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PET Imaging of Cyclooxygenases in Neurodegenerative Brain Disease

Primary Purpose

Dementia, Alzheimer's Disease, ALS

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
11C-MC1
11C-PS13
18f-florbetaben
Sponsored by
National Institute of Mental Health (NIMH)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Dementia focused on measuring ALS, PET Imaging, Inflammation, Cyclooxygenase-2, Dementia, PD

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers
  • INCLUSION CRITERIA:

Patients: In order to be eligible to participate in this study, patients must meet all of the following criteria:

  1. Be male or female, aged 18 or older.
  2. Be able (or have their Legally Authorized Representative (LAR) be able) to understand the study and be willing to sign a written informed consent document.
  3. Have been diagnosed by a neurologist or psychiatrist with ALS, PD, or an adult onset neurodegenerative dementia, such as AD (including amyloid negative subjects), FTD, corticobasal syndrome, or Huntington s disease.
  4. Be in good general health as evidenced by medical history and physical examination.
  5. Have their radial artery pulse checked for the presence of adequate ulnar collateral flow and the absence of any metal or foreign objects in both wrists.
  6. Agree to adhere to the lifestyle considerations.<TAB>

Healthy volunteers: In order to be eligible to participate in this study, healthy volunteer subjects must meet all of the following criteria:

  1. Be male or female, aged 18 or older.
  2. Be able to understand the study and be willing to sign a written informed consent document.
  3. Be in good general health, as evidenced by medical history and physical examination, and have no cognitive impairment.
  4. Be enrolled in 01-M-0254, The Evaluation of Participants with Mood and Anxiety Disorders and Healthy Volunteers or 17-M-0181, Recruitment and Characterization of Healthy Research Volunteers for NIMH Intramural Studies .
  5. Have their radial artery pulse checked for the presence of adequate ulnar collateral flow and the absence of any metal or foreign objects in both wrists.
  6. Agree to adhere to the lifestyle considerations.

EXCLUSION CRITERIA:

Both patients and healthy volunteers who meet any of the following criteria will be excluded from participation in this study:

  1. Clinically significant abnormalities on EKG or laboratory testing. This includes CBC; acute care panel (Na, K, Cl, CO2, creatinine, glucose, urea nitrogen); hepatic panel (alkaline phosphatase, ALT, AST, bilirubin total, and bilirubin direct); mineral panel (albumin, calcium, magnesium, phosphorus); prothrombin and partial prothrombin tests;
  2. Subjects should not have taken NSAIDs for two weeks prior to the PET scan. Aspirin, corticosteroids (with the exception of skin products), or immunosuppressants (e.g. methotrexate) must not have been taken in the prior month.
  3. Contraindications to ketoprofen, such as hypersensitivity to ketoprofen or history of upper or lower gastrointestinal bleeding.
  4. Have other major neurological or medical diseases that may cause cognitive dysfunction, such as structural brain diseases, metabolic diseases, paraneoplastic syndromes, infectious diseases, or other significant neurological abnormalities.
  5. Have an unstable medical condition that, in the opinion of the investigators, makes participation unsafe (e.g., an active infection or untreated malignancy).
  6. Are unable to travel to the NIH.
  7. Have recent exposure to radiation related to research (e.g., PET from other research) that, when combined with this study, would be above the allowable limits.
  8. Have an inability to lie flat and/or lie still on the camera bed for at least two hours, including claustrophobia, overweight greater than the maximum for the scanner, and uncontrollable behavioral symptoms, which will be screened by an interview with the patient and/or caregiver during the screening visit.
  9. Participants must not have substance use disorder or alcohol use disorder. However, alcohol or cannabis use by themselves are not exclusion criteria, unless that use impairs function.
  10. Participants should not be under treatment with Aduhelm, nor should they have been treated in the past.
  11. Are unable to have an MRI scan (e.g., because of pacemakers or other implanted electrical devices, brain stimulators, dental implants, aneurysm clips (metal clips on the wall of a large artery), metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner, implanted delivery pumps, shrapnel fragments, or metal fragments in the eye).
  12. Pregnancy
  13. HIV infection
  14. Be NIMH staff or an NIH employee who is a subordinate/relative/co-worker of the investigators.

