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IGC-AD1 Trial on Agitation in Dementia Due to Alzheimer's (IGC-AD1-P2)

Primary Purpose

Alzheimer Disease, Agitation,Psychomotor, Depression

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Agitation management in Alzheimer's disease (IGC-AD1-Active)
Agitation management in Alzheimer's disease (IGC-AD1-Placebo)
Sponsored by
IGC Pharma LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring Cannabis, Tetrahydrocannabinol, THC, Melatonin, Alzheimer's, Marijuana, Hemp, Agitation, Dementia, Depression, Anxiety, Memory, NPI, CMAI, Dronabinol

Eligibility Criteria

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

Inclusion Criteria:

To be eligible to participate in this study, an individual must meet all the following criteria:

  1. Participant and/or Caregiver must provide a signed and dated Informed Consent Form (ICF) prior to any study procedures.
  2. Must have a Caregiver who is able and willing to comply with all required study procedures.
  3. The Caregiver must be known to the Participant and must be able to use electronic devices such as a cell phone, video conference over a laptop or cell phone, weighing scale, and be able to learn to take blood pressure, among others.
  4. Based on local practice, Participants that cannot consent may have Caregiver's consent provided by the Caregiver as, among others a) Power of Attorney, or b) is a spouse, or c) a sibling or d) a child or e) a close relation. The practice of accepting consent must be consistent with established practice at the site and jurisdiction.
  5. Participants must consent to CYP450 and apolipoprotein E (ApoE) genotyping, Pharmacokinetics and storage of blood samples for future genetic testing.
  6. Diagnosis of Alzheimer's by National Institute on Aging and Alzheimer's Association (NIA-AA) criteria.
  7. Clinically significant Agitation assessed by:

    1. Neuropsychiatric Inventory (NPI (Agitation) ≥ 4.
    2. The presence of clinically significant, persistent Agitation based on the International Psychogeriatric Association (IPA) definition rather than those with recent onset and occasional symptoms, and
    3. Agitation not attributable to another psychiatric disorder, suboptimal care conditions, other underlining medical condition, or the physiological effects of a substance.
  8. Negative drug screen, except for benzodiazepines if Participant has been using them in stable doses for at least 3 months before screening.
  9. All medications used for behavioral symptoms should be in stable doses for at least 3 months before screening.
  10. Women must be of no childbearing potential (postmenopausal, defined as cessation of menses for at least 12 months, without an alternative medical cause for amenorrhea) or surgically sterile (hysterectomy, bilateral oophorectomy, or bilateral tubal ligation)).

Exclusion Criteria:

An individual who meets any of the following criteria will be excluded from participation in this study:

  1. Prior adverse reaction to cannabinoids or to any component of study drug (IGC-AD1 and placebo): Tetrahydrocannabinol (THC), melatonin, honey, curcumin, ethyl alcohol, vitamin-E tocopheryl polyethylene glycol succinate (TPGS), ascorbic acid, water, tween-80, and rutin.
  2. Serious or unstable medical illness, including cardiovascular, hepatic, renal, respiratory, endocrine, neurologic, hematologic disease, which might confound assessment of safety outcomes.
  3. History of seizures, schizophrenia, or bipolar disorder.
  4. Has participated in an investigational drug or device study within 30 days prior to study start.
  5. Urine drug screen positive for drug use, except for benzodiazepines if Participant was using them previously and their dose had remained stable for at least 3 months before screening.
  6. History of Alcohol and Drug use, excluding marijuana, within one year prior to enrollment.
  7. Hypertension: Participants with a history of uncontrolled hypertension as determined by the PI and Participants with a hypertensive crisis in the six months prior to enrollment.
  8. Falls: Participants with a history of recurrent falls defined as more than two falls in the six-month period prior to enrollment and a history of falls resulting in injuries or associated with a new acute illness, loss of consciousness, fever, or abnormal blood pressure (the definition of recurrent falls is taken from American Family Physician (AFP).

Sites / Locations

  • Site 700Recruiting
  • Site 1100
  • Site 400Recruiting
  • Site 800
  • Site 900Recruiting
  • Site 1000
  • Site 300
  • Site 100Recruiting
  • Site 200Recruiting
  • Site 500Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Active Comparator: IGC-AD1Active

Placebo Comparator: IGC-AD1 Placebo

Arm Description

IGC-AD1 Active Treatment THC plus another API plus excipients.

IGC-AD1 Placebo, similar to Active in color, taste, and texture, with excipients but without APIs.

