Efficacy and Safety of 26-Week Treatment of AR1001 in Patients With Mild to Moderate Alzheimer's Disease
Primary Purpose
Mild to Moderate Alzheimer's Disease
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
AR1001
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Mild to Moderate Alzheimer's Disease focused on measuring Alzheimer's disease
Eligibility Criteria
Inclusion Criteria
- Male or female subjects aged 55-80 years at the time of signing the Informed Consent Form.
- Subjects (or subject's legally acceptable representative) and caregiver(s) who can sign an Informed Consent to participate in the study. Same caregiver(s) must assist the subject throughout the entire duration of the study.
- Subjects who have a diagnosis of probable Alzheimer's disease according to the NIA-AA (National Institute of Aging and Alzheimer's Associations, 2011) criteria with mild to moderate dementia (stage 4 - 5) at screening.
- Subjects who have mild-to-moderate cognitive impairment with MMSE Score of 16-26 at screening.
- Subjects who have an MRI (either 1.5T or 3T) or CT scan performed after onset of symptoms and prior to randomization with findings consistent with the diagnosis of dementia due to Alzheimer's disease and without any other clinically significant comorbid pathologies.
- Subjects who have one (or more) identified adult study partner(s) who, in the opinion of the investigator, has sufficient contact with and knowledge about the subject as to be able to report knowledgeably about the subject's safety, compliance and adherence, cognition, function, and behavior.
Exclusion Criteria
- Subjects who are female who are pregnant, nursing, or of childbearing potential and not practicing effective contraception.
- Subjects who have signs of delirium.
- Subjects who have had a cortical stroke within the preceding 2 years.
- Subjects who have any diagnosis of dementia other than that related to Alzheimer's Disease, including concomitant vascular dementia.
- Subjects who have a PET scan performed after onset of symptoms with negative amyloid results.
- Subjects with a history of myocardial infarction, unstable angina, New York Heart Association (NYHA) class III or IV heart failure or stroke within the last 12 months.
- Subjects with uncontrolled hypertension (systolic blood pressure >160mm Hg or diastolic blood pressure > 95mm Hg) or hypotension (systolic blood pressure <90mm Hg or diastolic blood pressure <50mm Hg).
- Subjects who have clinically significant renal impairment (creatinine > 1.5x ULN) or hepatic impairment (AST or ALT > 2.5x ULN or total bilirubin > 1.5x ULN).
Subjects who have history of cancer or malignant tumor within 5 years prior to screening with the exception of:
- Basal or squamous cell carcinoma of the skin or cervical dysplasia which has been adequately treated.
- In situ Grade 1 cervical cancer, fully treated at least 2 years prior to screening and without recurrence.
- Prostate cancer, confined to the prostate gland, which has been adequately treated (surgery and/or radiation) with normal or low and stable PSA levels for 2 years prior to screening.
- Subjects who have history of untreated thyroid disorder or a seizure disorder.
- Subjects who are being treated, or likely to require treatment during the study, with any medications prohibited by the study protocol.
- Subjects who have participated in any investigational drug or device trial within the previous 30 days or five half-lives of the investigational drug at screening, whichever one is longer.
- Subjects who have any other clinically significant abnormal result in laboratory tests such as abnormally low B12 or high TSH levels, as determined by the Investigator.
- Subjects 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.
- Subjects whose treatment with FDA-approved AD medication (donepezil, galantamine, memantine, rivastigmine or their combinations) has not been stable for at least 3 months prior to screening. Treatment and dosing should remain stable, with no changes throughout the trial.
- Subjects who are currently receiving (or unable to stop use for at least 21 days [3 weeks] prior to receiving the first dose of the AR1001 and throughout the study) prescription or non-prescription medications or other products known to be moderate or potent inhibitors/inducers of CYP3A4.
- Subjects who have had any intake of grapefruit, grapefruit juice, Seville oranges, Seville orange marmalade, or other products containing grapefruit or Seville oranges within 7 days of the first administration of the AR1001 and throughout the study.
