A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia

Introduction Behavioural variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder often neuropathologically associated with the accumulation of abnormally hyperphosphorylated tau, for which there is currently no disease-modifying treatment. Previous work by our group has shown sodium...

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Main Authors: Rebekah M Ahmed, Lucy Vivash, Dennis Velakoulis, Leonid Churilov, Olivier Piguet, David Darby, Terence J O'Brien, Charles B Malpas, Mark Walterfang, Amy Brodtmann, Ashley I Bush, Christopher M Hovens, T Kalincik
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Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e040100.full
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author Rebekah M Ahmed
Lucy Vivash
Dennis Velakoulis
Leonid Churilov
Olivier Piguet
David Darby
Terence J O'Brien
Charles B Malpas
Mark Walterfang
Amy Brodtmann
Ashley I Bush
Christopher M Hovens
T Kalincik
author_facet Rebekah M Ahmed
Lucy Vivash
Dennis Velakoulis
Leonid Churilov
Olivier Piguet
David Darby
Terence J O'Brien
Charles B Malpas
Mark Walterfang
Amy Brodtmann
Ashley I Bush
Christopher M Hovens
T Kalincik
author_sort Rebekah M Ahmed
collection DOAJ
description Introduction Behavioural variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder often neuropathologically associated with the accumulation of abnormally hyperphosphorylated tau, for which there is currently no disease-modifying treatment. Previous work by our group has shown sodium selenate upregulates the activity of protein phosphatase 2 in the brain, increasing the rate of tau dephosphorylation. The objective of this study is to evaluate the efficacy and safety of sodium selenate as a disease-modifying treatment for bvFTD.Methods and analysis This will be a multisite, phase IIb, double-blind placebo-controlled trial of sodium selenate. One hundred and twenty participants will be enrolled across 4 Australian academic hospitals. Following screening eligible participants will be randomised (1:1) to sodium selenate (15 mg three times a day) or placebo for 52 weeks. Participants will have regular safety and efficacy visits throughout the study period. The primary study outcome will be percentage brain volume change (PBVC) as measured on MRI over 52 weeks of treatment. This will be analysed with a general linear model (analysis of covariance (ANCOVA)) with the PBVC as an output, the treatment as an input and the baseline brain volume as covariate for adjustment purposes. Secondary outcomes include safety and tolerability measures, and efficacy measures; change in cerebrospinal fluid total-tau, Addenbrooke’s Cognitive Examination-III and Cambridge Behavioural Inventory-Revised scores over the 52 weeks of treatment. These will also be analysed with ANCOVA where the corresponding baseline measure will be incorporated in the model. Additional exploratory outcomes will include other imaging, cognitive and biospecimen analyses.Ethics and dissemination The study was approved by the Human Research and Ethics Committee of the lead site as part of the Australian Multisite Ethics approval system. The results of the study will be presented at national and international conferences and published in peer-reviewed journals.Trial registration number ACTRN12620000236998 .
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spelling doaj-art-e73d7ab59c06481ea1a9081344c570332024-11-25T07:10:07ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-040100A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementiaRebekah M Ahmed0Lucy Vivash1Dennis Velakoulis2Leonid Churilov3Olivier Piguet4David Darby5Terence J O'Brien6Charles B Malpas7Mark Walterfang8Amy Brodtmann9Ashley I Bush10Christopher M Hovens11T Kalincik121University of Sydney, Camperdown, NSW, AustraliaMonash University Central Clinical School, Melbourne, Victoria, Australia15Melbourne Neuropsychiatry Centre, North West Mental Health and The University of Melbourne, Melbourne, Australia7 Medicine, The University of Melbourne, Melbourne, Victoria, Australia3Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia2 Neurology Department, Florey Institute of Neuroscience and Mental Health—Austin Campus, Heidelberg, Victoria, Australia3 Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia1 Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, AustraliaNeuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Victoria, AustraliaCognitive Health Initiative, Central Clinical School, Monash University, Clayton, Victoria, AustraliaFlorey Institute for Neuroscience and Mental Health, Melbourne, Victoria, AustraliaDepartment of Surgery, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, AustraliaDepartment of Neurology, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, AustraliaIntroduction Behavioural variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder often neuropathologically associated with the accumulation of abnormally hyperphosphorylated tau, for which there is currently no disease-modifying treatment. Previous work by our group has shown sodium selenate upregulates the activity of protein phosphatase 2 in the brain, increasing the rate of tau dephosphorylation. The objective of this study is to evaluate the efficacy and safety of sodium selenate as a disease-modifying treatment for bvFTD.Methods and analysis This will be a multisite, phase IIb, double-blind placebo-controlled trial of sodium selenate. One hundred and twenty participants will be enrolled across 4 Australian academic hospitals. Following screening eligible participants will be randomised (1:1) to sodium selenate (15 mg three times a day) or placebo for 52 weeks. Participants will have regular safety and efficacy visits throughout the study period. The primary study outcome will be percentage brain volume change (PBVC) as measured on MRI over 52 weeks of treatment. This will be analysed with a general linear model (analysis of covariance (ANCOVA)) with the PBVC as an output, the treatment as an input and the baseline brain volume as covariate for adjustment purposes. Secondary outcomes include safety and tolerability measures, and efficacy measures; change in cerebrospinal fluid total-tau, Addenbrooke’s Cognitive Examination-III and Cambridge Behavioural Inventory-Revised scores over the 52 weeks of treatment. These will also be analysed with ANCOVA where the corresponding baseline measure will be incorporated in the model. Additional exploratory outcomes will include other imaging, cognitive and biospecimen analyses.Ethics and dissemination The study was approved by the Human Research and Ethics Committee of the lead site as part of the Australian Multisite Ethics approval system. The results of the study will be presented at national and international conferences and published in peer-reviewed journals.Trial registration number ACTRN12620000236998 .https://bmjopen.bmj.com/content/10/11/e040100.full
spellingShingle Rebekah M Ahmed
Lucy Vivash
Dennis Velakoulis
Leonid Churilov
Olivier Piguet
David Darby
Terence J O'Brien
Charles B Malpas
Mark Walterfang
Amy Brodtmann
Ashley I Bush
Christopher M Hovens
T Kalincik
A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia
BMJ Open
title A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia
title_full A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia
title_fullStr A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia
title_full_unstemmed A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia
title_short A study protocol for a phase II randomised, double-blind, placebo-controlled trial of sodium selenate as a disease-modifying treatment for behavioural variant frontotemporal dementia
title_sort study protocol for a phase ii randomised double blind placebo controlled trial of sodium selenate as a disease modifying treatment for behavioural variant frontotemporal dementia
url https://bmjopen.bmj.com/content/10/11/e040100.full
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