Abstract
Background: Sodium oligomannate (GV-971), a marine-derived oligosaccharide, is a novel agent that may improve cognition in AD patients.Methods: The 24-week multi-center, randomized, double-blind, placebo parallel controlled clinical trial was conducted in AD in China between 24 October 2011 and 10 July 2013. The study included a 4-week screening/washout period, followed by a 24-week treatment period. Patients were randomized 1:1:1 ratio to receive GV-971 900 mg, 600 mg, or placebo capsule in treatment period, respectively. The primary outcome was cognitive improvement as assessed by changes in Alzheimer's Disease Assessment Scale-cognitive subscale 12-item (ADAS-cog12) scores from baseline to week 24. The secondary efficacy outcomes included CIBIC-Plus, ADCS-ADL and NPI at 24 weeks after treatment compared with baseline. A sub-group study was assessment of the change in cerebral glucose metabolism by fluorodeoxyglucose positron emission tomography measurements.Results: Comparing with placebo group (n=83, change -1.45), the ADAS-Cog12 score change in GV-971 600mg group (n=76) was -1.39 (p=0.89), GV-971 900mg group (n=83) was -2.58 (p=0.30). The treatment responders according to CIBIC-plus assessment was significantly higher in GV-971 900mg group than placebo group (92.77% vs 79.52%, p<0.05). GV-971 900mg subgroup showed a significantly lower cerebral metabolic rate for glucose decline than the placebo subgroup at the left precuneus, right posterior cingulate, and right hippocampus. The respective rates of treatment-related AEs were 5.9%, 14.3%, and 3.5%.Conclusions: GV-971 was safe and well tolerated. GV-971 900mg was chosen for phase III clinical study.Trial registration: ClinicalTrials.gov, NCT01453569. Registered 18 October, 2011, https://clinicaltrials.gov/ct2/show/NCT01453569?term=NCT01453569&draw=2&rank=1.