Alzheimer's DiseasePhase 3REFLECT-3NCT00348140
Rosiglitazone (Extended Release Tablets) As Adjunctive Therapy In Subjects With Mild To Moderate Alzheimer's Disease
A Phase 3 study testing Rosiglitazone Extended Release 2mg and Rosiglitazone Extended Release 8mg in people with Alzheimer's Disease, run by GlaxoSmithKline at 194 sites in 22 countries.
Trial summary
Rosiglitazone (RSG) has been tested in clinical studies and is approved by the FDA as a treatment for type II diabetes mellitus, a disease that occurs when the body is unable to effectively use glucose. RSG XR, the investigational drug used in this study, is an extended-release form of RSG. Read more about this study
- Who is it for?
- Ages 50 to 90 years
- Conditions the study is for
- Alzheimer's Disease
- What is being tested?
- Rosiglitazone Extended Release 2mg and Rosiglitazone Extended Release 8mg
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,468 participants
- Where
- 194 sitesin 22 countries
- Study dates
- 12 Jul 2006to 20 Mar 2009
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 to 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- A subject will be eligible for inclusion in this study only if all of the following criteria apply:
- Male or female subject with a clinical diagnosis of probable Alzheimer's disease in accordance with NINCDS-ADRDA criteria (Appendix 2).
- (Note: National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and Alzheimer's Disease and Related Disorders Association (ADRDA).)
- Subject has mild to moderate Alzheimer's disease as defined by a MMSE score 10 to 26 inclusive at Screening.
- Hachinski Ischemia Score ≤ 4 at Screening (See Appendix 3).
- Age ≥50 and ≤90 years.
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- At least 6 months of ongoing acetylcholinesterase inhibitor therapy for Alzheimer's disease, with stable dosing for at least the last 2 months (and with no intent to change for the duration of the study).
- Current use of medication is in accordance with the criteria listed in Table 2 (Permitted Medications, Section 8.1).
- Female subjects must be post-menopausal (i.e. >1 year without menstrual period), surgically sterile, or agree to use adequate method of contraception (Appendix 4) for the duration of the study. Female subjects who are pre-menopausal or who have been post-menopausal for <1 year must undertake pregnancy testing (urine test) at Visit 1, which must be negative.
- Brain CT or MRI scan performed within the past 12 months or at Screening, showing no evidence of any other potential cause of dementia other than Alzheimer's disease.
- (Note: Questionable CT or MRI scans should be discussed with the medical monitor, using central imaging guidelines.)
- Neurological exam without focal changes (excluding changes attributable to AD or peripheral trauma).
- Subject has the ability to comply with procedures for cognitive and other testing.
- Subject lives with (or has substantial periods of contact with) a regular caregiver who is willing to attend all visits, oversee the subject's compliance with protocol-specified procedures and study medication, and report on subject's status.
- (Note: A non-cohabiting caregiver must spend sufficient time with the subject so that, in the opinion of the Investigator, the caregiver can reliably assess cognitive function, activities and behavior, and report on the subject's compliance and health. As caregiver time spent with a potential subject is anticipated to be highly variable across countries and cultures, GSK will consider a variety of different measures by which this stipulation may be met, and GSK should be consulted if adequacy of a caregiver situation is in doubt. However, as guidance, the ability for a caregiver to meet his/her expected responsibilities for this study would normally be possible when the caregiver spends no less than 10 hours per week with the subject, divided over multiple days.)
- Subject has provided full written informed consent prior to the performance of any protocol-specified procedure; or if unable to provide informed consent due to cognitive status, full written informed consent on behalf of the subject has been provided by a legally acceptable representative.
- (Note: Consent by legally acceptable representative is allowed where this is in accordance with local laws, regulations and ethics committee policy.)
- Caregiver has provided full written informed consent on his/her own behalf prior to the performance of any protocol-specified procedure.
- Subjects considered for enrolment must have a QTc (either QTc B (Bazett's correction) or QTc F (Fridericia's correction)) <450msec at Visit 1, with the exception of subjects with bundle branch block (for whom either QTc B or QTc F must be <480msec).
- (Note: For the purposes of these criteria, QTc B is defined as (QT interval [msec]) / (square root of RR interval [seconds]); and QTc F is defined as (QT interval [msec]) / (cube root of RR interval [seconds]).)
Who cannot join
- A subject will not be eligible for inclusion in this study if any of the following criteria apply:
- Diagnosis of possible, probable, or definite vascular dementia in accordance with NINDS-AIREN criteria (Appendix 5).
- (Note: National Institute of Neurological Disorders and Stroke (NINDS) and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN).)
- History or evidence of any other CNS disorder that could be interpreted as a cause of dementia: e.g. cerebrovascular disease (stroke, hemorrhage), structural abnormality, epilepsy, infectious or inflammatory/demyelinating CNS conditions, Parkinson's disease.
- Evidence of the following disorders: current vitamin B12 deficiency, positive syphilis serology, or active thyroid dysfunction (particularly that suggestive of hypothyroidism), including abnormally high or low serum levels of thyroid stimulating hormone (TSH), that are clinically significant in the opinion of the investigator.
- (Note: Testing is required for each parameter only when no result is available from previous 12 months.)
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- History of Type 1 diabetes mellitus or secondary diabetes mellitus.
- Type 2 diabetes mellitus where the subject is being treated with insulin, a PPARγ agonist, or an insulin secretagogue (e.g. a sulfonylurea or glitinide).
- Any patient with an HbA1c ≥8.5%. (See Section 6.3.8.4 for Safety Measures for Enrolled Subjects with Type 2 Diabetes Mellitus.)
- History or clinical/investigational evidence of congestive heart failure defined by the New York Heart Association criteria (Class I to IV cardiac status; Appendix 6).
- History of cardiovascular event within the last 6 months (i.e. intervention, percutaneous coronary intervention, vascular surgery, acute coronary syndrome [non Q-wave myocardial infarction, Q-wave myocardial infarction, unstable angina] or significant arrhythmia; or major intervention (e.g. cardiac surgery or angiography plus stenting) scheduled).
- History of significant psychiatric illness such as schizophrenia or bipolar affective disorder that in the opinion of the Investigator would interfere with participation in the study, major depressive disorder (according to DSM-IV) in the past year, or current active depression requiring initiation of treatment.
