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A Phase IIa Multi-Center Study of 18F-FDG PET, Safety, and Tolerability of AZD0530 in Mild Alzheimer's Disease

Primary Purpose

Alzheimer's Disease

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AZD0530 100mg daily
AZD0530 125mg daily
Placebo
Sponsored by
Yale University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease

Eligibility Criteria

55 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. NIA-Alzheimer's Association core clinical criteria for probable AD
  2. 18F-Florbetapir scan with evidence of elevated Aβ (based on central review)
  3. Age between 55-85 (inclusive)
  4. MMSE score between 18 and 26 (inclusive)
  5. Stability of permitted medications for 4 weeks. In particular:

    • Stable doses of antidepressants lacking significant anticholinergic side effects (if they are not currently depressed and do not have a history of major depression within the past 1 year)
    • Cholinesterase inhibitors and memantine are allowable if stable for 12 weeks prior to screen
  6. Geriatric Depression Scale less than 6 [Note: a score ≥6 on this screening scale may be permissible, if the subject is examined by a site clinician and judged not to be depressed.]
  7. Study partner is available who has frequent contact with the subject (e.g., average of 10 hours per week or more), and can accompany the subject to most visits to answer questions about the subject
  8. Visual and auditory acuity adequate for neuropsychological testing
  9. Good general health with no disease expected to interfere with the study
  10. Subject is not pregnant, lactating, or of childbearing potential (i.e., women must be two years post-menopausal or surgically sterile)
  11. Modified Hachinski less than or equal to 4
  12. Completed six grades of education or has a good work history
  13. Must speak English or Spanish fluently

Exclusion Criteria

  1. Any significant neurologic disease other than AD, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities
  2. Screening/baseline MRI scan with evidence of infection, infarction, or other focal lesions or multiple lacunes or lacunes in a critical memory structure
  3. Subjects that have any contraindications for MRI studies, including claustrophobia, the presence of metal (ferromagnetic) implants, or cardiac pacemaker
  4. Major depression, bipolar disorder as described in DSM-IV within the past 1 year or psychotic features, agitation or behavioral problems within 3 months, which could lead to difficulty complying with the protocol
  5. History of schizophrenia (DSM V criteria)
  6. History of alcohol or substance abuse or dependence within the past 2 years (DSM V criteria)
  7. Clinically significant or unstable medical condition, including uncontrolled hypertension, uncontrolled diabetes, or significant cardiac, pulmonary, renal, hepatic, endocrine, or other systemic disease in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results, or the subject's ability to participate in the study.
  8. Has had a history within the last 5 years of a primary or recurrent malignant disease with the exception of non-melanoma skin cancers, resected cutaneous squamous cell carcinoma in situ, basal cell carcinoma, cervical carcinoma in situ, or in situ prostate cancer with normal prostate-specific antigen post-treatment
  9. Clinically significant abnormalities in B12 or TFTs that might interfere with the study. A low B12 is exclusionary, unless follow-up labs (homocysteine (HC) and methylmalonic acid (MMA)) indicate that it is not physiologically significant.
  10. Residence in skilled nursing facility.
  11. Use of any excluded medication as described in study protocol
  12. Current or recent participation in any procedures involving radioactive agents, including current, past, or anticipated exposure to radiation in the workplace, such that the total radiation dose exposure to the subject in a given year would exceed the limits of annual and total dose commitment set forth in the US Code of Federal Regulations (CFR) Title 21 Section 361.1. This guideline is an effective dose of 5 rem received per year.
  13. Neutropenia defined as absolute neutrophils count of <1,800/microliter
  14. Thrombocytopenia defined as platelet count <120x103/microliter
  15. For CSF sub-study participants, a current blood clotting or bleeding disorder, or significantly abnormal PT or PTT at screening
  16. Clinically significant abnormalities in screening laboratories, including:

    • Aspartate aminotransferase (AST) >1.5 times ULN
    • Alanine aminotransferase (ALT) > 1.5 times ULN
    • Total bilirubin >1.5 times ULN
    • Serum creatinine >2.0 times ULN
  17. History of interstitial lung disease
  18. Patients whom the PI deems to be otherwise ineligible