Sites / Locations

  • National Institutes of Health Clinical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Only one arm

Arm Description

All subjects receive the same tests

Outcomes

Primary Outcome Measures

Measure the concentration of radioligands
Density of COX-1 and COX-2 in brain

Secondary Outcome Measures

Measure the retest variability and reliability of the radioligans
Density of COX-1 and COX-2 in brain

Full Information

First Posted
May 20, 2020
Last Updated
October 21, 2023
Sponsor
National Institute of Mental Health (NIMH)
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1. Study Identification

Unique Protocol Identification Number
NCT04396873
Brief Title
PET Imaging of Cyclooxygenases in Neurodegenerative Brain Disease
Official Title
Phase 1 Study: PET Imaging of Cyclooxygenases in Neurodegenerative Brain Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 20, 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 17, 2021 (Actual)
Primary Completion Date
April 11, 2026 (Anticipated)
Study Completion Date
October 3, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Mental Health (NIMH)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Background: About 5 million adults in the U.S. have Alzheimer s disease or another adult-onset neurodegenerative disorder. Many studies have found that inflammation in the brain contributes to these diseases. Researchers want to find a better way to measure this inflammation. Objective: To learn whether COX-1 and/or COX-2 is elevated in the brains of individuals with neurodegenerative brain disease compared to healthy volunteers. Eligibility: Adults age 18 years and older in good general health who have an adult-onset neurodegenerative dementia, such as AD, FTD, corticobasal syndrome, or Huntington s disease and healthy adult volunteers enrolled in protocols 01-M-0254 or 17-M-0181. Design: Participants will be screened with medical history, physical exam with vital signs, and lab tests. They will have a neuropsychological testing. Their heart function will be measured. Participants will have a magnetic resonance imaging (MRI) scan. The MRI scanner is a metal tube surrounded by a strong magnetic field. Participants will lie on a table that slides in and out of the tube. The machine makes noise. Participants will get earplugs. Participants will have 2 PET scans. They will be injected with the study drugs through an intravenous catheter placed in an arm vein. The PET scanner is shaped like a doughnut. Participants will lie on a bed that slides in and out of the scanner. A plastic mask will be molded to their head to keep them from moving. A thin plastic tube will be put into an artery at the wrist or elbow crease area. This will be used to draw blood during the scan. Participants will have 2-3 study visits. Participation lasts 1 week to 4 months, depending on scheduling.
Detailed Description
Study Description: This pilot/exploratory study will examine whether cyclooxygenase 1 (COX-1) and COX-2 are elevated in the brain of individuals with neurodegenerative brain disease compared to healthy volunteers. Objectives: Primary Objective: To determine whether COX-1 and/or COX-2 is elevated in the brains of individuals with neurodegenerative brain disease compared to healthy volunteers. Secondary Objective: 1) To determine retest variability and reliability for each radioligand. 2) To evaluate the specific binding of [11C]PS13 to COX-1 in healthy subjects through blocking study using Ketoprofen, a COX-1 inhibitor Endpoints: Primary Endpoint: Measurement of COX-1 and COX-2 density in brain after PET scans with [11C]PS13 and [11C]MC1, respectively. Secondary endpoint: 1) To measure whole-brain distribution volume (VT) of COX-1 and COX-2 in a retest setting; 2) To correlate VT with the presence of amyloid in Alzheimer s disease (AD) patients 3) To calculate the specific binding of [11C]PS13 with a Lassen plot

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dementia, Alzheimer's Disease, ALS, Parkinson's Disease
Keywords
ALS, PET Imaging, Inflammation, Cyclooxygenase-2, Dementia, PD

