Study to Evaluate the Safety and Efficacy of AstroStem in Treatment of Alzheimer's Disease
Primary Purpose
Alzheimer Disease
Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
AstroStem
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease
Eligibility Criteria
Inclusion Criteria:
- Male or female patients aged 50 and above at the time of signing the Informed Consent Form
- Patients who can understand and provide written informed consent (assent)
- Patients who have a diagnosis of probable mild Alzheimer's Disease(AD) according to the National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria within one year of the start of treatment
- Patients who have an MMSE Score of 20 to 24 at screening
- Patients who have a Clinical Dementia Rating (CDR)-Global Score of 0.5 to 1 at baseline
- Patients who have any FDA-approved AD medication (donepezil, galantamine, memantine, rivastigmine or any combination) since their AD diagnosis receiving a stable dose of medical teratment for at least 12 weeks prior to Screening and were to stay on a stable dose during the study
- Patients who have one (or more) identified adult caregiver (study partner) who is able to read, understand, and speak the designated language at the study site; who either lives with the subject or sees the subject for ≥2 hours/day ≥4 days/week; and who agrees to accompany the subject to each study visit and to participate in the subject's clinical assessments
- Patients who have a diagnosis of probable mild AD according to Amyloid PET scan at screening
Exclusion Criteria:
- Female patients who are pregnant, nursing, or of childbearing potential while not practicing effective contraception
- Patients who have signs of delirium
- Patients who have had a cortical stroke within the preceding 2 years
- Patients who have a prolonged QTc interval at screening; >450 msec for males or >470 msec for females
- Patients who have a diagnosis of severe white matter hyperintensity (WMH), which is defined as ≥25mm of the deep white matter and ≥10mm of the periventricular capping/banding in lengths
- Patients who have a diagnosis of dementia or cause of cognitive impairment other than AD
- Patients who have a significant abnormal result in laboratory tests, in the opinion of the investigator
- Patients who have participated in any investigational drug, stem cell therapy, or device trial within the previous 3 months at screening
- Patients with any current psychiatric diagnosis other than AD if, in the judgment of the investigator, the psychiatric disorder or symptom is likely to confound interpretation of drug effect, affect cognitive assessments, or affect the subject´s ability to complete the study
- Patients who are known to have autosomal dominant mutation-associated presenile AD
- Patients who show signs of Acquired Immunodeficiency Syndrome (AIDS), Hepatitis B Virus (HBV), Hepatitis C (HCV), Venereal Disease Research Laboratory (VDRL)
- Patients who have any conditions that would contraindicate an MRI, such as the presence metallic objects in the eyes, skin, or heart
- Patients who have >4 cerebral microhemorrhages (regardless of their anatomical location or diagnostic characterization as "possible" or "definite"), a single area of superficial siderosis, or evidence of a prior microhemorrhage as assessed by MRI
- Patients who have history of malignant cancer within the last 5 years (The following is a partial list of conditions that are permissible for study entry: non-metastatic basal and/or squamous cell carcinoma of the skin, in situ cervical, or non-progressive prostate cancer)
- Patients who have suspected active lung disease based on chest X-ray
- Patients who are hypersensitive to fetal bovine serum or penicillin
- Patients who are currently using immunosuppressants, cytotoxic drug, corticosteroids or similar steroidal anti-inflammatory medication (e.g., Prednisone) on a regular basis (exceptions allowed include; regular use of steroidal nasal sprays, topical steroids, and estrogen-replacement therapy)
- Patients for whom the investigator judges the liposuction may cause a problem
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Treatment
Placebo Control
Arm Description
Treatment group will be administered via intravenously AstroStem which consists of two syringes and each syringe contains 2.0 x 10^8 cells / 20 mL of saline with 30% auto-serum.
Placebo control group will receive AstroStem Placebo.
Outcomes
Primary Outcome Measures
SUVR (Standard Uptake Value Ratio)
Standard Uptake Value Ratio (SUVR) of the Amyloid PET scan
Secondary Outcome Measures
CDR-SB score (Clinical Dementia Rating Sum of Boxes)
Changes of CDR-SOB from baseline at Week 52 Score range: 0-18.0 0 = normal, 0.5-4.0 = questionable cognitive dementia, 4.5-9.0 = mild dementia, 9.5-15.5 = moderate dementia, and 16.0-18.0 = severe dementia
ADAS-Cog-11 score (Alzheimer's Disease assessment Scale-Cognitive Subscale (11 items))
Change of ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive subscale) from Baseline at Week 52 Score range: 0-70 A score of 70 represents the most severe impairment and 0 represents the least impairment
MMSE (Mini-mental status examination)
Change from baseline to Week 52 in the Mini-mental status examination (MMSE) score. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual-spatial skills. The Mini-Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment.
