Alzheimer's DiseasePhase 4AD-CombiNCT01921972
The Efficacy of a Combination Regimen in Patients With Mild to Moderate Probable Alzheimer's Disease
A Phase 4 study testing Galantamine CR and Memantine in people with Alzheimer's Disease, run by Charite University, Berlin, Germany.
Trial summary
This is a national multicenter, double-blind, randomized, parallel-group trial of 12 months in duration. Following a 4 week wash-out period, subjects will be randomized to one of 2 treatment groups: (1) galantamine CR 24 mg/day with dose-titration over twelve weeks[maintenance phase from week 9], (2) a combination of… Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Alzheimer's Disease
- What is being tested?
- Galantamine CR and Memantine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 232 participants
- Where
- No sites listed yet
- Study dates
- Nov 2004to May 2009
- Phase
- Phase 4
- Are there results?
- None posted in the registry
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Willingness to participate, as indicated by written informed consent of the patient. The competence of the participating patient has to be assessed by a physician who is not involved in this trial.
- Male or postmenopausal female outpatients.
- Age of > 50 years at time of randomization.
- Diagnosis of probable Alzheimer's Disease (according to NINCDS-ADRDA criteria).
- Clinical and psychometric rating cut-off score (valid at randomisation): MMSE range of 15 to 26 points.
- MRI brain scan not older than 12 months (before randomization) compatible with the diagnosis of Alzheimer's Disease. (The MRI brain scan must be repeated if older than 12 months or if clinically indicated).
- Patient being ambulatory having adequate vision and hearing abilities to allow neuropsychological testing.
- Patient with a knowledgeable, cooperative, reliable caregiver/informant who is willing to follow the study procedure as indicated by written informed consent.
Who cannot join
- Dementia of any other type than AD:
- vascular dementia
- HIS Score (modified acc. to Rosen) > 5 or
- evidence for VD acc. to NINCDS-AIREN criteria.
- depressive pseudodementia defined acc. to DSM-IV criteria for major depression.
- other non-AD dementia.
Show all 27Show fewer
- Significant neurological disease other than AD, such as cerebral tumor, Huntington's disease, Parkinson's disease, normal pressure hydrocephalus, subdural hematoma, mental retardation, history of brain surgery or serious head trauma with residual deficits.
- Diagnosis of psychosis (requiring hospitalization or antipsychotic therapy for more than two weeks) within the past 10 years not associated with AD or a diagnosis of alcoholism or drug dependence within the past 10 years.
- History of epileptic seizures or patient receiving antiepileptic drugs.
- Abnormal laboratory test results considered clinically relevant for dementia: e.g., electrolyte changes, folate deficiency, vitamin B12 deficiency, pathological thyroid function (T3 and TSH levels), positive syphilis serology.
- Patient who, in the opinion of the investigator, is suffering from an acute or poorly controlled illness, such as:
- Presently uncontrolled hypertension (> 180 mmHg systolic or > 100 mmHg diastolic).
- Myocardial infarction within the last six months.
- Patient with uncompensated congestive heart failure (NYHA Class III or IV)
- Severe renal, hepatic or gastrointestinal disease, which could alter absorption, metabolism or excretion of the trial drug.
- Serum creatinine > 130 μmol/l or 1.5 mg/dl, transaminases (ALAT, ASAT) or GGT > twice the upper limit of normal range.
- Uncontrolled diabetes on entry into the double-blind phase of the research project (fasting blood glucose > 10.0 mmol/l or 180 mg/dl in repeated tests) or patient requiring insulin treatment.
- Patient taking any inadmissible medication, such as:
- Any investigational drug.
- Anticonvulsants (incl. barbiturates).
- Anti-Parkinson agents.
- Dopaminergic agents.
- Amantadine.
- Antimuscarinic agents (i. e., anticholinergics).
- Selegiline, MAOI.
