S-Equol in Alzheimer's Disease 2 Trial
- Conditions
- Alzheimer Disease
- Interventions
- Registration Number
- NCT03101085
- Lead Sponsor
- Russell Swerdlow
- Brief Summary
By doing this study researchers hope to learn if S-equol, a compound that acts like estrogen in the body, causes an increase in mitochondrial activity. Researchers also hope to determine the safety and tolerability of a therapeutic dose of S-equol and whether or not it influences cognition.
- Detailed Description
Enrolled participants with a diagnosis of Alzheimer's Disease (AD) will be randomized to receive either S-equol or placebo first, and then cross over to receive the opposite intervention. The study, therefore, consists of two treatment periods with randomly assigned treatment order. Specifically, subjects are randomized to either: (1) S-equol for one month, then placebo for one month; or (2) placebo for one month, then S-equol for one month.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 40
- Have a diagnosis of Alzheimer's Disease (AD)
- Have a study partner who has a close relationship with the participant and will attend study visits with the participant
- Do not possess an Alkylphenol ethoxylates 4 (APOE4) variant of the APOE gene
- Speak English as their primary language
- Have not had any medication changes within the past 30 days
- Reside in a nursing home or dementia special care unit
- Have a potentially confounding, serious medical risk such as insulin-requiring diabetes, any history of cancer that required a chemotherapy or radiation therapy intervention within the past 5 years, or a recent cardiac event
- Have any clinically significant abnormal safety laboratory values at the SEAD2 screening visit
- Have any clinically significant abnormal findings on vital signs measurements, or on physical or neurological examination at the SEAD2 screening visit
- Use any type of systemic estrogen or testosterone replacement therapy
- Has participated in another clinical trial or received any investigational drug or investigational therapy within 30 days before the screening visit
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description S-equol First, Then Placebo S-equol and Placebo In this arm, participants receive S-equol 50mg twice daily for one month, followed by placebo twice daily for one month. There was no washout period. Placebo First, Then S-equol Placebo and S-equol In this arm, participants receive placebo twice daily for one month, followed by S-equol 50mg twice daily for one month. There was no washout period.
- Primary Outcome Measures
Name Time Method Cytochrome Oxidase/Citrate Synthase (COX/CS) Activity Column 1 is the value after completing S-equol minus the value after completing placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 COX/CS value. For placebo then S-equol, this is the Visit 4 minus the Visit 3 COX/CS value. Cytochrome oxidase (COX) was measured in platelet mitochondria as a pseudo-first order rate constant (sec-1/mg protein), which was determined as a Vmax, spectrophotometrically, by tracking the change in absorbance as reduced cytochrome c is oxidized to oxidized cytochrome C. Citrate synthase (CS) is a soluble mitochondrial matrix enzyme whose activity was determined spectrophotometrically as a Vmax (micromoles/mg protein). Reporting the COX activity as a ratio to CS activity takes mitochondrial mass into account, and normalizes the COX activity per the amount of mitochondria present in the assay sample, with units 1/(seconds multiplied by micromoles).
- Secondary Outcome Measures
Name Time Method Logical Memory Test 2 (LMT2) - Delayed Recall Score after completion of S-equol minus score after completion of placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 LMT2 score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 LMT2 score. Scale range: 0-25. A higher score indicates better memory performance.
Number of Participants With Adverse Events 4 Months: From Visit 1 (Day 0) through Visit 1 (end of month 1, +/- 7 days), Visit 2 (end of month 2, +/- 7 days), Visit 3 (end of month 3, +/- 7days), and Post-Interventions Phone Call (end of month 4, +/- 7 days) List of adverse events as reported over the course of the study (safety labs, physical and neurological exams, vital signs, signs and symptoms).
Pattern of COX Activity Changes While on the Active Treatment Versus Placebo Arms of This Crossover Study. Visits 2, 3, 4 Participants are defined as responders or non-responders depending on the slope of COX/CS activity change. Those in the "Responder" group have a greater slope of COX/CS activity change going from off- to on-S-equol as compared to going from on- to off-S-equol.
Montreal Cognitive Assessment (MoCA) Score after completion of S-equol minus score after completion of placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 MoCA score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 MoCA score. Scale range: 0-30. A higher score indicates better global cognitive performance.
Stroop Interference Test Score after completing S-equol minus score after completing placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 Stroop Interference score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 Stroop Interference score. Scale range: 0-unlimited. A higher score indicates better executive function.
Alzheimer's Disease Assessment Scale-Cognitive Portion (ADASCog-11) Score after completion of S-equol minus score after completion of placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 ADASCog score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 ADASCog score. Scale range: 0-70. A lower score indicates better global cognitive performance.
Stroop Color Test Score Score after completion of S-equol minus score after completion of placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 Stroop Color Test score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 Stroop Color Test score. Scale range: 0-unlimited. A higher score indicates better executive function.
Logical Memory Test 1 (LMT1) - Immediate Recall Score after completion of S-equol minus score after completion of placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 LMT1 score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 LMT1 score. Scale range: 0-25. A higher score indicates better memory function.
Stroop Word Test Score after completion of S-equol minus score after completion of placebo. For S-equol then placebo, this is the Visit 3 minus the Visit 4 Stroop Word Test score. For placebo then S-equol, this is the Visit 4 minus the Visit 3 Stroop Word Test score. Scale range: 0-unlimited. A higher score indicates better executive function.
Trial Locations
- Locations (2)
Clinical and Translational Science Unit
🇺🇸Fairway, Kansas, United States
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States