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Proof-of-Concept Study of a Selective p38 MAPK Alpha Inhibitor, Neflamapimod, in Subjects With Mild Alzheimer's Disease (REVERSE-SD)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT03402659
Recruitment Status : Completed
First Posted : January 18, 2018
Last Update Posted : October 3, 2019
Worldwide Clinical Trials
VU University Medical Center
Information provided by (Responsible Party):
EIP Pharma Inc

Brief Summary:
This is a phase 2b, double-blind, placebo controlled proof-of-concept study of a an oral small molecule selective inhibitor of p38 alpha kinase, neflamapimod, administered for 24 weeks in subjects with mild Alzheimer's disease. The primary objective is to demonstrate significant improvement relative to placebo-treatment in episodic memory function, as assessed by the Hopkins Verbal Learning Test. Secondary endpoints include Clinical Dementia Rating scale (CDR), Wechsler Memory Scale (WMS), Mini-Mental-Status-Examination (MMSE) and Cerebrospinal fluid (CSF) biomarkers of AD disease activity and progression.

Condition or disease Intervention/treatment Phase
Alzheimer Disease Drug: neflamapimod Other: placebo Phase 2

Detailed Description:
Details provided elsewhere.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 161 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Double-blind, placebo-controlled
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Double-Blind, Placebo-Controlled Proof-of-Concept Study of a Selective p38 MAP Kinase Alpha Inhibitor, Neflamapimod, Administered for 24 Weeks in Subjects With Mild Alzheimer's Disease
Actual Study Start Date : December 29, 2017
Actual Primary Completion Date : June 30, 2019
Actual Study Completion Date : July 31, 2019

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: neflamapimod
40 mg hard gelatin capsules, taken twice daily with food.
Drug: neflamapimod
40 mg neflamapimod capsule
Other Name: VX-745

Placebo Comparator: placebo
hard gelatin capsules containing excipients only, weight- and size-matched; taken twice daily with food.
Other: placebo
matching placebo capsule

Primary Outcome Measures :
  1. Improvement in total and delayed recall on the Hopkins Verval Learning Test - Revised (HVLT-R) [ Time Frame: 24 weeks ]
    Combined change in z-scores of total recall and delayed recall on the HVLT-R in neflamapimod-treated subjects compared to placebo-recipients

Secondary Outcome Measures :
  1. Wechsler Memory Scale (WMS) Immediate and delayed Recall [ Time Frame: 24 weeks ]
    Change in WMS immediate and delayed recall composites in neflamapimod-treated subjects compared to placebo-recipients.

  2. Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) [ Time Frame: 24 weeks ]
    Change in total score of Clinical Dementia Rating Scale - Sum of Boxes (range 0-18) in neflamapimod-treated subjects compared to placebo-recipients.

  3. Mini-Mental State Examination (MMSE) [ Time Frame: 24 weeks ]
    Change in MMSE in neflamapimod-treated subjects compared to placebo-recipients

  4. Cerebrospinal fluid phospho-tau [ Time Frame: 24 weeks ]
    Change in CSF levels of p-tau181 protein in neflamapimod-treated subjects compared to placebo-recipients.

  5. Cereberspinal fluid amyloid beta 1-40 [ Time Frame: 24 weeks ]
    Change in CSF levels of amyloid beta 1-40 peptide in neflamapimod-treated subjects compared to placebo-recipients.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   55 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Men and women age 55 to 85 years, inclusive.
  2. Willing and able to provide informed consent.
  3. Must have mild cognitive impairment (MCI) or mild AD with evidence of progression ("Mild-AD"), as defined by the following:

    1. CDR-Global Score of 0.5 or 1.0, with CDR memory subscore of at least 0.5.
    2. MMSE score ranging from 20 to 28, inclusive.
    3. Positive biomarker for AD, as defined by a CSF Aβ1-42R below the threshold and phospho-tau above the threshold for the assay utilized in the study and assessed by the central laboratory.
  4. Computed tomography (CT) or magnetic resonance imaging (MRI) findings within 2 years of Screening that are compatible with AD and no other pathologic processes that might potentially account for the subject's cognitive impairment.
  5. If the subject is taking a single drug for AD (e.g., donepezil or other cholinesterase inhibitors or memantine; dual therapy is excluded), he/she has been on a stable dose for at least 2 months prior to baseline, and the dose must remain unchanged during the study unless required for management of adverse events (AEs).
  6. Adequate visual and auditory abilities to perform all aspects of the cognitive and functional assessments.
  7. Must have reliable informant or caregiver.

Exclusion Criteria:

  1. Evidence that the primary basis for cognitive impairment is neurodegenerative disease other than AD, including, but not limited to, vascular dementia, dementia with Lewy bodies, and Parkinson's disease.
  2. Suicidality, defined as active suicidal thoughts within 6 months before Screening or at Baseline, defined as answering yes to items 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS), or history of suicide attempt in previous 2 years, or, in the Investigator's opinion, at serious risk of suicide.
  3. History of major and active psychiatric disorder, moderate to severe depressive symptoms, and or other concurrent medical condition that, EIP-VX17-745-304, Version 1.0, 17 November, 2017 Page 7 of 46 EIP Pharma, LLC Confidential in the opinion of the Investigator, might compromise safety and/or compliance with study requirements.
  4. Diagnosis of alcohol or drug abuse within the previous 2 years.
  5. History of cancer within the last 5 years, except basal cell carcinoma, squamous skin carcinoma, prostate cancer or carcinoma in situ with no significant progression over the past 2 years.
  6. Poorly controlled clinically significant medical illness.
  7. History of serum B12 abnormality, anemia with hemoglobin ≤10 g/dL, thyroid function abnormality, electrolyte abnormality, or positive syphilis serology that have not been corrected and/or otherwise addressed.
  8. History of epilepsy or unexplained seizure within the past 5 years.
  9. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >3 × the upper limit of normal (ULN), total bilirubin >2 × ULN, and/or International Normalized Ratio (INR) >1.5
  10. Known human immunodeficiency virus, hepatitis B, or active hepatitis C virus infection.
  11. Subject participated in a study of an investigational drug less than 3 months or 5 half-lives of the investigation drug, whichever is longer, before enrollment in this study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03402659

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Sponsors and Collaborators
EIP Pharma Inc
Worldwide Clinical Trials
VU University Medical Center
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Study Director: John Alam, MD EIP Pharma
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Responsible Party: EIP Pharma Inc Identifier: NCT03402659    
Other Study ID Numbers: EIP-VX17-745-304
First Posted: January 18, 2018    Key Record Dates
Last Update Posted: October 3, 2019
Last Verified: August 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Alzheimer Disease
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Neurodegenerative Diseases
Neurocognitive Disorders
Mental Disorders