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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
Placebo oral tablet
Simufilam 100 mg tablet
Simufilam 50 mg oral tablet
Sponsored by
Cassava Sciences, Inc.
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 <= 26 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-h) 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. If receiving donepezil, any dose lower than 23 mg once daily.
  • The patient is a non-smoker for at least 3 years.
  • 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/Aβ42 in cerebrospinal fluid >= 0.28.
  • 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
  • Enrollment in the previous PTI-125 trial
  • A medical condition that would interfere with a lumbar puncture
  • Residence in a skilled nursing facility and requiring 24 h care.
  • Clinically significant laboratory test results
  • Clinically significant untreated hypothyroidism
  • Insufficiently controlled diabetes mellitus
  • Renal insufficiency (serum creatinine > ULN)
  • 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) > ULN or total bilirubin > ULN.
  • 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 interval 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 Central Nervous System 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 quaque die currently or within 3 months prior to randomization
  • Discontinued AChEI < 30 days prior to randomization
  • Antipsychotics; low doses are allowed only if the subject has received a stable dose for at least 3 months before randomization
  • Tricyclic antidepressants and monoamine oxidase inhibitors
  • Anxiolytics or sedative-hypnotics, including barbiturates (unless given in low doses for benign tremor); low doses of benzodiazepines and zolpidem are allowed
  • 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
  • Positive urine drug test at screening
  • Loss of a significant volume of blood (> 450 mL) within 4 weeks prior to the study
  • Suicidality on C-SSRS at screening

Sites / Locations

  • Cognitive Clinical Trials
  • Cognitive Clinical Trials
  • Optimus U
  • IMIC, Inc.
  • Cognitive Clinical Trials
  • Cognitive Clinical Trials
  • Advanced Memory Research Institute
  • Centex Studies, Inc.
  • Centex Studies, Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Placebo Cohort

Simufilam (PTI-125) 100 mg tablets Cohort

Simufilam (PTI-125) 50 mg tablets Cohort

Arm Description

Subjects administered placebo oral tablets twice daily (BID)

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

Subjects administered simufilam (PTI-125) 50 mg oral tablets twice daily (BID)

Outcomes

Primary Outcome Measures

Change From Baseline in CSF Abeta42
Change from Baseline (screening sample) to Day 28 in cerebrospinal fluid levels of Amyloid beta42
Change From Baseline in CSF Total Tau.
Change from Baseline (screening sample) to Day 28 in cerebrospinal fluid total tau.
Change From Baseline in CSF P-tau181
Change from Baseline (screening) to Day 28 in cerebrospinal fluid P-tau181
Change From Baseline in CSF Neurogranin
Change from Baseline (screening) to Day 28 in cerebrospinal fluid neurogranin
Change From Baseline in CSF Neurofilament Light Chain
Change from Baseline (screening) to Day 28 in cerebrospinal fluid neurofilament light chain
Change From Baseline in CSF YKL-40
Change from Baseline (screening) in cerebrospinal fluid YKL-40

Secondary Outcome Measures

Paired Associates Learning Test
Cognitive test assessing episodic memory. Boxes are displayed on the screen and are "opened" in a randomized order. One or more of them contains a pattern. The patterns are then displayed in the middle of the screen, one at a time and the participant must select the box in which the pattern was originally located. If the participant makes an error, the boxes are opened in sequence again to remind the participant of the locations of the patterns. The number of boxes increases progressively to a total of 8.
Spatial Working Memory Test
Cognitive assessment of spatial working memory: A number of colored squares (boxes) are shown on the screen. By selecting the boxes and using a process of elimination, the subject should find one yellow 'token' in each of a number of boxes and use them to fill up an empty column on the right-hand side of the screen. The number of boxes is gradually increased to a total of 8 for the subjects to search. The colors and positions of the boxes are changed from trial to trial to discourage stereotyped search strategies.
CSF IL-6, sTREM2, HMGB1, Albumin, IgG
Change from Baseline (screening sample) to Day 28 in secondary CSF biomarkers of neuroinflammation and blood-brain barrier integrity

Full Information

First Posted
August 26, 2019
Last Updated
September 7, 2021
Sponsor
Cassava Sciences, Inc.
Collaborators
National Institute on Aging (NIA)
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1. Study Identification

