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Study to Assess the Efficacy of XPro1595 in Patients With Mild Alzheimer's Disease With Biomarkers of Inflammation (MINDFuL)

Primary Purpose

Alzheimer Disease, Dementia, Brain Diseases

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
XPro1595
Placebo
Sponsored by
Inmune Bio, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer Disease focused on measuring Inflammation, Biomarker, TNF

Eligibility Criteria

60 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

To be eligible for study entry, patients must satisfy all of the following criteria:

  • Adult patients ≥ 60 years to ≤ 85 years of age at the time of consent;
  • Diagnosed with mild dementia as clinically described in McKhann, (2011) and corresponding to stage 4 of the revised AD staging system (Jack, 2018). Patients who have received previous therapy for Alzheimer's disease may still be eligible;
  • Amyloid positive (documented in medical history or assessed during screening through blood test);
  • Either currently or previously (in pre-AD condition) literate and capable of reading, writing, and communicating effectively with others;
  • Residence in an assisted living is allowed as is personal assistances provided in the home, however at time of enrollment participant must be able to perform most ADL with minimal assistance, and participant must be permitted sufficient independence to allow assessment of change in ADL;
  • Has a caregiver willing to serve as a study partner for the duration of the trial who either lives in the same household or interacts with the patient at least 4 hours per day and on at least 4 days per week, who is knowledgeable about the patient's daytime and night-time behaviors and who can be available to attend all clinic visits in person at which caregiver assessments are performed.

Exclusion Criteria:

Patients will be excluded from the study if 1 or more of the following criteria are applicable:

  • Have any contraindications to MRI scanning, including cardiac pacemaker/defibrillator, ferromagnetic metal implants (e.g., in-skull and cardiac devices other than those approved as safe for use in MRI scanners);
  • Receives considerable help to carry out basic ADL living either in the home or as a resident in a nursing home or similar facility;
  • Lifetime history of a major psychiatric disorder including schizophrenia and bipolar disorder. Major depressive disorder that has resulted in 2 or more hospitalizations in a lifetime. Major depressive episode during the past 5 years that is judged by the clinical team unlikely to have been part of Alzheimer's prodrome. History of suicidality. History of substance abuse within 12 months; use of cannabis or cannabis products within 6 months of consent;
  • Enrolled in another clinical trial where patients receive treatment with an investigational drug or treatment device or have received treatment on another AD clinical trial within the last 60 days from Day 1;
  • A prior organ or stem cell transplant;
  • Seated blood pressure of ≥ 165/105 mmHg at Screening.

Sites / Locations

  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational SiteRecruiting
  • INmune Bio Investigational Site
  • INmune Bio Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

1.0 mg/kg XPro1595

1.0 mg/kg Placebo

Arm Description

1.0 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 23 weeks.

1.0 mg/kg of Placebo will be administered via subcutaneous injection once a week for 23 weeks.

Outcomes

Primary Outcome Measures

Change in Early and Mild Alzheimer's Cognitive Composite (EMACC)
Change in the Early and Mild Alzheimer's cognitive composite (EMACC) from Baseline to Week 24 in the following assessments: International Shopping List Test-Immediate recall (Word List learning Test) Digit Span Forward and Backward Category Fluency Test (DKEFS) Letter Fluency Test (DKEFS) Trail Making Test Parts A and B Digit Symbol Coding Test To assess the efficacy of XPro1595 compared with placebo on cognitive performance in patients with mild AD

