ClinicalTrials.gg
CompletedNCT04658823Updated Feb 2, 2026

Efficacy and Safety of Tocotrienols in CADASIL

A Phase 2 interventional study of HOV-12020 (Palm tocotrienols complex) and Placebo in Cadasil, sponsored by Hovid Berhad. Completed at 1 site in France. Open to participants aged 45 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-02-02.

Sponsored by Hovid Berhad · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Feb 2024, 2 years 8 months ago, and no results have been posted to the registry.
Phase
Phase 2
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
45 Years to 75 Years
Sex
All
01

Study summary

CADASIL is a paradigmatic cerebral small vessel disease responsible for white-matter lesions, accumulation of lacunes, microbleeds and cerebral atrophy. The disease is responsible for stroke and cognitive decline associated with motor disability. The number of incident lacunes, and amount of cerebral atrophy were recently found to have a strong relationship to cognitive decline and disability progression over 3 years in a large sample of patients. Palm tocotrienols has previously shown evidence of therapeutic effect in attenuating the progression of WMH related to sporadic cerebral small vessel disease in a randomized controlled clinical trial. We hypothesize that palm tocotrienols complex (HOV-12020) can reduce the clinical progression in CADASIL.

02

Conditions studied

  • Cadasil

Keywords

  • CADASIL
  • Tocotrienols
  • Vitamin E
  • Vascular
  • Stroke
  • Dementia
  • Cerebral Small Vessel Disease
  • Cognitive disorder
  • Neurovascular disease
  • Hereditary multi-infarct
  • Cerebrovascular disease
03

In context

CADASIL

33 studies on the registry are indexed under CADASIL; 18 are open to participants now.

This study's enrollment of 50 is below the median of 60 across 10 interventional studies indexed under CADASIL.

Browse CADASIL studies →

Lead sponsor

This is the only study on the registry with Hovid Berhad as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
45 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male or female
  2. Participants aged 45 to 75 years inclusive, at the time of signing of
  3. Confirmed Diagnosis of CADASIL, defined by either:

    • A Typical mutation in the NOTCH3 gene responsible for an odd number of cystein residue OR
    • A positive skin showing typical granular osmiophilic material (GOM) in the vascular wall of small vessels with electron microscopy
  4. Presence of at least one prevalent lacune on the MRI identified on 3DT1 or FLAIR images.
  5. Presence of Confluent white matter hyperintensities (WMH) on T2-weighted or FLAIR MR images (Fazekas grade 2-3).
  6. score ≥15
  7. mRS at 0 - 3
  8. A woman of child bearing potential () is eligible to participate if she is not pregnant, not breastfeeding, and agrees to follow guidance (as described in Appendix 5) provided by the study clinician during the treatment period and for 28 days after the last dose of the study treatment.
  9. Capable of giving signed informed consent and have a patient representative willing to co-sign informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Exclusion criteria

Exclusion Criteria:

  1. Clinical stroke with persisting neurological deficit within 6 months prior to Screening.
  2. Any other neurodegenerative disorder, such as Parkinson's disease, Alzheimer's disease, or Huntington's disease.
  3. Current significant hematological, cardiac, pulmonary, metabolic, neurologic or psychiatric disorders, uncontrolled seizures, untreated hypertension, disorders increasing risk of bleeding (Hemophilia), or any other significant active medical condition which in the Investigator's opinion would impact participation in this study.
  4. History of myocardial infarction within 3 months prior to Screening, or current active angina pectoris, or symptomatic heart failure.
  5. History of cancer, within the past 5 years. Patients with basal cell carcinoma, squamous cell carcinoma, and Stage 1 prostate cancer can be included in the study.
  6. An episode of major depression within the last 6 months prior to Screening (clinically stable minor depression is not exclusionary).
  7. History of attempted suicide within 6 months prior to Screening or a positive response to items 4 or 5 of Columbia-Suicide Severity Rating Scale (C-SSRS) at Screening and Baseline.
  8. History of drug or alcohol abuse or dependence.
  9. to MRI: presence of a pacemaker, severe claustrophobia, cochlear implants, ferromagnetic devices or clips, intracranial vascular clips, insulin pumps, metallic implants.
  10. Pregnancy or breastfeeding women.
  11. History of (HIV), or C.
  12. History of allergy or severe intolerance to Vitamin E (tocopherols / tocotrienols).
  13. Presence at Screening of (ALT), aspartate aminotransferase (AST), amylase, or lipase 2x above the (ULN) of laboratory reference range, total 1.5x ULN, any other laboratory abnormality.
  14. Presence at Screening of \<60 (estimated by Cockcroft-Gault equation).
  15. Cognitive enhancers such as donepezil, are allowed only if stable dosage within 3 months prior to Screening.
  16. Use of tocotrienol supplementation within 3 months prior to Screening or any current use of Vitamin E other than study drug (all other vitamin supplements are allowed, if stable dosage within 3 months prior to screening).
  17. Participation in a clinical trial with product (IP) within 30 days prior to Screening. Patients participating in observational studies with no IP, will be allowed to participate in this study
  18. Indication for anti-coagulant therapy
  19. Patients with known sensitivity to polyoxyl castor oil or risk of allergy to soybean and peanuts.
Terms in these criteria, in plain language(14)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
50 participants (actual)

