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PTI-125 for Mild-to-moderate Alzheimer's Disease Patients

Primary Purpose

Alzheimer Disease

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PTI-125, 100 mg tablets
Sponsored by
Pain Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease

Eligibility Criteria

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

Inclusion Criteria:

  • Ages >= 50 and <= 85 years
  • Informed consent form (ICF) signed by the subject or legally acceptable representative.
  • Clinical diagnosis of dementia due to possible or probable Alzheimer's disease
  • Mini-Mental State Examination score >= 16 and <= 24 at screening
  • If female, postmenopausal for at least 1 year
  • Patient living at home, senior residential setting, or an institutional setting without the need for continuous (i.e. 24-hour) nursing care
  • General health status acceptable for participation in the study
  • Fluency (oral and written) in English or Spanish
  • If receiving memantine, rivastigmine, galantamine or an AChEI, receiving a stable dose for at least 3 months (90 days) before screening and with continuous dosing for at least 3 months. If receiving donepezil, receiving any dose lower than 23 mg once daily.
  • The patient is a non-smoker for at least 12 months.
  • The patient or legal representative must agree to comply with the drawing of blood samples and with a lumbar puncture and the drawing of cerebrospinal fluid samples.
  • The patient has a ratio of total tau/Abeta42 in cerebrospinal fluid >= 0.30.
  • Patient has a caregiver or legal representative responsible for administering the drug and recording the time.

Exclusion Criteria:

  • Exposure to an experimental drug, experimental biologic or experimental medical device within the longer of 5 half-lives or 3 months before screening
  • Residence in a skilled nursing facility
  • Clinically significant laboratory test results
  • Clinically significant untreated hypothyroidism (if treated, thyroid-stimulating hormone level and thyroid supplementation dose must be stable for at least 6 months before screening)
  • Insufficiently controlled diabetes mellitus or requiring insulin
  • Renal insufficiency (serum creatinine >2.0 mg/dL)
  • Malignant tumor within 3 years before screening (except squamous and basal cell carcinoma or cervical carcinoma in situ or localized prostate cancer or localized stage 1 bladder cancer)
  • History of ischemic colitis or ischemic enterocolitis
  • Unstable medical condition that is clinically significant in the judgment of the investigator
  • Alanine transaminase (ALT) or aspartate transaminase (AST) >2 times the upper limit of normal or total bilirubin greater than the upper limit of normal.
  • History of myocardial infarction or unstable angina within 6 months before screening
  • History of more than 1 myocardial infarction within 5 years before screening
  • Clinically significant cardiac arrhythmia (including atrial fibrillation), cardiomyopathy, or cardiac conduction defect (patients with a pacemaker are acceptable)
  • Symptomatic hypotension, or uncontrolled hypertension
  • Clinically significant abnormality on screening electrocardiogram (ECG), including but not necessarily limited to a confirmed corrected QT value >= 450 msec for males or >= 470 msec for females.
  • Stroke within 18 months before screening, or history of a stroke concomitant with onset of dementia
  • History of brain tumor or other clinically significant space-occupying lesion on CT or MRI
  • Head trauma with clinically significant loss of consciousness within 12 months before screening or concurrent with the onset of dementia
  • Onset of dementia secondary to cardiac arrest, surgery with general anesthesia, or resuscitation
  • Specific degenerative CNS disease diagnosis other than Alzheimer's disease (eg, Huntington's disease, Creutzfeld-Jacob disease, Down's syndrome, Frontotemporal Dementia, Parkinson's disease)
  • Wernicke's encephalopathy
  • Active acute or chronic Central Nervous System infection
  • Donepezil 23 mg or greater quaque die currently or within 3 months prior to enrollment in the study
  • Discontinued AChEI < 30 days prior to enrollment in the study
  • Antipsychotics; low doses are allowed only if given for sleep disturbances, agitation and/or aggression, and only if the subject has received a stable dose for at least 3 months before enrollment in the study
  • Tricyclic antidepressants and monoamine oxidase inhibitors; all other antidepressants are allowed only if the subject has received a stable dose for at least 3 months before enrollment in the study
  • Anxiolytics or sedative-hypnotics, including barbiturates (unless given in low doses for benign tremor); low doses of benzodiazepines and zolpidem are allowed only if given for insomnia/sleep disturbance, and only if the subject has received a stable dose for at least 3 months before enrollment in the study
  • Peripherally acting drugs with effects on cholinergic transmission
  • Immunosuppressants, including systemic corticosteroids, if taken in clinically immunosuppressive doses (Steroid use for allergy or other inflammation is permitted.)
  • Antiepileptic medications if taken for control of seizures
  • Chronic intake of opioid-containing analgesics
  • Sedating H1 antihistamines
  • Nicotine therapy (all dosage forms including a patch), varenicline (Chantix), or similar therapeutic agent within 30 days before screening
  • Clinically significant illness within 30 days of enrollment
  • History of significant neurological, hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, or metabolic disease
  • Positive serum hepatitis B surface antigen (HBsAg) or positive hepatitis C virus (HCV) antibody test at screening
  • Positive HIV test at screening
  • Loss of a significant volume of blood (> 450 mL) within 4 weeks prior to the study
  • Metformin or cimetidine.

