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Renew NCP-5 for the Treatment of Mild Cognitive Impairment Due to Alzheimer's Disease (AD) or Mild Dementia of the Alzheimer's Type

Primary Purpose

Alzheimer Disease, Cognitive Dysfunction, Mild Cognitive Impairment

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Renew NCP-5
Sponsored by
Renew Research, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Be 55-85 years of age at the time of signing the informed consent
  2. Be able to provide consent or have legally authorized representative/caregiver who can provide consent
  3. Be able to read and write in English or Spanish
  4. Have a clinical diagnosis consistent with 2011 National Institute of Aging - Alzheimer's Association (NIA-AA) "core clinical criteria" guidelines for: (i) The diagnosis of dementia due to Alzheimer's disease or (ii) The diagnosis of mild cognitive impairment due to Alzheimer's disease:

    • Montreal Cognitive Assessment (MOCA) score of greater than or equal to 11
    • All required checkboxes within the study checklist for "The diagnosis of probable AD dementia" must be "yes" or
    • All required checkboxes within the study checklist for "The diagnosis of mild cognitive impairment due to Alzheimer's disease" must be "yes"
  5. Stable medications for past 30 days and plan to remain on stable medications for the first 24 weeks of study participation for treatment of chronic conditions.
  6. Subject should have a caregiver, study partner or companion (which can be a domestic party) and may conduct the assessment over the phone if they don't accompany the participant).
  7. Must have the potential to improve by at least 2 points or more in the Vascular Dementia Assessment Scale cognitive subscale (vADAS-COG)

Exclusion Criteria:

  1. Unwilling or unable to participate in study procedures
  2. Weight >297 lbs. or >135 kg at screening
  3. Major confounding neurodegenerative or psychiatric disorder unrelated to the condition under study, including:

    1. History of clinically-evident stroke
    2. Current uncontrolled epileptic seizures or epilepsy
    3. Multiple Sclerosis or Parkinson's Disease
    4. Current clinically significant major psychiatric disorder (e.g., Major Depressive Disorder) according to the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria or significant psychiatric symptoms (e.g., hallucinations) that could impair the completion of the study
  4. Anyone with active or history of cerebral hemorrhage including subdural & subarachnoid or cerebral aneurysm
  5. Evidence of any of the following (based on Section 4.1.1(D) of the 2011 NIA-AA guidelines on The diagnosis of dementia due to Alzheimer's disease):

    1. Substantial concomitant cerebrovascular disease, defined by a history of a stroke temporally related to the onset or worsening of cognitive impairment; or the presence of multiple or extensive infarcts or severe white matter hyperintensity burden
    2. Core features of Dementia with Lewy bodies other than dementia itself
    3. Prominent features of behavioral variant frontotemporal dementia
    4. Prominent features of semantic variant primary progressive aphasia or nonfluent/agrammatic variant primary progressive aphasia
    5. Evidence for another concurrent, active neurological disease, non-neurological medical comorbidity or use of medication that could have a substantial effect on cognition
  6. In the opinion of the investigator, any current clinically-significant systemic illness or medical condition that is likely to result in deterioration of the subject's condition, affect the subject's safety during the study, or to be incompatible with performance of the study procedures, including:

