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Trial registered on ANZCTR
Registration number
ACTRN12620000506998
Ethics application status
Approved
Date submitted
23/03/2020
Date registered
23/04/2020
Date last updated
19/08/2022
Date data sharing statement initially provided
23/04/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
A Phase II randomised, double-blind, placebo-controlled trial of S-Adenosyl Methionine (SAMe) in participants with mild cognitive impairment or dementia due to Alzheimer’s disease
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Scientific title
A Phase II randomised, double-blind, placebo-controlled trial of S-Adenosyl Methionine (SAMe) in participants with mild cognitive impairment or dementia due to Alzheimer’s disease
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Secondary ID [1]
300840
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N/A
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Universal Trial Number (UTN)
U1111-1250-0482
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Trial acronym
SAMe
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Alzheimer's disease
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Mild Cognitive Impairment
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Condition category
Condition code
Neurological
314974
314974
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0
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Alzheimer's disease
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Mental Health
315040
315040
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
400mg S-adenosyl methionine, oral capsules, once daily for 6 months. Drug accountability will be monitored to ensure compliance at every visit.
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Intervention code [1]
317167
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Treatment: Drugs
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Comparator / control treatment
Matched Placebo, oral microcrystalline cellulose (MCC) capsules, once daily for 6 months.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Plasma levels of p-tau181
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Assessment method [1]
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Timepoint [1]
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Screening and six months (primary endpoint).
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Secondary outcome [1]
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Cognitive function assessment by RBANS,
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Assessment method [1]
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Timepoint [1]
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Screening and six months (secondary endpoint).
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Secondary outcome [2]
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Epigenetic changes in DNA methylation.
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Assessment method [2]
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Timepoint [2]
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Screening and six months (secondary endpoint).
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Secondary outcome [3]
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Safety assessment via the presence or absence of AE's and SAE's, assessed via participant or study partner self-report, physical examination, vital sign measurement and clinical safety blood testing at all visits.
Known/possible adverse events of SAMe drug may include agitation, anxiety, irritation, and restlessness and the potential to trigger bipolar episodes. There is also a theoretical risk of serotonin syndrome if combined with anti-depressant medications. As such, the study specifically excludes enrolment of individuals with a history of bipolar affective disorder, recent unstable psychiatric condition, or concurrent antidepressant intake.
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Assessment method [3]
381434
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Timepoint [3]
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Screening, Randomisation, 1 month, 3 months, six months, follow up (2 weeks post-treatment).
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Eligibility
Key inclusion criteria
1. Male and female participants aged 60 years and above at the time of signing the informed consent.
2. Participants who have mild cognitive impairment or dementia due to Alzheimer’s disease, according to the NIA-AA 2011 criteria.
3. Participants who have a standardised mini-mental state examination (sMMSE) score of 18 or above.
4. If using medications to treat symptoms of AD (e.g. donepezil), doses must be stable for at least 8 weeks prior to screening.
5. Living at home or in a community setting (assisted living) without continuous nursing care. Each subject must have a reliable caregiver or study partner who sees them at least 3 times weekly, can oversee the administration of study drug, and is willing and able to participate in all clinic visits and some study procedures. The responsible caregiver/ study partner must provide written informed consent to participate.
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Minimum age
60
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Any history of bipolar affective disorder.
2. Any medical condition (other than AD) which may contribute to the participant’s cognitive impairment.
3. Stroke or transient ischaemic attack in the past 1 year.
4. Clinically significant unstable psychiatric condition in the last 6 months.
5. Inability to swallow oral medications.
6. Other medical conditions, which in the opinion of the investigator, would limit the participant’s survival to < 6 months.
7. Concurrent use of anti-depressant medication (due to the possibility of serotonin syndrome).
8. Participation in another interventional clinical trial or intake of investigational drug within 4 weeks or 5 half-lives (whichever is longer) of the screening visit.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2021
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Actual
16/04/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
16
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
23011
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Austin Health - Heidelberg Repatriation Hospital - Heidelberg West
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Recruitment postcode(s) [1]
33719
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3052 - Parkville
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Recruitment postcode(s) [2]
38326
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3081 - Heidelberg West
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Alzheimer's Association
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Address [1]
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225 N. Michigan Ave., Fl. 17, Chicago, IL 60601
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Country [1]
305294
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United States of America
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Primary sponsor type
University
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Name
The University of Melbourne
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Address
The University of Melbourne
Victoria 3010
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Country
Australia
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Secondary sponsor category [1]
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Other Collaborative groups
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Name [1]
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The Walter and Eliza Hall Institute of Medical Research
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Address [1]
305654
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1G, Royal Parade, Parkville
Victoria 3052
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Country [1]
305654
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Melbourne Health Human Research Ethics Committee
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Ethics committee address [1]
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Level 2 South West 300 Grattan Street, Parkville Victoria 3010
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Ethics committee country [1]
305632
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Australia
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Date submitted for ethics approval [1]
305632
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Approval date [1]
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21/06/2019
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Ethics approval number [1]
305632
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Summary
Brief summary
Despite advances in the understanding of the underlying mechanisms of Alzheimer’s disease (AD) the commonest form of dementia, no effective disease modifying therapy exists to date. Plaques containing Amyloid-ß (Aß) and neurofibrillary tangles consisting of hyperphosphorylated tau are the core pathological hallmarks of AD. Widespread predominantly non-prescription use of S-adenosyl methionine (SAMe) currently occurs mainly for depression, osteoarthritis and liver disease. Given its critical role in tau homeostasis, a unique opportunity exists to examine the efficacy and safety of SAMe in a clinical trial of patients with Alzheimer’s disease. It is hypothesised that after six months of treatment with 400mg of oral SAMe, participants with mild cognitive impairment or mild AD will show reduced levels of p-tau181 in their plasma.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Nawaf Yassi
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Address
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Watson/Yassi Lab
Department of Population Health and Immunity
Walter and Eliza Hall Institute of Medical Research
1G Royal Parade, Parkville VIC 3052 Australia
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Country
101026
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Australia
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Phone
101026
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+61 3 9342 4422
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Fax
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Email
101026
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[email protected]
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Contact person for public queries
Name
101027
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Alisa Turbic
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Address
101027
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Watson/Yassi Lab
Department of Population Health and Immunity
Walter and Eliza Hall Institute of Medical Research
1G Royal Parade, Parkville VIC 3052 Australia
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Country
101027
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Australia
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Phone
101027
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+61393452210
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Fax
101027
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Email
101027
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[email protected]
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Contact person for scientific queries
Name
101028
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Nawaf Yassi
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Address
101028
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Watson/Yassi Lab
Department of Population Health and Immunity
Walter and Eliza Hall Institute of Medical Research
1G Royal Parade, Parkville VIC 3052 Australia
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Country
101028
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Australia
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Phone
101028
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+61 3 9342 4422
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Fax
101028
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Email
101028
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
No comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Protocol of a Phase II Randomized, Multi-Center, Double-Blind, Placebo-Controlled Trial of S-Adenosyl Methionine in Participants with Mild Cognitive Impairment or Dementia Due to Alzheimer's Disease.
2023
https://dx.doi.org/10.14283/jpad.2023.55
N.B. These documents automatically identified may not have been verified by the study sponsor.
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