ADCS-ADL-MCI (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory)
Change from baseline to Week 52 in the ADCS-ADl MCI 0-53 A score of 0 represents the most severe impairment and 53 represents the least impairment
C-SSRS (Columbia Suicide Severity Rating Scale)
Change from baseline to Week 52 in the Columbia Suicide Severity Rating Scale (C-SSRS) score. The suicidal ideation severity subscale ranges from 1 to 5 (with higher number indicating more severe ideation). The intensity of ideation subscale includes 5 questions each one ranging from 1 to 5 (with higher number indicating more intense ideation). The suicidal behavior subscale includes 4 yes/no questions. The suicidal behavior lethality subscale inquires about the level of actual or potential medical damage.
NPI (Neuropsychiatric Inventory)
Change from baseline to Week 52 in the Neuropsychiatric Inventory (NPI) score. The NPI is a structured interview with a caregiver or qualified study partner (defined as having direct contact > 2 days/week) that evaluates both presence and severity of 12 neuropsychiatric features which include: delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability, lability, apathy, aberrant motor behavior, night-time behavior, and appetite/ eating changes. If the response to the domain question is "No", the informant goes to the next question. If "Yes", the informant then rates both the Severity of the symptoms present within the last month on a 3-point scale ranging from 1 to 3 (mild to severe).
Treatment related Adverse Events
Number of subjects with treatment related adverse events as assessed by analysis of adverse events including symptoms, and abnormal findings on physical examination, vital signs, ECG, and standard laboratory examination results
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04482413
Brief Title
Study to Evaluate the Safety and Efficacy of AstroStem in Treatment of Alzheimer's Disease
Official Title
A Phase 2b, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of AstroStem, Autologous Adipose Tissue Derived Mesenchymal Stem Cells, in Patients With Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
February 1, 2023 (Anticipated)
Primary Completion Date
May 30, 2024 (Anticipated)
Study Completion Date
December 20, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nature Cell Co. Ltd.
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 study with 2 treatment arms, to compare the efficacy and safety of AstroStem vs. Placebo treatment in patients with mild Alzheimer's Disease(AD). Eligible patients diagnosed with AD within one year of the start of treatment will be enrolled. Patients who are randomized into the treatment group will be administered via intravenously AstroStem every 4 weeks from Week 0 to Week 36. On the other hand, patients who are randomized into the placebo control group will receive Placebo every 4 weeks from Week 0 to Week 36. After the final administration, patients will be scheduled for two follow-up visits, at Weeks 44 and 52, to assess efficacy and safety endpoints.
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
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Treatment
Arm Type
Experimental
Arm Description
Treatment group will be administered via intravenously AstroStem which consists of two syringes and each syringe contains 2.0 x 10^8 cells / 20 mL of saline with 30% auto-serum.
Arm Title
Placebo Control
Arm Type
Placebo Comparator
Arm Description
Placebo control group will receive AstroStem Placebo.
Intervention Type
Drug
Intervention Name(s)
AstroStem
Intervention Description
Treatment group receive AstroStem(Autologous adipose tissue derived mesenchymal stem cells, AdMSCs) every 4 weeks from Week 0 to Week 36.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
AstroStem Placebo
Intervention Description
Placebo control group receive 20 mL of Saline and auto serum every 4 weeks from Week 0 to Week 36.
Primary Outcome Measure Information:
Title
SUVR (Standard Uptake Value Ratio)
Description
Standard Uptake Value Ratio (SUVR) of the Amyloid PET scan
Time Frame
Baseline and 52 Weeks
Secondary Outcome Measure Information:
Title
CDR-SB score (Clinical Dementia Rating Sum of Boxes)
Description
Changes of CDR-SOB from baseline at Week 52 Score range: 0-18.0 0 = normal, 0.5-4.0 = questionable cognitive dementia, 4.5-9.0 = mild dementia, 9.5-15.5 = moderate dementia, and 16.0-18.0 = severe dementia
Time Frame
Baseline and 52 Weeks
Title
ADAS-Cog-11 score (Alzheimer's Disease assessment Scale-Cognitive Subscale (11 items))
Description
Change of ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive subscale) from Baseline at Week 52 Score range: 0-70 A score of 70 represents the most severe impairment and 0 represents the least impairment
Time Frame
Baseline and 52 Weeks
Title
MMSE (Mini-mental status examination)
Description
Change from baseline to Week 52 in the Mini-mental status examination (MMSE) score. The Mini-Mental State Exam (MMSE) is a widely used test of cognitive function among the elderly; it includes tests of orientation, attention, memory, language and visual-spatial skills. The Mini-Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment.