    1. History of head trauma with a diagnosis of moderate to severe traumatic brain injury
    2. Known current substantially elevated intracranial pressure
    3. Known current significant sleep deprivation
    4. Known history (within five years) or current significant drug abuse or alcoholism
  7. Any contraindication for MRI such as insulin pumps or pacemakers, including dual chamber pacemakers where atrial pacing may interfere with RenewTM NCP-5 inflation timing sequence
  8. Hypotension as defined as <80/50 blood pressure at the time of screening
  9. Ongoing uncontrolled severe hypertension (≥ 180 mmHg systolic or ≥ 110 mmHg diastolic
  10. Heart rates < 35 or >125 beats per minute (BPM) at screening
  11. Current uncontrolled arrhythmia. Controlled arrhythmia should have beat-to-beat, cycle-length variability less than ±25% at rest.
  12. Current congestive heart failure
  13. Cardiac catheterization within two weeks, any surgical intervention within six weeks before RenewTM NCP-5 treatment or a hip or knee replacement within 3 months as long as rehab is complete and symptoms have resolved.
  14. Known presence of abdominal aortic aneurysm
  15. Existing aortic insufficiency grade II or higher (regurgitation can prevent diastolic augmentation)
  16. Current or past venous thrombosis or thromboembolism
  17. Current limiting peripheral vascular disease with history strongly suggestive of lower extremity ischemia or claudication, arterial occlusive disease (aortoiliac, ileofemoral, or femoral popliteal)
  18. Demonstrable deficiency in sensation in lower extremities as a result of diabetes or other medical condition
  19. Current bleeding disorders.
  20. Current use of major anti-coagulation therapy (such as Heparin therapy or Coumadin® therapy) with International Normalized Ratio (INR) > 1.5
  21. Current severe pulmonary disease that prevents the subject from lying supine
  22. Presence of local infection, vasculitis, burn, open wound, or bone fracture on any limb which would prevent the ability to perform the RenewTM NCP-5 treatment
  23. Current use of medications that in the investigator's judgement are incompatible with the study goals
  24. Significant changes in existing medical plans for treatment of cognitive impairment or dementia in last three months and/or or planned changes during the trial
  25. Presence of any of the contraindications for using the RenewTM NCP-5 device
  26. Athletic injuries, including Charley horses, pulled muscles and/or edematous muscles; necrotizing cellulitis in the past 30 days which would prevent the ability to perform the RenewTM NCP-5 treatment (evaluate and treat prior to RenewTM NCP-5 treatment)
  27. Unwilling or unable to maintain stable exercise regimen throughout the trial
  28. Participation in any clinical drug trial 30 days or five half-lives, whichever is longer, prior to screening visit
  29. Use of any device to increase cerebral blood flow in the past 30 days.
  30. History of claustrophobia.
  31. Subject unable to lay supine for 90 minutes

Sites / Locations

  • Xenoscience
  • Irvine Clinical Research
  • Charter Research
  • Miami Dade Medical Research Institute
  • iResearch Atlanta
  • iResearch Savannah
  • University of Kansas Medical Center
  • Cardiovascular Advantages, LLC
  • Neuro-Behavioral Clinical Research
  • Northwest Clinical Research Center
  • St. James's Hospital
  • National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

Treatment Arm

Sham Arm

Arm Description

The first four sessions will be the escalation phase using the Renew NCP-5. There will be a 5-minute ramp up period where the pressure is increased 1 psi/min until the desired pressure is reached. The goal for the treatment group will be at least 2.5 psi for the first treatment, and then escalate the pressure gradually through the fourth session with an average goal of 3 psi/session. After the fourth session, the pressure will be slowly increased to reach the maximum level the subject can tolerate with a goal of reaching 3-6 psi.

The subjects will receive the same initial and maintenance treatment regimen on the Renew NCP-5. The pressure will not exceed an average of 0.5 psi over all treatments.

Outcomes

Primary Outcome Measures

Mean Change From Baseline to 24 Weeks in Vascular Dementia Assessment Scale Cognitive Subscale (vADAS-cog) Using the Average of Scores at 12, 18 and 24 Weeks.
The vADAS-cog assessment includes 17 subscale scores. The total score is the sum of all scaled scored from 0-120. The higher values represent more cognitive impairment. The change in vADAS-cog scores from baseline at the timepoints of 12, 18, and 24 weeks is averaged together for each patient. The primary outcome measure is the average of those values for all patients in a group.

Secondary Outcome Measures

Number of Participants With Treatment Related Adverse Events as Assessed by MedDRA.
Number of Participants With Treatment Related Serious Adverse Events as Assessed by MedDRA.

Full Information

First Posted
August 1, 2018
Last Updated
April 19, 2022
Sponsor
Renew Research, LLC
Collaborators
Navitas Clinical Research, Inc, ClinEdge, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03721705
Brief Title
Renew NCP-5 for the Treatment of Mild Cognitive Impairment Due to Alzheimer's Disease (AD) or Mild Dementia of the Alzheimer's Type
Official Title
A Randomized Pivotal Study of RenewTM NCP-5 for the Treatment of Mild Cognitive Impairment Due to Alzheimer's Disease or Mild Dementia of the Alzheimer's Type
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
November 12, 2018 (Actual)
Primary Completion Date
March 23, 2021 (Actual)
Study Completion Date
March 23, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Renew Research, LLC
Collaborators
Navitas Clinical Research, Inc, ClinEdge, LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A Randomized Pivotal Study of RenewTM NCP-5 for the Treatment of Mild Cognitive Impairment due to Alzheimer's Disease or Mild Dementia of the Alzheimer's Type is a pivotal, single blind, parallel design, multi-site study intends to examine the efficacy and safety of RenewTM NCP-5 therapy in the treatment of Cognitive Impairment due to Alzheimer's Disease or Mild Dementia of the Alzheimer's Type. Subjects will be prospectively randomized to treatment or sham (in a 1:1 ratio) using stratification for Cognitive Impairment due to Alzheimer's Disease or Mild Dementia of the Alzheimer's Type, and Cardiovascular Risk (CVR) score at multiple sites. Subjects, ages 55-85, will be consented for 13 months and will receive thirty-five 60-minute RenewTM NCP-5 treatment sessions during a 7-to-12-week initial treatment period, and then transition to a lower frequency maintenance period (twice a week) for a total treatment period of 24 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Cognitive Dysfunction, Mild Cognitive Impairment, Mild Dementia, Cognitive Decline, Dementia, Alzheimer Type

