Therapeutic protentional of the Dexketoprofen trometamol in subduing Alzheimer’s disease (AD) Dementia: A randomized controlled trial
试验速览
- 阶段
- 3 期
- 状态
- 尚未招募
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Change in Addenbrooke’s Cognitive Examination (ACE) total score from baseline assessed using the ACE scale at 3 months, 6 months, and 9 months after intervention
研究概览
简要总结
Alzheimer’s disease is a progressive neurodegenerative disorder with demonstrable pathology include amyloid beta plaques accumulation, neurofibrillary tau tangles, oxidative stress, mitochondrial dysfunction and neuroinflammation leading to synaptic impairment. Among these Quinone dihydroxypteridine Reductase, an oxidative stress regulating enzyme is upregulated in AD with roles in electron transport, oxidative stress and neurotransmitter synthesis and induction of induced nitric acid synthase . In this context, using structure-based drug designing, we found the FDA approved NSAID dexketoprofen trometamol blocks QDPR activity. Dexketoprofen trometamol demonstrated stable interactions with critical residues in the AChE receptor, forming multiple hydrogen bonds that enhance its binding potential. The binding free energy calculations supported dexketoprofen trometamol’s high affinity for AChE, surpassing that of established AD drugs like donepezil. Moreover, previous studies on transgenic mice models of AD showed that dexketoprofen trometamol administration showed improved cognition. One of the major limitations in Alzheimer’s treatment today is that no currently approved drug addresses the multiple pathogenic pathways of the disease simultaneously. Therefore, future treatment strategies have to be multi targeted therapies. Dexketoprofen trometamol is a candidate drug, because it targets three critical mechanisms implicated in AD progression Oxidative stress, Neuroinflammation, and Cholinergic dysfunction (through acetylcholinesterase inhibition). Dexketoprofen trometamol’s established safety makes it more conducive for performing this clinical trial. This makes it a highly promising candidate for multi-targeted therapy in Alzheimer’s, potentially offering disease-modifying benefits rather than just symptomatic relief.
HypothesisAdministering 75 mg of dexketoprofen trometamol daily for 9 months will result in significant improvement in cognitive function, as measured by validated neuropsychological assessments, in patients AD compared to a standard care alone.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- Participant, Investigator and Outcome Assessor Blinded
入排标准
- 年龄范围
- 60.00 Year(s) 至 99.00 Year(s)(—)
- 性别
- All
入选标准
- •Age sixty years or older Diagnosis of Alzheimers disease according to the revised National Institute on Aging and Alzheimers Association criteria of 2024, clinical stage three to five On a stable dose of approved Alzheimers disease medications such as donepezil or memantine for at least three months before enrollment Availability of a reliable caregiver able to support study participation, attend study visits, and report treatment compliance Adequate hepatic function defined as aspartate aminotransferase and alanine aminotransferase not more than two point five times the upper limit of normal, and total bilirubin not more than one point five times the upper limit of normal Adequate renal function defined as creatinine clearance of fifty milliliters per minute or more calculated using the Cockcroft Gault method Written informed consent obtained from the participant where decision making capacity allows and from a legally authorized representative.
排除标准
- •Severe dementia (stage greater than 5, NIA-AA 2024).
- •Presence of other neurodegenerative disorders (e.g., Parkinson s or Huntington s disease).
- •Active peptic ulcer disease, GI bleeding, severe renal/hepatic/cardiac dysfunction.
- •Chronic use of NSAIDs (other than study drug), corticosteroids, anticoagulants, or immunosuppressants within 4 weeks prior to enrollment.
- •Severe psychiatric comorbidities (schizophrenia, bipolar disorder) interfering with participation.
- •Substance or alcohol dependence in the last 5 years.
- •Participation in another interventional trial within the last 3 months.
结局指标
主要结局
Change in Addenbrooke’s Cognitive Examination (ACE) total score from baseline assessed using the ACE scale at 3 months, 6 months, and 9 months after intervention
时间窗: 3 months, 6 months, and 9 months after intervention
次要结局
- Instrumental Activities of Daily Living-Elderly (IADL-E), QoL SF-36 (RAND-36), Neuropsychiatriac inventory (NPI), Geriatric depression scale (GDS) and Amyloid beta 42/40 ratio, phosphorylated tau (p-tau), glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL) and BH4/BH2 ratio will be assessed using serum isolated from the blood samples(3 months, 6 months, and 9 months after intervention)
研究者
Sudheeran Kannoth
Amrita Institute of Medical Sciences
