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Antibiotics Against Amyloid Angiopathy (BATMAN)

Primary Purpose

Cerebral Amyloid Angiopathy

Status
Recruiting
Phase
Phase 1
Locations
Netherlands
Study Type
Interventional
Intervention
Minocycline
Placebo
Sponsored by
Leiden University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cerebral Amyloid Angiopathy

Eligibility Criteria

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

Inclusion Criteria: Age ≥18 years for D-CAA and age ≥55 years for sporadic-CAA Probable-CAA according to the Modified-Boston-Criteria or genetically proven D-CAA ≤ 2 ICH (occurrence of ICHs at least 1 year ago) and presence of ≥ 2 lobar microbleeds +/-cortical superficial siderosis Written informed consent Exclusion Criteria: Previous allergic reactions to minocycline Modified Rankin Score ≥3 Contraindications, such as: Contraindications for 7T MRI as determined by the 7Tesla safety committee. Examples of possible contra-indications are: claustrophobia, pacemakers and defibrillators, nerve stimulators, intracranial clips, intraorbital or intraocular metallic fragments, cochlear implants, ferromagnetic implants, hydrocephalus pump, intra-uterine device, permanent make-up, tattoos above the shoulders. In case of specific contra-indications for 7T a 3T will be made instead. - Specific contraindications for checkerboard fMRI: seizure within prior year, photosensitive epilepsy, noncorrectable visual impairment. - Contraindications for lumbar puncture: compression of the spinal cord, signs and symptoms of increased intracranial pressure, local infections of the skin at the puncture site, a coagulopathy or thrombocytopenia (<100). (Use of acetylsalicylic acid, NSAIDs, COX2 inhibitors or low-molecular-weight heparin are no contraindications for lumbar puncture.) Pregnancy/breast feeding Liver/renal failure Use of antibiotics <1 month SLE or other diseases known to generate inflammatory responses Previous/current/planned use of retinoids (since this is related to increasing risk of increased intracranial pressure) Current use of anaesthetics like methoxyflurane, agents inhibiting peristalsis, barbiturates, carbamazepine or fenytoïne

Sites / Locations

  • Leiden University Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Minocycline

Placebo

Arm Description

100 mg twice daily for 3 months

twice daily for 3 months

Outcomes

Primary Outcome Measures

inflammatory, vessel integrity and gelatinase pathway associated biomarkers in CSF
IL6, MCP-1, IBA-1, MMP2/9, and VEGF

Secondary Outcome Measures

safety and tolerability of minocycline
side effects and adverse events
progression of hemorrhagic markers on 7T MRI before and after treatment
cSS, cortical microbleeds

Full Information

First Posted
December 26, 2022
Last Updated
December 26, 2022
Sponsor
Leiden University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT05680389
Brief Title
Antibiotics Against Amyloid Angiopathy
Acronym
BATMAN
Official Title
Placebo-controlled, Randomized, Double-blind Study of Minocycline for Sporadic and Hereditary Cerebral Amyloid Angiopathy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 2, 2020 (Actual)
Primary Completion Date
December 2, 2023 (Anticipated)
Study Completion Date
December 2, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Leiden University Medical Center

4. Oversight

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

5. Study Description

Brief Summary
We will perform a randomized clinical trial with minocycline. Minocycline is an antibiotic of the tetracycline family and known to modulate inflammation, gelatinase activity and angiogenesis, which we know are central mechanisms in CAA-pathology. Our aim is to prove in a randomized clinical trial in a translational setting that minocycline treatment (duration 3 months) can decrease markers of neuroinflammation and the gelatinase pathway in the cerebrospinal fluid (CSF) of persons with D-CAA (n=30) and sporadic-CAA (n=30).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cerebral Amyloid Angiopathy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Minocycline
Arm Type
Experimental
Arm Description
100 mg twice daily for 3 months
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
twice daily for 3 months
Intervention Type
Drug
Intervention Name(s)
Minocycline
Intervention Description
100 mg twice daily for 3 months
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
twice daily for 3 months
Primary Outcome Measure Information:
Title
inflammatory, vessel integrity and gelatinase pathway associated biomarkers in CSF
Description
IL6, MCP-1, IBA-1, MMP2/9, and VEGF
Time Frame
3 months
Secondary Outcome Measure Information:
Title
safety and tolerability of minocycline
Description
side effects and adverse events
Time Frame
3 months
Title
progression of hemorrhagic markers on 7T MRI before and after treatment
Description
cSS, cortical microbleeds
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years for D-CAA and age ≥55 years for sporadic-CAA Probable-CAA according to the Modified-Boston-Criteria or genetically proven D-CAA ≤ 2 ICH (occurrence of ICHs at least 1 year ago) and presence of ≥ 2 lobar microbleeds +/-cortical superficial siderosis Written informed consent Exclusion Criteria: Previous allergic reactions to minocycline Modified Rankin Score ≥3 Contraindications, such as: Contraindications for 7T MRI as determined by the 7Tesla safety committee. Examples of possible contra-indications are: claustrophobia, pacemakers and defibrillators, nerve stimulators, intracranial clips, intraorbital or intraocular metallic fragments, cochlear implants, ferromagnetic implants, hydrocephalus pump, intra-uterine device, permanent make-up, tattoos above the shoulders. In case of specific contra-indications for 7T a 3T will be made instead. - Specific contraindications for checkerboard fMRI: seizure within prior year, photosensitive epilepsy, noncorrectable visual impairment. - Contraindications for lumbar puncture: compression of the spinal cord, signs and symptoms of increased intracranial pressure, local infections of the skin at the puncture site, a coagulopathy or thrombocytopenia (<100). (Use of acetylsalicylic acid, NSAIDs, COX2 inhibitors or low-molecular-weight heparin are no contraindications for lumbar puncture.) Pregnancy/breast feeding Liver/renal failure Use of antibiotics <1 month SLE or other diseases known to generate inflammatory responses Previous/current/planned use of retinoids (since this is related to increasing risk of increased intracranial pressure) Current use of anaesthetics like methoxyflurane, agents inhibiting peristalsis, barbiturates, carbamazepine or fenytoïne
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sabine Voigt, BSc
Phone
+31715261825
Email
BATMAN@lumc.nl
First Name & Middle Initial & Last Name or Official Title & Degree
Marieke Wermer, PhD
Email
BATMAN@lumc.nl
Facility Information:
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2333ZA
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sabine Voigt, BSc
Phone
+31715261825
Email
BATMAN@lumc.nl

12. IPD Sharing Statement

Plan to Share IPD
No

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Antibiotics Against Amyloid Angiopathy

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