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Participants will be randomized to either the treatment group or the sham group.
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
190 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm
Arm Type
Experimental
Arm Description
The first four sessions will be the escalation phase using the Renew NCP-5. There will be a 5-minute ramp up period where the pressure is increased 1 psi/min until the desired pressure is reached. The goal for the treatment group will be at least 2.5 psi for the first treatment, and then escalate the pressure gradually through the fourth session with an average goal of 3 psi/session. After the fourth session, the pressure will be slowly increased to reach the maximum level the subject can tolerate with a goal of reaching 3-6 psi.
Arm Title
Sham Arm
Arm Type
Sham Comparator
Arm Description
The subjects will receive the same initial and maintenance treatment regimen on the Renew NCP-5. The pressure will not exceed an average of 0.5 psi over all treatments.
Intervention Type
Device
Intervention Name(s)
Renew NCP-5
Intervention Description
Treatment will be given 3-5 times a week for a total of 35 treatments over 12 weeks.
Primary Outcome Measure Information:
Title
Mean Change From Baseline to 24 Weeks in Vascular Dementia Assessment Scale Cognitive Subscale (vADAS-cog) Using the Average of Scores at 12, 18 and 24 Weeks.
Description
The vADAS-cog assessment includes 17 subscale scores. The total score is the sum of all scaled scored from 0-120. The higher values represent more cognitive impairment. The change in vADAS-cog scores from baseline at the timepoints of 12, 18, and 24 weeks is averaged together for each patient. The primary outcome measure is the average of those values for all patients in a group.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Number of Participants With Treatment Related Adverse Events as Assessed by MedDRA.
Time Frame
24 weeks
Title
Number of Participants With Treatment Related Serious Adverse Events as Assessed by MedDRA.
Time Frame
24 weeks