- (Note: If not currently treated, but active depression is suspected, the Cornell Scale for Depression in Dementia (CSDD, Appendix 7) can be used by the Investigator as a guide for deciding whether a prospective subject requires treatment. If the subject has a CSDD score >7, the Investigator should decide if the subject has depression in need of prescribed medication, and a CSDD >12 is considered a strong indicator that treatment is needed. Subjects will be allowed to re-screen after their depression has been adequately managed for >3 months.)
- History or presence of gastro-intestinal, hepatic, or renal disease or other condition known to interfere with the absorption, distribution, metabolism, or excretion of drugs, or any other clinically relevant abnormality, medical or psychiatric condition, which, in the opinion of the Investigator, makes the subject unsuitable for inclusion in the study.
- Clinically significant peripheral edema at the time of screening.
- Current or recent drug or alcohol abuse or dependence (defined by DSM-IV criteria for substance-related disorders), or recent or remote history of the same if that could be a contributing factor to the dementia.
- Systolic blood pressure >165 or <90 mmHg or diastolic blood pressure >95 or <60 mmHg at the time of screening.
- Clinically significant anemia (i.e. hemoglobin <11 g/dL for males or <10 g/dL for females) or presence of hemoglobinopathies which would prevent accurate assessment of HbA1c.
- Abnormal kidney function tests (>1.5 times the upper limit of normal (ULN)).
- ALT, AST, or alkaline phosphatase values >2.5 times the ULN, total bilirubin values >1.5 times the ULN, or history of severe hepatobiliary disease (e.g. hepatitis B or C, or cirrhosis, Child-Pugh Class B/C).
- (Note: For subjects with a diagnosis of Gilberts Syndrome and an isolated increase in total bilirubin >1.5 ULN, fractionation should be performed. If all of the following conditions are met, the patient may enter or remain in the study, even if total bilirubin >1.5 ULN:
- an elevated unconjugated (indirect) bilirubin;
- the percentage of direct bilirubin <35%;
- ALT, AST, and alkaline phosphatase <2.5 ULN if subject is in screening (<2.0 ULN for Canadian subjects only), or ≤3 ULN if subject is already randomized into the study)
- History of a bone marrow transplant.
- Subject is unable (with assistance, if appropriate) to take study medication as prescribed throughout the study or is at risk of non-compliance with study medication or procedures.
- Subject is an immediate family member or employee of the participating Investigator, of any of the participating site staff, or of GSK.
- In France, a subject is neither affiliated with nor a beneficiary of a social security category.
- The French subject has participated in any study using an investigational drug during the previous 30 days or 5 half-lives (whichever is longer).
- Cognitive tasks prescribed for cognitive rehabilitation and performed under medical supervision are prohibited for 6 months prior to Screening, as well as for the duration of the study.
Trial locations and contacts
194 sites in 22 countries.
194 sites in 22 countries
United States49 sites
GSK Investigational Site
Amherst, New York, 14226
GSK Investigational Site
Centerville, Ohio, 45459
GSK Investigational Site
Charlottesville, Virginia, 22903
GSK Investigational Site
Chicago, Illinois, 60610
GSK Investigational Site
Columbus, Ohio, 43210
GSK Investigational Site
Decatur, Georgia, 30033
GSK Investigational Site
Deerfield Beach, Florida, 33064
GSK Investigational Site
Delray Beach, Florida, 33445
GSK Investigational Site
East Providence, Rhode Island, 02914
GSK Investigational Site
Eatontown, New Jersey, 07724
GSK Investigational Site
Fort Lauderdale, Florida, 33308
GSK Investigational Site
Greer, South Carolina, 29651
GSK Investigational Site
Hialeah, Florida, 33016
GSK Investigational Site
Jenkintown, Pennsylvania, 19046
GSK Investigational Site
Laguna Hills, California, 92653
GSK Investigational Site
Little Rock, Arkansas, 72205
GSK Investigational Site
Middleton, Wisconsin, 53562-2215
GSK Investigational Site
Milwaukee, Wisconsin, 53226
GSK Investigational Site
New York, New York, 10016
GSK Investigational Site
New York, New York, 10032
GSK Investigational Site
Norristown, Pennsylvania, 19401
GSK Investigational Site
Norwalk, Connecticut, 06851
GSK Investigational Site
Ocala, Florida, 34471
GSK Investigational Site
Oklahoma City, Oklahoma, 73112
GSK Investigational Site
Philadelphia, Pennsylvania, 19102
GSK Investigational Site
Philadelphia, Pennsylvania, 19115
GSK Investigational Site
Pittsburgh, Pennsylvania, 15213
GSK Investigational Site
Providence, Rhode Island, 02906
GSK Investigational Site
Raleigh, North Carolina, 27607
GSK Investigational Site
Redlands, California, 92374
GSK Investigational Site
Rochester, New York, 14620
GSK Investigational Site
Salt Lake City, Utah, 84107
GSK Investigational Site
San Antonio, Texas, 78229
GSK Investigational Site
San Diego, California, 92103
GSK Investigational Site
San Francisco, California, 94109
GSK Investigational Site
Seattle, Washington, 98108
GSK Investigational Site
Springfield, Massachusetts, 01104
GSK Investigational Site
St. Petersburg, Florida, 33702
GSK Investigational Site
Sun City, Arizona, 85351
GSK Investigational Site
Syracuse, New York, 13210
GSK Investigational Site
Tampa, Florida, 33617
GSK Investigational Site
Toledo, Ohio, 43623
GSK Investigational Site
Toms River, New Jersey, 08755
GSK Investigational Site
Tucson, Arizona, 85741
GSK Investigational Site
Tulsa, Oklahoma, 74104
GSK Investigational Site
West Yarmouth, Massachusetts, 02673
GSK Investigational Site
Whiting, New Jersey, 08759
GSK Investigational Site
Wichita Falls, Texas, 76309
GSK Investigational Site
Winston-Salem, North Carolina, 27103
Germany35 sites
GSK Investigational Site
Aalen, Baden-Wurttemberg, 73430
GSK Investigational Site
Alzenau in Unterfranken, Bavaria, 63755
GSK Investigational Site
Bad Homburg, Hesse, 61348
GSK Investigational Site
Bad Saarow, Brandenburg, 15526
GSK Investigational Site