Outcomes

Primary Outcome Measures

Agitation
Change in mean Cohen Mansfield Agitation Inventory (CMAI) score

Secondary Outcome Measures

Acute Agitation
Change in mean Cohen Mansfield Agitation Inventory (CMAI) score

Full Information

First Posted
September 14, 2022
Last Updated
October 16, 2023
Sponsor
IGC Pharma LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05543681
Brief Title
IGC-AD1 Trial on Agitation in Dementia Due to Alzheimer's
Acronym
IGC-AD1-P2
Official Title
A Phase 2, Multicenter, Double-Blind, Randomized, Placebo-Controlled, Trial of the Safety and Efficacy of IGC-AD1 on Agitation in Participants With Dementia Due to Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 11, 2022 (Actual)
Primary Completion Date
March 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
IGC Pharma LLC

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to assess the efficacy of an oral medication, IGC-AD1 that is a natural THC-based (Tetrahydrocannabinol) formulation, administered in micro doses, twice a day, on symptomatological Agitation, in patients with mild to severe dementia from Alzheimer's.
Detailed Description
This is a placebo-controlled, multi-site, parallel, double blind, randomized study. Enrollment is open for Participants ages 60 and above with mild to severe dementia due to Alzheimer's Disease, with established symptomatological Agitation, for a minimum of two weeks prior to enrollment, with Agitation due to other etiologies, or recent, or transient Agitation symptoms ruled out. Clinical Agitation is established with a baseline NPI-12 (Agitation Domain only) score ≥ 4 as well as meeting the IPA criteria for Agitation. The medication is titrated to BID over two days and down over two days at End of Trial (EOT). Caregivers will monitor and record in a logbook vitals daily using Sponsor provided scales and logbook. Safety will be monitored with daily calls to the Participant/Caregiver dyad for the first four days followed by calls every third day till EOT. Week two is an on-site visit with week-four being optional. Both solicited AEs and non-solicited AEs will be monitored, assessed, graded, and tabulated. Solicited AEs include the following: somnolence, falls, dizziness, asthenia, nausea, suicidal ideation, tachycardia, bradycardia, hypertension and hypotension, and BMI. The primary objective of the study is to assess the efficacy of IGC-AD1 on Agitation as scored by the CMAI between baseline and EOT with the secondary objective being acute efficacy as measured by the CMAI between baseline and week two. There are several exploratory objectives included elsewhere. The trial will also have blood draws for sparse Pharmacokinetics (PK).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Agitation,Psychomotor, Depression, Anxiety, Memory Impairment, Care Giving Burden, NPS, Agitated; State, Acute Reaction to Stress, Aggression, Aggressive Outburst
Keywords
Cannabis, Tetrahydrocannabinol, THC, Melatonin, Alzheimer's, Marijuana, Hemp, Agitation, Dementia, Depression, Anxiety, Memory, NPI, CMAI, Dronabinol

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Multi-site, Randomized, double-blind, placebo-controlled parallel-group trial in adults with mild to severe dementia from Alzheimer's and symptomatological Agitation.
Masking
ParticipantCare ProviderInvestigator
Masking Description
Double-blind for study site and participants
Allocation
Randomized
Enrollment
164 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active Comparator: IGC-AD1Active
Arm Type
Active Comparator
Arm Description
IGC-AD1 Active Treatment THC plus another API plus excipients.
Arm Title
Placebo Comparator: IGC-AD1 Placebo
Arm Type
Placebo Comparator
Arm Description
IGC-AD1 Placebo, similar to Active in color, taste, and texture, with excipients but without APIs.
Intervention Type
Drug
Intervention Name(s)
Agitation management in Alzheimer's disease (IGC-AD1-Active)
Other Intervention Name(s)
Active Study Drug, Study Drug, Active, IGC-AD1 Active
Intervention Description
A non-sterile solution for oral administration.
Intervention Type
Drug
Intervention Name(s)
Agitation management in Alzheimer's disease (IGC-AD1-Placebo)
Other Intervention Name(s)
IGC-AD1 Placebo, Non-active study drug, IGC-AD1 Non-Active, Placebo
Intervention Description
A non-sterile solution for oral administration similar in color and texture to the Active.
Primary Outcome Measure Information:
Title
Agitation
Description
Change in mean Cohen Mansfield Agitation Inventory (CMAI) score
Time Frame
Baseline to week six
Secondary Outcome Measure Information:
Title
Acute Agitation
Description
Change in mean Cohen Mansfield Agitation Inventory (CMAI) score
Time Frame
Baseline to week two
Other Pre-specified Outcome Measures:
Title
Agitation at week four
Description
Change in mean Cohen Mansfield Agitation Inventory (CMAI) score
Time Frame
Baseline to week four
Title
Participant overall wellbeing
Description
Change in the Clinical Global Impression Scale (CGI)
Time Frame
Baseline to weeks two and six
Title
Participant executive functions
Description
Change in Mini-Mental State Examination (MMSE2) score
Time Frame
Baseline to week six
Title
Depression
Description
Change in mean Cornell Scale for Depression in Dementia (CSDD) score
Time Frame
Baseline to weeks two, four, and six
Title
Neuropsychiatric symptoms
Description
Change in mean Neuropsychiatric Inventory (NPI-12) score
Time Frame
Baseline to weeks two, four, and six
Title
Participant quality of life
Description
Change in mean Quality of Life in Alzheimer's Disease (QOL-AD) score
Time Frame
Baseline to weeks two, four and six
Title
Caregiver burden
Description
Change in mean Zarit Burden Interview (ZBI) score
Time Frame
Baseline to weeks two and six
Title
Psychotropic drugs
Description
Change in type and dosage of psychotropic drugs
Time Frame
Baseline to six weeks
Title
CYP2C9 polymorphisms on agitation
Description
Change in mean Cohen Mansfield Agitation Inventory (CMAI) score for each type of metabolizer group (*1/*1, *1/*3, etc.)
Time Frame
Baseline to weeks two, four and six