- Any condition that precludes cooperation with the tests or other investigations during the study (e.g., seeing or hearing loss, relevant confusion or agitation, musculoskeletal disorders, contraindication for magnetic resonance imaging, i.e., presence of pacemaker, metallic implants in high risk areas, presence of metallic material in high risk areas, history of claustrophobia. Hip implants are not contraindicated).
- Patient has participated in an investigational clinical trial during the last 2 months.
About this study
Official title: Competence Network - Dementia (BMBF) "Pharmacological and Psychosocial Treatment" (Modul E.2) Part II: The Efficacy of a Combination Regimen in Patients With Mild to Moderate Probable Alzheimer's Disease
This is a national multicenter, double-blind, randomized, parallel-group trial of 12 months in duration. Following a 4 week wash-out period, subjects will be randomized to one of 2 treatment groups: (1) galantamine CR 24 mg/day with dose-titration over twelve weeks[maintenance phase from week 9], (2) a combination of galantamine CR 24 mg/day plus memantine 10 mg b.i.d. with a dose titration of sixteen weeks (12 weeks for galantamine [maintenance phase from week 9], additional 4 weeks for memantine).
Read the detailed description
Based on 1. the established efficacy of both, galantamine and memantine in subjects with Alzheimer's disease, 2. galantamine's dual mode of action being a cholinesterase inhibitor and an allosteric modulator of the nicotinic acetylcholine receptor (nAChR) an effect which might lead to enhanced neurotransmission in other neuronal populations, i.e., glutamatergic and GABAergic, 3. memantine's neuroprotective properties, which have been demonstrated in several experimental system, but not yet in a clinical setting the primary hypothesis is formulated that treatment with a combination of galantamine plus memantine, which may exert additional effects on the level of neurotransmitter modulation, will reduce the memory/cognitive problems in AD patients. The effects of the combination therapy will be compared to galantamine effects alone.
As a secondary hypothesis, it is proposed that a combination treatment with galantamine plus memantine could conceivably slow disease progression and/or delay the progression of dementia in probable AD. It is reasonable to assume that the effect will be clearer with a combination therapy (galantamine, memantine) than with cholinesterase inhibitors alone which have been evaluated in long-term clinical trials (rivastigmine, donepezil, galantamine). To corroborate a potential disease modifying effect and to more reliably separate it from a purely symptomatic effect, the disease progress will not only be tracked by clinical measures (CDR rating), but also by using volumetric MRI techniques. Fox et al. have developed a sensitive method to follow changes in overall brain volume over time. In 'normal' ageing about 0.2%/year (SD 0.3%) change in brain volume is documented, whereas in AD, changes of 2.8%/year (SD 1%) are measured. People 'at risk' for developing AD show changes of about 1.5%/year. Recently it was established that rates of hippocampal atrophy correlate with change in clinical status in ageing ('conversion') and AD. Overall, brain atrophy or MRI delineated hippocampal volumes and memory decline seem to be clearly linked. The project will prospectively investigate the validity of investigations of hippocampal volume in assessing therapeutic effects in AD. MR-proton-spectroscopy provides consistent evidence that the neuronal marker Nacetylaspartat (NAA) is reduced in AD, whereas the role of myo-inositol, choline and creatine is less clear. NAA is thought to be present exclusively in neurons in gray matter and in their axonal processes in white matter and not in glial cells. NAA signal loss suggests neuronal loss when it is observed in gray matter and loss of or damage to axonal structures when it is observed in white matter. A correlation of NAA decrease in tissue samples of patients with AD with the number of senile plaques and neurofibrillary tangles was reported. Recent results indicate that the severity of dementia in patients with AD is positively correlated with the decrease in NAA/Cr only in the parietal cortex and in the temporal lobe. These data are consistent with the observation that the amount of synaptic loss is the dominant indicator of dementia in AD. The cognitive decline in patients with AD may be linked with a neuronal loss or dysfunction preferentially in the temporoparietal association cortex. This project will prospectively investigate the validity of spectroscopic abnormalities in assessing therapeutic effects in AD.