Berlin, 10625
GSK Investigational Site
Berlin, 12163
GSK Investigational Site
Berlin, 12167
GSK Investigational Site
Berlin, 12555
GSK Investigational Site
Berlin, 13053
GSK Investigational Site
Berlin, 13125
GSK Investigational Site
Berlin, 13156
GSK Investigational Site
Berlin, 13187
GSK Investigational Site
Berlin, 13357
GSK Investigational Site
Berlin, 13439
GSK Investigational Site
Berlin, 13507
GSK Investigational Site
Berlin, 14163
GSK Investigational Site
Calw, Baden-Wurttemberg, 75365
GSK Investigational Site
Chemnitz, Saxony, 09111
GSK Investigational Site
Dresden, Saxony, 01097
GSK Investigational Site
Dresden, Saxony, 01307
GSK Investigational Site
Ellwangen, Baden-Wurttemberg, 73479
GSK Investigational Site
Erbach im Odenwald, Hesse, 64711
GSK Investigational Site
Gera, Thuringia, 07551
GSK Investigational Site
Jena, Thuringia, 07743
GSK Investigational Site
Leipzig, Saxony, 04103
GSK Investigational Site
Leipzig, Saxony, 04107
GSK Investigational Site
Leipzig, Saxony, 04157
GSK Investigational Site
Ludwigsburg, Baden-Wurttemberg, 71634
GSK Investigational Site
Munich, Bavaria, 81675
GSK Investigational Site
Stuttgart, Baden-Wurttemberg, 70176
GSK Investigational Site
Tübingen, Baden-Wurttemberg, 72076
GSK Investigational Site
Ulm, Baden-Wurttemberg, 89073
GSK Investigational Site
Ulm, Baden-Wurttemberg, 89075
GSK Investigational Site
Unterhaching, Bavaria, 82008
GSK Investigational Site
Wiesloch, Baden-Wurttemberg, 69168
Canada14 sites
GSK Investigational Site
Greenfield Park, Quebec, J4V 2J2
GSK Investigational Site
Kelowna, British Columbia, V1W 4V5
GSK Investigational Site
Kentville, Nova Scotia, B4N 4K9
GSK Investigational Site
Kingston, Ontario, K7L 5G2
GSK Investigational Site
Mirabel, Quebec, J7J 2K8
GSK Investigational Site
Montreal, Quebec, H4H 1R3
GSK Investigational Site
Ottawa, Ontario, K1G 4G3
GSK Investigational Site
Ottawa, Ontario, K1N 5C8
GSK Investigational Site
Peterborough, Ontario, K9H 2P4
GSK Investigational Site
Québec, G1R 3X5
GSK Investigational Site
Saint John, New Brunswick, E2L 3L6
GSK Investigational Site
Sherbrooke, Quebec, J1J 3H5
GSK Investigational Site
Toronto, Ontario, M3B 2S7
GSK Investigational Site
Toronto, Ontario, M6M 3Z5
France13 sites
GSK Investigational Site
Bordeaux, 33076
GSK Investigational Site
La Chapelle-sur-Erdre, 44240
GSK Investigational Site
La Seyne-sur-Mer, 83500
GSK Investigational Site
Lille, 59000
GSK Investigational Site
Limoges, 87042
GSK Investigational Site
Metz, 57000
GSK Investigational Site
Nantes, 44000
GSK Investigational Site
Nantes, 44300
GSK Investigational Site
Paris, 75013
GSK Investigational Site
Sautron, 44880
GSK Investigational Site
Toulon, 83000
GSK Investigational Site
Toulouse, 31300
GSK Investigational Site
Valence, 26000
Australia11 sites
GSK Investigational Site
Adelaide, South Australia, 5000
GSK Investigational Site
Auchenflower, Queensland, 4066
GSK Investigational Site
Cheltenham, Victoria, 3192
GSK Investigational Site
Chermside, Queensland, 4032
GSK Investigational Site
Heidelberg West, Victoria, 3084
GSK Investigational Site
Hornsby, New South Wales, 2077
GSK Investigational Site
Kew, Victoria, 3101
GSK Investigational Site
Kippa-Ring, Queensland, 4021
GSK Investigational Site
Nedlands, Western Australia, 6009
GSK Investigational Site
Randwick, New South Wales, 2031
GSK Investigational Site
Woodville, South Australia, 5011
Spain8 sites
GSK Investigational Site
Baracaldo/Vizcaya, 48903
GSK Investigational Site
Barcelona, 08003
GSK Investigational Site
Barcelona, 08014
GSK Investigational Site
Barcelona, 08025
GSK Investigational Site
Barcelona, 08036
GSK Investigational Site
Barcelona, 08907
GSK Investigational Site
Palma de Mallorca, 07014
GSK Investigational Site
Tarrasa, Barcelona, 08221
South Africa7 sites
GSK Investigational Site
Loeventstein, 7530
GSK Investigational Site
Oakdale, 7530
GSK Investigational Site
Richards Bay, 3900
GSK Investigational Site
Rosebank, 2196
GSK Investigational Site
Somerset West, 7130
GSK Investigational Site
Waverley, Bloemfontein, 9301
GSK Investigational Site
Willows, X14, Pretoria, 0040
Netherlands6 sites
GSK Investigational Site
's-Hertogenbosch, 5232 JL
GSK Investigational Site
Alkmaar, 1815 JD
GSK Investigational Site
Blaricum, 1261 AN
GSK Investigational Site
Hengelo, 7555 DL
GSK Investigational Site
Hilversum, 1213 XZ
GSK Investigational Site
The Hague, 2545 CH
Sweden6 sites
GSK Investigational Site
Falköping, SE-521 85
GSK Investigational Site
Jönköping, SE-551 85
GSK Investigational Site
Kalix, SE-952 82
GSK Investigational Site
Mölndal, SE-431 41
GSK Investigational Site
Sundsvall, SE-851 86
GSK Investigational Site
Umeå, SE-901 85
United Kingdom6 sites
GSK Investigational Site
Blackpool, Lancashire, FY2 0JH
GSK Investigational Site
Bradford, BD3 0DQ
GSK Investigational Site
Liverpool, L9 7LJ
GSK Investigational Site
Stirling, FK8 1RW
GSK Investigational Site
West End, Southampton, SO30 3JB
GSK Investigational Site
West of Scotland Science Park, Glasgow, G20 0XA
Belgium4 sites
GSK Investigational Site
Brussels, 1070
GSK Investigational Site
Kortrijk, 8500
GSK Investigational Site
Leuven, 3000
GSK Investigational Site
Woluwe-Saint-Lambert, 1200
Bulgaria4 sites
GSK Investigational Site
Sofia, 1113
GSK Investigational Site
Sofia, 1431
GSK Investigational Site
Sofia, 1527
GSK Investigational Site
Varna, 9010
Czechia4 sites
GSK Investigational Site
Olomouc, 775 20
GSK Investigational Site
Prague, 10000
GSK Investigational Site
Prague, 180 00
GSK Investigational Site
Trutnov, 541 01
Malaysia4 sites
GSK Investigational Site
Bandar Tun Razak, Cheras, 50586
GSK Investigational Site
Bandar Tun Razak, Cheras, 59100
GSK Investigational Site
Ipoh, 30990
GSK Investigational Site
Kelantan, 16150
Poland4 sites
GSK Investigational Site
Bydgoszcz, 85-796
GSK Investigational Site
Krakow, 31-530
GSK Investigational Site
Torun, 87-100
GSK Investigational Site
Warsaw, 02-097
Slovakia4 sites
GSK Investigational Site
Bratislava, 811 01
GSK Investigational Site
Bratislava, 811 07
GSK Investigational Site
Bratislava, 825 56
GSK Investigational Site
Košice, 041 66
