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A 24-Week Efficacy, Safety and Tolerability of Rivastigmine Patch Study in Patients With Probable Alzheimer's Disease

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Novartis ( Novartis Pharmaceuticals )
ClinicalTrials.gov Identifier:
NCT01399125
First received: July 19, 2011
Last updated: July 10, 2014
Last verified: July 2014
  Purpose

The purpose of this study is to assess the efficacy, safety, and tolerability of Exelon® patch in patients with probable AD (MMSE 10-20), in order to support a planned regulatory submission and registration of Exelon transdermal patch in China. The study is designed to confirm the non-inferiority of the efficacy of Exelon patch (target 10 cm² patch size) versus Exelon capsules (target 6.0 mg bid dose) on cognition, using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog).


Condition Intervention Phase
Alzheimer's Disease
Drug: Rivastigmine Patch
Drug: Rivastigmine Capsules
Drug: Placebo to Rivastigmine patch
Drug: Placebo to Rivastigmine capsules
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A 24-Week, Randomized, Double-blind, Double-dummy, Parallel-group, Active-controlled Study to Assess the Efficacy, Safety, and Tolerability of the Once-daily Rivastigmine Patch Formulation in Patients With Probable Alzheimer's Disease (Mini-Mental State Examination (MMSE) 10-20)

Resource links provided by NLM:


Further study details as provided by Novartis:

Primary Outcome Measures:
  • Change From Baseline on Cognition, Assessed by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) [ Time Frame: Change at 24 weeks ] [ Designated as safety issue: No ]
    The Alzheimer's Disease Assessment Scale (ADAS) is a performance-based test that measures specific cognitive and behavioral dysfunctions in patients with Alzheimer's Disease. The cognitive subscale of the ADAS (ADAS-Cog) comprises 11 items that are summed to a total score ranging from 0 to 70, with lower scores indicating less severe impairment. It was assessed by a mental health professional (e.g., M.D., Ph.D., Pharm.D., R.N., or other equivalent qualifications) with a minimum of 2 years research experience meeting certification requirements.


Secondary Outcome Measures:
  • Change From Baseline in Global Functioning, Assessed by the Alzheimer's Disease Assessment Scale Clinical Impression of Change (ADCS-CGIC) [ Time Frame: Change at 24 weeks ] [ Designated as safety issue: No ]
    Alzheimer's disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC) scale provides a single global rating of change from baseline. It was recommended that the baseline interview be conducted by two raters, one designated as the primary rater, the other as a backup. Both raters were independent trained clinicians, experienced in the assessment of patients with dementia. Neither rater was involved in any other way with the patients' treatment or evaluation throughout the study. At baseline, both raters had access to all of the patient's available records and evaluations. Subsequently, for all ratings of change from baseline, the rater relied solely on information obtained during the baseline interview of the patient and caregiver, including written notes and, if available, the baseline interview audio- or videotape. The rater had no access to any other safety or efficacy data, including all previous post-baseline ADCS-CGIC ratings by either rater.

  • Change From Baseline in Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) Total Score [ Time Frame: Change at 24 weeks ] [ Designated as safety issue: No ]
    Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) is a caregiver-based Activities of Daily Living (ADL) scale composed of 23 items developed for use in dementia clinical studies. It was designed to assess the patient's performance of both basic and instrumental activities of daily living such as those necessary for personal care, communicating and interacting with other people, maintaining a household, conducting hobbies and interests, as well as making judgments and decisions. Responses for each item were obtained from the caregiver through an interview. For each basic ADL, there was a forced choice of best response or a "yes" or "no" question with additional sub questions. Higher numbered scores and answers of "yes" reflected a more self-sufficient individual. Therefore, the higher total score, the higher functioning the patient was. The total score was the sum of all items and sub questions. The range for the total ADCS-ADL score was 0 to 78.

  • Change From Baseline in Neuropsychiatric Inventory (NPI) Total Score [ Time Frame: Change at 24 weeks ] [ Designated as safety issue: No ]
    NPI including Caregiver Distress Scale (NPI-D) assesses a wide range of behavior problems encountered in dementia patients to provide a means of distinguishing frequency and severity of changes in behavioral problems & facilitates rapid behavioral assessment using screening questions.10 behavioral problems & 2 neurovegetative domains were evaluated through an interview of the caregiver by a mental health professional. The scale includes both frequency & severity ratings of ea. domain as well as a composite domain score(frequency x severity). Frequency: 1(occasionally) - 4(very frequently)&severity:1(mild) - 3(marked).The sum of the composite scores of the 12 domains yields the NPI total score. The NPI-D: 0(not severe & not at all distressing) - 5 (very severe or extremely distressing) for each of the 12 domains. NPI-12 total score: from 0-144, the NPI-10 total score: from 0-120, & NPI-D score: from 0-60, all with higher scores indicating more severe behavioral disturbance.