Study arms

  • Experimental
    HOV-12020

    Palm tocotrienols complex Oral softgel capsule (containing 285mg mixed tocotrienols and tocopherol)

    Drug: HOV-12020 (Palm tocotrienols complex)

  • Placebo comparator
    PLACEBO

    Placebo Oral Softgel capsule (each capsule containing vitamin E stripped soybean oil)

    Drug: Placebo

Interventions

  • Oral Softgel capsule containing mixed tocotrienols and tocopherol with enhanced absorption delivery system; 1 capsule twice daily

    Also known as: HOV-12020, Palm Vitamin E, Tocotrienols, Tocovid Suprabio

  • DrugPlacebo

    Oral Softgel capsule containing soybean oil; 1 capsule twice daily

06

What researchers measure

Primary outcomes

  1. Incidence of manifestations related to clinical worsening

    Occurrence one failure event within 24 months after Baseline. A failure event is considered when at least one of the following manifestations is detected during the study period: * incident stroke * increase of disability corresponding to an increase in the mRS score of at least 1 point to result in a score of 2 or greater * cognitive decline corresponding to a reduction of at least 4 points of the VADAS-Cog score

    Time frame: 24 months

Secondary outcomes

  1. Incidence of adverse events

    Number of serious AEs, type of severe AEs, Total number of AEs

    Time frame: 24 months

Other outcomes

  1. Change of cognitive performance on CDR

    Individual variation of different cognitive measures obtained using the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB); score 0 to 18

    Time frame: 24 months

  2. Change of cognitive performances on MDRS

    Individual variation of different cognitive measures obtained using the Mattis Dementia Rating Scale (MDRS); score 0 to 144

    Time frame: 24 months

  3. Change of cognitive performances on sub-subscale of MDRS

    Individual variation of different cognitive measures obtained using the initiation/perseveration subscale of the MDRS (MDRS-I/P); score 0 to 37

    Time frame: 24 months

  4. Change of cognitive performances on TMT

    Individual variation of different cognitive measures obtained using the Trail Making Test Part A and B time

    Time frame: 24 months

  5. Changes of gait and balance performances on SPPB

    Between group difference on individual changes of the Short Physical Performance Battery (SPPB) score; score 0 (worst) to 12 (best)

    Time frame: 24 months

  6. Effects on Quality of life using SF3-6

    Between group differences in patient reported outcomes as assessed by the Short Form-36 (SF-36), score 0 to 100

    Time frame: 24 months

  7. Effects on Quality of life, using DAD

    Between group differences in patient reported outcomes as assessed by the Disability Assessment for Dementia (DAD) scores; score 0 to 100

    Time frame: 24 months

07

Study locations

1 site
  • Hôpital Lariboisière APHP
    Paris, 75010, France
08

References and documents

Publications

  • Chabriat H, Biard L, Guey S, Alili N, Machado C, Jabouley A, Reyes S, Lebenberg J, Guillonnet A, Dubus E, Taleb A, Julien F, Dias-Gastellier N, Fernandes F, Jouvent E, Herve D. Tocotrienol-rich vitamin E complex in CADASIL (T3CAD): a randomised, double-blind, placebo-controlled trial. EClinicalMedicine. 2026 Mar 30;94:103853. doi: 10.1016/j.eclinm.2026.103853. eCollection 2026 Apr. PubMed 42005919 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2020 to primary completion in Feb 2024, 38 months.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 29, 2020
First posted
Dec 9, 2020
StartActual
Dec 21, 2020
Primary completionActual
Feb 28, 2024
CompletionActual
Oct 31, 2024
Last update
Feb 2, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04658823
Lead sponsor
Hovid Berhad
Responsible party
Sponsor
First posted
Dec 9, 2020
Start date
Dec 21, 2020
Primary completion
Feb 28, 2024
Completion
Oct 31, 2024
Last update
Feb 2, 2026

Study contacts

Pr Hugues Chabriat
principal investigator · Hôpital Lariboisière APHP
David Ho
study director · Hovid Berhad

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Tocotrienols

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