Finland3 sites
GSK Investigational Site
Helsinki, 00120
GSK Investigational Site
Joensuu, 80100
GSK Investigational Site
Kuopio, 70211
Singapore3 sites
GSK Investigational Site
Singapore, 169608
GSK Investigational Site
Singapore, 308433
GSK Investigational Site
Singapore, 539747
South Korea3 sites
GSK Investigational Site
Seongnam-si, 463-707
GSK Investigational Site
Seoul, 138-736
GSK Investigational Site
Seoul, 150-713
Hong Kong2 sites
GSK Investigational Site
Hong Kong
GSK Investigational Site
Shatin
Philippines2 sites
GSK Investigational Site
Manila, 1000
GSK Investigational Site
Pasig, 1600
Slovenia2 sites
GSK Investigational Site
Ljubljana, 1000
GSK Investigational Site
Šempeter v Savinjski Dolini, 5290
About this study
Official title: A 54 Week, Double-blind, Randomised, Placebo-controlled, Parallel Group Study to Investigate the Effects of Rosiglitazone (Extended Release Tablets) as Adjunctive Therapy to Acetylcholinesterase Inhibitors on Cognition and Overall Clinical Response in APOE4-stratified Subjects With Mild to Moderate Alzheimer's Disease
Rosiglitazone (RSG) has been tested in clinical studies and is approved by the FDA as a treatment for type II diabetes mellitus, a disease that occurs when the body is unable to effectively use glucose. RSG XR, the investigational drug used in this study, is an extended-release form of RSG.
This study tests whether RSG XR safely provides clinical benefit to people with mild to moderate Alzheimer's disease (AD) when combined with one of the currently approved AD medications, Aricept®, Razadyne® or Exelon®. RSG XR is a new approach to AD therapy and this study tests a new way to treat AD by testing whether one's genetic makeup affects the response to the study drug. Clinical data suggesting that RSG may benefit AD patients was first seen in a small study performed at the University of Washington and then from a larger GSK study conducted in Europe and New Zealand. In the first study, subjects receiving RSG once daily for 6 months scored significantly better on 3 tests of memory and thought than those who did not receive RSG. In the GSK study, those that appeared to benefit most from treatment with RSG XR had a specific genetic pattern. They did not have the gene that caused them to produce the protein apolipoprotein E e4 (APOE e4). Subjects who have the APOE e4 gene may have two copies, one from each parent, or they may have only one APOE e4 gene meaning that they inherited either the APOE e2 or APOE e3 version of the gene, instead of APOE e4, from one of their parents. Subjects with one copy of the APOE e4 gene remained at their same level of thinking ability while those with two copies of the APOE e4 gene, continued to worsen during the 6-month treatment. The current study will more directly test the effectiveness or RSG XR on people who either have or lack the APOE e4 gene.
Read the detailed description
A 54-week, double-blind, randomized, placebo-controlled, parallel-group study to investigate the effects of rosiglitazone (extended release tablets) as adjunctive therapy to acetylcholinesterase inhibitors on cognition and overall clinical response in APOE e4-stratified subjects with mild to moderate Alzheimer's disease (REFLECT-3)
- Conditions
- Alzheimer's Disease
- Being tested
- Rosiglitazone Extended Release 2mg, Rosiglitazone Extended Release 8mg, Placebo
- Keywords
- adjunctive therapy, moderate, Alzheimer's disease, apolipoprotein E, mild, rosiglitazone, cognition
- Medical subject headings
- Alzheimer Disease, Lymphoma, Follicular
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Rosiglitazone Extended Release 2mgDrug
Rosiglitazone Extended Release 2mg OD
Rosiglitazone Extended Release 8mgDrug
Rosiglitazone Extended Release 8mg OD
PlaceboOther
Placebo
| Study group | Role | What they receive |
|---|---|---|
| Arm 1 | Experimental | Rosiglitazone Extended Release 2mg OD Receives: Drug: Rosiglitazone Extended Release 2mg |
| Arm 2 | Experimental | Rosiglitazone Extended Release 8mg OD Receives: Drug: Rosiglitazone Extended Release 8mg |
| Arm 3 | Placebo comparator | Placebo Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) Total Score at Week 48, as a Function of APOE ε4 Status in APOE4 Negatives Cohort
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Measured: Baseline (Week 0) and Week 48
Change From Baseline in ADAS-Cog Total Score at Week 48, as a Function of APOE ε4 Status in All Except E4/E4s Cohort
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Measured: Baseline (Week 0) and Week 48
Change From Baseline in ADAS-Cog Total Score at Week 48, as a Function of APOE ε4 Status in Full Population Cohort
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Measured: Baseline (Week 0) and Week 48
Change From Baseline in Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) Score at Week 48, as a Function of APOE ε4 Status in APOE4 Negatives Cohort
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Primary inference will be based on the week 48 treatment differences obtained from the MMRM model. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Measured: Baseline (Week 0) and Week 48
Change From Baseline in CDR-SB Score at Week 48, as a Function of APOE ε4 Status in All Except E4/E4s Cohort
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Primary inference will be based on the week 48 treatment differences obtained from the MMRM model. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Measured: Baseline (Week 0) and Week 48
Change From Baseline in CDR-SB Score at Week 48, as a Function of APOE ε4 Status in Full Population Cohort
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Primary inference will be based on the week 48 treatment differences obtained from the MMRM model. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Measured: Baseline (Week 0) and Week 48
Secondary outcomes (25)
Change From Baseline in ADAS-Cog Total Score at Weeks 8, 16, 24 and 36
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. It was calculated at Weeks 8, 16, 24 and 36. Full population data was presented.