The primary objective of this trial is to establish the hypothesis that a combination of galantamine plus memantine improves memory/cognitive performance to a larger extent than galantamine monotherapy in AD subjects after one year of double-blind treatment.
Memory/cognitive performance will be assessed with the ADAS-cog/11. The confirmatory statistical assessment of this hypothesis will be based on the change of the ADAS-cog/11 from baseline to the end of the treatment period.
Additional endpoint variables to be assessed in an exploratory manner in parallel to the ADAS-cog are:
- Preservation of functionality as assessed using the ADCS-ADL/AD scale.
- Global rating of dementia as assessed using the CDR rating instrument.
- Neuropsychiatric symptoms as assessed using the NPI rating instrument.
- Resource utilization as assessed using the RUD rating instrument.
- Caregiver burden as assessed using the burden interview (BI).
- Safety with adverse event reports, laboratory parameters, vital signs, physical examination and ECG
The secondary hypothesis states that the combination therapy with galantamine plus memantine is more effective than galantamine alone in delaying clinical progression of dementia in this population over an observation period of one year. Global severity of dementia will be assessed with the CDR scale.
Supplementary endpoint criteria for this hypothesis are:
- Reduction in the rate of serial MRI determined brain (hippocampal) atrophy and of MRS-based parameters.
- Safety with adverse event reports, laboratory parameters, vital signs, physical examination and ECG.
Further analyses of sub-groups (e.g., determined by biological variables) or biological outcome measures investigated by the diagnostic module with respect to the above measures are planned.
- Conditions
- Alzheimer's Disease
- Being tested
- Galantamine CR, Memantine, Placebo
- Keywords
- AD, Dementia
- Medical subject headings
- Alzheimer Disease, Dementia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Galantamine CRDrug
24 mg/day with dose-titration over twelve weeks
MemantineDrug
memantine 10 mg b.i.d. with a dose titration of sixteen weeks
PlaceboDrug
Placebo will be similar in appearance to Memantine
| Study group | Role | What they receive |
|---|---|---|
| Galantamine and Placebo | Active comparator | Subjects in this group will receive 4 weeks of 8 mg/day galantamine CR, followed by 4 weeks of 16 mg/day and from week 9 up to the end of the trial of 24 mg/day. Receives: Drug: Galantamine CR; Drug: Placebo |
| Galantamine and Memantine | Experimental | Galantamine titration will be performed as described above. Memantine titration will be performed over 4 weeks in steps of 5 mg/day up to 20mg/day (10 mg b.i.d.). 50 % of this group will receive galantamine first, 50 % of the group will receive memantine first to allow for differential qualitative evaluation of tolerability of a combination therapy. Receives: Drug: Galantamine CR; Drug: Memantine |
What is being measured
The primary outcome is the main question the study is designed to answer.
ADAScog/11
Alzheimer's Disease Assessment Scale (ADAS-cog/11) The ADAS consists of two parts - a cognitive subscale and a behavioral subscale. The behavioural subscale will not be used in this trial. The cognitive subscale, the ADAS-cog/11, consisting of Word Recall and Word Recognition memory tests, Object and Finger Naming, Commands, Constructional Praxis, Ideational Praxis, Orientation, Remembering Test Instructions, Spoken Language Ability, Comprehension of Spoken Language and Word Finding Difficulty will be the primary variable in this trial. In this trial the German version of the ADAS-cog/11 will be employed (Ihl \& Weyer, 1993).
Measured: change from Baseline to 12 months of treatment
Secondary outcomes (7)
ADCS-ADL
The ability to perform activities of daily living will be assessed using the AD version of the Alzheimer's Disease Cooperative Study ADL inventory (Galasko et al., 1997, 2004). This instrument comprises questions about 23 basic and instrumental ADLs. For each ADL, the scores range from 0 (non-performance of the activity or the need for extensive help) to the highest score (representing independent performance of the activity). The total score ranges from 0 (no function) to 78 (maximal function).