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: Be 55-85 years of age at the time of signing the informed consent Be able to provide consent or have legally authorized representative/caregiver who can provide consent Be able to read and write in English or Spanish Have a clinical diagnosis consistent with 2011 National Institute of Aging - Alzheimer's Association (NIA-AA) "core clinical criteria" guidelines for: (i) The diagnosis of dementia due to Alzheimer's disease or (ii) The diagnosis of mild cognitive impairment due to Alzheimer's disease: Montreal Cognitive Assessment (MOCA) score of greater than or equal to 11 All required checkboxes within the study checklist for "The diagnosis of probable AD dementia" must be "yes" or All required checkboxes within the study checklist for "The diagnosis of mild cognitive impairment due to Alzheimer's disease" must be "yes" Stable medications for past 30 days and plan to remain on stable medications for the first 24 weeks of study participation for treatment of chronic conditions. Subject should have a caregiver, study partner or companion (which can be a domestic party) and may conduct the assessment over the phone if they don't accompany the participant). Must have the potential to improve by at least 2 points or more in the Vascular Dementia Assessment Scale cognitive subscale (vADAS-COG) Exclusion Criteria: Unwilling or unable to participate in study procedures Weight >297 lbs. or >135 kg at screening Major confounding neurodegenerative or psychiatric disorder unrelated to the condition under study, including: History of clinically-evident stroke Current uncontrolled epileptic seizures or epilepsy Multiple Sclerosis or Parkinson's Disease Current clinically significant major psychiatric disorder (e.g., Major Depressive Disorder) according to the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria or significant psychiatric symptoms (e.g., hallucinations) that could impair the completion of the study Anyone with active or history of cerebral hemorrhage including subdural & subarachnoid or cerebral aneurysm Evidence of any of the following (based on Section 4.1.1(D) of the 2011 NIA-AA guidelines on The diagnosis of dementia due to Alzheimer's disease): Substantial concomitant cerebrovascular disease, defined by a history of a stroke temporally related to the onset or worsening of cognitive impairment; or the presence of multiple or extensive infarcts or severe white matter hyperintensity burden Core features of Dementia with Lewy bodies other than dementia itself Prominent features of behavioral variant frontotemporal dementia Prominent features of semantic variant primary progressive aphasia or nonfluent/agrammatic variant primary progressive aphasia Evidence for another concurrent, active neurological disease, non-neurological medical comorbidity or use of medication that could have a substantial effect on cognition In the opinion of the investigator, any current clinically-significant systemic illness or medical condition that is likely to result in deterioration of the subject's condition, affect the subject's safety during the study, or to be incompatible with performance of the study procedures, including: History of head trauma with a diagnosis of moderate to severe traumatic brain injury Known current substantially elevated intracranial pressure Known current significant sleep deprivation Known history (within five years) or current significant drug abuse or alcoholism Any contraindication for MRI such as insulin pumps or pacemakers, including dual chamber pacemakers where atrial pacing may interfere with RenewTM NCP-5 inflation timing sequence Hypotension as defined as <80/50 blood pressure at the time of screening Ongoing uncontrolled severe hypertension (≥ 180 mmHg systolic or ≥ 110 mmHg diastolic Heart rates < 35 or >125 beats per minute (BPM) at screening Current uncontrolled arrhythmia. Controlled arrhythmia should have beat-to-beat, cycle-length variability less than ±25% at rest. Current congestive heart failure Cardiac catheterization within two weeks, any surgical intervention within six weeks before RenewTM NCP-5 treatment or a hip or knee replacement within 3 months as long as rehab is complete and symptoms have resolved. Known presence of abdominal aortic aneurysm Existing aortic insufficiency grade II or higher (regurgitation can prevent diastolic augmentation) Current or past venous thrombosis or thromboembolism Current limiting peripheral vascular disease with history strongly suggestive of lower extremity ischemia or claudication, arterial occlusive disease (aortoiliac, ileofemoral, or femoral popliteal) Demonstrable deficiency in sensation in lower extremities as a result of diabetes or other medical condition Current bleeding disorders. Current use of major anti-coagulation therapy (such as Heparin therapy or Coumadin® therapy) with International Normalized Ratio (INR) > 1.5 Current severe pulmonary disease that prevents the subject from lying supine Presence of local infection, vasculitis, burn, open wound, or bone fracture on any limb which would prevent the ability to perform the RenewTM NCP-5 treatment Current use of medications that in the investigator's judgement are incompatible with the study goals Significant changes in existing medical plans for treatment of cognitive impairment or dementia in last three months and/or or planned changes during the trial Presence of any of the contraindications for using the RenewTM NCP-5 device Athletic injuries, including Charley horses, pulled muscles and/or edematous muscles; necrotizing cellulitis in the past 30 days which would prevent the ability to perform the RenewTM NCP-5 treatment (evaluate and treat prior to RenewTM NCP-5 treatment) Unwilling or unable to maintain stable exercise regimen throughout the trial Participation in any clinical drug trial 30 days or five half-lives, whichever is longer, prior to screening visit Use of any device to increase cerebral blood flow in the past 30 days. History of claustrophobia. Subject unable to lay supine for 90 minutes
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Billy Tally
Organizational Affiliation
Stage 2 Innovations
Official's Role
Study Director
Facility Information:
Facility Name
Xenoscience
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85004
Country
United States
Facility Name
Irvine Clinical Research
City
Irvine
State/Province
California
ZIP/Postal Code
92614
Country
United States
Facility Name
Charter Research
City
Lady Lake
State/Province
Florida
ZIP/Postal Code
32159
Country
United States
Facility Name
Miami Dade Medical Research Institute
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
iResearch Atlanta
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30030
Country
United States
Facility Name
iResearch Savannah
City
Savannah
State/Province
Georgia
ZIP/Postal Code
31405
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Cardiovascular Advantages, LLC
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70806
Country
United States
Facility Name
Neuro-Behavioral Clinical Research
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Facility Name
Northwest Clinical Research Center
City
Bellevue
State/Province
Washington
ZIP/Postal Code
98007
Country
United States
Facility Name
St. James's Hospital
City
Dublin
Country
Ireland
Facility Name
National University Hospital
City
Singapore
Country
Singapore

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Renew NCP-5 for the Treatment of Mild Cognitive Impairment Due to Alzheimer's Disease (AD) or Mild Dementia of the Alzheimer's Type

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