Unique Protocol Identification Number
NCT04079803
Brief Title
PTI-125 for Mild-to-moderate Alzheimer's Disease Patients
Official Title
A Phase 2b, Randomized, Double-blind, Placebo-controlled, Multiple Dose, Biomarker and Safety Study of PTI-125 in Mild-to-moderate Alzheimer's Disease Patients
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
September 9, 2019 (Actual)
Primary Completion Date
March 31, 2020 (Actual)
Study Completion Date
March 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cassava Sciences, Inc.
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 2b, Randomized, Double-blind, Placebo-controlled, multiple dose study of PTI-125 in mild-to-moderate Alzheimer's disease patients.
Detailed Description
This is a Phase 2b, Randomized, Double-blind, Placebo-controlled, multiple dose study of PTI-125 in mild-to-moderate Alzheimer's disease patients. A total of sixty (60) patients will be enrolled in the study. Patients will receive Placebo, 50 mg or 100 mg b.i.d. of PTI-125. The objective of this study are to investigate the safety, and biomarkers of PTI-125 following 28-day repeat 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
Parallel Assignment
Model Description
Approximately sixty (60) patients will be enrolled into the study and randomized to one of three cohorts. Cohorts will receive placebo or PTI-125 at 50 or 100 mg b.i.d. (n=20 per group)
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
The sponsor, participant, care provider, investigator including sub-investigators and outcomes assessors will be blinded to throughout the study which includes using an Integrated Web Response System (IWRS) and electronic data capture (EDC) to ensure blinding during the study.
Allocation
Randomized
Enrollment
64 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo Cohort
Arm Type
Placebo Comparator
Arm Description
Subjects administered placebo oral tablets twice daily (BID)
Arm Title
Simufilam (PTI-125) 100 mg tablets Cohort
Arm Type
Experimental
Arm Description
Subjects administered simufilam (PTI-125) 100 mg oral tablets twice daily (BID)
Arm Title
Simufilam (PTI-125) 50 mg tablets Cohort
Arm Type
Experimental
Arm Description
Subjects administered simufilam (PTI-125) 50 mg oral tablets twice daily (BID)
Intervention Type
Drug
Intervention Name(s)
Placebo oral tablet
Intervention Description
Oral placebo tablet
Intervention Type
Drug
Intervention Name(s)
Simufilam 100 mg tablet
Other Intervention Name(s)
PTI-125
Intervention Description
Simufilam 100 mg oral tablet
Intervention Type
Drug
Intervention Name(s)
Simufilam 50 mg oral tablet
Other Intervention Name(s)
PTI-125
Intervention Description
Simufilam 50 mg oral tablet
Primary Outcome Measure Information:
Title
Change From Baseline in CSF Abeta42
Description
Change from Baseline (screening sample) to Day 28 in cerebrospinal fluid levels of Amyloid beta42
Time Frame
Screening to Day 28
Title
Change From Baseline in CSF Total Tau.
Description
Change from Baseline (screening sample) to Day 28 in cerebrospinal fluid total tau.
Time Frame
Screening to Day 28
Title
Change From Baseline in CSF P-tau181
Description
Change from Baseline (screening) to Day 28 in cerebrospinal fluid P-tau181
Time Frame
Screening to Day 28
Title
Change From Baseline in CSF Neurogranin
Description
Change from Baseline (screening) to Day 28 in cerebrospinal fluid neurogranin
Time Frame
Screening to Day 28
Title
Change From Baseline in CSF Neurofilament Light Chain
Description
Change from Baseline (screening) to Day 28 in cerebrospinal fluid neurofilament light chain
Time Frame
Screening to Day 28
Title
Change From Baseline in CSF YKL-40
Description
Change from Baseline (screening) in cerebrospinal fluid YKL-40
Time Frame
Screening to Day 28
Secondary Outcome Measure Information:
Title
Paired Associates Learning Test
Description
Cognitive test assessing episodic memory. Boxes are displayed on the screen and are "opened" in a randomized order. One or more of them contains a pattern. The patterns are then displayed in the middle of the screen, one at a time and the participant must select the box in which the pattern was originally located. If the participant makes an error, the boxes are opened in sequence again to remind the participant of the locations of the patterns. The number of boxes increases progressively to a total of 8.
Time Frame
Day 1 to Day 28
Title
Spatial Working Memory Test
Description
Cognitive assessment of spatial working memory: A number of colored squares (boxes) are shown on the screen. By selecting the boxes and using a process of elimination, the subject should find one yellow 'token' in each of a number of boxes and use them to fill up an empty column on the right-hand side of the screen. The number of boxes is gradually increased to a total of 8 for the subjects to search. The colors and positions of the boxes are changed from trial to trial to discourage stereotyped search strategies.