Secondary Outcome Measures

Change in Clinical Dementia Rating (CDR)
Change from Baseline to Week 24 in Clinical Dementia Rating Scale (CDR) The CDR scale is a clinician-rated dementia staging system that tracks the progression of cognitive impairment in 6 categories (memory, orientation, judgement, and problem solving, community affairs, home and hobbies, and personal care). Each category is scored on a 5-point scale in which None = 0, Questionable = 0.5, Mild = 1, Moderate = 2, and Severe = 3. The global CDR score is established by clinical scoring rules and has values of 0 (no dementia), 0.5, (questionable dementia), 1 (mild dementia), 2 (moderate dementia), and 3 (severe dementia). The Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) is obtained by adding the ratings in each of the 6 categories and ranges from 0 to 18 with higher scores indicative of greater impairment. To assess the effect of XPro1595 compared with placebo on cognition and global function in patients with mild AD
Change in apparent fiber density (AFD)
Change from Baseline to Week 24 in apparent fiber density (AFD) To assess the efficacy of XPro1595 compared with placebo on axonal integrity in patients with mild AD
Change in Everyday Cognition (E-Cog)
Change from Baseline to Week 24 in Everyday Cognition (E-Cog) To evaluate the effect of XPro1595 compared with placebo on E-Cog
Change in Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL)
Change from Baseline to Week 24 in Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) To assess the effect of XPro1595 compared with placebo on ADL in patients with mild AD.
Change in myelin content
Change from Baseline to Week 24 in free-water-corrected tissue Radial diffusivity and 1 of the following i) MRI-specific myelin contrast: ii) a magnetization transfer ratio (MTR) iii) an inhomogeneous magnetization transfer (MT) or iv) an myelin water fraction (MWF) map To assess the efficacy of XPro1595 compared with placebo on myelin in patients with mild AD.
Change in non-cognitive behavioral symptoms
Change from Baseline to Week 24 in (Neuropsychiatric Inventory [NPI] caregiver items) To assess the effect of XPro1595 compared with placebo on noncognitive behavioral symptoms in patients with mild AD
Change in gray matter integrity
Change from Baseline to Week 24 in Cortical Disarray Measurement (CDM®) To assess the efficacy of XPro1595 compared with placebo on gray matter integrity in patients with mild AD
Change in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker amyloid)
Number of participants with a reduction in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration amyloid) from Baseline to Week 24. To assess the efficacy of XPro1595 compared with placebo on blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker amyloid).
Change in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau)
Change from Baseline to Week 24 in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau) To assess the efficacy of XPro1595 compared with placebo on blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau)
Change in brain structure neurodegeneration
Changes from Baseline to Week 24 in volumetric magnetic resonance imaging (MRI) To assess the efficacy of XPro1595 compared with placebo on brain structure neurodegeneration
Number of participants who experience adverse events and serious adverse events
Clinically significant abnormalities of laboratory values, physical findings, electrocardiogram findings and other safety assessments will be recorded as adverse events if the findings meet the defined criteria for adverse events.

Full Information

First Posted
March 7, 2022
Last Updated
September 29, 2023
Sponsor
Inmune Bio, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05318976
Brief Title
Study to Assess the Efficacy of XPro1595 in Patients With Mild Alzheimer's Disease With Biomarkers of Inflammation
Acronym
MINDFuL
Official Title
A Phase 2, Randomized, Placebo-Controlled, Double-Blind Study of XPro1595 in Patients With Mild Alzheimer's Disease With Biomarkers of Inflammation
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 28, 2022 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Inmune Bio, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to measure cognitive and biological biomarkers in subcutaneously administered XPro1595 or placebo in patients with mild ADi.
Detailed Description
This study is designed as a double-blind randomized, placebo-controlled, study investigating the safety, tolerability, and efficacy of XPro1595 in patients with mild AD with inflammation (ADi). The planned dose is 1.0 mg/kg of XPro1595 and matching placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Dementia, Brain Diseases, Central Nervous System Diseases, Nervous System Diseases, Tauopathies, Neurodegenerative Diseases, Neurocognitive Disorders, Mental Disorders
Keywords
Inflammation, Biomarker, TNF

