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Phase II Clinical Trial of Interleukin-2 in AD

Primary Purpose

Alzheimer Disease

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Interleukin-2
Placebo
Sponsored by
The Methodist Hospital Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease

Eligibility Criteria

50 Years - 86 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Diagnosis of probable Alzheimer disease according to National Institute on Aging-Alzheimer's Association (NIA-AA) criteria Male or female age 50 to 86 years MMSE between 12-26 Total bilirubin less than or equal to 1.5mg/dL Alanine aminotransferase level (ALT) and aspartate aminotransferase (AST) less than or equal to two times normal, Albumin greater than or equal to 3.0mg/dL Serum creatinine less than or equal to 1.5 mg/dL White Blood Count (WBC) >3,500/mm3; platelets >100,000/mm3; hematocrit (HCT) >32%. INR<1.4 If on medications affecting cognition (rivastigmine, galantamine, donepezil, memantine), participants must be on stable dosage for at least 4 weeks prior to screening and should remain at a stable dosage during the course of the study. English language speaking Formal education of eight or more years Stable pharmacological treatment of any other chronic conditions for at least 30 days prior to screening Exclusion Criteria: Serious, active bacterial, fungal or viral infection, active or latent tuberculosis History of severe pulmonary dysfunction Severe cardiac dysfunction defined as left ventricular ejection fraction <40% if an echocardiogram is medically indicated to clarify ongoing symptoms or EKG findings.; a history of non-controlled cardiac arrhythmias; history of cardiac tamponade; Unstable angina or MI in the last 3 months Hypersensitivity or allergy to IL-2 History of bowel ischemia/perforation, or GI bleeding requiring surgery Hospitalization or change of chronic concomitant medication within one month prior to screening. History of hemorrhage or infarct or > 3 lacunar infarcts, cerebral contusion, encephalomalacia, aneurysm, vascular malformation, subdural hematoma, hydrocephalus, space-occupying lesion (e.g. abscess or brain tumor with the exception of small incidental meningiomas) in prior CT or MRI. Clinical or laboratory findings consistent with: Other primary degenerative dementia, (dementia with Lewy bodies, fronto-temporal dementia, Huntington's disease, Jacob-Creutzfeld Disease, Down's syndrome, etc.) Other neurodegenerative condition (Parkinson's disease, amyotrophic lateral sclerosis, etc.) Seizure disorder History of infectious, metabolic or systemic diseases affecting the central nervous system (syphilis, vitamin B12 or folate deficiency, other laboratory values, etc.) Clinically significant abnormal T4 or TSH A current DSM-V diagnosis of active major depression, schizophrenia or bipolar disorder. Patients with depressive symptoms successfully managed by a stable dose of an antidepressant are allowed entry. Clinically significant, advanced or unstable disease that may interfere with outcome evaluations, such as: Respiratory insufficiency Bradycardia (<45/min.) or tachycardia (>100/min.) Poorly managed hypertension (systolic >160 mm Hg and/or diastolic >95 mm Hg) or hypotension (systolic <90 mm Hg and/or diastolic <60 mm Hg) Uncontrolled diabetes defined by HbA1c >8% History of cancer within 3 years of screening with the exception of fully excised non-melanoma skin cancers or non-metastatic prostate cancer that has been stable for at least 6 months. History of acute/chronic hepatitis B or C and/or carriers of hepatitis B Disability that may prevent the patient from completing all study requirements (e.g. blindness, deafness, severe language difficulty, etc.). Within 4 weeks of screening visit or during the course of the study, concurrent treatment with antipsychotic agents (except risperidone ≤1.5 mg/day, quetiapine ≤100 mg/day, olanzapine ≤5 mg/day, and aripiprazole ≤10 mg/day), antiepileptics (except lamotrigine, gabapentin and pregabalin for nonseizure indications), centrally active anti-hypertensive drugs (e.g., clonidine, l-methyl dopa, guanidine, guanfacine, etc.), opiate analgesics, systemic corticosteroids, psychostimulants, antiparkinsonian medications (except for non-parkinsonian indications) and mood stabilizers (e.g., valproate, lithium), sedatives, and anxiolytics with the exception that use of short- to medium-acting benzodiazepines for treatment of insomnia is permitted, however, use of sedatives or hypnotics should be avoided for 8 hours before administration of cognitive tests. Nootropic drugs except stable AD meds (acetylcholinesterase inhibitors and memantine. Suspected or known drug or alcohol abuse, i.e. more than approximately 60 g alcohol (approximately 1 liter of beer or 0.5 liter of wine) indicated by elevated MCV significantly above normal value at screening Suspected or known allergy to any components of the study treatments. Intake of investigational drug within the previous 30 days or five half-lives of the investigational drug, whichever is longer. Exposure to passive immunotherapies for AD (e.g. monoclonal antibodies) within the previous 180 days to dosing, and BACE inhibitors within the previous 30 days to dosing. Chronic steroid or interferon therapy Contraindication to undergoing an LP including, but not limited to: inability to tolerate an appropriately flexed position for the time necessary to perform an LP; INR >1.4 or other coagulopathy; platelet count of <100,000/μL; infection at the desired lumbar puncture site; taking anti-coagulant medication within 90 days of screening (Note: low dose aspirin is permitted); suspected non-communicating hydrocephalus or intracranial mass; prior history of spinal mass or trauma. Any condition, which in the opinion of the investigator makes the patient unsuitable for inclusion.

