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Modulation of Micro-RNA Pathways by Gemfibrozil in Predementia Alzheimer Disease

Primary Purpose

Preclinical Alzheimer's Disease

Status
Completed
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Gemfibrozil
Placebo
Sponsored by
Gregory Jicha, 323-5550
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Preclinical Alzheimer's Disease focused on measuring Alzheimer disease, mild cognitive impairment, normal cognition

Eligibility Criteria

65 Years - 90 Years (Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Participants must meet all of the following inclusion criteria in order to participate in the study:

  1. Men or women aged 65-90, inclusive.
  2. Stable medical condition for three months prior to screening visit, with no clinically significant abnormalities of hepatic, renal, and hematologic function defined as follows: Platelets > 100,000, Serum creatinine ≤ 1.6 mg/dL, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 1.5 upper limit of normal, No clinically significant abnormalities of other laboratory studies (CBC, chemistry panel)
  3. Non-diabetic or well controlled diabetes confirmed by fasting serum glucose <126 mg/dL.
  4. Stable medications for 4 weeks prior to screening visit.
  5. Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests.

    • Exceptions to these criteria may be considered on a case-by-case basis, at the discretion of the Project Director.

Exclusion Criteria:

  1. Female participants that are pregnant or of childbearing potential.
  2. Unstable medical conditions for three months prior to screening visit such as poorly controlled blood pressure, diabetes, or breathing problems…etc.
  3. Clinically significant abnormalities on liver, kidney or other blood tests
  4. Significant neurologic disease such as Alzheimer's disease, Parkinson's disease, stroke, brain tumor, multiple sclerosis or seizure disorder.
  5. Major depression in past 12 months (DSM-IV criteria), major mental illness such as schizophrenia, or recent (in past 12 months) alcohol or substance abuse.
  6. History of invasive cancer within the past two years.
  7. Contra-indications to lumbar puncture (bleeding disorder, platelet count < 100,000, anticoagulant treatment, major structural abnormality or sepsis in the area of the lumbosacral spine that would make a lumbar puncture technically difficult).
  8. Use of any investigational agents within 30 days prior to screening.
  9. Contra-indications to MRI (metallic implants, pacemaker, shrapnel, ect…)
  10. Sensitivity, intolerance, or allergies to gemfibrozil or any previous reaction to any cholesterol lowering medicine.
  11. Major surgery within eight weeks prior to the Baseline Visit.
  12. Blindness, deafness, language difficulties or any other disability which may prevent the potential participant from participating or cooperating in the protocol.
  13. Physically unacceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests.

    • Exceptions to these criteria may be considered on a case-by-case basis, at the discretion of the examining study physician.

Excluded Medications:

  1. Experimental drugs
  2. Repaglinide
  3. "Statins" including but not limited to atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor), or any combination medicines containing these drugs.
  4. Coumadin, warfarin, heparin, lovenox, Xarelto, apixaban or other anticoagulants. (Antiplatelet therapy is acceptable).

NOTE: If these drugs are discontinued 4 weeks or more before screening, then the participant can be eligible for the study.

Sites / Locations

  • University of Kentucky

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Gemfibrozil

Sugar pill

Arm Description

Gemfibrozil 600 mg by mouth twice daily for 48 weeks

Matching placebo capsule by mouth twice daily for 48 weeks

Outcomes

Primary Outcome Measures

Safety
Adverse events reported during the course of the trial
microRNA-107 levels
MicroRNA-107 levels will be measured in serum and cerebrospinal fluid
beta-amyloid levels
Beta-amyloid 1-40 and 1-42 levels will be measured in cerebrospinal fluid at baseline and at 48 weeks

Secondary Outcome Measures

Free and cued selective reminding test (FCSRT)
The FCSRT is a sensitive measure of memory performance that will be measured at baseline and after 48 weeks of gemfibrozil treatment
Paired associates learning (PAL)
The PAL is a sensitive, computerized measure of memory performance that will be measured at baseline and after 48 weeks of gemfibrozil treatment

Full Information

First Posted
January 22, 2014
Last Updated
October 6, 2019
Sponsor
Gregory Jicha, 323-5550
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1. Study Identification

Unique Protocol Identification Number
NCT02045056
Brief Title
Modulation of Micro-RNA Pathways by Gemfibrozil in Predementia Alzheimer Disease
Official Title
Modulation of Micro-RNA Pathways by Gemfibrozil in Predementia Alzheimer Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
May 2014 (Actual)
Primary Completion Date
June 30, 2018 (Actual)
Study Completion Date
June 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Gregory Jicha, 323-5550