Time Frame
Day 1 to Day 28
Title
CSF IL-6, sTREM2, HMGB1, Albumin, IgG
Description
Change from Baseline (screening sample) to Day 28 in secondary CSF biomarkers of neuroinflammation and blood-brain barrier integrity
Time Frame
Screening to Day 28
Other Pre-specified Outcome Measures:
Title
Target Engagement Assays: Change From Baseline in Filamin A (FLNA) Linkages to alpha7 Nicotinic Acetylcholine Receptor (alpha7nAChR) and Toll-like Receptor 4 (TLR4) in Subject Lymphocytes
Description
FLNA linkages to these two receptors were assessed by densitometric quantitation of immunoblot bands of each receptor (detected by a specific antibody) in anti-FLNA precipitates. The measure is noted as a ratio to total FLNA.
Time Frame
Day 1 to Day 28
Title
Plasma P-tau181
Description
Percent change in plasma P-tau181
Time Frame
Day 1 to Day 28
Title
Percent Change From Baseline in SavaDx, a Novel Plasma Biomarker
Description
SavaDx is a novel plasma biomarker
Time Frame
Day 1 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 <= 26 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-h) 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. If receiving donepezil, any dose lower than 23 mg once daily. The patient is a non-smoker for at least 3 years. 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/Aβ42 in cerebrospinal fluid >= 0.28. 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 Enrollment in the previous PTI-125 trial A medical condition that would interfere with a lumbar puncture Residence in a skilled nursing facility and requiring 24 h care. Clinically significant laboratory test results Clinically significant untreated hypothyroidism Insufficiently controlled diabetes mellitus Renal insufficiency (serum creatinine > ULN) 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) > ULN or total bilirubin > ULN. 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 interval 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 Central Nervous System 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 quaque die currently or within 3 months prior to randomization Discontinued AChEI < 30 days prior to randomization Antipsychotics; low doses are allowed only if the subject has received a stable dose for at least 3 months before randomization Tricyclic antidepressants and monoamine oxidase inhibitors Anxiolytics or sedative-hypnotics, including barbiturates (unless given in low doses for benign tremor); low doses of benzodiazepines and zolpidem are allowed 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 Positive urine drug test at screening Loss of a significant volume of blood (> 450 mL) within 4 weeks prior to the study Suicidality on C-SSRS at screening
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
Cognitive Clinical Trials
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85296
Country
United States
Facility Name
Cognitive Clinical Trials
City
Surprise
State/Province
Arizona
ZIP/Postal Code
85374
Country
United States
Facility Name
Optimus U
City
Miami
State/Province
Florida
ZIP/Postal Code
33125
Country
United States
Facility Name
IMIC, Inc.
City
Palmetto Bay
State/Province
Florida
ZIP/Postal Code
33157
Country
United States
Facility Name
Cognitive Clinical Trials
City
Bellevue
State/Province
Nebraska
ZIP/Postal Code
68005
Country
United States
Facility Name
Cognitive Clinical Trials
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68116
Country
United States
Facility Name
Advanced Memory Research Institute
City
Toms River
State/Province
New Jersey
ZIP/Postal Code
08755
Country
United States
Facility Name
Centex Studies, Inc.
City
Houston
State/Province
Texas
ZIP/Postal Code
77058
Country
United States
Facility Name
Centex Studies, Inc.
City
McAllen
State/Province
Texas
ZIP/Postal Code
78504
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33188449
Citation
Sever S. Role of actin cytoskeleton in podocytes. Pediatr Nephrol. 2021 Sep;36(9):2607-2614. doi: 10.1007/s00467-020-04812-z. Epub 2020 Nov 13.
Results Reference
derived
Links:
URL
http://nnjournal.net/article/view/2313
Description
Altered filamin A enables amyloid beta-induced tau hyperphosphorylation and neuroinflammation in Alzheimer's disease
URL
http://www.cassavasciences.com/science/publications
Description
PTI-125 and Alzheimer's Publications

Learn more about this trial

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

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