- Subjects, in the opinion of the Investigator, who are unsuitable to participate in the study.
Extension Phase Continuation Criterion
1. Subjects enrolled in AR1001-ADP2-US01 and completed 26 weeks of assigned dosing.
Sites / Locations
- Advanced Clinical Research, Inc.
- Northern California Research
- Syrentis Clinical Research
- Meridien Research
- Meridien - Maitland
- The Neurology Research Group
- Accelerated Enrollment Solutions (AES)
- IMIC, Inc
- Meridien Research - St Petersburg
- Meridien Research - Spring Hill
- Meridien Research - Tampa
- NeuroStudies, LLC
- Advanced Clinical Research
- Wake Research - CRCNV
- Rapid Medical Research
- Lynn Health Science Institute
- Palmetto Clinical Research
- Advanced Clinical Research - Cedar Park
- FMC Science
- Advanced Clinical Research, Inc.
- Kingfisher Cooperative, LLC
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Placebo Comparator
Active Comparator
Active Comparator
Arm Label
Placebo
AR1001 - 10 mg
AR1001 - 30 mg
Arm Description
Placebo, orally administered once daily for 26 weeks.
Active, AR1001 - 10 mg, orally administered once daily for 26 weeks.
Active, AR1001 - 30 mg, orally administered once daily for 26 weeks.
Outcomes
Primary Outcome Measures
ADAS-Cog 13
Change of ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive subscale) from baseline at Week 26
ADCS-CGIC
Change of ADCS-CGIC (Alzheimer's disease Cooperative Study-Clinical Global Impression of Change)
Secondary Outcome Measures
MMSE-2
Change of MMSE (Mini-mental status examination) from baseline at Week 26
NPI
Changes of NPI (Neuropsychiatric Inventory) from baseline at Week 26
GDS
Changes of GDS (Geriatric Depression Scale) from baseline at Week 26
C-SSRS
Changes of C-SSRS (Columbia Suicide Severity Rating Scale) from baseline at Week 26
QOL-AD
Changes of QOL-AD (Quality of Life in Alzheimer's Disease) from baseline at Week 26
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
NCT03625622
Brief Title
Efficacy and Safety of 26-Week Treatment of AR1001 in Patients With Mild to Moderate Alzheimer's Disease
Official Title
A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate Efficacy and Safety of 26-Week Treatment of AR1001 in Patients With Mild to Moderate Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
April 1, 2019 (Actual)
Primary Completion Date
December 22, 2020 (Actual)
Study Completion Date
June 28, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AriBio 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
A double-blinded, randomized, placebo-controlled study will be performed to evaluate the efficacy and safety of treating AR1001 in patients with mild to moderate Alzheimer's disease for 26 weeks.
Detailed Description
Alzheimer's Disease (AD) is the most prevalent neurodegenerative disorder in The United States affecting approximately 5.4 million Americans. AD is characterized by progressive loss in memory and as well as a decline in the ability to learn that is associated with neuronal death. Well known hallmarks of AD are neuritic plaques and neurofibrillary tangles and extensive inflammation. Currently, no treatment has been developed to fully cure or prevent the progression of dementia that is associated with AD.
AR1001 is a polypharmacological drug candidate being developed as a treatment for AD and shows great potential with favorable attributes for a central nervous system (CNS) drug (i.e., high specificity and potency, as well as good pharmacokinetic, bioavailability, CNS penetration, and ensured safety).
The clinical study of AR1001 aims to evaluate the efficacy and safety of AR1001 as a potential treatment for AD. Based on the preclinical results, AR1001 could be an effective treatment option with a mechanism of action that has not been explored for AD indication.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mild to Moderate Alzheimer's Disease
Keywords
Alzheimer's disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
After the first 26 weeks, subjects can participate in an optional extension study to receive either 10 mg or 30 mg AR1001 for another 26 weeks.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double-blind for study site and participants
Allocation
Randomized
Enrollment
210 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo, orally administered once daily for 26 weeks.
