Bexarotene Amyloid Treatment for Alzheimer's Disease (BEAT-AD)

This study has been completed.
Information provided by (Responsible Party):
The Cleveland Clinic Identifier:
First received: January 29, 2013
Last updated: May 28, 2015
Last verified: May 2015

Retinoid X receptors (RXR) are nuclear receptors that have been linked to numerous metabolic pathways relevant to Alzheimer's disease (AD) and Aβ (harmful protein) production and removal. The study drug "bexarotene" is an FDA approved anti-cancer agent but is not approved for use in Alzheimer's disease. Bexarotene acts as an RXR agonist that has reduced Aβ (harmful protein) in the brain in experimental models of Alzheimer's disease.

This study aims to determine the safety and effect on abnormal proteins found in the brain (based on brain scans) of 300 mg of "bexarotene" administered for one month compared to placebo (inactive agent).

Condition Intervention Phase
Alzheimer's Disease
Drug: Bexarotene
Drug: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A Double Blind Placebo Controlled Randomized Study to Evaluate the Efficacy and Safety of Bexarotene in Patients With Mild to Moderate Alzheimer's Disease

Resource links provided by NLM:

Further study details as provided by The Cleveland Clinic:

Primary Outcome Measures:
  • Standard uptake units regional (SUVR) on amyloid brain imaging obtained through 18F-AV-45 PET [ Time Frame: Week 4 ] [ Designated as safety issue: No ]
    The primary study endpoint is the change from baseline to Week 4 in amyloid burden as measured by standard uptake units regional (SUVR) on amyloid brain imaging obtained through 18F-AV-45 PET

Secondary Outcome Measures:
  • ADAS-Cog [ Time Frame: Week 4, week 8 ] [ Designated as safety issue: No ]
    • Change from baseline to Week 4 on the scores of ADAS-Cog and from baseline to week 8

  • Biomarkers [ Time Frame: Week 4, Week 8 ] [ Designated as safety issue: No ]
    • Change from baseline to Week 4 and Week 8 in biomarkers

  • SUVR change from Baseline to Week 8 [ Time Frame: Week 8 ] [ Designated as safety issue: No ]
    • Change from baseline to Week 8 in amyloid burden as measured by standard uptake units regional (SUVR) on amyloid brain imaging obtained through positron emission tomography (PET)

  • MRI changes [ Time Frame: Week 4, Week 8 ] [ Designated as safety issue: Yes ]
    brain MRI finding including the incidence of amyloid related imaging abnormalities-edema (AEIA-E), or amyloid related imaging abnormalities-hemorrhage or hemosiderosis (ARIA-H)

  • CDR-SOB [ Time Frame: Week 4, Week 8 ] [ Designated as safety issue: No ]
    CDR-SOB change from Baseline to Week 4 and from Baseline to Week 8

  • NPI [ Time Frame: Week 4, Week 8 ] [ Designated as safety issue: No ]
    NPI score change from Baseline to Week 4 and from Baseline to Week 8

  • ADCS-ADL [ Time Frame: Week 4, Week 8 ] [ Designated as safety issue: No ]
    Change from baseline to Week 4 on the scores of ADCS-ADL and change from baseline to week 8

Other Outcome Measures:
  • Lab Abnormalities, AEs [ Time Frame: Week 4 and Week 8 ] [ Designated as safety issue: Yes ]
    • Proportion of subjects with adverse events, serious adverse events and adverse events leading to discontinuation over the 4 week double blind treatment period
    • Proportion of subjects with laboratory abnormalities
    • Proportion of subjects with EKG abnormalities

Enrollment: 20
Study Start Date: February 2013
Study Completion Date: December 2014
Primary Completion Date: August 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Bexarotene treatment Arm

75 mg of Bexarotene BID for week 1, then increasing to 150 mg BID for weeks 2 to 4.

Weeks 5 to 8 is Open-label phase (150 mg BID for 4 weeks)

Drug: Bexarotene
Subjects will be randomized 4:1 to receive 4 weeks of double blind treatment of either Bexarotene or Placebo
Other Name: Targretin
Placebo Comparator: Placebo

1 placebo capsule BID for week 1, then increasing to 2 placebo capsules BID for weeks 2 to 4.

