Remembering Test Instructions. Scores range from 0 to 70 with lower scores indicating lesser severity. ADAS-Cog was measured at Screening, Randomization/Baseline, Week 4, Week 8 and Week 12. |
| Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 4, 8, 12 | The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 12 behavioral domains (12-item NPI) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. Frequency is scored from 1 (occasionally) to 4 (very frequently) and severity is rated from 1 (mild) to 3 (severe). The score for each domain is frequency multiplied by severity. Therefore, the score ranges from 1 to 12 with higher scores indicate worse condition. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12. |
| Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 4, 8, 12 | The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 12 behavioral domains (12-item NPI) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. NPI-12 Caregiver Distress score is scored for associated caregiver distress from 0 (no distress) to 5 (very severe or extreme). Higher scores indicate greater distress. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12. |
| Number of Participants With Adverse Events | AEs were reported through the study completion (up to 12 weeks) | An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a study medication and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a study medication, whether or not related to the study medication. Laboratory abnormalities should not be recorded as AEs unless determined to be clinically significant by the Investigator. The number of participants with adverse events within the BAC and placebo groups was determined. |
| Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 4, 8, 12 | The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 10 behavioral domains (10-item NPI) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. NPI-10 Caregiver Distress score is scored for associated caregiver distress from 0 (no distress) to 5 (very severe or extreme). Higher scores indicate greater distress. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12. |
Countries
United States
Participant flow
Recruitment details
Recruitment was conducted in the United States. The study was open for recruitment in December 2016 and the first participant was successfully enrolled in January 2017.
Pre-assignment details
The planned sample size was determined to be 45 versus 15 patients (3:1 ratio) for BAC treatment versus vehicle groups, 60 evaluable patients in total. To ensure the completion of 60 evaluable patients, around 75 patients were planned to be recruited. Actually, in this study, 80 eligible subjects were recruited and 59 evaluable subjects were achieved.
Participants by arm
| Arm | Count |
|---|---|
| BAC Treatment BAC, topically on external nasal skin, scalp, and neck, 30 g/day, 2 times daily for 12 weeks.
Subjects were randomized 3:1 to receive double blind treatment of BAC or matched vehicle | 60 |
| Matched Vehicle BAC matched vehicle, topically on external nasal skin, scalp, and neck, 30 g/day, 2 times daily for 12 weeks | 20 |
| Total | 80 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 |
| Overall Study | Protocol Violation | 4 | 1 |
| Overall Study | Withdrawal by Subject | 12 | 3 |
Baseline characteristics
| Characteristic | BAC Treatment | Matched Vehicle | Total |
|---|---|---|---|
| Age, Continuous | 73.2 years STANDARD_DEVIATION 9.65 | 73.1 years STANDARD_DEVIATION 9.19 | 73.2 years STANDARD_DEVIATION 9.48 |
| Dementia history Alzheimer's Disease | 42 Participants | 13 Participants | 55 Participants |
| Dementia history Mixed Dementia | 11 Participants | 6 Participants | 17 Participants |
| Dementia history Vascular Dementia | 7 Participants | 1 Participants | 8 Participants |
| Race/Ethnicity, Customized Race Africa Americans | 5 Participants | 2 Participants | 7 Participants |
| Race/Ethnicity, Customized Race Caucasians | 54 Participants | 17 Participants | 71 Participants |
| Race/Ethnicity, Customized Race Hispanic | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Race Hispanic Native American | 0 Participants | 1 Participants | 1 Participants |
| Region of Enrollment United States | 60 Participants | 20 Participants | 80 Participants |
| Sex: Female, Male Female | 41 Participants | 11 Participants | 52 Participants |
| Sex: Female, Male Male | 19 Participants | 9 Participants | 28 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 60 | 0 / 20 |
| other Total, other adverse events | 6 / 60 | 7 / 20 |
| serious Total, serious adverse events | 0 / 60 | 0 / 20 |
Outcome results
Primary
Change in Alzheimer Disease Assessment Scale-cognitive (ADAS-cog) Score at Week 12 Visit Compared to Baseline
The Alzheimer's Disease Assessment Scale- Cognitive (ADAS-Cog) Subscale test is the standard assessment tool and one of the most popular cognitive testing instrument in clinical trials. It is designed to assess various cognitive abilities such as those associated with memory, language and praxis. It consists of 11 parts: 1. Word Recall Task; 2. Naming Task; 3: Commands; 4: Constructional Praxis; 5. Ideational Praxis; 6. Orientation; 7. Word Recognition Task; 8. Language; 9. Comprehension of Spoken Language; 10. Word Finding Difficulty; and 11. Remembering Test Instructions. Scores range from 0 to 70 with lower scores indicating lesser severity. ADAS-Cog was measured at Screening, Randomization/Baseline, Week 4, Week 8 and Week 12.