Sites / Locations

  • Insite Clinical Research
  • Clinical Trials of Texas

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Simufilam (PTI-125)

Arm Description

Simufilam (PTI-125) 100 mg oral tablets administered twice daily (BID)

Outcomes

Primary Outcome Measures

Maximum Plasma Concentration (Cmax)
Blood draws will be done to evaluate levels of PTI-125 in the plasma using non-compartmental methods in WinNonlin.
Time to Maximum Plasma Concentration (Tmax)
Levels of PTI-125 will be assessed to determine how long it takes to reach the Cmax
Last Quantifiable Plasma Concentration (Clast)
Levels of PTI-125 will be assessed to determine the last time point where PTI-125 can be detected.
Time to Last Quantifiable Plasma Concentration (Tlast)
Levels of PTI-125 will be assessed to determine the elapsed time to where PTI-125 can last be detected in the plasma.
Area Under the Curve (AUClast)
AUC for PTI-125 plasma concentration from time zero to the last quantifiable plasma concentration.
Plasma Half-life (T1/2)
Assessment of the half-life in plasma of PTI-125

Secondary Outcome Measures

SavaDx (Biomarker)
Blood samples will be tested for the complementary diagnostic/biomarker for Alzheimer's disease.
CSF Biomarkers
A cerebrospinal fluid sample collection will be performed for Aβ42, tau, YKL40 and other potential CSF biomarkers

Full Information

First Posted
November 13, 2018
Last Updated
June 12, 2021
Sponsor
Pain Therapeutics
Collaborators
National Institute on Aging (NIA)
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1. Study Identification