Measured: change from Baseline to 12 months of treatment
Clinical Dementia Rating
The CDR Scale is a clinician-rated dementia staging system that tracks the progression of cognitive and functional deterioration. Scores are on a scale of 0 - 5, with 0 = no dementia, 0.5 = questionable dementia, 1 = mild dementia, 2 = moderate dementia, 3 = severe dementia, 4 = profound dementia, and 5 = terminal dementia. Cognitive and functional abilities that are assessed are memory, orientation, judgement and problem solving, community affairs, home and hobbies and personal care. Memory is considered the primary driver for scoring with the other categories secondary.
Measured: change from Baseline to 12 months of treatment
Neuropsychiatric Inventory NPI
The Neuropsychiatric Inventory (Cummings et al., 1994) is used to assess 10 areas of non-cognitive symptoms which are common in dementia, including delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability/lability, apathy, and aberrant motor activity. The NPI uses a screening strategy to minimize administration time. Interrater reliability and test-retest reliability are acceptable.
Measured: change from Baseline to 12 months of treatment
Resource Utilization of Dementia Scale (RUD)
For each patient, use of medical and social services will be determined using the Resource Utilization of Dementia Scale (Wimo et al., 1998). This instrument is used to rate the primary caregiver (time spent on caring, occupational status, use of medical and social services, use of medications) and the patient (living arrangement, nursing home and hospital admissions, use of medical and social services) to estimate healthcare cost
Measured: change from Baseline to 12 months of treatment
Burden Interview (BI)
The Burden Interview (Zarit \& Zarit, 1983, 1990) has been designed to assess the stress experienced by family caregivers of elderly and disabled persons. It can be completed by caregivers themselves or as part of an interview. Caregivers are asked to respond to a series of 22 items about the impact of the patient's disabilities on their life. For each item caregivers are to indicate how often they have felt that way: never, rarely, sometimes, quite frequently, or nearly always.
The Burden Interview is scored by summing the responses of the individual items. The total score ranges from 0 to 88. Higher scores indicate greater caregiver distress.
Measured: change from Baseline to 12 months of treatment
Adverse Event Reports
Measured: 12 months of treatment
Rate of brain atrophy
Serial volumetric MRI will generate data-sets used for whole brain rate of atrophy determinations, hippocampal rate of atrophy measurements as well as MR-spectroscopic parameters
Measured: change from baseline to 12 months of treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Aug 2013 (estimated)
- Study startNov 2004
- Primary completionNov 2008
- Study completionMay 2009
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)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 Charite University, Berlin, GermanyThe 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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 232 participants (actual)
Sponsor and investigators
- Lead sponsor
- Charite University, Berlin, Germany
- Sponsor type
- University, hospital or other
- Collaborators
- German Federal Ministry of Education and Research
- Responsible party
- Principal investigator, Isabella Heuser, Charite University, Berlin, Germany
- Investigators
- Isabella Heuser, Prof. Dr., Study director, Free University of BerlinWolfgang Maier, Prof. Dr., Principal investigator, University of BonnWolfgang Gaebel, Prof. Dr., Principal investigator, Heinrich-Heine University, DuesseldorfJohannes Kornhuber, Prof. Dr., Principal investigator, University of Erlangen-NürnbergKonrad Maurer, Prof. Dr., Principal investigator, University of FrankfurtC H Lücking, Prof. Dr., Principal investigator, University of FreiburgEckhart Rüther, Prof. Dr., Principal investigator, University of GöttingenMathias Berger, Prof. Dr., Principal investigator, University of Freiburg
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01921972
- Sponsor's protocol ID
- Modul E.2 II
- Acronym
- AD-Combi
- Status last verified
- Aug 2013
- First submitted
- 7 Aug 2013
- Last updated
- 14 Aug 2013
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Lim AWY, Schneider L, Loy C. Galantamine for dementia due to Alzheimer's disease and mild cognitive impairment. Cochrane Database Syst Rev. 2024 Nov 5;11(11):CD001747. doi: 10.1002/14651858.CD001747.pub4.
