As a traditional Chinese medicine compound, SaiLuoTong capsule is proven to have beneficial effects on learning and memory ability in animal models of vascular dementia (VaD). The study hypothesis is that SaiLuoTong capsule will be effective in the treatment of patients with VaD and will be well tolerated. The purpose of the study is to determine the efficacy and safety of SaiLuoTong capsule on patients with mild to moderate VaD. The outcome measures include general cognitive function, executive function, daily living skills, and mental behavior changes of symptoms in VaD patients.
Vascular dementia (VaD) is a clinical syndrome of acquired intellectual and functional impairment that results from cerebrovascular diseases. SaiLuoTong capsule is a traditional Chinese medicine compound; it is composed of ginseng extract (the main composition: ginseng total saponins), ginkgo biloba extract (the main composition: YinXingTong ester) and safflower extract (the main composition: the west safflower total glycosides). The function of SaiLuoTong capsule is Yiqi Huoxue and Huayu Tongluo in Chinese traditional medicine theory. Pharmacodynamics studies showed that SaiLuoTong capsule can significantly improve neurological symptoms caused by focal cerebral ischemia in animals, and learning and memory ability in animal models of VaD. Based on these previous evidences, we conduct this study to assess the efficacy and safety of SaiLuoTong capsule in patients with mild to moderate VaD. This study is a phase 2 clinical trial of SaiLuoTong capsule for treatment of vascular dementia. The initial study is a 26-week, multicentre, randomized, double -blind, placebo-controlled study. Patients who complete the initial 26-week trial will be eligible to continue in a 26-week open-label extension study. The primary and secondary objectives of this study are as following: Primary Objectives: 1. To assess the efficacy of SaiLuoTong capsule on cognitive and global functioning in patients with mild-to-moderate VaD; 2. To assess the safety and tolerability of SaiLuoTong capsule in patients with mild-to-moderate VaD. Secondary Objectives: 1. To assess the efficacy of SaiLuoTong capsule in improving the ability to do activities of daily living, executive function, and neuropsychiatric symptoms in patients with mild-to-moderate VaD; 2. To assess the efficacy of different dosage regimens of SaiLuoTong in patients with mild-to-moderate VaD; 3. To assess the efficacy of SaiLuoTong treatment of different duration in patients with mild-to-moderate VaD; 4. To assess the efficacy of SaiLuoTong capsule on different etiological subtypes of VaD, including large-vessel VaD, small-vessel VaD, and VaD of mixed large-vessel and small-vessel origin; 5. To assess the efficacy of SaiLuoTong capsule in mild VaD patients and moderate VaD patients separately; 6. To assess to effect of apolipoprotein E (ApoE) ε4 allele on trial outcomes. The study will assess the changes in cognitive function, daily living skills, executive functions, behavioral and psychological symptoms. The primary measures of effectiveness include the change from baseline in the vascular dementia assessment scale cognitive subscale (V-ADAS-cog) and Alzheimer's disease cooperative study-clinical global impression of change (ADCS-CGIC). Secondary measures of effectiveness include the change from baseline in the Alzheimer's disease cooperative study-activities of daily living inventory (ADCS-ADL), mini-mental state examination (MMSE), clinical dementia rating scale (CDR), sum of boxes of CDR(CDR-sb), clock drawing task (CLOX), Chinese version of executive interview 25 (C-EXIT25) and neuropsychiatric inventory (NPI). Safety measures include physical examinations, vital signs, electrocardiography, laboratory tests, and adverse events records.
high dose group of SaiLuoTong capsule: take three pills (180 mg) of SaiLuoTong capsule each time, twice a day, 0.5 hours after breakfast and dinner, taking with lukewarm water.
low dose group of SaiLuoTong capsule: take two pills (120 mg) of SaiLuoTong capsule plus one pill of placebo (analog SaiLuoTong capsule) each time, twice a day, 0.5 hours after breakfast and dinner, taking with lukewarm water.
The control group is randomly divided into two groups by 1:1. During the first 26 weeks, all subjects will take three pills of placebo each time, twice a day. During the last 26 weeks, the subjects in the placebo group will take two pills of SaiLuoTong plus one pill of placebo or three pills of SaiLuoTong each time, twice a day.
Dongzhimen Hospital affiliated to Beijing University of Chinese Traditional Medicine
Beijing, Beijing Municipality, China
Beijing Friendship Hospital of Capital Medical University
V-ADAS-cog
The V-ADAS-cog comprises the ADAS-cog plus the Maze and Number Cancellation test to specifically assess executive function.
Time frame: weeks 0, 13, 26, 39, and 52
ADCS-CGIC
The ADCS-CGIC involves comparison of data acquisition from both home and clinic and the use of both informant-ratings and self-ratings. Important outcomes include clinical global impressions of change (CGIC) as indicators of clinically meaningful change.
Time frame: weeks 0, 13, 26, 39, and 52
ADCS - ADL
An inventory to assess the patient's ability to do basic activities of daily living and instrumental activities of daily living.
Time frame: weeks 0, 26, and 52
MMSE
The MMSE is a global test of cognitive function, for which the total score ranges from 0 to 30, with higher scores indicating lesser severity.
Time frame: screening, weeks 0, 26, and 52
CDR scale
The CDR is a numeric scale used to quantify the severity of symptoms of dementia (i.e. its 'stage').
Time frame: screening, weeks 0, 26, and 52
CLOX
It was designed to elicit executive impairment and to discriminate it from non-executive constructional failure.
Time frame: weeks 0, 26, and 52
C-EXIT25
The C-EXIT25 is a measure of executive function based on a 15-min interview addressing 25 items related to executive cognition.
Time frame: weeks 0, 26, and 52
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
372
Beijing, Beijing Municipality, China
Xuan Wu Hospital of Capital Medical University
Beijing, Beijing Municipality, China
The Chinese Traditional Medical Hospital of Guangdong Province
Guangzhou, Guangdong, China
Southern Hospital of Southern Medical
Guangzhou, Guangdong, China
The First Hospital of Hunan University of Chinese Traditional Medicine
Changsha, Hunan, China
The First people's Hospital of Chenzhou
Chenzhou, Hunan, China
The Central Hospital of Baotou
Baotou, Inner Mongolia, China
The Zhongda Hospital of Southeast University
Nanjing, Jiangsu, China
Chinese Traditional Medical Hospital of Jiangsu Province
Nanjing, Jiangsu, China
...and 6 more locations
NPI
The NPI is used to assess neuropsychiatric symptoms. The NPI uses a screening strategy to minimize administration time, examining and scoring only those behavioral domains with positive responses to screening questions.
Time frame: weeks 0, 26, and 52
CDR-sb
CDR-sb is the sum of boxes of CDR, with higher scores indicating severer degree of impairment.
Time frame: weeks 0, 26, and 52