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An Efficacy, and Safety Study Of BXCL501 For The Treatment Of Agitation Associated With Dementia

Primary Purpose

Agitation, Dementia

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
BXCL501
BXCL501
Placebo film
Sponsored by
BioXcel Therapeutics Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Agitation

Eligibility Criteria

65 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Individuals diagnosed with any form of dementia (i.e., probable Alzheimer's Disease; vascular dementia; mixed; frontotemporal dementia)
  2. Subjects who have met DSM-5 criteria for dementia (major neurocognitive disorder) who have instances of acute psychomotor agitation.
  3. History of psychomotor agitation (e.g., kick, bite, flailing) to the point that it impairs social activities, requires staffing, or medical intervention, or impairs ability for functional activities of daily living.
  4. Subjects are expected to exhibit behaviors that are congruent with the International Psychogeriatric Association criterion for agitation representing a change from the subject's usual behavior.
  5. Subjects who have a score of ≤16 on the Mini-Mental State Exam (MMSE).
  6. Subjects with a remote (>5 years) history of stroke may be included, regardless of size/location.
  7. Subjects who read, understand, and provide written informed consent, or who have a legally authorized representative (LAR).
  8. Subjects who are deemed to be medically appropriate for study participation by the principal investigator.
  9. Subjects who are at their current location for at least 14 days before screening and plan to remain at the same location for the duration of the study.
  10. Subjects who have the capability to participate in the study and self-administer the investigational product.
  11. Subjects who are on a stable concomitant medications regimen for the treatment of any concurrent conditions for at least one month prior to the screening visit.

Exclusion Criteria:

  1. Subjects who have dementia associated with Parkinson's disease and/or Lewy Body Disease are excluded.
  2. Subjects suffering from alcohol and/or substance abuse.
  3. Subjects with agitation caused by acute intoxication must be excluded.
  4. Subjects with significant risk of suicide or homicide per the investigator's assessment.
  5. Subjects who have hydrocephalus, seizure disorder, or history of significant head trauma, subarachnoid bleeding, brain tumor, encephalopathy, meningitis, or focal neurological findings, with a recent (1 year) large (non-microvascular) stroke who may be considered medically unstable or in recovery must be excluded.
  6. History of clinically significant syncope or syncopal attacks, orthostatic hypotension within the past 2 years.
  7. Subjects with laboratory or ECG abnormalities.
  8. Subjects with serious, unstable, or uncontrolled medical illnesses must be excluded.
  9. Subjects who have received an investigational drug within 30 days prior to Screening must be excluded.
  10. Subjects who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving dexmedetomidine must be excluded.
  11. Subjects whose agitation is attributed to pain or infection, delirium, concomitant medications, environmental conditions, or another psychiatric condition or medical condition as determined by the investigator.

Sites / Locations

  • Bioxcel Clinical Research Site
  • Bioxcel Clinical Research Site
  • BioXcel Clinical Research Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

40 micrograms

60 micrograms

Placebo

Arm Description

Sublingual film containing 40 micrograms Dexmedetomidine

Sublingual film containing 60 micrograms Dexmedetomidine

Sublingual Placebo film

Outcomes

Primary Outcome Measures

Change in Positive and Negative Syndrome Scale- Excited Component (PEC) Total Score
The Positive and Negative Syndrome Scale - Excited Component (PEC) comprises 5 items associated with agitation: poor impulse control, tension, hostility, uncooperativeness, and excitement; each scored 1 (minimum) to 7 (maximum). The PEC, the sum of these 5 subscales, thus ranges from 5 (absence of agitation) to 35 (extremely severe).

