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Huperzine A in Alzheimer's Disease

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ClinicalTrials.gov Identifier: NCT00083590
Recruitment Status : Completed
First Posted : May 27, 2004
Last Update Posted : February 21, 2008
Alzheimer's Disease Cooperative Study (ADCS)
Information provided by:
National Institute on Aging (NIA)

Brief Summary:
The present study will evaluate the safety and efficacy of the Chinese herb huperzine A in the treatment of Alzheimer's disease (AD) in a randomized controlled trial of its effect on cognitive function.

Condition or disease Intervention/treatment Phase
Alzheimer Disease Drug: Huperzine A Phase 2

Detailed Description:

Huperzine A is a natural cholinesterase inhibitor derived from the Chinese herb Huperzia serrata. There is evidence that huperzine A may compare favorably in symptomatic efficacy to cholinesterase inhibitors currently in use. In addition, huperzine A has antioxidant and neuroprotective properties that suggest that it may be useful as a disease-modifying treatment for Alzheimer's disease (AD). The drug is currently available as a nutraceutical in this country, and is being used by some U.S. clinicians to treat AD. However, there have been no controlled clinical trials outside China assessing its toxicity and efficacy. The present study will evaluate huperzine A in the treatment of AD in a randomized controlled trial of its effect on cognitive function.

The primary aim of this multicenter, double-blind, placebo-controlled therapeutic Phase II trial is to determine whether treatment with huperzine A 200µg twice a day improves cognitive function in individuals with AD. Secondary aims of this study are to: a) determine whether treatment with huperzine A 400µg twice a day improves cognitive function in individuals with AD; b) determine the effect of huperzine A treatment on global clinical status, activities of daily living, and behavior in AD; c) evaluate the tolerability of huperzine A treatment at dosages of 200µg twice a day and 400µg twice a day in AD; and d) determine the relationship between blood cholinesterase activity and cognitive function in individuals with AD treated with huperzine A. A total of 150 participants will be randomly assigned to three groups of equal size. This will allow a comparison of huperzine A 200µg twice a day, huperzine A 400µg twice a day, and placebo. The primary outcome measures will be the change in score on the ADAScog at the 16 week visit. Secondary outcome measures include the ADCS clinical global impression of change (CGIC) (Schneider et al 1997) and activities of daily living (ADL) (Galasko et al 1997) scales, and the Neuropsychiatric Inventory (Cummings 1997). Volunteers must be able to participate in the study for 24 weeks and make 9 visits to the trial site.

At the end of the double-blind study, participants will be invited to continue huperzine A treatment for 6 months in an open-label extension phase. Participants will receive 200µg of huperzine A twice a day for six consecutive months, and will be assessed at 3-month intervals (months 6, 9, and 12, with month 6 assessments coinciding with the final visit of the double-blind phase).

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 150 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: A Multi-Center, Double-Blind, Placebo-Controlled Therapeutic Trial to Determine Whether Natural Huperzine A Improves Cognitive Function
Study Start Date : April 2004
Primary Completion Date : November 2007
Study Completion Date : November 2007

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Information from the National Library of Medicine

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Ages Eligible for Study:   55 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

The selection process is designed to allow enrollment of all people with AD who are likely to be testable at the conclusion of the study period, and who do not have concurrent medical conditions or medications that might influence cognitive testing or that would increase the risk of treatment. Women and members of minority groups are encouraged to volunteer.

Inclusion Criteria:

  • NINDS/ADRDA criteria for probable AD.
  • Mini Mental State Examination between 10 and 24, inclusive.
  • Stable medical condition for 3 months prior to screening.
  • Supervision available for administration of study medications.
  • Study partner to accompany participant to all scheduled visits.
  • Fluent in English or Spanish.
  • Age 55 years or older.
  • Modified Hachinski score equal to or less than 4.
  • CT or MRI since onset of memory impairment demonstrating absence of clinically significant focal lesion.
  • Able to complete baseline assessments.
  • 6 years of education, or work history sufficient to exclude mental retardation.
  • Able to ingest oral medication.
  • Stable doses of medications for 4 weeks prior to screening.
  • Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests.

Exclusion Criteria:

  • History of active peptic ulcer disease within 1 year of screening.
  • Clinically significant cardiac arrhythmia.
  • Resting pulse less than 50.
  • Active neoplastic (cancer) disease (skin tumors other than melanoma are not excluded; participants with stable prostate cancer may be included at the discretion of the Project Director).
  • Use of another investigational agent within 2 months of screening.
  • History of clinically significant stroke.
  • Current evidence or history in the past 2 years of epilepsy, focal brain lesion, head injury with loss of consciousness and/or immediate confusion after the injury, or DSM-IV criteria for any major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse.
  • Blindness, deafness, language difficulties or any other disability which may prevent the participant from participating or cooperating in the protocol.
  • Residence in a skilled nursing facility; but patients in an assisted living facility are acceptable.