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
168 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Only one arm
Arm Type
Other
Arm Description
All subjects receive the same tests
Intervention Type
Drug
Intervention Name(s)
11C-MC1
Intervention Description
Injected IV followed by PET scanning
Intervention Type
Drug
Intervention Name(s)
11C-PS13
Intervention Description
Injected IV followed by PET scanning
Intervention Type
Drug
Intervention Name(s)
18f-florbetaben
Intervention Description
Injected IV followed by PET scanning
Primary Outcome Measure Information:
Title
Measure the concentration of radioligands
Description
Density of COX-1 and COX-2 in brain
Time Frame
1-2 days
Secondary Outcome Measure Information:
Title
Measure the retest variability and reliability of the radioligans
Description
Density of COX-1 and COX-2 in brain
Time Frame
1-2 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
INCLUSION CRITERIA: Patients: In order to be eligible to participate in this study, patients must meet all of the following criteria: Aged 18 or older. Be able (or have their Legally Authorized Representative (LAR) be able) to understand the study and be willing to sign a written informed consent document. Have been diagnosed by a neurologist or psychiatrist with MCI, ALS, PD, or an adult onset neurodegenerative dementia, such as AD (including amyloid negative subjects), FTD, corticobasal syndrome, or Huntington s disease. Be in good general health as evidenced by medical history and physical examination. Have their radial artery pulse checked for the presence of adequate ulnar collateral flow and the absence of any metal or foreign objects in both wrists. Agree to adhere to the lifestyle considerations. Healthy volunteers: In order to be eligible to participate in this study, healthy volunteer subjects must meet all of the following criteria: Aged 18 or older. Female participants of childbearing potential must be using a medically acceptable means of contraception Able provide informed consent. Be in good general health, as evidenced by medical history and physical examination, and have no cognitive impairment. Be enrolled in 01-M-0254, The Evaluation of Participants with Mood and Anxiety Disorders and Healthy Volunteers or 17-M-0181, Recruitment and Characterization of Healthy Research Volunteers for NIMH Intramural Studies Have their radial artery pulse checked for the presence of adequate ulnar collateral flow and the absence of any metal or foreign objects in both wrists. Agree to adhere to the lifestyle considerations. EXCLUSION CRITERIA: Both patients and healthy volunteers who meet any of the following criteria will be excluded from participation in this study: Clinically significant abnormalities on EKG or laboratory testing. This includes CBC and acute care panel (Na, K, Cl, CO2, creatinine, glucose, urea nitrogen). Any lab value that is two-times the upper limit or even lower values in the investigator s judgment. Creatinine level >1.3 mg/dL Subjects should not have taken Non-Steroidal Anti-Inflammatory Drug NSAIDs for two weeks prior to the PET scan. Aspirin, corticosteroids (with the exception of skin products), or immunosuppressants (e.g., methotrexate) must not have been taken in the prior month. Contraindications to ketoprofen, such as hypersensitivity to ketoprofen or history of upper or lower gastrointestinal bleeding. Have other major neurological or medical diseases that may cause cognitive dysfunction, such as structural brain diseases, metabolic diseases, paraneoplastic syndromes, infectious diseases, or other significant neurological abnormalities. Have an unstable medical condition that, in the opinion of the investigators, makes participation unsafe (e.g., an active infection or untreated malignancy). Are unable to travel to the NIH. Have recent exposure to radiation related to research (e.g., PET from other research) that, when combined with this study, would be above the allowable limits. Have an inability to lie flat and/or lie still on the camera bed for at least two hours, including claustrophobia, overweight greater than the maximum for the scanner, and uncontrollable behavioral symptoms, which will be screened by an interview with the patient and/or caregiver during the screening visit. Participants must not have substance use disorder or alcohol use disorder. However, alcohol or cannabis use by themselves are not exclusion criteria, unless that use impairs function of daily life. Participants should not be under treatment with Aduhelm, nor should they have been treated in the past. Are unable to have an MRI scan (e.g., because of pacemakers or other implanted electrical devices, brain stimulators, dental implants, aneurysm clips (metal clips on the wall of a large artery), metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner, implanted delivery pumps, shrapnel fragments, or metal fragments in the eye). Pregnancy HIV infection Be NIMH staff or an NIH employee who is a subordinate/relative/co-worker of the investigators.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Maria D Ferraris Araneta, C.R.N.P.
Phone
(301) 496-9423
Email
ferrarism@mail.nih.gov
First Name & Middle Initial & Last Name or Official Title & Degree
Robert B Innis, M.D.
Phone
(301) 594-1368
Email
robert.innis@nih.gov
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert B Innis, M.D.
Organizational Affiliation
National Institute of Mental Health (NIMH)
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Institutes of Health Clinical Center
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)
Phone
800-411-1222
Ext
TTY8664111010
Email
prpl@cc.nih.gov

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
.results will be shared
IPD Sharing Time Frame
18 months after closure of protocol to Clincialtrials.gov
IPD Sharing Access Criteria
BTRIS
Links:
URL
https://clinicalstudies.info.nih.gov/cgi/detail.cgi?A_2020-M-0082.html
Description
NIH Clinical Center Detailed Web Page

Learn more about this trial

PET Imaging of Cyclooxygenases in Neurodegenerative Brain Disease

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