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
(2:1) XPro1595 (1mg/kg), placebo Weekly subcutaneous injections
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
201 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
1.0 mg/kg XPro1595
Arm Type
Experimental
Arm Description
1.0 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 23 weeks.
Arm Title
1.0 mg/kg Placebo
Arm Type
Placebo Comparator
Arm Description
1.0 mg/kg of Placebo will be administered via subcutaneous injection once a week for 23 weeks.
Intervention Type
Drug
Intervention Name(s)
XPro1595
Other Intervention Name(s)
INB03/XPro™, XENP1595, DN-TNF
Intervention Description
XPro1595 will be delivered by subcutaneous injection once a week
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Matching Placebo
Intervention Description
Placebo will be delivered by subcutaneous injection once a week
Primary Outcome Measure Information:
Title
Change in Early and Mild Alzheimer's Cognitive Composite (EMACC)
Description
Change in the Early and Mild Alzheimer's cognitive composite (EMACC) from Baseline to Week 24 in the following assessments: International Shopping List Test-Immediate recall (Word List learning Test) Digit Span Forward and Backward Category Fluency Test (DKEFS) Letter Fluency Test (DKEFS) Trail Making Test Parts A and B Digit Symbol Coding Test To assess the efficacy of XPro1595 compared with placebo on cognitive performance in patients with mild AD
Time Frame
24 Weeks
Secondary Outcome Measure Information:
Title
Change in Clinical Dementia Rating (CDR)
Description
Change from Baseline to Week 24 in Clinical Dementia Rating Scale (CDR) The CDR scale is a clinician-rated dementia staging system that tracks the progression of cognitive impairment in 6 categories (memory, orientation, judgement, and problem solving, community affairs, home and hobbies, and personal care). Each category is scored on a 5-point scale in which None = 0, Questionable = 0.5, Mild = 1, Moderate = 2, and Severe = 3. The global CDR score is established by clinical scoring rules and has values of 0 (no dementia), 0.5, (questionable dementia), 1 (mild dementia), 2 (moderate dementia), and 3 (severe dementia). The Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) is obtained by adding the ratings in each of the 6 categories and ranges from 0 to 18 with higher scores indicative of greater impairment. To assess the effect of XPro1595 compared with placebo on cognition and global function in patients with mild AD
Time Frame
24 Weeks
Title
Change in apparent fiber density (AFD)
Description
Change from Baseline to Week 24 in apparent fiber density (AFD) To assess the efficacy of XPro1595 compared with placebo on axonal integrity in patients with mild AD
Time Frame
24 Weeks
Title
Change in Everyday Cognition (E-Cog)
Description
Change from Baseline to Week 24 in Everyday Cognition (E-Cog) To evaluate the effect of XPro1595 compared with placebo on E-Cog
Time Frame
24 Weeks
Title
Change in Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL)
Description
Change from Baseline to Week 24 in Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) To assess the effect of XPro1595 compared with placebo on ADL in patients with mild AD.
Time Frame
24 Weeks
Title
Change in myelin content
Description
Change from Baseline to Week 24 in free-water-corrected tissue Radial diffusivity and 1 of the following i) MRI-specific myelin contrast: ii) a magnetization transfer ratio (MTR) iii) an inhomogeneous magnetization transfer (MT) or iv) an myelin water fraction (MWF) map To assess the efficacy of XPro1595 compared with placebo on myelin in patients with mild AD.
Time Frame
24 Weeks
Title
Change in non-cognitive behavioral symptoms
Description
Change from Baseline to Week 24 in (Neuropsychiatric Inventory [NPI] caregiver items) To assess the effect of XPro1595 compared with placebo on noncognitive behavioral symptoms in patients with mild AD
Time Frame
24 Weeks
Title
Change in gray matter integrity
Description
Change from Baseline to Week 24 in Cortical Disarray Measurement (CDM®) To assess the efficacy of XPro1595 compared with placebo on gray matter integrity in patients with mild AD
Time Frame
24 Weeks
Title
Change in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker amyloid)
Description
Number of participants with a reduction in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration amyloid) from Baseline to Week 24. To assess the efficacy of XPro1595 compared with placebo on blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker amyloid).
Time Frame
24 Weeks
Title
Change in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau)
Description
Change from Baseline to Week 24 in blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau) To assess the efficacy of XPro1595 compared with placebo on blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau)
Time Frame
24 Weeks
Title
Change in brain structure neurodegeneration
Description
Changes from Baseline to Week 24 in volumetric magnetic resonance imaging (MRI) To assess the efficacy of XPro1595 compared with placebo on brain structure neurodegeneration
Time Frame
24 Weeks
Title
Number of participants who experience adverse events and serious adverse events
Description
Clinically significant abnormalities of laboratory values, physical findings, electrocardiogram findings and other safety assessments will be recorded as adverse events if the findings meet the defined criteria for adverse events.
Time Frame
Baseline up to 28 days post last dose
Other Pre-specified Outcome Measures:
Title
Change in Goal Attainment Scale (GAS)
Description
Change in individual goals based on the Goal Attainment Scale (GAS) The achievement of each goal is rated on a 5-point attainment scale (-2, -1, 0, +1, +2) to allow standardized scoring of personalized outcomes. A participant's overall goal attainment is quantified using a formula that takes into account the number of goals that have been set, and the extent to which they are correlated with each other. For each identified goal area, the caregiver will be asked to give a detailed description of the patient's current (baseline) status and goal status, which will be recorded at the -1 and 0 levels on the 5-point scale, respectively. The remaining levels of the scale will then be set: somewhat better than the goal (+1), much better than the goal (+2), and much worse than the goal (-2). To evaluate the effect of XPro1595 compared with placebo on goal attainment scores
Time Frame
24 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be eligible for study entry, patients must satisfy all of the following criteria: Adult patients ≥ 60 years to ≤ 85 years of age at the time of consent; Diagnosed with mild dementia as clinically described in McKhann, (2011) and corresponding to stage 4 of the revised AD staging system (Jack, 2018). Patients who have received previous therapy for Alzheimer's disease may still be eligible; Amyloid positive (documented in medical history or assessed during screening through blood test); Either currently or previously (in pre-AD condition) literate and capable of reading, writing, and communicating effectively with others; Residence in an assisted living is allowed as is personal assistances provided in the home, however at time of enrollment participant must be able to perform most ADL with minimal assistance, and participant must be permitted sufficient independence to allow assessment of change in ADL; Has a caregiver willing to serve as a study partner for the duration of the trial who either lives in the same household or interacts with the patient at least 4 hours per day and on at least 4 days per week, who is knowledgeable about the patient's daytime and night-time behaviors and who can be available to attend all clinic visits in person at which caregiver assessments are performed. Exclusion Criteria: Patients will be excluded from the study if 1 or more of the following criteria are applicable: Have any contraindications to MRI scanning, including cardiac pacemaker/defibrillator, ferromagnetic metal implants (e.g., in-skull and cardiac devices other than those approved as safe for use in MRI scanners); Receives considerable help to carry out basic ADL living either in the home or as a resident in a nursing home or similar facility; Lifetime history of a major psychiatric disorder including schizophrenia and bipolar disorder. Major depressive disorder that has resulted in 2 or more hospitalizations in a lifetime. Major depressive episode during the past 5 years that is judged by the clinical team unlikely to have been part of Alzheimer's prodrome. History of suicidality. History of substance abuse within 12 months; use of cannabis or cannabis products within 6 months of consent; Enrolled in another clinical trial where patients receive treatment with an investigational drug or treatment device or have received treatment on another AD clinical trial within the last 60 days from Day 1; A prior organ or stem cell transplant; Seated blood pressure of ≥ 165/105 mmHg at Screening.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
INmune Bio
Phone
(858)964-3720
Email
trials@inmunebio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Therese Blomberg
Organizational Affiliation
INmune Bio
Official's Role
Study Director
Facility Information:
Facility Name
INmune Bio Investigational Site
City
Darlinghurst
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Macquarie Park
State/Province
New South Wales
ZIP/Postal Code
2113
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5011
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Box Hill
State/Province
Victoria
ZIP/Postal Code
3128
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Carlton
State/Province
Victoria
ZIP/Postal Code
3053
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Ivanhoe
State/Province
Victoria
ZIP/Postal Code
3079
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Perth
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1Z 1G3
Country
Canada
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.
Facility Name
INmune Bio Investigational Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4G 3E8
Country
Canada
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
INmune Bio, Inc.