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and efficacy of gemfibrozil in modulating microRNA-107 levels for the prevention of Alzheimer's disease in subjects with intact cognition and mild cognitive impairment
Detailed Description
Double-blind, placebo controlled, parallel-design. 48 cognitively-intact subjects, and 24 subjects with early cognitive decline (CDR 0.5) will be randomly assigned to treatment with gemfibrozil (600 mg orally twice a day) or placebo for 52 weeks. Safety assessments will include routine assessment of adverse events, safety labs, and brain magnetic resonance imaging.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Preclinical Alzheimer's Disease
Keywords
Alzheimer disease, mild cognitive impairment, normal cognition

7. Study Design

Primary Purpose
Prevention
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
72 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gemfibrozil
Arm Type
Experimental
Arm Description
Gemfibrozil 600 mg by mouth twice daily for 48 weeks
Arm Title
Sugar pill
Arm Type
Placebo Comparator
Arm Description
Matching placebo capsule by mouth twice daily for 48 weeks
Intervention Type
Drug
Intervention Name(s)
Gemfibrozil
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Safety
Description
Adverse events reported during the course of the trial
Time Frame
52 weeks
Title
microRNA-107 levels
Description
MicroRNA-107 levels will be measured in serum and cerebrospinal fluid
Time Frame
48 weeks
Title
beta-amyloid levels
Description
Beta-amyloid 1-40 and 1-42 levels will be measured in cerebrospinal fluid at baseline and at 48 weeks
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
Free and cued selective reminding test (FCSRT)
Description
The FCSRT is a sensitive measure of memory performance that will be measured at baseline and after 48 weeks of gemfibrozil treatment
Time Frame
48 weeks
Title
Paired associates learning (PAL)
Description
The PAL is a sensitive, computerized measure of memory performance that will be measured at baseline and after 48 weeks of gemfibrozil treatment
Time Frame
48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participants must meet all of the following inclusion criteria in order to participate in the study: Men or women aged 65-90, inclusive. Stable medical condition for three months prior to screening visit, with no clinically significant abnormalities of hepatic, renal, and hematologic function defined as follows: Platelets > 100,000, Serum creatinine ≤ 1.6 mg/dL, aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 1.5 upper limit of normal, No clinically significant abnormalities of other laboratory studies (CBC, chemistry panel) Non-diabetic or well controlled diabetes confirmed by fasting serum glucose <126 mg/dL. Stable medications for 4 weeks prior to screening visit. Physically acceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests. Exceptions to these criteria may be considered on a case-by-case basis, at the discretion of the Project Director. Exclusion Criteria: Female participants that are pregnant or of childbearing potential. Unstable medical conditions for three months prior to screening visit such as poorly controlled blood pressure, diabetes, or breathing problems…etc. Clinically significant abnormalities on liver, kidney or other blood tests Significant neurologic disease such as Alzheimer's disease, Parkinson's disease, stroke, brain tumor, multiple sclerosis or seizure disorder. Major depression in past 12 months (DSM-IV criteria), major mental illness such as schizophrenia, or recent (in past 12 months) alcohol or substance abuse. History of invasive cancer within the past two years. Contra-indications to lumbar puncture (bleeding disorder, platelet count < 100,000, anticoagulant treatment, major structural abnormality or sepsis in the area of the lumbosacral spine that would make a lumbar puncture technically difficult). Use of any investigational agents within 30 days prior to screening. Contra-indications to MRI (metallic implants, pacemaker, shrapnel, ect…) Sensitivity, intolerance, or allergies to gemfibrozil or any previous reaction to any cholesterol lowering medicine. Major surgery within eight weeks prior to the Baseline Visit. Blindness, deafness, language difficulties or any other disability which may prevent the potential participant from participating or cooperating in the protocol. Physically unacceptable for this study as confirmed by medical history, physical exam, neurological exam and clinical tests. Exceptions to these criteria may be considered on a case-by-case basis, at the discretion of the examining study physician. Excluded Medications: Experimental drugs Repaglinide "Statins" including but not limited to atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor), or any combination medicines containing these drugs. Coumadin, warfarin, heparin, lovenox, Xarelto, apixaban or other anticoagulants. (Antiplatelet therapy is acceptable). NOTE: If these drugs are discontinued 4 weeks or more before screening, then the participant can be eligible for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory A Jicha, MD, PhD
Organizational Affiliation
University of Kentucky
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Kentucky
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536-0230
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Modulation of Micro-RNA Pathways by Gemfibrozil in Predementia Alzheimer Disease

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