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be eligible to participate in this study, an individual must meet all the following criteria: Participant and/or Caregiver must provide a signed and dated Informed Consent Form (ICF) prior to any study procedures. Must have a Caregiver who is able and willing to comply with all required study procedures. The Caregiver must be known to the Participant and must be able to use electronic devices such as a cell phone, video conference over a laptop or cell phone, weighing scale, and be able to learn to take blood pressure, among others. Based on local practice, Participants that cannot consent may have Caregiver's consent provided by the Caregiver as, among others a) Power of Attorney, or b) is a spouse, or c) a sibling or d) a child or e) a close relation. The practice of accepting consent must be consistent with established practice at the site and jurisdiction. Participants must consent to CYP450 and apolipoprotein E (ApoE) genotyping, Pharmacokinetics and storage of blood samples for future genetic testing. Diagnosis of Alzheimer's by National Institute on Aging and Alzheimer's Association (NIA-AA) criteria. Clinically significant Agitation assessed by: Neuropsychiatric Inventory (NPI (Agitation) ≥ 4. The presence of clinically significant, persistent Agitation based on the International Psychogeriatric Association (IPA) definition rather than those with recent onset and occasional symptoms, and Agitation not attributable to another psychiatric disorder, suboptimal care conditions, other underlining medical condition, or the physiological effects of a substance. Negative drug screen, except for benzodiazepines if Participant has been using them in stable doses for at least 3 months before screening. All medications used for behavioral symptoms should be in stable doses for at least 3 months before screening. Women must be of no childbearing potential (postmenopausal, defined as cessation of menses for at least 12 months, without an alternative medical cause for amenorrhea) or surgically sterile (hysterectomy, bilateral oophorectomy, or bilateral tubal ligation)). Exclusion Criteria: An individual who meets any of the following criteria will be excluded from participation in this study: Prior adverse reaction to cannabinoids or to any component of study drug (IGC-AD1 and placebo): Tetrahydrocannabinol (THC), melatonin, honey, curcumin, ethyl alcohol, vitamin-E tocopheryl polyethylene glycol succinate (TPGS), ascorbic acid, water, tween-80, and rutin. Serious or unstable medical illness, including cardiovascular, hepatic, renal, respiratory, endocrine, neurologic, hematologic disease, which might confound assessment of safety outcomes. History of seizures, schizophrenia, or bipolar disorder. Has participated in an investigational drug or device study within 30 days prior to study start. Urine drug screen positive for drug use, except for benzodiazepines if Participant was using them previously and their dose had remained stable for at least 3 months before screening. History of Alcohol and Drug use, excluding marijuana, within one year prior to enrollment. Hypertension: Participants with a history of uncontrolled hypertension as determined by the PI and Participants with a hypertensive crisis in the six months prior to enrollment. Falls: Participants with a history of recurrent falls defined as more than two falls in the six-month period prior to enrollment and a history of falls resulting in injuries or associated with a new acute illness, loss of consciousness, fever, or abnormal blood pressure (the definition of recurrent falls is taken from American Family Physician (AFP).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Evelyn Gutierrez
Phone
3013394270
Email
egutierrez@igcpharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ram Mukunda, MS
Phone
3015294996
Email
ram@igcpharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr. Saadia Shahnawaz, MD
Organizational Affiliation
IGC Pharma LLC
Official's Role
Study Director
Facility Information:
Facility Name
Site 700
City
Melbourne
State/Province
Florida
ZIP/Postal Code
32940
Country
United States
Individual Site Status
Recruiting
Facility Name
Site 1100
City
Port Charlotte
State/Province
Florida
ZIP/Postal Code
33952
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Site 400
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21237
Country
United States
Individual Site Status
Recruiting
Facility Name
Site 800
City
Newton
State/Province
Massachusetts
ZIP/Postal Code
02459
Country
United States
Individual Site Status
Not yet recruiting
Facility Name
Site 900
City
Amherst
State/Province
New York
ZIP/Postal Code
02459
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Site 900
Facility Name
Site 1000
City
Toronto
State/Province
Ontario
ZIP/Postal Code
ON M6A 2E1
Country
Canada
Individual Site Status
Not yet recruiting
Facility Name
Site 300
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H3Z 2Y5
Country
Canada
Individual Site Status
Active, not recruiting
Facility Name
Site 100
City
Bayamón
ZIP/Postal Code
00961
Country
Puerto Rico
Individual Site Status
Recruiting
Facility Name
Site 200
City
Bayamón
ZIP/Postal Code
00961
Country
Puerto Rico
Individual Site Status
Recruiting
Facility Name
Site 500
City
Rio Piedras
ZIP/Postal Code
00935
Country
Puerto Rico
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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IGC-AD1 Trial on Agitation in Dementia Due to Alzheimer's

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