Sites / Locations

  • Houston Methodist Research InstituteRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

Aldesleukin every 4 weeks

Aldesleukin every 2 weeks

Placebo

Arm Description

Outcomes

Primary Outcome Measures

To assess the safety and the tolerability of IL-2 in AD patients
Primary endpoint: - Number of participants with adverse events and with abnormal laboratory findings (serum chemistry, hematology)

Secondary Outcome Measures

To investigate the impact of IL-2 administration on the blood Treg population in AD patients
Secondary Endpoint: - Change in Treg percentage out of total CD4 cells

Full Information

First Posted
October 17, 2023
Last Updated
October 17, 2023
Sponsor
The Methodist Hospital Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT06096090
Brief Title
Phase II Clinical Trial of Interleukin-2 in AD
Official Title
A Phase II Clinical Trial of Interleukin-2 (IL-2) in Patients With Mild to Moderate Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2022 (Actual)
Primary Completion Date
December 30, 2024 (Anticipated)
Study Completion Date
December 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Methodist Hospital Research Institute

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.
No

5. Study Description

Brief Summary
Neuroinflammation is a significant component of Alzheimer disease (AD). Our group recently demonstrated that regulatory T cells (Tregs) have a compromised phenotype and reduced suppressive function in AD patients, skewing the immune system toward a proinflammatory status and potentially contributing to disease progression. Low dose interleukin-2 (IL-2) is now viewed as a promising immunoregulatory drug with the capacity to selectively expand and restore functional Tregs. This study is a phase II, randomized, double-blind, placebo-controlled study to assess low dose IL-2 therapy in AD patients. Up to 40 Alzheimer's disease patients in the mild- to moderate clinical dementia stages (MMSE scores: 12-26) will be randomized to five-day-courses of subcutaneous IL-2 or placebo for a total of 6 months. We will evaluate the safety and tolerability of IL-2 treatment and the possible effects of IL-2 treatment on peripheral and central inflammation. The expected time participants will be in the study is 30 weeks.

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
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Aldesleukin every 4 weeks
Arm Type
Active Comparator
Arm Title
Aldesleukin every 2 weeks
Arm Type
Active Comparator
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Interleukin-2
Intervention Description
Low dose Interleukin-2 (Aldesleukin) administration to expand Regulatory T cells
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo administration
Primary Outcome Measure Information:
Title
To assess the safety and the tolerability of IL-2 in AD patients
Description
Primary endpoint: - Number of participants with adverse events and with abnormal laboratory findings (serum chemistry, hematology)
Time Frame
6 months treatment phase
Secondary Outcome Measure Information:
Title
To investigate the impact of IL-2 administration on the blood Treg population in AD patients
Description
Secondary Endpoint: - Change in Treg percentage out of total CD4 cells
Time Frame
6 months treatment phase

