Professor Peter Passmore
Queen's University Belfast
A randomized controlled trial of calcium channel blockade (CCB) with amlodipine for the treatment of subcortical ischaemic vascular dementia (SIVD). (AFFECT clinical trial).
Alzheimer's disease & other dementias
Vascular dementia (VaD) is a highly significant health issue, affecting millions of people worldwide, and
presenting a substantial challenge and burden for health service provision, health economics and informal
and formal care. Despite this there are no effective pharmacological treatments. Developing new, effective
treatments is therefore an urgent imperative to ensure this enormous unmet need is addressed. Currently
this is not being fulfilled by any ongoing research.
SIVD is the most common type of VaD. It is a progressive condition, with many patients with SIVD
showing hypertension and hypercholesterolaemia in addition to other cardiovascular comorbidities. It is
increasingly the most important form of VaD, yet there is only one currently registered pharmacological
treatment trial for SIVD.
This study will compare the effectiveness of active intervention involving use of the calcium channel
blocking medication (CCB) amlodipine to placebo in 588 people with SIVD in a double blind, randomised
controlled trial (RCT). The use of amlodipine is based on convincing data for the potential value of the
CCB drug class and the need for further elucidation of their efficacy.
This study will provide valuable evidence regarding the efficacy of amlodipine treatment on cognition in
people with SIVD, in addition to secondary outcome measures including overall function, neuropsychiatric
symptoms, carer burden and cost-effectiveness. The outcomes therefore have the potential to influence
prescribing practice and result in improved treatment for people with SIVD.