A Pilot Clinical Trial of Exendin-4 in Alzheimer's Disease
- Exendin-4 (or Exenatide) is a medication currently used to treat diabetes, but it has shown promising results in tests of its effectiveness in protecting neurons from damaging processes associated with Alzheimer s disease. It is possible that Exendin-4 may be a treatment for Alzheimer s disease, which involves the gradual deterioration and death of neurons. Researchers are interested in studying the safety and comparing the effects of Exendin-4 with placebo to on congestive performance, overall clinical progression, various chemicals measured in blood and cerebrospinal fluid, and brain MRI, in individuals with early-stage Alzheimer's disease or mild cognitive impairment.
- To determine the safety and tolerability, as well as to acquire preliminary evidence for the effectiveness of twice daily administration of Exendin-4 as a treatment for early-stage Alzheimer s disease or mild cognitive impairment.
- Individuals at least 60 years of age who have objective evidence of early-stage Alzheimer's disease or mild cognitive impairment in screening testing.
- Participants will be screened.
- Following the telephone screening, two in-person screening visits to determine eligibility.
- The screening visit will involve a medical history and neurological examination, tests of memory and cognition, a lumbar puncture, collection of blood and saliva samples, and brain Magnetic Resonance Imagine (MRI) studies. Participants will be required to appoint a Durable Power of Attorney for research and medical care during this protocol.
- Eligible participants will be divided into two groups. One group will receive Exendin-4, and the other will receive a placebo. Participants will keep a medication diary and will be scheduled for additional study visits 1 and 2 weeks after the start of the treatment.
- Participants will have regular followup visits with blood tests, imaging studies, and other examinations 6, 12, and18 months after the start of the treatment. Another lumbar puncture may be performed optionally at the 18-month followup visit.
Mild Cognitive Impairment
Drug: Exendin-4 (Exenatide)
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Primary Purpose: Treatment
|Official Title:||A Pilot Study of Exendin-4 in Alzheimer s Disease|
- Safety and tolerability of Exendin-4 administered twice daily via SC injections [ Time Frame: 18 months ] [ Designated as safety issue: Yes ]
- Behavioral and cognitive performance measures [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Changes on structural and functional MRI and MRS [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Hormonal and metabolic changes and changes in cerebrospinal fluid and plasma Alzheimer s disease biomarkers. [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Clinical Dementia Rating (CDR) scale sum-of-boxes [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Alzheimer's Disease Assessment scale - cognitive sub-scale (ADAS-cog) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
|Study Start Date:||November 2010|
|Study Completion Date:||November 2016|
|Primary Completion Date:||November 2016 (Final data collection date for primary outcome measure)|
Please refer to this study by its ClinicalTrials.gov identifier: NCT01255163
|United States, Maryland|
|National Institute on Aging, Clinical Research Unit|
|Baltimore, Maryland, United States, 21224|
|Principal Investigator:||Dimitrios I Kapogiannis, M.D.||National Institute on Aging (NIA)|