Time frame: Week 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BAC Treatment | Change in Alzheimer Disease Assessment Scale-cognitive (ADAS-cog) Score at Week 12 Visit Compared to Baseline | -0.05 score on a scale | Standard Deviation 5.726 |
| Matched Vehicle | Change in Alzheimer Disease Assessment Scale-cognitive (ADAS-cog) Score at Week 12 Visit Compared to Baseline | -2.25 score on a scale | Standard Deviation 4.973 |
Secondary
Change in ADAS-cog Score at All Post Treatment Visits (Except Week 12 Visit) Compared to Baseline
The Alzheimer's Disease Assessment Scale- Cognitive (ADAS-Cog) Subscale test is the standard assessment tool and one of the most popular cognitive testing instrument in clinical trials. It is designed to assess various cognitive abilities such as those associated with memory, language and praxis. It consists of 11 parts: 1. Word Recall Task; 2. Naming Task; 3: Commands; 4: Constructional Praxis; 5. Ideational Praxis; 6. Orientation; 7. Word Recognition Task; 8. Language; 9. Comprehension of Spoken Language; 10. Word Finding Difficulty; and 11. Remembering Test Instructions. Scores range from 0 to 70 with lower scores indicating lesser severity. ADAS-Cog was measured at Screening, Randomization/Baseline, Week 4, Week 8 and Week 12.
Time frame: Week 4, 8
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in ADAS-cog Score at All Post Treatment Visits (Except Week 12 Visit) Compared to Baseline | Week 4 - Baseline | -0.51 score on a scale | Standard Deviation 4.096 |
| BAC Treatment | Change in ADAS-cog Score at All Post Treatment Visits (Except Week 12 Visit) Compared to Baseline | Week 8 - Baseline | -0.79 score on a scale | Standard Deviation 4.177 |
| Matched Vehicle | Change in ADAS-cog Score at All Post Treatment Visits (Except Week 12 Visit) Compared to Baseline | Week 4 - Baseline | -2.33 score on a scale | Standard Deviation 4.393 |
| Matched Vehicle | Change in ADAS-cog Score at All Post Treatment Visits (Except Week 12 Visit) Compared to Baseline | Week 8 - Baseline | -2.06 score on a scale | Standard Deviation 5.068 |
Secondary
Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline
An inventory of informant based items to assess activities of daily living and instrumental activities of daily living, i.e. functional performance, of Alzheimer's disease (AD). It consists of 23-item inventory of ADL, rated based on extent of assistance the patient requires (independently, with supervision, with physical help): 0 (total independence in performing an activity) to 4 (total inability to act independently). Each question varies in the number of options to choose. Total score range: 0 to 78; higher scores indicate less functional impairment. ADL will be measured at Randomization/Baseline, Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 4 - Baseline | -0.71 score on a scale | Standard Deviation 3.613 |
| BAC Treatment | Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 8 - Baseline | 0.08 score on a scale | Standard Deviation 3.188 |
| BAC Treatment | Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 12 - Baseline | 0.23 score on a scale | Standard Deviation 3.241 |
| Matched Vehicle | Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 4 - Baseline | 1.17 score on a scale | Standard Deviation 4.618 |
| Matched Vehicle | Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 8 - Baseline | 0.53 score on a scale | Standard Deviation 6.084 |
| Matched Vehicle | Change in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Score at All Post Treatment Visits Compared to Baseline | Week 12 - Baseline | 1.75 score on a scale | Standard Deviation 5.422 |
Secondary
Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline
This is a multi-item instrument that examines orientation, registration, attention, calculation, recall, visuospatial abilities and language. The score ranges from 0 to 30, with higher scores indicating better cognitive function. MMSE was measured at Screening, Randomization/Baseline, Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 4 - Baseline | 0.61 score on a scale | Standard Deviation 2.089 |
| BAC Treatment | Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 8 - Baseline | 0.25 score on a scale | Standard Deviation 1.732 |
| BAC Treatment | Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 12 - Baseline | 0.43 score on a scale | Standard Deviation 2.182 |
| Matched Vehicle | Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 4 - Baseline | 0.17 score on a scale | Standard Deviation 2.431 |
| Matched Vehicle | Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 8 - Baseline | 1.35 score on a scale | Standard Deviation 2.691 |
| Matched Vehicle | Change in Mini-Mental State Examination (MMSE) Score at All Post Treatment Visits Compared to Baseline | Week 12 - Baseline | 0.56 score on a scale | Standard Deviation 2.476 |
Secondary
Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score
The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 10 behavioral domains (10-item NPI) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. NPI-10 Caregiver Distress score is scored for associated caregiver distress from 0 (no distress) to 5 (very severe or extreme). Higher scores indicate greater distress. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 4 - Baseline | -0.02 score on a scale | Standard Deviation 2.839 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 8 - Baseline | -0.52 score on a scale | Standard Deviation 1.902 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 12 - Baseline | -0.91 score on a scale | Standard Deviation 2.595 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 4 - Baseline | -1.94 score on a scale | Standard Deviation 4.094 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 8 - Baseline | -2.06 score on a scale | Standard Deviation 4.451 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Caregiver Distress Score | Week 12 - Baseline | -2.25 score on a scale | Standard Deviation 4.74 |
Secondary
Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity
The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 10 behavioral domains (10-item NPI, section A\ J) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. Frequency is scored from 1 (occasionally) to 4 (very frequently) and severity is rated from 1 (mild) to 3 (severe). The score for each domain is frequency multiplied by severity. Therefore, the score ranges from 1 to 12 with higher scores indicate worse condition. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 4 - Baseline | -0.37 score on a scale | Standard Deviation 8.607 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 8 - Baseline | -0.75 score on a scale | Standard Deviation 4.024 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 12 - Baseline | -1.48 score on a scale | Standard Deviation 6.55 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 4 - Baseline | -2.28 score on a scale | Standard Deviation 6.952 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 8 - Baseline | -2.76 score on a scale | Standard Deviation 6.25 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-10 Frequency × Severity | Week 12 - Baseline | -3.13 score on a scale | Standard Deviation 6.672 |
Secondary
Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score
The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 12 behavioral domains (12-item NPI) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. NPI-12 Caregiver Distress score is scored for associated caregiver distress from 0 (no distress) to 5 (very severe or extreme). Higher scores indicate greater distress. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 4 - Baseline | -0.02 score on a scale | Standard Deviation 3.01 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 8 - Baseline | -0.67 score on a scale | Standard Deviation 2.291 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 12 - Baseline | -0.93 score on a scale | Standard Deviation 2.84 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 4 - Baseline | -2.56 score on a scale | Standard Deviation 5.193 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 8 - Baseline | -2.76 score on a scale | Standard Deviation 5.815 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Caregiver Distress Score | Week 12 - Baseline | -3.13 score on a scale | Standard Deviation 6.174 |
Secondary
Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score
The NPI is the behavior instrument most widely used in clinical trials of anti-dementia agents. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions. Both the frequency and the severity of each behavior are determined. Information for the NPI is obtained from a caregiver familiar with the patient's behavior. The NPI assesses 12 behavioral domains (12-item NPI) common in dementia. Each NPI domain is scored by the caregiver based on a standardized interview administered by the clinician. Frequency is scored from 1 (occasionally) to 4 (very frequently) and severity is rated from 1 (mild) to 3 (severe). The score for each domain is frequency multiplied by severity. Therefore, the score ranges from 1 to 12 with higher scores indicate worse condition. NPI was measured at Randomization/Baseline, Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 4 - Baseline | -0.61 score on a scale | Standard Deviation 9.944 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 8 - Baseline | -1.29 score on a scale | Standard Deviation 6.348 |
| BAC Treatment | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 12 - Baseline | -1.80 score on a scale | Standard Deviation 8.582 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 4 - Baseline | -3.89 score on a scale | Standard Deviation 9.074 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 8 - Baseline | -4.76 score on a scale | Standard Deviation 9.437 |
| Matched Vehicle | Change in Neuropsychiatric Inventory (NPI) Score at All Post Treatment Visits Compared to Baseline: NPI-12 Frequency × Severity Score | Week 12 - Baseline | -5.50 score on a scale | Standard Deviation 10.047 |
Secondary
Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits
This is a global measure of detectable change in cognition, function and behavior. The format for CIBIS/CIBIC-Plus consists of the assessment of an independent clinician based on observation of the patient at an interview, and information provided by the caregiver. The clinician's assessing severity at baseline and overall impression for assessing severity of the global change in disease severity, compared with baseline, is rated. The CIBIS/CIBIC plus examined general, cognitive, and behavioral function and activities of daily living on a 7-point categorical rating scale, ranging from a score of 0 indicating Not assessed, to a score of 7 indicating Among the most extremely ill patients for CIBIS and ranging from 1 indicating Very much improved, to a score of 7 indicating Marked worsening, and with a score of 4 indicating no change for CIBIC-Plus. CIBIS was measured at Randomization visit and CIBIC-Plus was measured at Week 4, Week 8, and Week 12.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 4. No change | 41 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 4. No change | 36 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 5. Minimal worsening | 3 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 5. Minimal worsening | 8 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 2. Much improved | 1 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 6. Moderate worsening | 1 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 6. Moderate worsening | 0 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 1. Very much improved | 0 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 2. Much improved | 1 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 1. Very much improved | 0 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 3. Minimal improved | 2 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 3. Minimal improved | 6 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 4. No change | 33 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 2. Much improved | 1 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 5. Minimal worsening | 5 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 1. Very much improved | 1 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 6. Moderate worsening | 2 Participants |