Arm Title
AR1001 - 10 mg
Arm Type
Active Comparator
Arm Description
Active, AR1001 - 10 mg, orally administered once daily for 26 weeks.
Arm Title
AR1001 - 30 mg
Arm Type
Active Comparator
Arm Description
Active, AR1001 - 30 mg, orally administered once daily for 26 weeks.
Intervention Type
Drug
Intervention Name(s)
AR1001
Intervention Description
AR1001 Active Oral Tablet
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo Oral Tablet
Primary Outcome Measure Information:
Title
ADAS-Cog 13
Description
Change of ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive subscale) from baseline at Week 26
Time Frame
26 weeks
Title
ADCS-CGIC
Description
Change of ADCS-CGIC (Alzheimer's disease Cooperative Study-Clinical Global Impression of Change)
Time Frame
26 weeks
Secondary Outcome Measure Information:
Title
MMSE-2
Description
Change of MMSE (Mini-mental status examination) from baseline at Week 26
Time Frame
26 weeks
Title
NPI
Description
Changes of NPI (Neuropsychiatric Inventory) from baseline at Week 26
Time Frame
26 weeks
Title
GDS
Description
Changes of GDS (Geriatric Depression Scale) from baseline at Week 26
Time Frame
26 weeks
Title
C-SSRS
Description
Changes of C-SSRS (Columbia Suicide Severity Rating Scale) from baseline at Week 26
Time Frame
26 weeks
Title
QOL-AD
Description
Changes of QOL-AD (Quality of Life in Alzheimer's Disease) from baseline at Week 26
Time Frame
26 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
26 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria
Male or female subjects aged 55-80 years at the time of signing the Informed Consent Form.
Subjects (or subject's legally acceptable representative) and caregiver(s) who can sign an Informed Consent to participate in the study. Same caregiver(s) must assist the subject throughout the entire duration of the study.
Subjects who have a diagnosis of probable Alzheimer's disease according to the NIA-AA (National Institute of Aging and Alzheimer's Associations, 2011) criteria with mild to moderate dementia (stage 4 - 5) at screening.
Subjects who have mild-to-moderate cognitive impairment with MMSE Score of 16-26 at screening.
Subjects who have an MRI (either 1.5T or 3T) or CT scan performed after onset of symptoms and prior to randomization with findings consistent with the diagnosis of dementia due to Alzheimer's disease and without any other clinically significant comorbid pathologies.
Subjects who have one (or more) identified adult study partner(s) who, in the opinion of the investigator, has sufficient contact with and knowledge about the subject as to be able to report knowledgeably about the subject's safety, compliance and adherence, cognition, function, and behavior.
Exclusion Criteria
Subjects who are female who are pregnant, nursing, or of childbearing potential and not practicing effective contraception.
Subjects who have signs of delirium.
Subjects who have had a cortical stroke within the preceding 2 years.
Subjects who have any diagnosis of dementia other than that related to Alzheimer's Disease, including concomitant vascular dementia.
Subjects who have a PET scan performed after onset of symptoms with negative amyloid results.
Subjects with a history of myocardial infarction, unstable angina, New York Heart Association (NYHA) class III or IV heart failure or stroke within the last 12 months.
Subjects with uncontrolled hypertension (systolic blood pressure >160mm Hg or diastolic blood pressure > 95mm Hg) or hypotension (systolic blood pressure <90mm Hg or diastolic blood pressure <50mm Hg).
Subjects who have clinically significant renal impairment (creatinine > 1.5x ULN) or hepatic impairment (AST or ALT > 2.5x ULN or total bilirubin > 1.5x ULN).
Subjects who have history of cancer or malignant tumor within 5 years prior to screening with the exception of:
Basal or squamous cell carcinoma of the skin or cervical dysplasia which has been adequately treated.
In situ Grade 1 cervical cancer, fully treated at least 2 years prior to screening and without recurrence.
Prostate cancer, confined to the prostate gland, which has been adequately treated (surgery and/or radiation) with normal or low and stable PSA levels for 2 years prior to screening.
Subjects who have history of untreated thyroid disorder or a seizure disorder.