  • Change From Baseline in Mini-Mental State Examination (MMSE) Total Score [ Time Frame: Change at 24 weeks ] [ Designated as safety issue: No ]
    The Mini-Mental State Examination (MMSE) was used to establish patient's eligibility for the study and it was also used as an efficacy parameter in the Double-blind Treatment Period. The MMSE is a brief, practical screening test for cognitive dysfunction. The test consists of five sections (orientation, registration, attention-calculation, recall, and language) and results in a total possible score of 30, with higher scores indicating betterfunction. The total MMSE score at screening was between 10 and 20, inclusive, in order forthe patient to be eligible to participate in the trial.


Enrollment: 501
Study Start Date: July 2011
Study Completion Date: May 2013
Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Rivastigmine patch
Once-daily target patch size 10 cm²
Drug: Rivastigmine Patch
Once-daily target patch size 10 cm²
Other Name: ENA713, Exelon
Drug: Placebo to Rivastigmine capsules
matching Placebo to Rivastigmine capsules
Other Name: placebo
Active Comparator: Rivastigmine capsules
Twice-daily target dose of 6 mg oral capsule
Drug: Rivastigmine Capsules
Twice-daily target dose of 6 mg oral capsule
Other Name: ENA713, Exelon
Drug: Placebo to Rivastigmine patch
Matching placebo to Rivastigmine patch
Other Name: placebo

  Eligibility

Ages Eligible for Study:   50 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • have a diagnosis of dementia of the Alzheimer's type according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria;
  • have a clinical diagnosis of probable AD according to NINCDS/ADRDA criteria.
  • have a brain scan (magnetic resonance imaging (MRI) or computed tomography (CT)) consistent with the diagnosis of AD. The brain scan must have been performed within one year prior to randomization;
  • have an MMSE score of ≥ 10 and ≤ 20;
  • have sufficient education to have been able to read, write, and communicate effectively during the premorbid state;
  • be residing with someone in the community throughout the study or, if living alone, in contact with the primary caregiver everyday;

Exclusion criteria:

  • have an advanced, severe, progressive, or unstable infectious, metabolic, immune, endocrinologic, hepatic, hematological, pulmonary, cardiovascular, gastrointestinal, and/or urological condition that may interfere with efficacy and safety assessments or put the patient at special risk;
  • have a history or current diagnosis of any medical or neurological condition other than AD that is identified as contributing cause of the patient's dementia;
  • have a current diagnosis of probable or possible vascular dementia according to the National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences criteria (NINDS-AIREN);
  • have a score of > 4 on the Modified Hachinski Ischemic Scale (MHIS);
  • have a current DSM-IV diagnosis of major depression, unless, in the opinion of the investigator, is in remission for at least 12 weeks;

Other protocol-defined inclusion/exclusion criteria may apply

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01399125

Locations
China, Fujian
Novartis Investigative Site
Fuzhou, Fujian, China
China, Hubei
Novartis Investigative Site
Wuhan, Hubei, China, 430022
Novartis Investigative Site
Wuhan, Hubei, China, 430030
China, Jiangsu
Novartis Investigative Site
Nanjing, Jiangsu, China, 210029
Novartis Investigative Site
Suzhou, Jiangsu, China, 215004
China, Jilin
Novartis Investigative Site
Changchun, Jilin, China, 130021
China, Shanghai
Novartis Investigative Site
Shanghai, Shanghai, China, 200080
China, Shanxi
Novartis Investigative Site
Xi'an, Shanxi, China, 710032
China, Sichuan
Novartis Investigative Site
Chengdu, Sichuan, China, 610041
China, Zhejiang
Novartis Investigative Site
Hangzhou, Zhejiang, China, 310009
China
Novartis Investigative Site
Beijing, China, 100730
Novartis Investigative Site
Beijing, China, 100028
Novartis Investigative Site
Shanghai, China, 200040
Novartis Investigative Site
Shanghai, China, 200127
Novartis Investigative Site
Shanghai, China, 200003
Novartis Investigative Site
Shanghai, China, 200025
Sponsors and Collaborators
Novartis Pharmaceuticals
Investigators
Study Director: Novartis Pharmaceuticals Novartis Pharmaceuticals
  More Information

No publications provided

Responsible Party: Novartis ( Novartis Pharmaceuticals )
ClinicalTrials.gov Identifier: NCT01399125     History of Changes
Other Study ID Numbers: CENA713D2344
Study First Received: July 19, 2011
Results First Received: May 5, 2014
Last Updated: July 10, 2014
Health Authority: United States: Food and Drug Administration
China: Ethics Committee
China: Food and Drug Administration

Keywords provided by Novartis:
Alzheimer's
Rivastigmine
Patch
Dementia

Additional relevant MeSH terms:
Alzheimer Disease
Brain Diseases
Central Nervous System Diseases
Delirium, Dementia, Amnestic, Cognitive Disorders
Dementia
Mental Disorders
Nervous System Diseases
Neurodegenerative Diseases
Tauopathies
Rivastigmine
Central Nervous System Agents
Cholinergic Agents
Cholinesterase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Neuroprotective Agents
Neurotransmitter Agents
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on November 27, 2014