| BAC Treatment | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 3. Minimal improved | 2 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 6. Moderate worsening | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 1. Very much improved | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 2. Much improved | 1 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 3. Minimal improved | 3 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 5. Minimal worsening | 4 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 6. Moderate worsening | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 1. Very much improved | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 2. Much improved | 1 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 3. Minimal improved | 1 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 4. No change | 13 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 5. Minimal worsening | 2 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 8 | 6. Moderate worsening | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 1. Very much improved | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 2. Much improved | 2 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 3. Minimal improved | 0 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 4. No change | 11 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 12 | 5. Minimal worsening | 3 Participants |
| Matched Vehicle | Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-plus) Score at All Post Treatment Visits | Week 4 | 4. No change | 10 Participants |
Secondary
Number of Participants With Adverse Events
An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a study medication and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a study medication, whether or not related to the study medication. Laboratory abnormalities should not be recorded as AEs unless determined to be clinically significant by the Investigator. The number of participants with adverse events within the BAC and placebo groups was determined.
Time frame: AEs were reported through the study completion (up to 12 weeks)
Population: All randomized patients who have received at least one dose study medication.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| BAC Treatment | Number of Participants With Adverse Events | 20 Participants |
| Matched Vehicle | Number of Participants With Adverse Events | 7 Participants |
Post Hoc
Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve)
The ADAS-Cog Subscale test is the standard assessment tool and one of the most popular cognitive testing instrument in clinical trials. It is designed to assess various cognitive abilities such as those associated with memory, language and praxis. Scores range from 0 to 70 with lower scores indicating lesser severity. Responder analysis consist of two steps. (1) The baseline ADAS-cog score score is deducted from the post-treatment visit ADAS-cog score; (2) the minus baseline score in step 1 is being dichotomized into two binary variable of either responder or non-responder. Patients who make progress or remain unchanged on the cognitive test are considered as responders, whereas patients who have deterioration on the cognitive test are considered as non-responders.
Time frame: Week 4, 8, and 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| BAC Treatment | Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 4 - Baseline | 13 Participants |
| BAC Treatment | Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 8 - Baseline | 10 Participants |
| BAC Treatment | Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 12 - Baseline | 11 Participants |
| Matched Vehicle | Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 4 - Baseline | 7 Participants |
| Matched Vehicle | Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 8 - Baseline | 6 Participants |
| Matched Vehicle | Responder Analysis of ADAS-cog Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 12 - Baseline | 4 Participants |
Post Hoc
Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve)
This is a multi-item instrument that examines orientation, registration, attention, calculation, recall, visuospatial abilities and language. The maximum score is 30, with higher scores indicating better cognitive function. ). Responder analysis consist of two steps. (1) The baseline MMSE score is deducted from the post-treatment visit MMSE score; (2) the minus baseline score in step 1 is being dichotomized into two binary variable of either responder or non-responder. Patients who make progress or remain unchanged on the cognitive test compared to baseline are considered as responders, whereas patients who have deterioration on the cognitive test compared to baseline are considered as non-responders.
Time frame: Week 4, 8, 12
Population: All randomized patients who have received at least one dose of study medication.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| BAC Treatment | Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 8 - baseline | 12 Participants |
| BAC Treatment | Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 4 - baseline | 13 Participants |
| BAC Treatment | Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 12 - baseline | 12 Participants |
| Matched Vehicle | Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 8 - baseline | 6 Participants |
| Matched Vehicle | Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 4 - baseline | 5 Participants |
| Matched Vehicle | Responder Analysis of MMSE Score at All Post Treatment Visits Compared to Baseline, on All Subjects Not Receiving Any Dementia Medication (Naïve) | Week 12 - baseline | 5 Participants |