Unique Protocol Identification Number
NCT03748706
Brief Title
PTI-125 for Mild-to-moderate Alzheimer's Disease Patients
Official Title
A Phase 2a, Open-label, Multiple Dose, Safety, Pharmacokinetic and Biomarker Study of PTl-125 in Mild-to-moderate Alzheimer's Disease Patients
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
March 7, 2019 (Actual)
Primary Completion Date
May 8, 2019 (Actual)
Study Completion Date
May 8, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pain Therapeutics
Collaborators
National Institute on Aging (NIA)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 2a, multi-center, open-label study of PTI-125 in mild-to-moderate Alzheimer's disease patients.
Detailed Description
This is a Phase 2a, multi-center, open-label study of PTI-125 in mild-to-moderate AD patients, 50-85 years of age. A total of twelve (12) patients will be enrolled into the study. Patients will receive 100 mg b.i.d. of PTI-125. The objectives of this study are to investigate the safety, pharmacokinetics and effect on biomarkers of PTI-125 following 28-day repeat-dose oral administration.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Simufilam (PTI-125)
Arm Type
Experimental
Arm Description
Simufilam (PTI-125) 100 mg oral tablets administered twice daily (BID)
Intervention Type
Drug
Intervention Name(s)
PTI-125, 100 mg tablets
Intervention Description
PTI-125, 100 mg tablets taken twice a day for 28 days
Primary Outcome Measure Information:
Title
Maximum Plasma Concentration (Cmax)
Description
Blood draws will be done to evaluate levels of PTI-125 in the plasma using non-compartmental methods in WinNonlin.
Time Frame
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose
Title
Time to Maximum Plasma Concentration (Tmax)
Description
Levels of PTI-125 will be assessed to determine how long it takes to reach the Cmax
Time Frame
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose
Title
Last Quantifiable Plasma Concentration (Clast)
Description
Levels of PTI-125 will be assessed to determine the last time point where PTI-125 can be detected.
Time Frame
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose
Title
Time to Last Quantifiable Plasma Concentration (Tlast)
Description
Levels of PTI-125 will be assessed to determine the elapsed time to where PTI-125 can last be detected in the plasma.
Time Frame
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose
Title
Area Under the Curve (AUClast)
Description
AUC for PTI-125 plasma concentration from time zero to the last quantifiable plasma concentration.
Time Frame
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose
Title
Plasma Half-life (T1/2)
Description
Assessment of the half-life in plasma of PTI-125
Time Frame
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose
Secondary Outcome Measure Information:
Title
SavaDx (Biomarker)
Description
Blood samples will be tested for the complementary diagnostic/biomarker for Alzheimer's disease.
Time Frame
Study Day 1 and Day 28
Title
CSF Biomarkers
Description
A cerebrospinal fluid sample collection will be performed for Aβ42, tau, YKL40 and other potential CSF biomarkers
Time Frame
Change from Baseline to Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ages >= 50 and <= 85 years Informed consent form (ICF) signed by the subject or legally acceptable representative. Clinical diagnosis of dementia due to possible or probable Alzheimer's disease Mini-Mental State Examination score >= 16 and <= 24 at screening If female, postmenopausal for at least 1 year Patient living at home, senior residential setting, or an institutional setting without the need for continuous (i.e. 24-hour) nursing care General health status acceptable for participation in the study Fluency (oral and written) in English or Spanish If receiving memantine, rivastigmine, galantamine or an AChEI, receiving a stable dose for at least 3 months (90 days) before screening and with continuous dosing for at least 3 months. If receiving donepezil, receiving any dose lower than 23 mg once daily. The patient is a non-smoker for at least 12 months. The patient or legal representative must agree to comply with the drawing of blood samples and with a lumbar puncture and the drawing of cerebrospinal fluid samples. The patient has a ratio of total tau/Abeta42 in cerebrospinal fluid >= 0.30. Patient has a caregiver or legal representative responsible for administering the drug and recording the time. Exclusion Criteria: Exposure to an experimental drug, experimental biologic or experimental medical device within the longer of 5 half-lives or 3 months before screening Residence in a skilled nursing facility Clinically significant laboratory test results Clinically significant untreated hypothyroidism (if treated, thyroid-stimulating hormone level and thyroid supplementation dose must be stable for at least 6 months before screening) Insufficiently controlled diabetes mellitus or requiring insulin Renal insufficiency (serum creatinine >2.0 mg/dL) Malignant tumor within 3 years before screening (except squamous and basal cell carcinoma