Excluded Medications:

  • Use of cholinesterase inhibitors (galantamine, rivastigmine, donepezil, and tacrine) within 2 months of screening.
  • Regular use of narcotic analgesics (>2 doses per week) within 4 weeks of screening.
  • Use of medications with significant central nervous system anticholinergic activity within 2 months of screening (e.g. tricyclic antidepressants, diphenhydramine).
  • Use of anti-Parkinsonian medications (including Sinemet, amantadine, bromocriptine, pergolide, selegiline) within 2 months of screening.
  • Participation in any other investigational drug study within 2 months of screening (individuals may not participate in any other drug study while participating in this protocol).
  • Use of estrogen is allowed if the dose has been stable for 3 months prior to screening.
  • Use of vitamin E is allowed if the dose has been stable for 3 months prior to screening.
  • Use of memantine is allowed if the dose has been stable for 3 months prior to screening.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00083590

  Hide Study Locations
United States, Alabama
University of Alabama
Birmingham, Alabama, United States, 35294
United States, Arizona
Banner Alzheimer's Institute
Phoenix, Arizona, United States, 85006
United States, California
University of California, Irvine
Irvine, California, United States, 92697
University of California, San Diego, Alzheimer's Disease Research Center
La Jolla, California, United States, 92037
University of Southern California
Los Angeles, California, United States, 90033
University of California, Davis
Sacramento, California, United States, 95817
United States, District of Columbia
Howard University School of Medicine
Washington, DC, District of Columbia, United States, 20060
Georgetown University Medical Center, Memory Disorders Program
Washington, District of Columbia, United States, 20057
United States, Florida
MD Clinical
Fort Lauderdale, Florida, United States, 33321
Roskamp Institute Memory Clinic
Tampa, Florida, United States, 33617
University of South Florida, Suncoast Alzheimer's and Gerontology Center
Tampa, Florida, United States, 33617
Premiere Research Institute
West Palm Beach, Florida, United States, 33407
United States, Georgia
Emory University
Atlanta, Georgia, United States, 30329
United States, Illinois
Rush Alzheimer's Disease Center, Rush University Medical Center
Chicago, Illinois, United States, 60612
United States, Massachusetts
ICPS Group
Boston, Massachusetts, United States, 02131
United States, Nevada
University of Nevada School of Medicine
Las Vegas, Nevada, United States, 89102
United States, New Jersey
Alzheimer's Research Corporation
Manchester, New Jersey, United States, 08759
University of Medicine and Dentistry of New Jersey
Piscataway, New Jersey, United States, 08855
United States, New York
Albany Medical Center
Albany, New York, United States, 12208
New York University Medical Center
New York, New York, United States, 10016
Mount Sinai School of Medicine
New York, New York, United States, 10029
Nathan S. Kline Institute for Psychiatric Research
Orangeburg, New York, United States, 10962
University of Rochester Medical Center
Rochester, New York, United States, 14620
United States, North Carolina
University of North Carolina
Chapel Hill, North Carolina, United States, 27599
United States, Oregon
Oregon Health and Science University
Portland, Oregon, United States, 97201
United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15213
United States, South Carolina
Medical University of South Carolina
North Charleston, South Carolina, United States, 29406
United States, Texas
University of Texas Southwestern Medical Center
Dallas, Texas, United States, 75390
United States, Vermont
University of Vermont College of Medicine
Burlington, Vermont, United States, 05401
Sponsors and Collaborators
National Institute on Aging (NIA)
Alzheimer's Disease Cooperative Study (ADCS)
Principal Investigator: Paul S. Aisen, MD Georgetown University Medical Center, Memory Disorders Program

ClinicalTrials.gov Identifier: NCT00083590     History of Changes
Other Study ID Numbers: IA0052
IND 63,997
First Posted: May 27, 2004    Key Record Dates
Last Update Posted: February 21, 2008
Last Verified: February 2008

Keywords provided by National Institute on Aging (NIA):
Alzheimer disease
Cholinesterase inhibitor

Additional relevant MeSH terms:
Alzheimer Disease
Huperzine A
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Neurodegenerative Diseases
Neurocognitive Disorders
Mental Disorders
Cholinesterase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Cholinergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Neuroprotective Agents
Protective Agents