The LUCINDA Trial: LeUprolide Plus Cholinesterase Inhibition to Reduce Neurological Decline in Alzheimer's

Weill Cornell Medicine (WCM)

Status and phase

Active, not recruiting

Phase 2

Conditions

Alzheimer Disease

Mild Cognitive Impairment

Treatments

Drug: Eligard 22.5Mg Suspension for Injection

Drug: Placebo

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT03649724

R01AG057681-01A1 (U.S. NIH Grant/Contract)

19-05020209

Details and patient eligibility

About

The LUCINDA Trial is a three-site, phase II, randomized, double-blind, placebo-controlled study of leuprolide acetate (Eligard) in women with Mild Cognitive Impairment or Alzheimer's Disease taking a stable dose of a cholinesterase inhibitor medication like donepezil. Its objective is to assess the efficacy of a 48-week regimen of leuprolide (22.5 mg per 12 weeks) compared to placebo on cognitive function, global function and plasma and neuroimaging biomarkers.

Full description

This project aims to re-purpose the safe and well-tolerated gonadotropin-releasing hormone (GnRH) analogue Leuprolide Acetate for use in Alzheimer's Disease (AD). Leuprolide Acetate is currently used in adults for prostate cancer, endometriosis, uterine fibroids and in preparation for in-vitro fertilization, and in children for central precocious puberty. The purpose of this study to confirm and extend results from a prior phase II study (Bowen et al, 2015) which demonstrated that Leuprolide halted cognitive and functional decline in a subgroup of women with mild-moderate AD who were also taking the acetylcholinesterase inhibitor donepezil. Objectives are to replicate, in the same subgroup, Leuprolide's clinical EFFICACY in this prior trial and to add neuroimaging and plasma BIOMARKERS that will help elucidate Leuprolide's likely multiple mechanisms of action in AD. These mechanisms include decreasing levels of Luteinizing Hormone (LH) based on extensive preclinical evidence that decreasing LH preserves cognition and decreases amyloid deposition and tau phosphorylation in animal models of AD, as well as new evidence that GnRH analogues may have anti-inflammatory effects.

Enrollment

180 estimated patients

Sex

Female

Ages

60 to 120 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Female, post-menopausal
Probable AD or MCI due to AD according to NIA-AA criteria
Taking a stable dose of a cholinesterase inhibitor such as donepezil/Aricept and dosage likely to remain stable throughout the trial
MOCA > 11 or blind MOCA > 8 (inclusive) at screening visit
Hachinski score <5 supporting clinical judgment that dementia is not of vascular origin
Fluent in English
has a study partner / caregiver who interacts with the subject for at least 5 hours per week on average and can participate in evaluations

Exclusion criteria

Presence based on exam, history or MRI of significant brain disease other than AD such as schizophrenia, epilepsy, Parkinson's disease or large territory stroke
Current substance abuse in accord with DSM V criteria
Significantly depressed (Geriatric Depression Scale > 10)
Physical or psychological MRI contraindications, or likely unable to tolerate neuroimaging
Taking other medications known to affect serum sex hormone or gonadotropin concentrations such as estrogen and/or progesterone for hormone replacement therapy, goserelin or danazol
Presence of significant systemic illness likely to interfere with participation in or completion of the study or to affect study results such as cancer within 5 years (other than non-melanoma skin cancer), autoimmune disease, recent myocardial infarction, signs/symptoms of organ failure based on history, ECG, screening laboratory and/or physical exams
Receiving other investigational drugs within 30 days or 5 half-lives prior to randomization, whichever is longer