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dc.contributor.authorLam, Virginie
dc.contributor.authorClarnette, Roger
dc.contributor.authorFrancis, Roslyn
dc.contributor.authorBynevelt, Michael
dc.contributor.authorWatts, Gerald
dc.contributor.authorFlicker, Leon
dc.contributor.authorOrr, Carolyn F
dc.contributor.authorLoh, Poh
dc.contributor.authorLautenschlager, Nicola
dc.contributor.authorReid, Christopher M
dc.contributor.authorFoster, Jonathan K
dc.contributor.authorDhaliwal, Satvinder S
dc.contributor.authorRobinson, Suzanne
dc.contributor.authorCorti, Emily
dc.contributor.authorVaccarezza, Mauro
dc.contributor.authorHorgan, Ben
dc.contributor.authorTakechi, Ryu
dc.contributor.authorMamo, John
dc.identifier.citationLam, V. and Clarnette, R. and Francis, R. and Bynevelt, M. and Watts, G. and Flicker, L. and Orr, C.F. et al. 2022. Efficacy of probucol on cognitive function in Alzheimer's disease: study protocol for a double-blind, placebo-controlled, randomised phase II trial (PIA study). BMJ Open. 12 (2): Article No. e058826.

INTRODUCTION: Preclinical, clinical and epidemiological studies support the hypothesis that aberrant systemic metabolism of amyloid beta (Aβ) in the peripheral circulation is causally related to the development of Alzheimer's disease (AD). Specifically, recent studies suggest that increased plasma concentrations of lipoprotein-Aβ compromise the brain microvasculature, resulting in extravasation and retention of the lipoprotein-Aβ moiety. The latter results in an inflammatory response and neurodegeneration ensues. Probucol, a historic cholesterol-lowering drug, has been shown in murine models to suppress lipoprotein-Aβ secretion, concomitant with maintaining blood-brain-barrier function, suppressing neurovascular inflammation and supporting cognitive function. This protocol details the probucol in Alzheimer's study, a drug intervention trial investigating if probucol has potential to attenuate cognitive decline, delay brain atrophy and reduce cerebral amyloid burden in patients with mild-to-moderate AD.

METHODS AND ANALYSIS: The study is a phase II, randomised, placebo-controlled, double-blind single-site clinical trial held in Perth, Australia. The target sample is 314 participants with mild-to-moderate AD. Participants will be recruited and randomised (1:1) to a 104-week intervention consisting of placebo induction for 2 weeks followed by 102 weeks of probucol (Lorelco) or placebo. The primary outcome is changed in cognitive performance determined via the Alzheimer's Disease Assessment Scales-Cognitive Subscale test between baseline and 104 weeks. Secondary outcomes measures will be the change in brain structure and function, cerebral amyloid load, quality of life, and the safety and tolerability of Lorelco, after a 104week intervention.

ETHICS AND DISSEMINATION: The study has been approved by the Bellberry Limited Human Research Ethics Committee (approval number: HREC2019-11-1063; Version 4, 6 October 2021). Informed consent will be obtained from participants prior to any study procedures being performed. The investigator group will disseminate study findings through peer-reviewed publications, key conferences and local stakeholder events.

TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12621000726853).

dc.subjectclinical trials
dc.titleEfficacy of probucol on cognitive function in Alzheimer's disease: study protocol for a double-blind, placebo-controlled, randomised phase II trial (PIA study).
dc.typeJournal Article
dcterms.source.titleBMJ Open
curtin.departmentCurtin Medical School
curtin.departmentCurtin School of Population Health
curtin.departmentCurtin Health Innovation Research Institute(CHIRI)
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidLam, Virginie [0000-0001-8463-645X]
curtin.contributor.orcidRobinson, Suzanne [0000-0001-5703-6475]
curtin.contributor.orcidCorti, Emily [0000-0003-3130-6611]
curtin.contributor.orcidVaccarezza, Mauro [0000-0003-3060-318X]
curtin.contributor.orcidTakechi, Ryu [0000-0001-6359-3382]
curtin.contributor.orcidMamo, John [0000-0002-5741-7849]
curtin.contributor.researcheridRobinson, Suzanne [B-6604-2013]
curtin.contributor.researcheridTakechi, Ryu [D-3692-2012]
curtin.contributor.scopusauthoridLam, Virginie [36096751600]
curtin.contributor.scopusauthoridRobinson, Suzanne [36803108700]
curtin.contributor.scopusauthoridVaccarezza, Mauro [6701350504]
curtin.contributor.scopusauthoridTakechi, Ryu [24173759200]
curtin.contributor.scopusauthoridMamo, John [7006456735]

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