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Efficacy Study of Cilostazol and Aspirin on Cerebral Small Vessel Disease

Phase 4
Conditions
Cerebral Small Vessel Disease
Interventions
Registration Number
NCT01932203
Lead Sponsor
Inha University Hospital
Brief Summary

There may be a difference in efficacy of cilostazol and aspirin on progression of white matter changes in cerebral small vessel disease.

Detailed Description

The primary objective of this study is to compare the efficacy of aspirin and cilostazol on volume of white matter changes in cerebral small vessel disease.

The secondary objectives are to compare the impact of aspirin and cilostazol on DTI parameters, lacune, microbleeds, brain atrophy, cognition, depression, neurologic signs, gait, urination, and activities of daily living.

We also investigate risk factors associated with progression of cerebral small vessel disease.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
255
Inclusion Criteria
  • 50 to 85 years of age

  • He/She can walk to the hospital (walker or cane is permissible).

  • Cerebral small vessel disease is observed on brain MRI.

    1. presence of one or more lacunar infarction and 2) moderate or severe confluent leukoaraiosis (defined as grade 2 or 3 on a modified Fazekas scale): periventricular WMCs with cap or rims lager than 5mm and deep subcortical WMCs >10 mm in maximum diameter
  • written informed consent

Exclusion Criteria
  • Any patient with contraindication of antiplatelets
  • Any patient with cardioembolic source
  • Carotid bruit or large cerebral artery stenosis >50%
  • Cortical infarction or subcortical infarction lager than 1.5 cm
  • bleeding tendency
  • chronic liver disease (AST or ALT >100 IL/L)
  • chronic renal disease (Creatinine >3.0mg/dL)
  • active gastrointestinal ulcer
  • any patients with any severe or unstable medical disease that may prevent them from completing study requirements (i.e., unstable or severe asthma)
  • Anemia (Hb <10g/dL) or thrombocytopenia
  • Cardiac pacemaker or contraindication to MRI
  • Pregnancy or breast-feeding
  • drug or alcohol addiction
  • Any other white matte disease (i.e., Multiple sclerosis, sarcoidosis, or brain irradiation, etc) or brain tumor
  • Parkinson's disease, Alzheimer's disease or any other neurodegenerative disease
  • any hearing or visual impairment that can disturb the efficient evaluation of the patient
  • recent cerebral infarction with 3 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
aspirinaspirinaspirin 100mg by mouth once a day for 104 weeks
CilostazolcilostazolPletaal SR 200mg by mouth once a day for 104 weeks
Primary Outcome Measures
NameTimeMethod
Volume of white matter changes (WMCs)baseline, week 104

Measure change of WMC on brain MRI

Secondary Outcome Measures
NameTimeMethod
Number of lacunesbaseline and week 104

High number means tissue damage.

Mean diffusivity (MD) and Fraction Anisotropy (FA) on Diffusion Tensor Imagingbaseline and week 104

High MD and low FA means tissue damage.

number of microbleedsbaseline and week 104

High number means tissue damage.

brain volume and cortical thicknessbaseline and week 104

Low score means tissue damage.

Mini-Mental State Examinationbaseline, week 52, and week 104

Measure global cognition. Score range is 0-30. Higher score means good cognition.

Neurocognitive testbaseline, week 52, and week 104

Seoul Verbal Learning Test, Boston Naming test-short form, ROCF copy, animal fluency, phonemic fluency, Stroop test, Digit-symbol test, Trail making test

Clinical Dementia Rating scale-sum of boxesbaseline, week 52, and week 104

Measure global cognition. Score range is 0-18. Higher score means good cognition.

Barthel Indexbaseline, week 52, and week 104

Measure physical ADL. Score range is 0-20. Higher score means good physical ADL.

King's Health Questionnairebaseline, week 42, and week 104

Measure voiding function. Higher score means bad function.

Geriatric Depression Scale-Short formbaseline, week 52, and week 104

Measure depression. Score range is 0-15. Higher score means depression.

Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI)baseline, week 52, and week 104

Measure abnormal behavior. Score range is 0-144. Higher score means severe abnormal behavior.

Bayer Activities of Daily Livingbaseline, week 52, and week 104

Measure instrumental activities of daily living (ADL). Score range is 1-10. Higher score means bad ADL.

Timed UP and Go (TUG) testbasline, week 52, and week 104

Measure gait. Higher score means bad gait.

Pyramidal and Extrapyramidal Scale (PEPS)baseline, week 52, and week 104

Measure neurologic signs. Score range is 0-60. Higher score means many abnormal neurologic signs.

Adverse eventbaseline, week 4, 16, 28, 40, 52, 64, 76, 88, and 104

measure any adverse events

Trial Locations

Locations (19)

Dongtan Sacred Heart Hospital, Hallym University College of Medicine

🇰🇷

Hwaseong-si, Gyeonggi-do, Korea, Republic of

Hallym University Medical Center

🇰🇷

Anyang, Korea, Republic of

Eulji University School of Medicine

🇰🇷

Daejeon, Korea, Republic of

Chungang University Hospital

🇰🇷

Seoul, Korea, Republic of

National Health Insurance Corporation Ilsan Hospital

🇰🇷

Goyang-si, Gyeonggi-do, Korea, Republic of

Gachon University Gil Medical

🇰🇷

Incheon, Korea, Republic of

Soonchunhyang University Bucheon Hospital

🇰🇷

Bucheon, Korea, Republic of

Dong-A University Hospital

🇰🇷

Pusan, Korea, Republic of

Wonkwang University Iksan Hospital

🇰🇷

Iksan, Jeollabuk-do, Korea, Republic of

Konyang University Hospital

🇰🇷

Daejeon, Korea, Republic of

Myongji Hospital

🇰🇷

Goyang-si, Gyeonggi-do, Korea, Republic of

Chonnam National University Hospital

🇰🇷

Gwangju, Korea, Republic of

Bucheon St.Mary's Hospital

🇰🇷

Bucheon, Korea, Republic of

Inha University Hospital

🇰🇷

Incheon, Korea, Republic of

Pusan National University Hospital

🇰🇷

Pusan, Korea, Republic of

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

Kyung Hee University Hospital

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Ewha Womans University Mokdong Hospital

🇰🇷

Seoul, Korea, Republic of

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