Subjects who are being treated, or likely to require treatment during the study, with any medications prohibited by the study protocol.
Subjects who have participated in any investigational drug or device trial within the previous 30 days or five half-lives of the investigational drug at screening, whichever one is longer.
Subjects who have any other clinically significant abnormal result in laboratory tests such as abnormally low B12 or high TSH levels, as determined by the Investigator.
Subjects 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.
Subjects whose treatment with FDA-approved AD medication (donepezil, galantamine, memantine, rivastigmine or their combinations) has not been stable for at least 3 months prior to screening. Treatment and dosing should remain stable, with no changes throughout the trial.
Subjects who are currently receiving (or unable to stop use for at least 21 days [3 weeks] prior to receiving the first dose of the AR1001 and throughout the study) prescription or non-prescription medications or other products known to be moderate or potent inhibitors/inducers of CYP3A4.
Subjects who have had any intake of grapefruit, grapefruit juice, Seville oranges, Seville orange marmalade, or other products containing grapefruit or Seville oranges within 7 days of the first administration of the AR1001 and throughout the study.
Subjects, in the opinion of the Investigator, who are unsuitable to participate in the study.
Extension Phase Continuation Criterion
1. Subjects enrolled in AR1001-ADP2-US01 and completed 26 weeks of assigned dosing.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Rock
Organizational Affiliation
SVP of global development
Official's Role
Study Director
Facility Information:
Facility Name
Advanced Clinical Research, Inc.
City
Banning
State/Province
California
ZIP/Postal Code
92220
Country
United States
Facility Name
Northern California Research
City
Sacramento
State/Province
California
ZIP/Postal Code
95821
Country
United States
Facility Name
Syrentis Clinical Research
City
Santa Ana
State/Province
California
ZIP/Postal Code
92705
Country
United States
Facility Name
Meridien Research
City
Lakeland
State/Province
Florida
ZIP/Postal Code
33805
Country
United States
Facility Name
Meridien - Maitland
City
Maitland
State/Province
Florida
ZIP/Postal Code
32751
Country
United States
Facility Name
The Neurology Research Group
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Accelerated Enrollment Solutions (AES)
City
Orlando
State/Province
Florida
ZIP/Postal Code
32806
Country
United States
Facility Name
IMIC, Inc
City
Palmetto Bay
State/Province
Florida
ZIP/Postal Code
33157
Country
United States
Facility Name
Meridien Research - St Petersburg
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33709
Country
United States
Facility Name
Meridien Research - Spring Hill
City
Spring Hill
State/Province
Florida
ZIP/Postal Code
34609
Country
United States
Facility Name
Meridien Research - Tampa
City
Tampa
State/Province
Florida
ZIP/Postal Code
33634
Country
United States
Facility Name
NeuroStudies, LLC
City
Decatur
State/Province
Georgia
ZIP/Postal Code
30033
Country
United States
Facility Name
Advanced Clinical Research
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
Facility Name
Wake Research - CRCNV
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89106
Country
United States
Facility Name
Rapid Medical Research
City
Beachwood
State/Province
Ohio
ZIP/Postal Code
44122
Country
United States
Facility Name
Lynn Health Science Institute
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73112
Country
United States
Facility Name
Palmetto Clinical Research
City
Summerville
State/Province
South Carolina
ZIP/Postal Code
29485
Country
United States
Facility Name
Advanced Clinical Research - Cedar Park
City
Cedar Park
State/Province
Texas
ZIP/Postal Code
78613
Country
United States
Facility Name
FMC Science
City
Lampasas
State/Province
Texas
ZIP/Postal Code
76550
Country
United States
Facility Name
Advanced Clinical Research, Inc.
City
West Jordan
State/Province
Utah
ZIP/Postal Code
84088
Country
United States
Facility Name
Kingfisher Cooperative, LLC
City
Spokane
State/Province
Washington
ZIP/Postal Code
99202
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Efficacy and Safety of 26-Week Treatment of AR1001 in Patients With Mild to Moderate Alzheimer's Disease
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