Secondary Outcome Measures

Change From Baseline for Pittsburgh Agitation Scale
The Pittsburgh Agitation Scale (PAS) assesses agitation for individuals with dementia across four behavior groups: aberrant vocalizations, motor agitation, aggressiveness, and resisting care. Each behavior group is scored ranging from 0 (not present) to 4 (maximally present).
Change From Baseline for Agitation-Calmness Evaluation Scale
The Agitation-Calmness Evaluation Scale (ACES) is a single item measure rating overall agitation and sedation, where 1 indicates marked agitation; 2 - moderate agitation; 3 - mild agitation; 4 - normal behavior; 5 - mild calmness; 6 - moderate calmness; 7 - marked calmness; 8 - deep sleep; and 9 - unarousable
Clinical Global Impression - Improvement
The Clinical Global Impression - Improvement (CGI-I) for agitation in response to treatment measures the current level of agitation relative to the level of agitation prior to administration of study intervention. The CGI-I scores range from 1 to 7 with a score of 1 indicating very much improved, and a score of 7 indicating very much worse.

Full Information

First Posted
February 28, 2022
Last Updated
August 24, 2023
Sponsor
BioXcel Therapeutics Inc
Collaborators
Cognitive Research Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT05276830
Brief Title
An Efficacy, and Safety Study Of BXCL501 For The Treatment Of Agitation Associated With Dementia
Official Title
A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Efficacy, and Safety Study of BXCL501 For The Treatment of Agitation Associated With Dementia
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Terminated
Why Stopped
Study was terminated for business reasons; not due to safety or efficacy concerns
Study Start Date
February 8, 2022 (Actual)
Primary Completion Date
April 1, 2022 (Actual)
Study Completion Date
April 1, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioXcel Therapeutics Inc
Collaborators
Cognitive Research Corporation