or cervical carcinoma in situ or localized prostate cancer or localized stage 1 bladder cancer) History of ischemic colitis or ischemic enterocolitis Unstable medical condition that is clinically significant in the judgment of the investigator Alanine transaminase (ALT) or aspartate transaminase (AST) >2 times the upper limit of normal or total bilirubin greater than the upper limit of normal. History of myocardial infarction or unstable angina within 6 months before screening History of more than 1 myocardial infarction within 5 years before screening Clinically significant cardiac arrhythmia (including atrial fibrillation), cardiomyopathy, or cardiac conduction defect (patients with a pacemaker are acceptable) Symptomatic hypotension, or uncontrolled hypertension Clinically significant abnormality on screening electrocardiogram (ECG), including but not necessarily limited to a confirmed corrected QT value >= 450 msec for males or >= 470 msec for females. Stroke within 18 months before screening, or history of a stroke concomitant with onset of dementia History of brain tumor or other clinically significant space-occupying lesion on CT or MRI Head trauma with clinically significant loss of consciousness within 12 months before screening or concurrent with the onset of dementia Onset of dementia secondary to cardiac arrest, surgery with general anesthesia, or resuscitation Specific degenerative CNS disease diagnosis other than Alzheimer's disease (eg, Huntington's disease, Creutzfeld-Jacob disease, Down's syndrome, Frontotemporal Dementia, Parkinson's disease) Wernicke's encephalopathy Active acute or chronic Central Nervous System infection Donepezil 23 mg or greater quaque die currently or within 3 months prior to enrollment in the study Discontinued AChEI < 30 days prior to enrollment in the study Antipsychotics; low doses are allowed only if given for sleep disturbances, agitation and/or aggression, and only if the subject has received a stable dose for at least 3 months before enrollment in the study Tricyclic antidepressants and monoamine oxidase inhibitors; all other antidepressants are allowed only if the subject has received a stable dose for at least 3 months before enrollment in the study Anxiolytics or sedative-hypnotics, including barbiturates (unless given in low doses for benign tremor); low doses of benzodiazepines and zolpidem are allowed only if given for insomnia/sleep disturbance, and only if the subject has received a stable dose for at least 3 months before enrollment in the study Peripherally acting drugs with effects on cholinergic transmission Immunosuppressants, including systemic corticosteroids, if taken in clinically immunosuppressive doses (Steroid use for allergy or other inflammation is permitted.) Antiepileptic medications if taken for control of seizures Chronic intake of opioid-containing analgesics Sedating H1 antihistamines Nicotine therapy (all dosage forms including a patch), varenicline (Chantix), or similar therapeutic agent within 30 days before screening Clinically significant illness within 30 days of enrollment History of significant neurological, hepatic, renal, endocrine, cardiovascular, gastrointestinal, pulmonary, or metabolic disease Positive serum hepatitis B surface antigen (HBsAg) or positive hepatitis C virus (HCV) antibody test at screening Positive HIV test at screening Loss of a significant volume of blood (> 450 mL) within 4 weeks prior to the study Metformin or cimetidine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lindsay Burns, PhD
Organizational Affiliation
Cassava Sciences, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Insite Clinical Research
City
DeSoto
State/Province
Texas
ZIP/Postal Code
75115
Country
United States
Facility Name
Clinical Trials of Texas
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28438486
Citation
Wang HY, Lee KC, Pei Z, Khan A, Bakshi K, Burns LH. PTI-125 binds and reverses an altered conformation of filamin A to reduce Alzheimer's disease pathogenesis. Neurobiol Aging. 2017 Jul;55:99-114. doi: 10.1016/j.neurobiolaging.2017.03.016. Epub 2017 Mar 31.
Results Reference
background
PubMed Identifier
22815492
Citation
Wang HY, Bakshi K, Frankfurt M, Stucky A, Goberdhan M, Shah SM, Burns LH. Reducing amyloid-related Alzheimer's disease pathogenesis by a small molecule targeting filamin A. J Neurosci. 2012 Jul 18;32(29):9773-84. doi: 10.1523/JNEUROSCI.0354-12.2012. Erratum In: J Neurosci. 2021 Dec 15;41(50):10405. J Neurosci. 2022 Jan 19;42(3):529.
Results Reference
background
PubMed Identifier
32920628
Citation
Wang HY, Pei Z, Lee KC, Lopez-Brignoni E, Nikolov B, Crowley CA, Marsman MR, Barbier R, Friedmann N, Burns LH. PTI-125 Reduces Biomarkers of Alzheimer's Disease in Patients. J Prev Alzheimers Dis. 2020;7(4):256-264. doi: 10.14283/jpad.2020.6.
Results Reference
result
Links:
URL
http://www.cassavasciences.com
Description
Cassava Sciences company website

Learn more about this trial

PTI-125 for Mild-to-moderate Alzheimer's Disease Patients

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