Measured: Baseline (Week 0) and Week 8, 16, 24, 36
Change From Baseline in CDR-SB Score at Weeks 12, 24 and 36
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. It was calculated at Weeks 12, 24 and 36. Full population data was presented.
Measured: Baseline (Week 0) and Week 12, 24, 36
Change From Screening in Mini Mental State Examination (MMSE) Total Score
The MMSE consists of 11 tests of orientation, memory (recent and immediate), concentration, language and praxis. Scores range from 0 to 30, with lower scores indicating greater cognitive impairment. The scale is completed by the investigator, based on the performance of the participant. Change from screening was calculated as value at scheduled time point minus screening value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Full population data was presented.
Measured: Screening (Week -4) and Week 48
Change From Baseline in Disability Assessment for Dementia (DAD) Total Score
The DAD assessed the ability of a participant to execute basic and instrumental activities of daily living (ADL) and leisure activities. The scale consists of 40 questions assessing basic and instrumental ADLs. This scale assessed a participants' ability to initiate, plan, and perform activities related to hygiene, dressing, continence, eating, meal preparation, telephoning, going on an outing, finance and correspondence, medications, leisure, and housework. Each item was scored as yes: 1, no: 0 and N/A: not applicable. Higher scores indicate less disability with a score of 100 indicating no disability and 0 indicating no functional ability. The percentage score was calculated as (DAD Total score /Total number of applicable items) multiplied by 100. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Baseline (Week 0) and Week 8, 16, 24, 48
Change From Baseline in Neuropsychiatric Inventory (NPI) Total Score
NPI is an assessment of frequency and severity of behavioral disturbances in dementia that comprised of 10 dimensions: delusions, hallucinations, dysphoria, apathy, euphoria, disinhibition, aggressiveness and agitation, irritability, anxiety, aberrant motor activity. Participant's caregiver asked about behavior in participant. If "Yes", informant then rated both severity on a 3-point scale, 1-mild to 3-severe (total range: 0-36) and frequency using a 4-point scale, 1-occasionally to 4-very frequently. Total score was frequency × severity. Distress was scored on 5-point scale, 0-no distress to 5-very severe or extreme. Total NPI score was calculated by adding all domain scores; NPI total score: 0-144 and NPI distress score: 0-60, higher scores indicated more severe behavioral disturbance. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Adjusted means were presented. Full population data was presented.
Measured: Baseline (Week 0) and Week 8, 16, 24, 48
Change From Baseline in Domains of the Resource Utilization in Dementia Scale (RUD)- Q1 and Q2 Caregiver Hours
The RUD instrument was developed as a comprehensive tool to assess the amount of resource use among demented patients. RUD assessd both formal and informal resource use of the patient and the primary caregiver, making it possible to calculate costs from a societal perspective. Q1 corresponds to the number of hours during the last month the caregiver spent assisting the patient with toilet visits, eating, dressing, grooming, walking and bathing and Q2 corresponds to the number of hours during the last month the caregiver spent assisting the patient with shopping, food preparation, housekeeping, laundry, transportation, taking medication and managing financial matters. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Full population data was presented.
Measured: Baseline (Week 0) and Week 12, 24, 36, 48
Change From Baseline in European Quality of Life -5 Dimensions (EQ-5D) Scale Total Score- Thermometer Score
The EQ-5D Proxy is an assessment of quality of life and utility benefit. The EQ-5D Proxy is composed of two parts: part two is the visual analogue scale 'Thermometer'. Caregivers are asked to respond as they feel the participant would on dimensions of mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The 'Thermometer' has endpoints of 100 (best imaginable health state) and 0 (worst imaginable health state). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Full population data was presented.
Measured: Baseline (Week 0) and Week 12, 36, 48
Change From Baseline in EQ-5D Scale Total Score- Utility Score
The EQ-5D Proxy is an assessment of quality of life and utility benefit. The EQ-5D Proxy is composed of two parts: part one is the five dimensional Health State Classification. The Utility score is a caregiver rating of health status on dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Answers to each question were responded to on a 3-point scale which indicates the level of impairment (level 1= no problem; level 2=some or moderate problem(s) and level 3=unable, or extreme problem with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Full population data was presented.
Measured: Baseline (Week 0) and Week 12, 36, 48
Change From Baseline in Alzheimer's Carer's Quality of Life Instrument (ACQLI) Score
The ACQLI is an assessment of caregiver quality of life. This instrument consisted of 30 questions exploring various aspects of carer's quality of life. Each of the questions had two point response, and the 30 questions were summed to provide a total score. Items were assumed to be unidimensional (i.e., represent a single variable) and were scored 0/1 (false/true) before summation into a total score with a 0-30 range. To ease comparisons between scales, ACQLI scores were transformed to range between 0-100 (100: worse). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Full population data was presented.
Measured: Baseline (Week 0) and Week 12, 36, 48
Change in ADAS-Cog Total Score for Observed Cases at Week 54 Compared to Week 48
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. It was of interest to compare the single blind phase data between the treatment groups defined based on the double blind treatment group. This analysis only included participants who received at least one dose of single-blind medication. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Week 48 and Week 54
Change in CDR-SB Total Score for Observed Cases at Week 54 Compared to Week 48
The CDR-SB was a validated clinical assessment of global function in participants with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). It was of interest to compare the single blind phase data between the treatment groups defined based on the double blind treatment group. This analysis only included participants who received at least one dose of single-blind medication. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Week 48 and Week 54
Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 48
Blood samples were collected for assessments of HbA1c levels at Baseline and up to Week 48. Change from Baseline was calculated as value at scheduled time point minus Baseline value . Baseline was defined as value at Week 0. Endpoint treatment differences which were adjusted to take account of missing data are derived. Full population data was presented.
Measured: Baseline (Week 0) and Week 48
Number of Participants With On-treatment Adverse Events (AEs), Serious Adverse Events (SAEs) and Severity of AEs
AE was defined as any untoward medical occurrence in a participant temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. SAE was any untoward medical occurrence that, at any dose results in death, was life threatening, required hospitalization or prolongation of existing hospitalization, resulted in disability/incapacity, was a congenital anomaly/birth defect or was considered as medically significant.