Sites / Locations

  • Barrow Neurological Institute
  • Banner Sun Health Research Institute
  • University of California, Los Angeles
  • Yale Alzheimer's Disease Research Unit
  • Georgetown University
  • Wien Center for Clinical Research/Mount Sinai Medical Center
  • University of South Florida - Health Byrd Alzheimer Institute
  • Northwestern University
  • Rush University Medical Center
  • Indiana University
  • University of Iowa
  • University of Kentucky
  • Brigham and Women's Hospital
  • University of Michigan, Ann Arbor
  • Mount Sinai School of Medicine
  • University of Rochester Medical Center
  • Wake Forest University Health Sciences
  • Oregon Health & Science University
  • University of Pittsburgh, Alzheimer's Disease Research Center
  • Roper St. Francis Hospital
  • University of Washington
  • University of British Columbia, Clinic for AD & Related Disorders

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AZD0530 100mg daily

AZD0530 Placebo

Arm Description

Patients in the experimental group (50%) will be started on this dose. After 2 weeks, patients with a plasma drug level of <100ng/ml will receive 125mg AZD0530 daily and remain in the same experimental group as patient receiving 100mg daily.

50% of patients will receive placebo treatment for the duration of the study,

Outcomes

Primary Outcome Measures

Change in Brain Glucose Uptake Measured Using 18F-FDG PET Imaging
Composite measure of brain glucose uptake using F18-FDG PET in a pre-defined set of brain regions, between baseline and 12 months.
Number of Participants With One or More Serious/Other Adverse Events Subjects With Mild AD as Assessed by Analysis of Adverse Events, Including Symptoms, and Abnormal Findings on Physical and Neurological Examinations, and Standard Labs.
Assessment of any adverse effects between drug and placebo-treated subjects

Secondary Outcome Measures

The Effect of Treatment With AZD0530 on Cognitive and Behavioral Function
The change in cognitive function between baseline and 12 months will be measured by the following tests: Alzheimer Disease Assessment Scale - Cognitive 11 (ADAS-cog11). Measures: Cognitive function Maximum score: 70; Minimum score: 0. Higher score equals worse cognitive function Mini-Mental State Examination (MMSE) Measures: Cognitive Function Maximum score: 30; Minimum score: 0. Higher score equal better cognitive function Alzheimer Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL) Measures: Ability to perform routine daily activities Maximum score: 78; Minimum score: 0. Higher score equals better ability to perform activities of daily living Clinical Dementia Rating Sum of Boxes (CDR-SO) Measures: Dementia severity Maximum score: 18; Minimum score: 0. Higher score equals more severe dementia.
Percent Change in Brain Volume Before and After Treatment
Change in volume of pre-defined brain regions between baseline and 12 months of treatment.
Cerebrospinal Fluid Levels of Total Tau, Phospho-tau (p-Tau), and Amyloid-beta 1-42 (Abeta 1-42)
Measure concentration of Tau and Amyloid-beta 1-42 biomarkers in the cerebrospinal fluid between baseline and 12 months of treatment
Change in Brain Glucose Uptake Measured Using 18F-FDG PET Imaging
The results from the primary outcome with brain FDG-PET imaging was analyzed by ApoE genotype. Composite measure of brain glucose uptake using F18-FDG PET in a pre-defined set of brain regions, between baseline and 12 months.

Full Information

First Posted
June 12, 2014
Last Updated
July 25, 2019
Sponsor
Yale University
Collaborators
Alzheimer's Therapeutic Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT02167256
Brief Title
A Phase IIa Multi-Center Study of 18F-FDG PET, Safety, and Tolerability of AZD0530 in Mild Alzheimer's Disease
Official Title
A Phase IIa Multi-Center Study of 18F-FDG PET, Safety, and Tolerability of AZD0530 in Mild Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
December 2014 (Actual)
Primary Completion Date
February 27, 2018 (Actual)
Study Completion Date
February 27, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Yale University
Collaborators
Alzheimer's Therapeutic Research Institute