Weeks 5 to 8 is Open-label phase (150 mg BID for 4 weeks)

Drug: Placebo


Ages Eligible for Study:   50 Years to 90 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Males or females 50 to 90 of age inclusive.
  • Diagnosis of probable AD according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.
  • Willing and able to provide informed consent by either the subject or subject's legal representative.
  • Willing and able to comply with study visits, treatment plan, laboratory tests, brain imaging and other procedures.
  • Subjects must have a positive 18f-AV-45 PET scan as determined by a qualified rater.
  • Mini-Mental State Examinations (MMSE) score between 10-20 inclusive.
  • Must have a study partner who is able and willing to comply with all required study procedures.
  • Females must be postmenopausal.
  • Have at least eight years of education and should have previously (in pre-AD condition) been capable of reading, writing, and communicating effectively with others in English.
  • If receiving therapy with a cholinesterase inhibitor and/or memantine, the dose of these agents has been stable for at least 4 weeks prior to randomization
  • Normal laboratory findings at baseline including CBC, chemistry panel, serum lipids, liver functions, TSH, and vitamin B12.
  • Must consent to ApoE genotyping

Exclusion Criteria:

  • Any clinically relevant neurological disorder capable of producing a dementia syndrome including Parkinson's disease, stroke, vascular dementia, dementia with Lewy bodies, frontotemporal dementia and others.
  • 4 or more micro-hemorrhages (amyloid-related imaging abnormalities - hemorrhage type (ARIA-H) on baseline MRI or any evidence of amyloid-related imaging abnormalities - effusion type (ARIA-E) (Sperling et al, 2011).
  • History of malignancy within the past five years with the exception of basal cell or squamous cell cancer, in-situ cervical cancer, or localized prostate cancer.
  • History of seizure in the past three years prior to randomization
  • Any contraindication of having brain MRI
  • Any contraindication of having PET (inability to lie flat and still for the duration of the scan, intolerance to previous PET such as hypersensitivity reaction to PET ligand or imaging agent)
  • The subject has any unstable medical illness including hypertension, congestive heart failure, chronic obstructive pulmonary disease, renal failure, liver failure or other organ compromise.
  • Other clinically important abnormality on vital signs, physical examination, neurologic examination, laboratory results, or electrocardiogram (ECG) examination (e.g. Atrial fibrillation) that could compromise the study or be detrimental to the subject.
  • The subject has received bexarotene previously.
  • The subject has an allergy to bexarotene.
  • Has had a PET scan in the past 12 months.
  • Has had radiotherapy in the past year.
  • Have participated in an investigational drug or device study within 30 days prior to Visit 2.
  • Have been treated with immunomodulators to treat AD (vaccines, antibodies etc) within 6 months prior to visit 2
  • Unable to swallow uncrushed oral medication in capsule form
  • Have any condition or reason that, in the opinion of the investigator, which could interfere with the ability of the patients to participate or complete the trials, or places the patient at undue risk or complicates the interpretation of safety or efficacy data.
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01782742

United States, Nevada
Cleveland Clinic Lou Ruvo Center for Brain Health
Las Vegas, Nevada, United States, 89106
Sponsors and Collaborators
The Cleveland Clinic
Principal Investigator: Jeffrey L Cummings, MD, ScD The Cleveland Clinic
  More Information

No publications provided

Responsible Party: The Cleveland Clinic Identifier: NCT01782742     History of Changes
Other Study ID Numbers: CCF-IRB 12-783 
Study First Received: January 29, 2013
Last Updated: May 28, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by The Cleveland Clinic:
Mild to Moderate Alzheimer's Disease

Additional relevant MeSH terms:
Alzheimer Disease
Brain Diseases
Central Nervous System Diseases
Delirium, Dementia, Amnestic, Cognitive Disorders
Mental Disorders
Nervous System Diseases
Neurodegenerative Diseases
Anticarcinogenic Agents
Antineoplastic Agents
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents
Therapeutic Uses processed this record on February 04, 2016