Measured: Upto Week 48
Number of Participants With Change From Baseline in Vital Signs of Clinical Concern at Any Time on Treatment- Weight
Body weight was measured at all visits, without shoes and wearing light clothing. The assessment was performed a t Baseline and up to Week 54. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Upto Week 54
Number of Participants With Change From Baseline in Vital Signs of Clinical Concern at Any Time on Treatment- Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)
SBP and DBP of participants were recorded in sitting posture as vital sign at each visit. The blood pressure (BP) values were identified as of potential clinical concern if the values were out of the reference range (for SBP, 90 to 140 mmHg and DBP, 50 to 90 mmHg) or meet a change from baseline criterion. The change from baseline criterion for SBP, was increase from Baseline (high) if increased by more than or equal to (>=) 40 mm Hg from Baseline; decrease from Baseline (low) if decreased by >= 30 mmHg from Baseline. For DBP, increase from baseline (high) if increased by >=30 mmHg from baseline; decrease from Baseline (low) if decreased by >= 20 mmHg from Baseline. Baseline was defined as value at Week 0.
Measured: Upto Week 54
Number of Participants With Change From Baseline in Vital Signs of Clinical Concern at Any Time on Treatment- Heart Rate (HR)
HR of participants were recorded in sitting posture as vital sign at each visit. The HR values were identified as of potential clinical concern if the values were out of the reference range (50 to 100 beats per minute) or meet a change from baseline criterion. The change from baseline criterion for HR, was increase from Baseline (high) if increased by more than or equal to (>=) 30 from Baseline; decrease from Baseline (low) if decreased by >= 30 from Baseline. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Upto Week 54
Change From Baseline in Weight
Body weight was measured at all visits, without shoes and wearing light clothing. The assessment was performed at Baseline, Weeks 4, 8, 12, 16, 24, 36, 48, 54. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Baseline (Week 0) and Weeks 4, 8, 12, 16, 24, 36, 48, 54
Change From Baseline in Hemoglobin
Hematology parameters were assessed at Baseline, Weeks 4, 16, 36, 48. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Baseline (Week 0) and Weeks 4, 16, 36, 48
Change From Baseline in Hematocrit
Hematology parameters were assessed at Baseline and up to Week 48. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0.
Measured: Baseline (Week 0) and Weeks 4, 16, 36, 48
Any Time on Treatment Differences in Frequencies of Hematology Data Outside the Reference Range
Haematology parameters were identified as of PCC (high [H], low [L]), if the values were out of the reference range (RR). The range for parameters was: platelet (100AV-500AV), red blood cell (RBC , 0.8-1.2), hemoglobin (L: female [F]:10, male [M]:11; H: F:16.5-AV, M:18), hematocrit (0.8-1.2), white blood cell (WBC, 3-15), Total neutrophils (ANC- absolute Neutrophil count) (0.75-1.5), lymphocytes (0.75-1.5), monocyte s (0.75-2), eosinophils (none -2), basophils (none -2), mean corpuscle volume (MCV, 0.8-1.2), mean corpuscular hemoglobin (MCH, 0.8-1.2), mean corpuscular hemoglobin concentration (MCHC , 0.8-1.2), red cell distribution width (RDW, 0.8-1.2), Neutrophil bands (none-1) and segmented neutrophils (0.75-1.3). Full population data was presented.
Measured: Up to Week 48
Any Time on Treatment Differences in Frequencies of Clinical Chemistry Data Outside the Reference Range
Clinical chemistry parameters were identified as of PCC (High, Low), if values were out of RR: Alanine amino transferase (ALT,none-120 [250percent upper limit of RR, ULRR ]),Album in (0.75-2),Aldolase(1.1-1.1),Aspartate amino transferase (AST,none-105 (3-64y),137.5(65+y),>250 percent ULRR), Alkaline phosphatase(ALP,none-312.5 (20+y),>250percent ULRR),blood urea nitrogen(BUN)/Creatinine ratio(none-1.25),BUN(none-11),Chloride(80-115),Calcium (0.75-1.25),Carbon dioxide(CO2,15-40) content,Creatinine (22,<50percent lower limit of RR [LLRR ]-155, >125percent ULRR),Creatine phosphokinase(CPK,none-1.25),Gamma glutamyl transferase(GGT,none-2.5),Glucose (3.6-7.8),HbA1C, High density lipoprotein (HDL,0.65-none),Lactate dehydrogenase (LDH,none -2), Low density lipoprotein(LDL,none-1.25),Magnesium (0.5-2),Potassium (3-5.5),Phosphorus inorganic(0.5-1.5), Sodium (130-150), Total protein (0.8-1.5),Total cholesterol(none -1.5),Direct Billirubin.
Measured: Upto Week 48
Changes From Baseline in Electrocardiogram (ECG) Parameters- HR
Triplicate 12-lead ECG measures was obtained digitally, approximately one minute apart after the participant had rested in the supine position in a quiet room (no TV, minimal talking) for atleast 10 minutes. The ECG parameters includes HR. The assessments were performed at Baseline and up to Week 54. Change from Baseline was calculated as value at scheduled time point minus Baseline value . Baseline was defined as value at Week 0. Full population data was presented.
Measured: Baseline (Week 0) and Weeks 4, 8, 16, 24, 36, 48, 54
Changes From Baseline in ECG Parameters- RR Interval, QT Interval, QTcB, QTcF, PR Interval and QRS Duration
Triplicate 12-lead ECG measures was obtained digitally, approximately one minute apart after the participant had rested in the supine position in a quiet room (no TV, minimal talking) for atleast 10 minutes. The ECG parameters includes PR interval, QRS duration, QT - uncorrected interval, QTc Bazett (QTcB), QTc Fridericia (QTcF) and RR interval. The assessments were performed at Baseline and up to Week 54. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Full population data was presented.
Measured: Baseline (Week 0) and Weeks 4, 8, 16, 24, 36, 48, 54
Change From Baseline in HbA1c up to Week 54
Blood samples were collected for assessments of HbA1c levels at Baseline, Weeks 12, 24, 36, 48, 54. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0.
Measured: Baseline (Week 0) and Weeks 12, 24, 36, 48, 54
Change From Baseline in Short Term Memory Assessment
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Questions 1 (word recall) and 7 (word recognition) of ADAS-Cog questionnaire was summed to get a short term memory assessment. The score for Question 1 was calculated as the mean number of words not recalled over the trials for which data was available. If data for all three trials was missing, or if the score for Question 7 was missing then the short term memory score will also be set to missing. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented.
Measured: Baseline (Week 0) and upto Week 48
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jul 2006 (estimated)
- Study start12 Jul 2006
- Primary completion20 Mar 2009
- Study completion20 Mar 2009
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Alzheimer's DiseaseStudies of the same condition, open and under way.