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
A randomized, double-blind, placebo-controlled parallel group 3-arm study assessing efficacy, safety, and tolerability of two doses BXCL501 in male and female geriatric residents (65 years and older) with acute agitation associated with all forms of dementia (i.e., probably Alzheimer's Disease, vascular dementia; mixed; frontotemporal dementia) excluding Parkinson's-Related Dementia and Lewy Body Dementia.
Detailed Description
The study will enroll at least 75 subjects to receive a single film consisting of BXCL501 40 μg dose, BXCL501 60 μg dose, or matching placebo film. Subjects must reside in a residential care facility and must require at least moderate assistance with activities of daily living (e.g., bathing, dressing, and toileting). The subject must be able to self-administer the film to participate in the study. The effects of BXCL 501 on acute agitation will be assessed by the following scales: PEC, PAS, ACES, and CGI-I.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Study will randomize subjects 1:1:1 to receive BXCL501 40 μg, BXCL501 60 μg, or matching placebo film
Masking
ParticipantInvestigator
Masking Description
Double-Blind, Placebo controlled
Allocation
Randomized
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
40 micrograms
Arm Type
Experimental
Arm Description
Sublingual film containing 40 micrograms Dexmedetomidine
Arm Title
60 micrograms
Arm Type
Experimental
Arm Description
Sublingual film containing 60 micrograms Dexmedetomidine
Arm Title
Placebo
Arm Type
Experimental
Arm Description
Sublingual Placebo film
Intervention Type
Drug
Intervention Name(s)
BXCL501
Other Intervention Name(s)
Dexmedetomidine
Intervention Description
Sublingual film containing 40 Micrograms BXCL501
Intervention Type
Drug
Intervention Name(s)
BXCL501
Other Intervention Name(s)
Dexmedetomidine
Intervention Description
Sublingual film containing 60 Micrograms BXCL501
Intervention Type
Drug
Intervention Name(s)
Placebo film
Other Intervention Name(s)
Placebo
Intervention Description
Matching Sublingual Placebo film
Primary Outcome Measure Information:
Title
Change in Positive and Negative Syndrome Scale- Excited Component (PEC) Total Score
Description
The Positive and Negative Syndrome Scale - Excited Component (PEC) comprises 5 items associated with agitation: poor impulse control, tension, hostility, uncooperativeness, and excitement; each scored 1 (minimum) to 7 (maximum). The PEC, the sum of these 5 subscales, thus ranges from 5 (absence of agitation) to 35 (extremely severe).
Time Frame
120 minutes
Secondary Outcome Measure Information:
Title
Change From Baseline for Pittsburgh Agitation Scale
Description
The Pittsburgh Agitation Scale (PAS) assesses agitation for individuals with dementia across four behavior groups: aberrant vocalizations, motor agitation, aggressiveness, and resisting care. Each behavior group is scored ranging from 0 (not present) to 4 (maximally present).
Time Frame
120 minutes
Title
Change From Baseline for Agitation-Calmness Evaluation Scale
Description
The Agitation-Calmness Evaluation Scale (ACES) is a single item measure rating overall agitation and sedation, where 1 indicates marked agitation; 2 - moderate agitation; 3 - mild agitation; 4 - normal behavior; 5 - mild calmness; 6 - moderate calmness; 7 - marked calmness; 8 - deep sleep; and 9 - unarousable
Time Frame
120 minutes
Title
Clinical Global Impression - Improvement
Description
The Clinical Global Impression - Improvement (CGI-I) for agitation in response to treatment measures the current level of agitation relative to the level of agitation prior to administration of study intervention. The CGI-I scores range from 1 to 7 with a score of 1 indicating very much improved, and a score of 7 indicating very much worse.
Time Frame
120 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Individuals diagnosed with any form of dementia (i.e., probable Alzheimer's Disease; vascular dementia; mixed; frontotemporal dementia) Subjects who have met DSM-5 criteria for dementia (major neurocognitive disorder) who have instances of acute psychomotor agitation. History of psychomotor agitation (e.g., kick, bite, flailing) to the point that it impairs social activities, requires staffing, or medical intervention, or impairs ability for functional activities of daily living. Subjects are expected to exhibit behaviors that are congruent with the International Psychogeriatric Association criterion for agitation representing a change from the subject's usual behavior. Subjects who have a score of ≤16 on the Mini-Mental State Exam (MMSE). Subjects with a remote (>5 years) history of stroke may be included, regardless of size/location. Subjects who read, understand, and provide written informed consent, or who have a legally authorized representative (LAR). Subjects who are deemed to be medically appropriate for study participation by the principal investigator. Subjects who are at their current location for at least 14 days before screening and plan to remain at the same location for the duration of the study. Subjects who have the capability to participate in the study and self-administer the investigational product. Subjects who are on a stable concomitant medications regimen for the treatment of any concurrent conditions for at least one month prior to the screening visit. Exclusion Criteria: Subjects who have dementia associated with Parkinson's disease and/or Lewy Body Disease are excluded. Subjects suffering from alcohol and/or substance abuse. Subjects with agitation caused by acute intoxication must be excluded. Subjects with significant risk of suicide or homicide per the investigator's assessment. Subjects who have hydrocephalus, seizure disorder, or history of significant head trauma, subarachnoid bleeding, brain tumor, encephalopathy, meningitis, or focal neurological findings, with a recent (1 year) large (non-microvascular) stroke who may be considered medically unstable or in recovery must be excluded. History of clinically significant syncope or syncopal attacks, orthostatic hypotension within the past 2 years. Subjects with laboratory or ECG abnormalities. Subjects with serious, unstable, or uncontrolled medical illnesses must be excluded. Subjects who have received an investigational drug within 30 days prior to Screening must be excluded. Subjects who are considered by the investigator, for any reason, to be an unsuitable candidate for receiving dexmedetomidine must be excluded. Subjects whose agitation is attributed to pain or infection, delirium, concomitant medications, environmental conditions, or another psychiatric condition or medical condition as determined by the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert Risinger, MD
Organizational Affiliation
BioXcel Therapeutics
Official's Role
Study Chair
Facility Information:
Facility Name
Bioxcel Clinical Research Site
City
North Miami
State/Province
Florida
ZIP/Postal Code
33161
Country
United States
Facility Name
Bioxcel Clinical Research Site
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01103
Country
United States
Facility Name
BioXcel Clinical Research Site
City
Toms River
State/Province
New Jersey
ZIP/Postal Code
08755
Country
United States

12. IPD Sharing Statement

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An Efficacy, and Safety Study Of BXCL501 For The Treatment Of Agitation Associated With Dementia

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