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
86 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of probable Alzheimer disease according to National Institute on Aging-Alzheimer's Association (NIA-AA) criteria Male or female age 50 to 86 years MMSE between 12-26 Total bilirubin less than or equal to 1.5mg/dL Alanine aminotransferase level (ALT) and aspartate aminotransferase (AST) less than or equal to two times normal, Albumin greater than or equal to 3.0mg/dL Serum creatinine less than or equal to 1.5 mg/dL White Blood Count (WBC) >3,500/mm3; platelets >100,000/mm3; hematocrit (HCT) >32%. INR<1.4 If on medications affecting cognition (rivastigmine, galantamine, donepezil, memantine), participants must be on stable dosage for at least 4 weeks prior to screening and should remain at a stable dosage during the course of the study. English language speaking Formal education of eight or more years Stable pharmacological treatment of any other chronic conditions for at least 30 days prior to screening Exclusion Criteria: Serious, active bacterial, fungal or viral infection, active or latent tuberculosis History of severe pulmonary dysfunction Severe cardiac dysfunction defined as left ventricular ejection fraction <40% if an echocardiogram is medically indicated to clarify ongoing symptoms or EKG findings.; a history of non-controlled cardiac arrhythmias; history of cardiac tamponade; Unstable angina or MI in the last 3 months Hypersensitivity or allergy to IL-2 History of bowel ischemia/perforation, or GI bleeding requiring surgery Hospitalization or change of chronic concomitant medication within one month prior to screening. History of hemorrhage or infarct or > 3 lacunar infarcts, cerebral contusion, encephalomalacia, aneurysm, vascular malformation, subdural hematoma, hydrocephalus, space-occupying lesion (e.g. abscess or brain tumor with the exception of small incidental meningiomas) in prior CT or MRI. Clinical or laboratory findings consistent with: Other primary degenerative dementia, (dementia with Lewy bodies, fronto-temporal dementia, Huntington's disease, Jacob-Creutzfeld Disease, Down's syndrome, etc.) Other neurodegenerative condition (Parkinson's disease, amyotrophic lateral sclerosis, etc.) Seizure disorder History of infectious, metabolic or systemic diseases affecting the central nervous system (syphilis, vitamin B12 or folate deficiency, other laboratory values, etc.) Clinically significant abnormal T4 or TSH A current DSM-V diagnosis of active major depression, schizophrenia or bipolar disorder. Patients with depressive symptoms successfully managed by a stable dose of an antidepressant are allowed entry. Clinically significant, advanced or unstable disease that may interfere with outcome evaluations, such as: Respiratory insufficiency Bradycardia (<45/min.) or tachycardia (>100/min.) Poorly managed hypertension (systolic >160 mm Hg and/or diastolic >95 mm Hg) or hypotension (systolic <90 mm Hg and/or diastolic <60 mm Hg) Uncontrolled diabetes defined by HbA1c >8% History of cancer within 3 years of screening with the exception of fully excised non-melanoma skin cancers or non-metastatic prostate cancer that has been stable for at least 6 months. History of acute/chronic hepatitis B or C and/or carriers of hepatitis B Disability that may prevent the patient from completing all study requirements (e.g. blindness, deafness, severe language difficulty, etc.). Within 4 weeks of screening visit or during the course of the study, concurrent treatment with antipsychotic agents (except risperidone ≤1.5 mg/day, quetiapine ≤100 mg/day, olanzapine ≤5 mg/day, and aripiprazole ≤10 mg/day), antiepileptics (except lamotrigine, gabapentin and pregabalin for nonseizure indications), centrally active anti-hypertensive drugs (e.g., clonidine, l-methyl dopa, guanidine, guanfacine, etc.), opiate analgesics, systemic corticosteroids, psychostimulants, antiparkinsonian medications (except for non-parkinsonian indications) and mood stabilizers (e.g., valproate, lithium), sedatives, and anxiolytics with the exception that use of short- to medium-acting benzodiazepines for treatment of insomnia is permitted, however, use of sedatives or hypnotics should be avoided for 8 hours before administration of cognitive tests. Nootropic drugs except stable AD meds (acetylcholinesterase inhibitors and memantine. Suspected or known drug or alcohol abuse, i.e. more than approximately 60 g alcohol (approximately 1 liter of beer or 0.5 liter of wine) indicated by elevated MCV significantly above normal value at screening Suspected or known allergy to any components of the study treatments. Intake of investigational drug within the previous 30 days or five half-lives of the investigational drug, whichever is longer. Exposure to passive immunotherapies for AD (e.g. monoclonal antibodies) within the previous 180 days to dosing, and BACE inhibitors within the previous 30 days to dosing. Chronic steroid or interferon therapy Contraindication to undergoing an LP including, but not limited to: inability to tolerate an appropriately flexed position for the time necessary to perform an LP; INR >1.4 or other coagulopathy; platelet count of <100,000/μL; infection at the desired lumbar puncture site; taking anti-coagulant medication within 90 days of screening (Note: low dose aspirin is permitted); suspected non-communicating hydrocephalus or intracranial mass; prior history of spinal mass or trauma. Any condition, which in the opinion of the investigator makes the patient unsuitable for inclusion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alireza Faridar, MD
Phone
7134411150
Email
afaridar@houstonmethodist.org
Facility Information:
Facility Name
Houston Methodist Research Institute
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alireza Faridar
Phone
713-441-1150
Email
afaridar@houstonmethodist.org

12. IPD Sharing Statement

Plan to Share IPD
Yes

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Phase II Clinical Trial of Interleukin-2 in AD

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