- More trials run by GlaxoSmithKlineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 1,468 participants (actual)
Sponsor and investigators
- Lead sponsor
- GlaxoSmithKline
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- GSK Clinical Trials, Study director, GlaxoSmithKline
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00348140
- Sponsor's protocol ID
- AVA102670
- Acronym
- REFLECT-3
- Status last verified
- Aug 2017
- First submitted
- 30 Jun 2006
- Last updated
- 5 Sep 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.
Publications
Harrington C, Sawchak S, Chiang C, Davies J, Donovan C, Saunders AM, Irizarry M, Jeter B, Zvartau-Hind M, van Dyck CH, Gold M. Rosiglitazone does not improve cognition or global function when used as adjunctive therapy to AChE inhibitors in mild-to-moderate Alzheimer's disease: two phase 3 studies. Curr Alzheimer Res. 2011 Aug;8(5):592-606. doi: 10.2174/156720511796391935.
PubMed 21592048
Study at a glance
From the registry record, last updated by the sponsor on 5 Sep 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 54 Week, Double-blind, Randomised, Placebo-controlled, Parallel Group Study to Investigate the Effects of Rosiglitazone (Extended Release Tablets) as Adjunctive Therapy to Acetylcholinesterase Inhibitors on Cognition and Overall Clinical Response in APOE4-stratified Subjects With Mild to Moderate Alzheimer's Disease
- ClinicalTrials.gov ID
- NCT00348140
- Acronym / sponsor ID
- REFLECT-3 / AVA102670
- Conditions
- Alzheimer's Disease
- Keywords
- adjunctive therapy, moderate, Alzheimer's disease, apolipoprotein E, mild, rosiglitazone, cognition
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,468 participants (actual)
- Lead sponsor
- GlaxoSmithKlineIndustry (pharma, biotech, devices)
- Study start
- 12 Jul 2006 (actual)
- Primary completion
- 20 Mar 2009 (actual)
- Study completion
- 20 Mar 2009 (actual)
- First posted
- 4 Jul 2006 (estimated)
- Results
- Posted 5 Sep 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Rosiglitazone (RSG) has been tested in clinical studies and is approved by the FDA as a treatment for type II diabetes mellitus, a disease that occurs when the body is unable to effectively use glucose. RSG XR, the investigational drug used in this study, is an extended-release form of RSG.
This study tests whether RSG XR safely provides clinical benefit to people with mild to moderate Alzheimer's disease (AD) when combined with one of the currently approved AD medications, Aricept®, Razadyne® or Exelon®. RSG XR is a new approach to AD therapy and this study tests a new way to treat AD by testing whether one's genetic makeup affects the response to the study drug. Clinical data suggesting that RSG may benefit AD patients was first seen in a small study performed at the University of Washington and then from a larger GSK study conducted in Europe and New Zealand. In the first study, subjects receiving RSG once daily for 6 months scored significantly better on 3 tests of memory and thought than those who did not receive RSG. In the GSK study, those that appeared to benefit most from treatment with RSG XR had a specific genetic pattern. They did not have the gene that caused them to produce the protein apolipoprotein E e4 (APOE e4). Subjects who have the APOE e4 gene may have two copies, one from each parent, or they may have only one APOE e4 gene meaning that they inherited either the APOE e2 or APOE e3 version of the gene, instead of APOE e4, from one of their parents. Subjects with one copy of the APOE e4 gene remained at their same level of thinking ability while those with two copies of the APOE e4 gene, continued to worsen during the 6-month treatment. The current study will more directly test the effectiveness or RSG XR on people who either have or lack the APOE e4 gene.
Detailed description
A 54-week, double-blind, randomized, placebo-controlled, parallel-group study to investigate the effects of rosiglitazone (extended release tablets) as adjunctive therapy to acetylcholinesterase inhibitors on cognition and overall clinical response in APOE e4-stratified subjects with mild to moderate Alzheimer's disease (REFLECT-3)
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Arm 1 | Experimental | Drug: Rosiglitazone Extended Release 2mgRosiglitazone Extended Release 2mg OD |
| Arm 2 | Experimental | Drug: Rosiglitazone Extended Release 8mgRosiglitazone Extended Release 8mg OD |
| Arm 3 | Placebo comparator | Other: PlaceboPlacebo |
Who may qualify
- Ages
- 50 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (20 listed)
- A subject will be eligible for inclusion in this study only if all of the following criteria apply:
- Male or female subject with a clinical diagnosis of probable Alzheimer's disease in accordance with NINCDS-ADRDA criteria (Appendix 2).
- (Note: National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and Alzheimer's Disease and Related Disorders Association (ADRDA).)
- Subject has mild to moderate Alzheimer's disease as defined by a MMSE score 10 to 26 inclusive at Screening.
- Hachinski Ischemia Score ≤ 4 at Screening (See Appendix 3).
Key exclusion criteria (30 listed)
- A subject will not be eligible for inclusion in this study if any of the following criteria apply:
- Diagnosis of possible, probable, or definite vascular dementia in accordance with NINDS-AIREN criteria (Appendix 5).
- (Note: National Institute of Neurological Disorders and Stroke (NINDS) and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN).)
- History or evidence of any other CNS disorder that could be interpreted as a cause of dementia: e.g. cerebrovascular disease (stroke, hemorrhage), structural abnormality, epilepsy, infectious or inflammatory/demyelinating CNS conditions, Parkinson's disease.
