The purpose of this study is to compare the efficacy and safety of andrographolide 140 mg administered twice a day orally versus a placebo as a modifying treatment of the disease in patients with the progressive forms of Multiple Sclerosis (MS). The principal outcome is to determine the efficacy, of andrographolide in retarding the progression of brain atrophy in patients with progressive forms of MS.
1. Evaluate the clinical efficacy of andrographolide 140 mg administered orally twice a day versus a placebo in: * Delay in the disability capacity progression through the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) at 24 months compared to the baseline. * Delay in cognitive impairment by means of Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT) and depression (Beck) at 24 months compared to the baseline. * Quality of life Multiple Sclerosis Impact Scale (MSIS 29) and fatigue (Krupp) through parameters reported by the patients at at 24 months compared to the baseline. * Tolerability of andrographolide measured by the Treatment Satisfaction Questionnaire for Medication (TSQM) at 24 months. * Delay in the decrease in brain volume measured by Magnetic Resonance (MR) at 24 months compared to the baseline. * Number and volume of new lesions or larger size in T2 by MR at 24 months compared to the baseline. * Number of new hipointense lesions in T1 or (gadolinium captive) by MR at 24 months compared to the baseline. * Delay in the retineal thinning measured by Optical Coherence Tomography (OCT) and visual field at 24 months compared to the baseline. * Safety of andrographolide at 24 months through the record of adverse effects in symptom dairy and programmed interviews. 2. Explore the pharmacokinetic of andrographolide 140 mg administered orally twice day in: * bio availability and concentration of andrographolide in the patients with treatment. * half-life, maximum concentration, clearance of andrographolide in equilibrium state. 3. Determine the immunomodulatory effects of andrographolide 140 mg administered twice a day orally on lymphocyte populations in patients through the: * Determination of Th1, Th2, Th17 and Treg lymphocyte sub-populations. * Determination of cytokines IFNgama, TNFalpha, IL2, IL17alpha and TGFbeta. Population: adult patients, men and women with progressive forms of MS. The number of patients to be selected will be 68, to randomly assign 34 patients to each group.
Study Type
INTERVENTIONAL
Allocation
140 mg andrographolides coated tablets twice a day orally administered for 24 months.
140 mg excipients coated tablets twice a day orally administered for 24 months
Multiple Sclerosis Centre, Pontificia Universidad Catolica de Chile
Santiago, Santiago Metropolitan, Chile
RECRUITINGBrain atrophy in patients with progressive forms of MS
Retarding the progression of brain atrophy as measured by MR quantified by the percentage of change in volume size utilizing SIENA.
Time frame: 24 months
Expanded Disability Status Scale (EDSS)
Delay in the disability capacity progression through the Expanded Disability Status Scale (EDSS) at 24 months compared to the baseline.
Time frame: 24 months
Paced Auditory Serial Addition Test (PASAT)
Delay in cognitive impairment by means of Paced Auditory Serial Addition Test (PASAT) at 24 months compared to the baseline.
Time frame: 24 months
Quality of life Multiple Sclerosis Impact Scale (MSIS 29)
Quality of life Multiple Sclerosis Impact Scale (MSIS 29) through parameters reported by the patients at 24 months compared to the baseline.
Time frame: 24 months
Treatment Satisfaction Questionnaire for Medication (TSQM)
Tolerability of andrographolide measured by the Treatment Satisfaction Questionnaire for Medication (TSQM) at 24 months.
Time frame: 24 months
Number of new T2 lesions
Number of new lesions T2 by MR at 24 months compared to the baseline.
Time frame: 24 months
New hypointense lesions in T1
Number of new hypointense lesions in T1 by MR at 24 months compared to the baseline.
Time frame: 24 months
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RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
68
Optical Coherence Tomography (OCT)
Delay in the retinal thinning measured by Optical Coherence Tomography (OCT) at 24 months compared to the baseline.
Time frame: 24 months
Record of adverse effects in daily symptoms and programmed interviews.
Safety of andrographolide at 24 months through the record of adverse effects in daily symptoms and programmed interviews.
Time frame: 24 months
Multiple Sclerosis Functional Composite (MSFC)
Delay in the disability capacity progression through the Multiple Sclerosis Functional Composite (MSFC) at 24 months compared to the baseline.
Time frame: 24 months
Symbol Digit Modalities Test (SDMT)
Delay in cognitive impairment by means of Symbol Digit Modalities Test (SDMT) at 24 months compared to the baseline.
Time frame: 24 months
Depression by Beck scale
Evaluate mood disorders by means of Beck scale at 24 months compared to the baseline.
Time frame: 24 months
Fatigue by Krupp scale
Evaluate fatigue by Krupp scale reported by the patients at 24 months compared to the baseline.
Time frame: 24 months
Number of new gadolinium enhancement lesions in T1 by MR
Number of new gadolinium enhancement lesions in T1 by MR at 24 months compared to the baseline.
Time frame: 24 months
Visual field
Change in visual field at 24 months compared to the baseline.
Time frame: 24 months
Volume of new T2 lesions
Volume of size in T2 by MR at 24 months compared to the baseline.
Time frame: 24 months