PubMed 39498781Peters O, Fuentes M, Joachim LK, Jessen F, Luckhaus C, Kornhuber J, Pantel J, Hull M, Schmidtke K, Ruther E, Moller HJ, Kurz A, Wiltfang J, Maier W, Wiese B, Frolich L, Heuser I. Combined treatment with memantine and galantamine-CR compared with galantamine-CR only in antidementia drug naive patients with mild-to-moderate Alzheimer's disease. Alzheimers Dement (N Y). 2015 Oct 19;1(3):198-204. doi: 10.1016/j.trci.2015.10.001. eCollection 2015 Nov.
PubMed 29854939
Study at a glance
From the registry record, last updated by the sponsor on 14 Aug 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Competence Network - Dementia (BMBF) "Pharmacological and Psychosocial Treatment" (Modul E.2) Part II: The Efficacy of a Combination Regimen in Patients With Mild to Moderate Probable Alzheimer's Disease
- ClinicalTrials.gov ID
- NCT01921972
- Acronym / sponsor ID
- AD-Combi / Modul E.2 II
- Conditions
- Alzheimer's Disease
- Keywords
- AD, Dementia
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 232 participants (actual)
- Lead sponsor
- Charite University, Berlin, GermanyUniversity, hospital or other
- Collaborators
- German Federal Ministry of Education and Research
- Study start
- Nov 2004
- Primary completion
- Nov 2008 (actual)
- Study completion
- May 2009 (actual)
- First posted
- 14 Aug 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a national multicenter, double-blind, randomized, parallel-group trial of 12 months in duration. Following a 4 week wash-out period, subjects will be randomized to one of 2 treatment groups: (1) galantamine CR 24 mg/day with dose-titration over twelve weeks[maintenance phase from week 9], (2) a combination of galantamine CR 24 mg/day plus memantine 10 mg b.i.d. with a dose titration of sixteen weeks (12 weeks for galantamine [maintenance phase from week 9], additional 4 weeks for memantine).
Detailed description
Based on 1. the established efficacy of both, galantamine and memantine in subjects with Alzheimer's disease, 2. galantamine's dual mode of action being a cholinesterase inhibitor and an allosteric modulator of the nicotinic acetylcholine receptor (nAChR) an effect which might lead to enhanced neurotransmission in other neuronal populations, i.e., glutamatergic and GABAergic, 3. memantine's neuroprotective properties, which have been demonstrated in several experimental system, but not yet in a clinical setting the primary hypothesis is formulated that treatment with a combination of galantamine plus memantine, which may exert additional effects on the level of neurotransmitter modulation, will reduce the memory/cognitive problems in AD patients. The effects of the combination therapy will be compared to galantamine effects alone.
