Bilikiewicz A, Gaus W
Clinic for Psychiatric Diseases, Medical University of Gdansk, Gdansk.
J Alzheimers Dis. 2004 Feb;6(1):17-26. doi: 10.3233/jad-2004-6103.
This study was designed to confirm or negate findings from earlier trials demonstrating that Colostrinin, a novel compound derived from ewes' colostrum, has potential in the treatment of mild or moderate Alzheimer's Disease (AD). 105 patients were recruited from six psychiatric centres in Poland. The trial consisted of a 15 week double-blind phase comparing Colostrinin with placebo, followed by a second 15 week open labelled phase when all patients received Colostrinin. The dosage of Colostrinin was 100 microg on alternate days for three weeks followed by two weeks drug-free. This cycle was repeated three times for each phase. The primary outcome measures used were Alzheimer's Disease Assessment Scale-cognitive portion (ADAS-cog) and Clinical Global Impression of Change (CGIC). Secondary outcome measures were Instrumental Activities of Daily Living (IADL); Mini-Mental State Examination (MMSE); ADAS-non cognitive test (ADAS-non cog); and overall Patient Response. The main outcome measures were assessed at week 15 when active was compared with placebo but all parameters were evaluated at baseline, week 15 and week 30. Two separate statistical analyses were undertaken, a Full Sample Analysis (FSA) in which all missing values were replaced with the worst result observed and a Valid for Efficacy (VFE) analysis in which those patients who had serious protocol violations were excluded. This resulted in 14 patients being excluded from the VFE-analysis. The FSA analysis at week 15 showed a stabilizing effect of Colostrinin on cognitive function in ADAS-cog (p = 0.02) and on daily function in IADL (p = 0.02). The overall patient response was also in favour of the active (p = 0.03). Patients graded as mild on entry also showed a superior response of ADAS-cog compared with more advanced cases (p = 0.01). Evidence from this study indicates an early beneficial effect on cognitive symptoms and daily function. Colostrinin has potential value in the treatment AD.
本研究旨在证实或否定早期试验的结果,这些试验表明初乳素(一种源自母羊初乳的新型化合物)在治疗轻度或中度阿尔茨海默病(AD)方面具有潜力。从波兰的六个精神病中心招募了105名患者。该试验包括一个为期15周的双盲阶段,将初乳素与安慰剂进行比较,随后是第二个为期15周的开放标签阶段,在此阶段所有患者都接受初乳素治疗。初乳素的剂量为每隔一天100微克,持续三周,然后停药两周。每个阶段重复这个周期三次。使用的主要结局指标是阿尔茨海默病评估量表认知部分(ADAS-cog)和临床总体印象变化(CGIC)。次要结局指标是日常生活活动能力(IADL);简易精神状态检查(MMSE);ADAS非认知测试(ADAS-non cog);以及患者总体反应。主要结局指标在第15周进行评估,将活性药物与安慰剂进行比较,但所有参数在基线、第15周和第30周进行评估。进行了两项独立的统计分析,一项是全样本分析(FSA),其中所有缺失值都被替换为观察到的最差结果,另一项是有效性验证(VFE)分析,其中排除了那些严重违反方案的患者。这导致14名患者被排除在VFE分析之外。第15周的FSA分析显示,初乳素对ADAS-cog中的认知功能(p = 0.02)和IADL中的日常功能(p = 0.02)有稳定作用。患者总体反应也有利于活性药物组(p = 0.03)。入组时评定为轻度的患者与病情更严重的患者相比,ADAS-cog反应也更优(p = 0.01)。这项研究的证据表明,初乳素对认知症状和日常功能有早期有益作用。初乳素在治疗AD方面具有潜在价值。