The primary objective of this Phase 2a study is to evaluate the maximal tolerated dose of ANAVEX2-73 in patients with AD in a repeated-dose administration scheme, with the secondary objectives being to explore the relationship between dosing regimen and pharmacodynamics efficacy outcomes and to evaluate the bioavailability of the oral form used and to explore the relationship of ANAVEX2-73 as add-on therapy to AD standard of care.
This is a Phase 2a study consisting of two parts, PART A and PART B. The first part (PART A) is a simple randomised, open-label, 2-period, cross-over, adaptive design study lasting for each participant up to 36 days. The second part (PART B) is an open-label extension for an additional period of 52 weeks, so as to establish a longer drug effect for the participants who wish to continue on oral daily dose. The complete timeline of the study includes the screening assessments within 28 days prior to simple randomisation and initiation of the study. The first administration of study medication will occur after all baseline and screening procedures have been passed (baseline is defined as pre-dosing period timeframe day -28 to day -1). No study procedures will be undertaken until a current informed consent form has been signed by each participant or their respective carer or responsible person. The design of the first part (PART A) of the study involves two periods, two administration routes and two dose levels: In one period the intravenous (iv) form will be given and in the other period the oral dose will be given. The first period will involve 12 administrations (either oral or iv) and the second period will involve 11 administrations (either oral or iv). The very first administration in the first period is intended as a full pharmacokinetic (PK) screen over the first 48 hours (Day 1 to Day 3). After that, 11 daily administrations complete the first period (Day 3 to Day 13). After a wash-out period of 11 days, the second period of the study starts, involving again 11 daily administrations. Therefore, the first part (PART A) of the study is scheduled to be completed in 36 days. The study design asks for 32 participants, 16 males and 16 female participants. All participants have the option to go on to the second part (PART B) of the study, the extended open-label study exploring the cognitive effect of the drug for another 52 weeks where the oral form will be exclusively administered. Safety and tolerability will be constantly assessed throughout the study, starting from the first dose of study medication.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Melbourne Health - The Royal Melbourne Hospital
Melbourne, Victoria, Australia
Austin Health - Heidelberg Repatriation Hospital
Melbourne, Victoria, Australia
Caulfield Hospital
Melbourne, Victoria, Australia
Nucleus Network- Centre for Clinical Studies
Melbourne, Victoria, Australia
To determine maximum tolerated dose of Anavex2-73.
Time frame: 36 Days
PK sampling- blood test results
Time frame: First part (PART A), first period (hours): 1, 48, 264; second period (hours): 1, 72, 264; extension period (PART B): Week 1, 12 and 26.
Mini-mental state examination score (MMSE)
Time frame: Baseline, and during the extension period at Week 1, 12, 26, 36, 48, and 52
Score from ADCS-ADL (Alzheimer's Disease Co-operative Study - Activities of Daily Living Inventory)
Time frame: Baseline, and during the extension period at Week 1, 12, 26, 36, 48, and 52
Cogstate Brief Battery (CBB) Score and International Shopping List Task (ISLT) Score
Time frame: At baseline, Day 1, 2, 6, 9, 12 of Period 1 and Day 1, 2, 6, 9, 12 of Period 2 and during the extension period at Week 12, 36, 48, and 52.
Electroencephalographic activity, including event-related potentials (EEG/ERP)
Time frame: baseline, Day 1, 5, 11 of Period 1 and Day 1, 5, 11 of Period 2 and, Week 12, 36, 48, and 52 of the extension period
Hamilton Psychiatric Rating Scale for Depression (HAM-D) Score
Time frame: Baseline at Period 1
Rosen Modified Hachinski Ischemic Score (RM/HIS10)
Time frame: Baseline at period 1
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50 mg hard gelatin capsule
St. Vincent's Hospital
Melbourne, Victoria, Australia