Imperial College London
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ProfessorPareshMalhotra

Faculty of Medicine, Department of Brain Sciences

Professor of Clinical Neurology
 
 
 
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Contact

 

+44 (0)20 3313 5525p.malhotra

 
 
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Location

 

Lab BlockCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hoang:2022:10.1186/s13063-022-06190-3,
author = {Hoang, K and Watt, H and Golemme, M and Perry, R and Ritchie, C and Wilson, D and Pickett, J and Fox, C and Howard, R and Malhotra, P},
doi = {10.1186/s13063-022-06190-3},
journal = {Trials},
title = {Noradrenergic add-on therapy with extended-release guanfacine in alzheimer’s disease: study protocol for a randomised clinical trial (NorAD) and COVID-19 amendments},
url = {http://dx.doi.org/10.1186/s13063-022-06190-3},
volume = {23},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Guanfacine is a α2A adrenergic receptor agonist approved for treating Attention Deficit Hyperactivity Disorder (ADHD). It is thought to act via postsynaptic receptors in the prefrontal cortex, modulating executive functions including the regulation of attention. Attention is affected early in Alzheimer’s Disease (AD), and this may relate to pathological changes within the locus coeruleus, the main source of noradrenergic pathways within the brain. Given that cholinergic pathways, also involved in attention, are disrupted in AD, the combination of noradrenergic and cholinergic treatments may have a synergistic effect in symptomatic AD. The primary objective of the NorAD trial is to evaluate change in cognition with 12 weeks treatment of extended-release guanfacine (GXR) against a placebo as a combination therapy with cholinesterase inhibitors in participants with mild to moderate Alzheimer’s Disease.Methods/Design:NorAD is a 3-month, single-centre, randomised, double-blind, placebo-controlled, phase III trial of extended-release guanfacine (GXR) in participants with mild to moderate Alzheimer’s Disease. A total of 160 participants will be randomised to receive either daily guanfacine or placebo in combination with approved cholinesterase treatment for 12 weeks. The primary outcome is change in cognition, as measured by the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog), from baseline to follow-up in the treatment group compared to the placebo group. Secondary outcomes include change in additional cognitive measures of attention (Tests of Attention: Trails A and B, Digit-symbol substitution, Test of Everyday attention and CANTAB-RVP), neuropsychiatric symptoms (Neuropsychiatric Inventory), caregiver burden (Zarit Burden Interview) and activities of daily living (Alzheimer’s Disease Co-operative Study – Activities of Daily Living Inventory). From July 2020 observation of change following cessation
AU  - Hoang,K
AU  - Watt,H
AU  - Golemme,M
AU  - Perry,R
AU  - Ritchie,C
AU  - Wilson,D
AU  - Pickett,J
AU  - Fox,C
AU  - Howard,R
AU  - Malhotra,P
DO  - 10.1186/s13063-022-06190-3
PY  - 2022///
SN  - 1745-6215
TI  - Noradrenergic add-on therapy with extended-release guanfacine in alzheimer’s disease: study protocol for a randomised clinical trial (NorAD) and COVID-19 amendments
T2  - Trials
UR  - http://dx.doi.org/10.1186/s13063-022-06190-3
UR  - https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06190-3
UR  - http://hdl.handle.net/10044/1/96348
VL  - 23
ER  -
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