As a secondary hypothesis, it is proposed that a combination treatment with galantamine plus memantine could conceivably slow disease progression and/or delay the progression of dementia in probable AD. It is reasonable to assume that the effect will be clearer with a combination therapy (galantamine, memantine) than with cholinesterase inhibitors alone which have been evaluated in long-term clinical trials (rivastigmine, donepezil, galantamine). To corroborate a potential disease modifying effect and to more reliably separate it from a purely symptomatic effect, the disease progress will not only be tracked by clinical measures (CDR rating), but also by using volumetric MRI techniques. Fox et al. have developed a sensitive method to follow changes in overall brain volume over time. In 'normal' ageing about 0.2%/year (SD 0.3%) change in brain volume is documented, whereas in AD, changes of 2.8%/year (SD 1%) are measured. People 'at risk' for developing AD show changes of about 1.5%/year. Recently it was established that rates of hippocampal atrophy correlate with change in clinical status in ageing ('conversion') and AD. Overall, brain atrophy or MRI delineated hippocampal volumes and memory decline seem to be clearly linked. The project will prospectively investigate the validity of investigations of hippocampal volume in assessing therapeutic effects in AD. MR-proton-spectroscopy provides consistent evidence that the neuronal marker Nacetylaspartat (NAA) is reduced in AD, whereas the role of myo-inositol, choline and creatine is less clear. NAA is thought to be present exclusively in neurons in gray matter and in their axonal processes in white matter and not in glial cells. NAA signal loss suggests neuronal loss when it is observed in gray matter and loss of or damage to axonal structures when it is observed in white matter. A correlation of NAA decrease in tissue samples of patients with AD with the number of senile plaques and neurofibrillary tangles was reported. Recent results indicate that the severity of dementia in patients with AD is positively correlated with the decrease in NAA/Cr only in the parietal cortex and in the temporal lobe. These data are consistent with the observation that the amount of synaptic loss is the dominant indicator of dementia in AD. The cognitive decline in patients with AD may be linked with a neuronal loss or dysfunction preferentially in the temporoparietal association cortex. This project will prospectively investigate the validity of spectroscopic abnormalities in assessing therapeutic effects in AD.
The primary objective of this trial is to establish the hypothesis that a combination of galantamine plus memantine improves memory/cognitive performance to a larger extent than galantamine monotherapy in AD subjects after one year of double-blind treatment.
Memory/cognitive performance will be assessed with the ADAS-cog/11. The confirmatory statistical assessment of this hypothesis will be based on the change of the ADAS-cog/11 from baseline to the end of the treatment period.
Additional endpoint variables to be assessed in an exploratory manner in parallel to the ADAS-cog are:
- Preservation of functionality as assessed using the ADCS-ADL/AD scale.
- Global rating of dementia as assessed using the CDR rating instrument.
- Neuropsychiatric symptoms as assessed using the NPI rating instrument.
- Resource utilization as assessed using the RUD rating instrument.
- Caregiver burden as assessed using the burden interview (BI).
- Safety with adverse event reports, laboratory parameters, vital signs, physical examination and ECG
The secondary hypothesis states that the combination therapy with galantamine plus memantine is more effective than galantamine alone in delaying clinical progression of dementia in this population over an observation period of one year. Global severity of dementia will be assessed with the CDR scale.
Supplementary endpoint criteria for this hypothesis are:
- Reduction in the rate of serial MRI determined brain (hippocampal) atrophy and of MRS-based parameters.
- Safety with adverse event reports, laboratory parameters, vital signs, physical examination and ECG.
Further analyses of sub-groups (e.g., determined by biological variables) or biological outcome measures investigated by the diagnostic module with respect to the above measures are planned.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Galantamine and Placebo | Active comparator | Drug: Galantamine CR, Drug: PlaceboSubjects in this group will receive 4 weeks of 8 mg/day galantamine CR, followed by 4 weeks of 16 mg/day and from week 9 up to the end of the trial of 24 mg/day. |
| Galantamine and Memantine | Experimental | Drug: Galantamine CR, Drug: MemantineGalantamine titration will be performed as described above. Memantine titration will be performed over 4 weeks in steps of 5 mg/day up to 20mg/day (10 mg b.i.d.). 50 % of this group will receive galantamine first, 50 % of the group will receive memantine first to allow for differential qualitative evaluation of tolerability of a combination therapy. |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Willingness to participate, as indicated by written informed consent of the patient. The competence of the participating patient has to be assessed by a physician who is not involved in this trial.
- Male or postmenopausal female outpatients.
- Age of > 50 years at time of randomization.
- Diagnosis of probable Alzheimer's Disease (according to NINCDS-ADRDA criteria).
- Clinical and psychometric rating cut-off score (valid at randomisation): MMSE range of 15 to 26 points.
Key exclusion criteria (27 listed)
- Dementia of any other type than AD:
- Significant neurological disease other than AD, such as cerebral tumor, Huntington's disease, Parkinson's disease, normal pressure hydrocephalus, subdural hematoma, mental retardation, history of brain surgery or serious head trauma with residual deficits.