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
16705109
Citation
Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA. 2006 May 17;295(19):2275-85. doi: 10.1001/jama.295.19.2275. Erratum In: JAMA. 2006 Jun 7;295(21):2482.
Results Reference
background
PubMed Identifier
21239393
Citation
Chance SA, Clover L, Cousijn H, Currah L, Pettingill R, Esiri MM. Microanatomical correlates of cognitive ability and decline: normal ageing, MCI, and Alzheimer's disease. Cereb Cortex. 2011 Aug;21(8):1870-8. doi: 10.1093/cercor/bhq264. Epub 2011 Jan 14.
Results Reference
background
PubMed Identifier
27470609
Citation
Chou RC, Kane M, Ghimire S, Gautam S, Gui J. Treatment for Rheumatoid Arthritis and Risk of Alzheimer's Disease: A Nested Case-Control Analysis. CNS Drugs. 2016 Nov;30(11):1111-1120. doi: 10.1007/s40263-016-0374-z.
Results Reference
background
PubMed Identifier
22966039
Citation
Clark I, Atwood C, Bowen R, Paz-Filho G, Vissel B. Tumor necrosis factor-induced cerebral insulin resistance in Alzheimer's disease links numerous treatment rationales. Pharmacol Rev. 2012 Oct;64(4):1004-26. doi: 10.1124/pr.112.005850. Epub 2012 Sep 10.
Results Reference
background
Links:
URL
https://www.alz.org/alzheimers-dementia/facts-figures
Description
Alzheimer's Association annual report releasing statistics regarding Alzheimer's disease

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Study to Assess the Efficacy of XPro1595 in Patients With Mild Alzheimer's Disease With Biomarkers of Inflammation

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