- Evidence of the following disorders: current vitamin B12 deficiency, positive syphilis serology, or active thyroid dysfunction (particularly that suggestive of hypothyroidism), including abnormally high or low serum levels of thyroid stimulating hormone (TSH), that are clinically significant in the opinion of the investigator.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Rosiglitazone Extended Release 2mgRosiglitazone Extended Release 2mg OD | Drug | Arm 1 |
| Rosiglitazone Extended Release 8mgRosiglitazone Extended Release 8mg OD | Drug | Arm 2 |
| PlaceboPlacebo | Other | Arm 3 |
Primary outcome
Change From Baseline in Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) Total Score at Week 48, as a Function of APOE ε4 Status in APOE4 Negatives Cohort
Time frame: Baseline (Week 0) and Week 48
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value at Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Change From Baseline in ADAS-Cog Total Score at Week 48, as a Function of APOE ε4 Status in All Except E4/E4s Cohort
Time frame: Baseline (Week 0) and Week 48
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Change From Baseline in ADAS-Cog Total Score at Week 48, as a Function of APOE ε4 Status in Full Population Cohort
Time frame: Baseline (Week 0) and Week 48
The 11-item ADAS-Cog assessed a range of cognitive abilities including memory, comprehension, orientation in time and place and spontaneous speech. Most items were evaluated by tests, but some were dependent on clinician ratings on a five point scale. Scores range from 0 to 70 with higher scores indicating greater dysfunction. Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Change From Baseline in Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) Score at Week 48, as a Function of APOE ε4 Status in APOE4 Negatives Cohort
Time frame: Baseline (Week 0) and Week 48
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Primary inference will be based on the week 48 treatment differences obtained from the MMRM model. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Change From Baseline in CDR-SB Score at Week 48, as a Function of APOE ε4 Status in All Except E4/E4s Cohort
Time frame: Baseline (Week 0) and Week 48
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Primary inference will be based on the week 48 treatment differences obtained from the MMRM model. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
Change From Baseline in CDR-SB Score at Week 48, as a Function of APOE ε4 Status in Full Population Cohort
Time frame: Baseline (Week 0) and Week 48
The CDR-SB was a validated clinical assessment of global function in patients with AD. Impairment was scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or "box scores", can be added together to give the CDR-Sum of Boxes which ranges from 0 to 18 (severe impairment). Change from Baseline was calculated as value at scheduled time point minus Baseline value. Baseline was defined as value a t Week 0. Estimated value was calculated by Active treatment minus Placebo. The adjusted means were presented. Primary inference will be based on the week 48 treatment differences obtained from the MMRM model. A hierarchical testing procedure was used to control for statistical tests in the two RSG dose groups and the genetic subgroups.
25 secondary outcomes
Change From Baseline in ADAS-Cog Total Score at Weeks 8, 16, 24 and 36
Time frame: Baseline (Week 0) and Week 8, 16, 24, 36
Change From Baseline in CDR-SB Score at Weeks 12, 24 and 36
Time frame: Baseline (Week 0) and Week 12, 24, 36
Change From Screening in Mini Mental State Examination (MMSE) Total Score
Time frame: Screening (Week -4) and Week 48
Change From Baseline in Disability Assessment for Dementia (DAD) Total Score
Time frame: Baseline (Week 0) and Week 8, 16, 24, 48
Change From Baseline in Neuropsychiatric Inventory (NPI) Total Score
Time frame: Baseline (Week 0) and Week 8, 16, 24, 48
Change From Baseline in Domains of the Resource Utilization in Dementia Scale (RUD)- Q1 and Q2 Caregiver Hours
Time frame: Baseline (Week 0) and Week 12, 24, 36, 48
Change From Baseline in European Quality of Life -5 Dimensions (EQ-5D) Scale Total Score- Thermometer Score
Time frame: Baseline (Week 0) and Week 12, 36, 48
Change From Baseline in EQ-5D Scale Total Score- Utility Score
Time frame: Baseline (Week 0) and Week 12, 36, 48
Change From Baseline in Alzheimer's Carer's Quality of Life Instrument (ACQLI) Score
Time frame: Baseline (Week 0) and Week 12, 36, 48
Change in ADAS-Cog Total Score for Observed Cases at Week 54 Compared to Week 48
Time frame: Week 48 and Week 54
Change in CDR-SB Total Score for Observed Cases at Week 54 Compared to Week 48
Time frame: Week 48 and Week 54
Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 48
Time frame: Baseline (Week 0) and Week 48
Number of Participants With On-treatment Adverse Events (AEs), Serious Adverse Events (SAEs) and Severity of AEs
Time frame: Upto Week 48
Number of Participants With Change From Baseline in Vital Signs of Clinical Concern at Any Time on Treatment- Weight
Time frame: Upto Week 54
Number of Participants With Change From Baseline in Vital Signs of Clinical Concern at Any Time on Treatment- Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)
Time frame: Upto Week 54
Number of Participants With Change From Baseline in Vital Signs of Clinical Concern at Any Time on Treatment- Heart Rate (HR)
Time frame: Upto Week 54
Change From Baseline in Weight
Time frame: Baseline (Week 0) and Weeks 4, 8, 12, 16, 24, 36, 48, 54
Change From Baseline in Hemoglobin
Time frame: Baseline (Week 0) and Weeks 4, 16, 36, 48
Change From Baseline in Hematocrit
Time frame: Baseline (Week 0) and Weeks 4, 16, 36, 48
Any Time on Treatment Differences in Frequencies of Hematology Data Outside the Reference Range
Time frame: Up to Week 48
Any Time on Treatment Differences in Frequencies of Clinical Chemistry Data Outside the Reference Range
Time frame: Upto Week 48
Changes From Baseline in Electrocardiogram (ECG) Parameters- HR
Time frame: Baseline (Week 0) and Weeks 4, 8, 16, 24, 36, 48, 54
Changes From Baseline in ECG Parameters- RR Interval, QT Interval, QTcB, QTcF, PR Interval and QRS Duration
Time frame: Baseline (Week 0) and Weeks 4, 8, 16, 24, 36, 48, 54
Change From Baseline in HbA1c up to Week 54
Time frame: Baseline (Week 0) and Weeks 12, 24, 36, 48, 54
Change From Baseline in Short Term Memory Assessment
Time frame: Baseline (Week 0) and upto Week 48
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Sep 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 21592048Harrington C, Sawchak S, Chiang C, Davies J, Donovan C, Saunders AM, Irizarry M, Jeter B, Zvartau-Hind M, van Dyck CH, Gold M. Rosiglitazone does not improve cognition or global function when used as adjunctive therapy to AChE inhibitors in mild-to-moderate Alzheimer's disease: two phase 3 studies. Curr Alzheimer Res. 2011 Aug;8(5):592-606. doi: 10.2174/156720511796391935.
- Researchers can use this site to request access to anonymised patient level data and/or supporting documents from clinical studies to conduct further research.Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
GSK Clinical Trials study director
GlaxoSmithKline
194 sites in 22 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Rosiglitazone Extended Release 2mg and Rosiglitazone Extended Release 8mg in people with Alzheimer's Disease, run by GlaxoSmithKline at 194 sites in 22 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 20 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Sep 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 194 sites in United States, Germany, Canada, France, Australia and 17 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 5 Sep 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change From Baseline in Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog) Total Score at Week 48, as a Function of APOE ε4 Status in APOE4 Negatives Cohort (time frame: Baseline (Week 0) and Week 48). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00348140, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Sep 2017.