The study is designed as a classic, randomized, double blind, placebo controlled, parallel group study including one active dose of PU AD and matching placebo, designed to assess safety, tolerability and pharmacological effects of oral PU AD (dihydrochloride salt) in subjects with mild AD
This is a multicenter, randomized, double blind, placebo controlled, parallel group Phase 2A study with one active dose of PU AD and matching placebo, once daily (qd), designed to assess safety, tolerability and pharmacological effects of oral PU AD (dihydrochloride salt) in subjects with mild AD. This study will be performed at up to 50 clinical sites in the US and approximately 150 subjects are expected to participate in this study, with 75 subjects in each treatment arm randomized 1:1. Subjects with mild AD meeting all inclusion criteria and none of the exclusion criteria are eligible to participate in this study. The study consists of a Screening Period (including Pre treatment) (4 weeks), Treatment Period (24 weeks), and a safety Follow up visit (within 30 days \[±7 days\] after the last dose of IMP). The expected study duration is 24 Months. The Screening Visit and Pre treatment Visit will take place within 4 weeks of dosing to assess eligibility of subjects. Enrolled subjects will return to the site for randomization and baseline assessments at Week 1. Subjects will be randomized with a 1:1 ratio to one of two treatment arms: 30 mg PU AD or matching 30 mg placebo qd. During the 24 Week Treatment Period, subjects will be administered 30 mg PU AD or matching 30 mg placebo qd, orally. According to investigator's clinical judgement, subjects experiencing intolerable AEs, if medically necessary, may be allowed to adjust the dose regimen from 30 mg qd to 30 mg every other day (qod), with approval by the medical monitor. If patients still cannot tolerate the adjusted dose regimen, the investigator must discuss early termination with the medical monitor. Subjects will return to the site at Week 2, Week 4, Week 6, Week 12, Week 18, and Week 24 for study assessments as specified PK sampling time points are specified in and will support a population PK model. . Any subject who discontinues prior to completion of the study, and reached 12 weeks of treatment should have all scheduled assessments of the Week 24/Early Termination (ET) Visit completed. All subjects will return to the site for a Follow up Visit, within 30 days (±7 days) after the last dose of study for safety assessments at the Week 28/End of Study (EoS) Visit
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
4
Tau PET imaging enables the longitudinal assessment of the spatial pattern of tau deposition. Tau accumulates with progression of AD dementia and may be sensitive to disease related changes, particularly those due to intervention with a drug thought to work through a tau related mechanism. Quantitative assessments will be utilized to evaluate the target engagement and pharmacological effects of PU-AD after 6 months of treatment
Measurement of neuronal function with FDG PET can help to understand the relationship between target engagement and potential clinical effects. FDG PET will be acquired using stringent quality control. Since glucose metabolism captures all neuronal activity, in order to isolate effects due to treatment, patients will be maintained in a consistent state during the tracer uptake period. Subject motion during image acquisition will be minimized and monitored. Images will be quality controlled, processed, and measured quantitatively using methods that maximize signal to noise associated with technical and physiologic variability
SFM Clinical Research, LLC
Boca Raton, Florida, United States
Brain Matters Research
Delray Beach, Florida, United States
JEM Research
Lake Worth, Florida, United States
Fluorodeoxyglucose Positron emission tomography (FDG-PET)
Change from baseline in pharmacologic parameters over 6 months for FDG-PET measurements
Time frame: 6 months
incidence and severity of Adverse Events (AEs), serious adverse events (SAEs)
safety and tolerability, assessed by incidence and severity of AEs, SAEs, and AE's leading to withdrawal of treatment during the course of the study
Time frame: 6 months
Tau Positron emission tomography (Tau PET )standardized uptake value ratio (SUVR)
Change from baseline in pharmacologic parameters over 6 months measurements
Time frame: 6 months
Ratio of p-Tau to t-tau in Cerebrospinal fluid (CSF)
Change from baseline in pharmacologic parameters over 6 months using Ratio of p-Tau to t-tau in Cerebrospinal fluid (CSF)
Time frame: 6 months
Alzheimer's Disease composite score (ADCOMS)
Change from baseline in pharmacologic parameters over 6 months using ADCOMS scales
Time frame: 6 months
Global Statistical Test (GST) combining Alzheimer's Disease Assessment Scale Cognitive (ADAS-Cog), Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL), and Clinical Dementia Rating Sum of Boxes (CDR-sb)
Change from baseline in pharmacologic parameters over 6 months using Global Statistical Test (GST) combining Alzheimer's Disease Assessment Scale Cognitive (ADAS-Cog), Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL), and Clinical Dementia Rating Sum of Boxes (CDR-sb)
Time frame: 6 months
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A broad set of biomarkers are being assessed in this study to indicate whether this treatment is able to impact multiple pathways associated with AD related to neurodegeneration
Changes in blood biomarkers may be observable if treatment affects cerebral amyloidosis and loss of nerve cells
Alzheimer's Disease composite score (ADCOMS+), CDR sb, Alzheimer's Disease Assessment Scale Cognitive (ADAS cog), Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS ADL), Mini Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale Cognitive (ADAS-COG 12)
PU-AD 30mg daily for 6mos
Placebo 30mg daily for 6mos
Med-Care Research
Miami, Florida, United States
Miami Dade Medical Research Institute, LLC
Miami, Florida, United States
Neurostudies, Inc
Port Charlotte, Florida, United States
Premiere Research Institute
West Palm Beach, Florida, United States
Conquest Research LLC
Winter Park, Florida, United States
Advanced Clinical Institute, Inc.
Neptune City, New Jersey, United States
Princeton Medical Institute
Princeton, New Jersey, United States
Pharmacokinetic (PK)
PK of PU-AD in this population
Time frame: 6 months