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
AZD0530 is an inhibitor of Src and Abl family kinases1. It has been developed as treatment for malignancies because these kinases play a role in tumor invasion and proliferation. However, the Src family kinases (SFKs) are highly expressed in brain and have major effects on synaptic plasticity2. Moreover, the investigators have recently shown that a specific SFK, namely Fyn, is aberrantly activated by specific conformations of the Amyloid Beta (Aß) peptide from Alzheimer's disease (AD). Genetic deletion of Fyn rescues AD deficits in preclinical models. This clinical trial will test the potential benefit of AZD0530 for Alzheimer's disease modification.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
159 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AZD0530 100mg daily
Arm Type
Experimental
Arm Description
Patients in the experimental group (50%) will be started on this dose. After 2 weeks, patients with a plasma drug level of <100ng/ml will receive 125mg AZD0530 daily and remain in the same experimental group as patient receiving 100mg daily.
Arm Title
AZD0530 Placebo
Arm Type
Placebo Comparator
Arm Description
50% of patients will receive placebo treatment for the duration of the study,
Intervention Type
Drug
Intervention Name(s)
AZD0530 100mg daily
Other Intervention Name(s)
saracatinib
Intervention Description
All patients in experimental group (50%) will be started on 100mg AZD0530 daily
Intervention Type
Drug
Intervention Name(s)
AZD0530 125mg daily
Other Intervention Name(s)
saracatinib
Intervention Description
Patients with plasma drug level <100ng/ml after 2 weeks of 100mg AZD0530 daily will receive 125mg daily of AZD0530.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
saracatinib
Intervention Description
50% of patients will receive placebo treatment for the duration of the study.
Primary Outcome Measure Information:
Title
Change in Brain Glucose Uptake Measured Using 18F-FDG PET Imaging
Description
Composite measure of brain glucose uptake using F18-FDG PET in a pre-defined set of brain regions, between baseline and 12 months.
Time Frame
12 months
Title
Number of Participants With One or More Serious/Other Adverse Events Subjects With Mild AD as Assessed by Analysis of Adverse Events, Including Symptoms, and Abnormal Findings on Physical and Neurological Examinations, and Standard Labs.
Description
Assessment of any adverse effects between drug and placebo-treated subjects
Time Frame
12 months
Secondary Outcome Measure Information:
Title
The Effect of Treatment With AZD0530 on Cognitive and Behavioral Function
Description
The change in cognitive function between baseline and 12 months will be measured by the following tests: Alzheimer Disease Assessment Scale - Cognitive 11 (ADAS-cog11). Measures: Cognitive function Maximum score: 70; Minimum score: 0. Higher score equals worse cognitive function Mini-Mental State Examination (MMSE) Measures: Cognitive Function Maximum score: 30; Minimum score: 0. Higher score equal better cognitive function Alzheimer Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL) Measures: Ability to perform routine daily activities Maximum score: 78; Minimum score: 0. Higher score equals better ability to perform activities of daily living Clinical Dementia Rating Sum of Boxes (CDR-SO) Measures: Dementia severity Maximum score: 18; Minimum score: 0. Higher score equals more severe dementia.
Time Frame
12 months
Title
Percent Change in Brain Volume Before and After Treatment
Description
Change in volume of pre-defined brain regions between baseline and 12 months of treatment.
Time Frame
12 months
Title
Cerebrospinal Fluid Levels of Total Tau, Phospho-tau (p-Tau), and Amyloid-beta 1-42 (Abeta 1-42)
Description
Measure concentration of Tau and Amyloid-beta 1-42 biomarkers in the cerebrospinal fluid between baseline and 12 months of treatment
Time Frame
12 months
Title
Change in Brain Glucose Uptake Measured Using 18F-FDG PET Imaging
Description
The results from the primary outcome with brain FDG-PET imaging was analyzed by ApoE genotype. Composite measure of brain glucose uptake using F18-FDG PET in a pre-defined set of brain regions, between baseline and 12 months.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria NIA-Alzheimer's Association core clinical criteria for probable AD 18F-Florbetapir scan with evidence of elevated Aβ (based on central review) Age between 55-85 (inclusive) MMSE score between 18 and 26 (inclusive) Stability of permitted medications for 4 weeks. In particular: Stable doses of antidepressants lacking significant anticholinergic side effects (if they are not currently depressed and do not have a history of major depression within the past 1 year) Cholinesterase inhibitors and memantine are allowable if stable for 12 weeks prior to screen Geriatric Depression Scale less than 6 [Note: a score ≥6 on this screening scale may be permissible, if the subject is examined by a site clinician and judged not to be depressed.] Study partner is available who has frequent contact with the subject (e.g., average of 10 hours per week or more), and can accompany the subject to most visits to answer questions about the subject Visual and auditory acuity adequate for neuropsychological testing Good general health with no disease expected to interfere with the study Subject is not pregnant, lactating, or of childbearing potential (i.e., women must be two years post-menopausal or surgically sterile) Modified Hachinski less than or equal to 4 Completed six grades of