Time Frame
Baseline and 52 Weeks
Title
ADCS-ADL-MCI (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory)
Description
Change from baseline to Week 52 in the ADCS-ADl MCI 0-53 A score of 0 represents the most severe impairment and 53 represents the least impairment
Time Frame
Baseline and 52 Weeks
Title
C-SSRS (Columbia Suicide Severity Rating Scale)
Description
Change from baseline to Week 52 in the Columbia Suicide Severity Rating Scale (C-SSRS) score. The suicidal ideation severity subscale ranges from 1 to 5 (with higher number indicating more severe ideation). The intensity of ideation subscale includes 5 questions each one ranging from 1 to 5 (with higher number indicating more intense ideation). The suicidal behavior subscale includes 4 yes/no questions. The suicidal behavior lethality subscale inquires about the level of actual or potential medical damage.
Time Frame
Baseline and 52 Weeks
Title
NPI (Neuropsychiatric Inventory)
Description
Change from baseline to Week 52 in the Neuropsychiatric Inventory (NPI) score. The NPI is a structured interview with a caregiver or qualified study partner (defined as having direct contact > 2 days/week) that evaluates both presence and severity of 12 neuropsychiatric features which include: delusions, hallucinations, dysphoria, anxiety, agitation/aggression, euphoria, disinhibition, irritability, lability, apathy, aberrant motor behavior, night-time behavior, and appetite/ eating changes. If the response to the domain question is "No", the informant goes to the next question. If "Yes", the informant then rates both the Severity of the symptoms present within the last month on a 3-point scale ranging from 1 to 3 (mild to severe).
Time Frame
Baseline and 52 Weeks
Title
Treatment related Adverse Events
Description
Number of subjects with treatment related adverse events as assessed by analysis of adverse events including symptoms, and abnormal findings on physical examination, vital signs, ECG, and standard laboratory examination results
Time Frame
Baseline and 52 Weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female patients aged 50 and above at the time of signing the Informed Consent Form
Patients who can understand and provide written informed consent (assent)
Patients who have a diagnosis of probable mild Alzheimer's Disease(AD) according to the National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria within one year of the start of treatment
Patients who have an MMSE Score of 20 to 24 at screening
Patients who have a Clinical Dementia Rating (CDR)-Global Score of 0.5 to 1 at baseline
Patients who have any FDA-approved AD medication (donepezil, galantamine, memantine, rivastigmine or any combination) since their AD diagnosis receiving a stable dose of medical teratment for at least 12 weeks prior to Screening and were to stay on a stable dose during the study
Patients who have one (or more) identified adult caregiver (study partner) who is able to read, understand, and speak the designated language at the study site; who either lives with the subject or sees the subject for ≥2 hours/day ≥4 days/week; and who agrees to accompany the subject to each study visit and to participate in the subject's clinical assessments
Patients who have a diagnosis of probable mild AD according to Amyloid PET scan at screening
Exclusion Criteria:
Female patients who are pregnant, nursing, or of childbearing potential while not practicing effective contraception
Patients who have signs of delirium
Patients who have had a cortical stroke within the preceding 2 years
Patients who have a prolonged QTc interval at screening; >450 msec for males or >470 msec for females
Patients who have a diagnosis of severe white matter hyperintensity (WMH), which is defined as ≥25mm of the deep white matter and ≥10mm of the periventricular capping/banding in lengths
Patients who have a diagnosis of dementia or cause of cognitive impairment other than AD
Patients who have a significant abnormal result in laboratory tests, in the opinion of the investigator
Patients who have participated in any investigational drug, stem cell therapy, or device trial within the previous 3 months at screening
Patients with any current psychiatric diagnosis other than AD if, in the judgment of the investigator, the psychiatric disorder or symptom is likely to confound interpretation of drug effect, affect cognitive assessments, or affect the subject´s ability to complete the study
Patients who are known to have autosomal dominant mutation-associated presenile AD
Patients who show signs of Acquired Immunodeficiency Syndrome (AIDS), Hepatitis B Virus (HBV), Hepatitis C (HCV), Venereal Disease Research Laboratory (VDRL)
Patients who have any conditions that would contraindicate an MRI, such as the presence metallic objects in the eyes, skin, or heart
Patients who have >4 cerebral microhemorrhages (regardless of their anatomical location or diagnostic characterization as "possible" or "definite"), a single area of superficial siderosis, or evidence of a prior microhemorrhage as assessed by MRI
Patients who have history of malignant cancer within the last 5 years (The following is a partial list of conditions that are permissible for study entry: non-metastatic basal and/or squamous cell carcinoma of the skin, in situ cervical, or non-progressive prostate cancer)
Patients who have suspected active lung disease based on chest X-ray
Patients who are hypersensitive to fetal bovine serum or penicillin
Patients who are currently using immunosuppressants, cytotoxic drug, corticosteroids or similar steroidal anti-inflammatory medication (e.g., Prednisone) on a regular basis (exceptions allowed include; regular use of steroidal nasal sprays, topical steroids, and estrogen-replacement therapy)
Patients for whom the investigator judges the liposuction may cause a problem
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hugh Lee
Phone
301-540-2600
Email
hughlee@kcrnresearch.com
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Study to Evaluate the Safety and Efficacy of AstroStem in Treatment of Alzheimer's Disease
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