- Diagnosis of psychosis (requiring hospitalization or antipsychotic therapy for more than two weeks) within the past 10 years not associated with AD or a diagnosis of alcoholism or drug dependence within the past 10 years.
- History of epileptic seizures or patient receiving antiepileptic drugs.
- Abnormal laboratory test results considered clinically relevant for dementia: e.g., electrolyte changes, folate deficiency, vitamin B12 deficiency, pathological thyroid function (T3 and TSH levels), positive syphilis serology.
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 |
|---|---|---|
| Galantamine CR24 mg/day with dose-titration over twelve weeks | Drug | Galantamine and Memantine, Galantamine and Placebo |
| Memantinememantine 10 mg b.i.d. with a dose titration of sixteen weeks | Drug | Galantamine and Memantine |
| PlaceboPlacebo will be similar in appearance to Memantine | Drug | Galantamine and Placebo |
Primary outcome
ADAScog/11
Time frame: change from Baseline to 12 months of treatment
Alzheimer's Disease Assessment Scale (ADAS-cog/11) The ADAS consists of two parts - a cognitive subscale and a behavioral subscale. The behavioural subscale will not be used in this trial. The cognitive subscale, the ADAS-cog/11, consisting of Word Recall and Word Recognition memory tests, Object and Finger Naming, Commands, Constructional Praxis, Ideational Praxis, Orientation, Remembering Test Instructions, Spoken Language Ability, Comprehension of Spoken Language and Word Finding Difficulty will be the primary variable in this trial. In this trial the German version of the ADAS-cog/11 will be employed (Ihl \& Weyer, 1993).
7 secondary outcomes
ADCS-ADL
Time frame: change from Baseline to 12 months of treatment
Clinical Dementia Rating
Time frame: change from Baseline to 12 months of treatment
Neuropsychiatric Inventory NPI
Time frame: change from Baseline to 12 months of treatment
Resource Utilization of Dementia Scale (RUD)
Time frame: change from Baseline to 12 months of treatment
Burden Interview (BI)
Time frame: change from Baseline to 12 months of treatment
Adverse Event Reports
Time frame: 12 months of treatment
Rate of brain atrophy
Time frame: change from baseline to 12 months of treatment
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Aug 2013.
- Derived from this study: PubMed 39498781Lim AWY, Schneider L, Loy C. Galantamine for dementia due to Alzheimer's disease and mild cognitive impairment. Cochrane Database Syst Rev. 2024 Nov 5;11(11):CD001747. doi: 10.1002/14651858.CD001747.pub4.
- Derived from this study: PubMed 29854939Peters O, Fuentes M, Joachim LK, Jessen F, Luckhaus C, Kornhuber J, Pantel J, Hull M, Schmidtke K, Ruther E, Moller HJ, Kurz A, Wiltfang J, Maier W, Wiese B, Frolich L, Heuser I. Combined treatment with memantine and galantamine-CR compared with galantamine-CR only in antidementia drug naive patients with mild-to-moderate Alzheimer's disease. Alzheimers Dement (N Y). 2015 Oct 19;1(3):198-204. doi: 10.1016/j.trci.2015.10.001. eCollection 2015 Nov.
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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.
Isabella Heuser, Prof. Dr. study director
Free University of Berlin
Wolfgang Maier, Prof. Dr. principal investigator
University of Bonn
Wolfgang Gaebel, Prof. Dr. principal investigator
Heinrich-Heine University, Duesseldorf
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Galantamine CR and Memantine in people with Alzheimer's Disease, run by Charite University, Berlin, Germany.
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 8 inclusion and 27 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 14 Aug 2013. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
ADAScog/11 (time frame: change from Baseline to 12 months of treatment). 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 NCT01921972, which also lists 2 linked publications.
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 14 Aug 2013.