education or has a good work history Must speak English or Spanish fluently Exclusion Criteria Any significant neurologic disease other than AD, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities Screening/baseline MRI scan with evidence of infection, infarction, or other focal lesions or multiple lacunes or lacunes in a critical memory structure Subjects that have any contraindications for MRI studies, including claustrophobia, the presence of metal (ferromagnetic) implants, or cardiac pacemaker Major depression, bipolar disorder as described in DSM-IV within the past 1 year or psychotic features, agitation or behavioral problems within 3 months, which could lead to difficulty complying with the protocol History of schizophrenia (DSM V criteria) History of alcohol or substance abuse or dependence within the past 2 years (DSM V criteria) Clinically significant or unstable medical condition, including uncontrolled hypertension, uncontrolled diabetes, or significant cardiac, pulmonary, renal, hepatic, endocrine, or other systemic disease in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results, or the subject's ability to participate in the study. Has had a history within the last 5 years of a primary or recurrent malignant disease with the exception of non-melanoma skin cancers, resected cutaneous squamous cell carcinoma in situ, basal cell carcinoma, cervical carcinoma in situ, or in situ prostate cancer with normal prostate-specific antigen post-treatment Clinically significant abnormalities in B12 or TFTs that might interfere with the study. A low B12 is exclusionary, unless follow-up labs (homocysteine (HC) and methylmalonic acid (MMA)) indicate that it is not physiologically significant. Residence in skilled nursing facility. Use of any excluded medication as described in study protocol Current or recent participation in any procedures involving radioactive agents, including current, past, or anticipated exposure to radiation in the workplace, such that the total radiation dose exposure to the subject in a given year would exceed the limits of annual and total dose commitment set forth in the US Code of Federal Regulations (CFR) Title 21 Section 361.1. This guideline is an effective dose of 5 rem received per year. Neutropenia defined as absolute neutrophils count of <1,800/microliter Thrombocytopenia defined as platelet count <120x103/microliter For CSF sub-study participants, a current blood clotting or bleeding disorder, or significantly abnormal PT or PTT at screening Clinically significant abnormalities in screening laboratories, including: Aspartate aminotransferase (AST) >1.5 times ULN Alanine aminotransferase (ALT) > 1.5 times ULN Total bilirubin >1.5 times ULN Serum creatinine >2.0 times ULN History of interstitial lung disease Patients whom the PI deems to be otherwise ineligible
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher H van Dyck, MD
Organizational Affiliation
Yale University
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Paul Aisen, MD, PhD
Organizational Affiliation
USC Alzheimer's Therapeutic Research Institute (ATRI)
Official's Role
Study Director
Facility Information:
Facility Name
Barrow Neurological Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
Banner Sun Health Research Institute
City
Sun City
State/Province
Arizona
ZIP/Postal Code
85351
Country
United States
Facility Name
University of California, Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Yale Alzheimer's Disease Research Unit
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Georgetown University
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20057
Country
United States
Facility Name
Wien Center for Clinical Research/Mount Sinai Medical Center
City
Miami Beach
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
University of South Florida - Health Byrd Alzheimer Institute
City
Tampa
State/Province
Florida
ZIP/Postal Code
33613
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
University of Kentucky
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40504
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
University of Michigan, Ann Arbor
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48105-2945
Country
United States
Facility Name
Mount Sinai School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
University of Rochester Medical Center
City
Rochester
State/Province
New York
ZIP/Postal Code
14620
Country
United States
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pittsburgh, Alzheimer's Disease Research Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Roper St. Francis Hospital
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29401
Country
United States
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98108
Country
United States
Facility Name
University of British Columbia, Clinic for AD & Related Disorders
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6T 1Z3
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
31329216
Citation
van Dyck CH, Nygaard HB, Chen K, Donohue MC, Raman R, Rissman RA, Brewer JB, Koeppe RA, Chow TW, Rafii MS, Gessert D, Choi J, Turner RS, Kaye JA, Gale SA, Reiman EM, Aisen PS, Strittmatter SM. Effect of AZD0530 on Cerebral Metabolic Decline in Alzheimer Disease: A Randomized Clinical Trial. JAMA Neurol. 2019 Oct 1;76(10):1219-1229. doi: 10.1001/jamaneurol.2019.2050.
Results Reference
derived

Learn more about this trial

A Phase IIa Multi-Center Study of 18F-FDG PET, Safety, and Tolerability of AZD0530 in Mild Alzheimer's Disease

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