1. Study Overview NeuroTherapia Inc. is conducting a clinical study to explore the safety and effects of a new drug called NTRX- 07. This drug targets people with mild cognitive impairment (MCI) or mild to moderate Alzheimer's disease (AD). The study's primary focus is on safety and how the drug interacts with the body over a short-term period of 28 days. This research is important as it aims to find new ways to manage symptoms and slow the progression of AD. 2. Key Objectives Primary Objective: * To assess the safety and tolerability of NTRX-07 in patients with AD. * Safety and tolerability will be measured by monitoring any side effects or adverse events in participants during and after the treatment period. Secondary Objective: * To study how NTRX-07 is processed by the body, including how it is absorbed, distributed, metabolized, and eliminated. * This includes measuring the drug levels in the blood and cerebrospinal fluid (CSF) over time. 3. Study Design • Type of Study: o A randomized, double-masked, placebo-controlled study. "Randomized" means participants are randomly assigned to receive either the actual drug (NTRX-07) or a placebo (an inactive substance). "Double-masked" indicates that neither the participants nor the researchers know who receives the real drug or the placebo, reducing bias and ensuring objective results. • Participants: * 48 individuals with MCI or mild to moderate AD. • Treatment Groups: * Participants will be split into two groups: 24 will receive NTRX-07, and 24 will receive a placebo. • Duration: * The study will last up to 7-10 weeks for each participant, including a 28-day period during which they take the drug or placebo daily. 4. Study Procedures • Screening Period: * Before starting the treatment, participants will undergo a screening period of up to 45 days. During this time, they will have tests to confirm their eligibility, including physical exams, blood tests, cognitive assessments, and brain imaging (MRI). • Treatment Period (28 days): * Participants will take the study drug or placebo daily for 28 days. During this period, they will visit the study center for evaluations, including safety checks, cognitive tests, blood and CSF sampling, and EEG tests (to measure brain activity). • Follow-Up: * After the treatment period, participants will have a follow-up visit 7 days later for final safety assessments. 5. Safety Monitoring and Assessments * The study's primary focus is on safety. Researchers will monitor participants closely for any adverse events, such as side effects, throughout the study. * Safety assessments will include monitoring vital signs (blood pressure, heart rate, temperature), conducting laboratory tests (blood and urine analysis), performing physical examinations, and using electrocardiograms (ECGs) to monitor heart health. 6. Exploratory Assessments • Although this study primarily focuses on safety, researchers will also conduct exploratory assessments to observe any potential positive effects of NTRX-07 on brain function and symptoms of AD. These will include: o Cognitive Testing: * Standard tests like the AD Assessment Scale-Cognitive Subscale (ADAS-cog) and the Mini-Mental State Examination (MMSE) will be used to evaluate any changes in cognitive function. o Brain Imaging: * MRI scans will help assess changes in brain structure and inflammation. o Biomarkers: * Blood and CSF samples will be analyzed for specific biomarkers related to inflammation, brain health, and AD progression. 7. Eligibility Criteria * Inclusion Criteria: * Individuals aged 65-88 with a confirmed diagnosis of MCI or mild to moderate AD. * Must have a caregiver who can assist with the study requirements. * Must be able to undergo specific procedures like MRI scans and CSF sampling. * Exclusion Criteria: * Individuals with other significant health conditions or history of neurological disorders other than AD. * Those currently participating in another clinical trial or have certain medication restrictions. 8. Importance of the Study AD is a progressive condition that affects memory, thinking, and behavior. Current treatments only manage symptoms temporarily, and there is an need for new therapies. NTRX-07 is a novel drug that has shown promise in animal studies, potentially reducing brain inflammation, clearing harmful proteins, and improving memory and learning. This study is an essential step toward understanding if NTRX-07 can offer a safe and effective treatment option for people with AD. 9. Summary This clinical trial is designed to test the safety and processing of a new drug, NTRX-07, in people with MCI or mild to moderate AD. Participants will be carefully monitored for any side effects while researchers also gather data on the drug's impact on brain function. If successful, this study could lead to more advanced trials and, ultimately, a new treatment option for those affected by AD.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
48
Neuro Health Centrum s.r.o.
Brno, Czechia
RECRUITINGNeuropsychiatrie s.r.o.
Prague, Czechia
RECRUITINGSemmelweis University
Budapest, Hungary
NOT_YET_RECRUITINGSemmelweis University
Budapest, Hungary
NOT_YET_RECRUITINGSzpital Uniwersytecki W Krakowie
Krakow, Poland
RECRUITINGWrocławskie Centrum Alzheimerowskie
Wroclaw, Poland
RECRUITINGAdverse event incidence in NTRX-07 treated participants
Incidence of adverse events during the trial, compared between the active treatment and placebo groups, through study completion, about 6 weeks.
Time frame: From date of randomization through final study visit, up to 6 weeks.
Plasma Pharmacokinetics of NTRX-07 - Area under the curve
Mean area under the curve determined by plasma levels from time zero to 10 hrs post-dose
Time frame: First day of dosing and Day 28
Plasma Pharmacokinetics of NTRX-07 - Maximum concentration
Mean Maximum concentration determined by plasma levels from time zero to to 10 hrs post-dose
Time frame: First day of dosing and Day 28
Cerebrospinal fluid Pharmacokinetics of NTRX-07 - concentration compared to simultaneous plasma levels
Mean ratio of CSF concentration to plasma levels at 90 minutes post-dose
Time frame: Day 28
Change in ADAS-cog in treated participants from baseline
Time frame: Baseline and Day 28
Change in MMSE in treated participants from baseline
Time frame: Baseline and day 28.
Change in Free-water by MRI in treated participants
Free water determined by MRI as a measure of neuroinflammation
Time frame: Baseline and last day of dosing + up to 5 days
Change in Cortical Disarray Measurement (CDM) determined by MRI in treated subjects
Cortical Disarray Measurement as measure of neuronal interconnectivity
Time frame: Baseline and last day of dosing + up to 5 days
Change in Quantitative EEG in treated participants
32 lead EEG; absolute power and relative power in the different frequency bands, 10 min eyes shut followed by 10 min eyes open. EEG processing involves the computation of the spectra of artifact-free segments. The Hanning window is used, and the FFT algorithm is analyzed using Matlab scripts. The AUC of spectrum segments provides estimations of power in each frequency band of interest. Absolute powers and relative powers are provided for each band. For each band, relative power is the absolute power divided by the power of the total band.
Time frame: Baseline and Day 28
Change in Quantitative EEG p-300 evoked response in treated participants
The P300 wave is an evoked potential that reflects the decision-making process in the cerebral cortex in a situation of cognitive task. It is obtained by repeated stimulations with two types of auditory stimuli: a group of stimuli constituting the background (stimuli called "standard" or "frequent"), against different stimuli which are less frequent (stimuli named "odd" or "rare" or "deviant"). The P300 wave is characterized by a positive deflection occurring approximately 300 ms after odd stimuli. The standard stimulus is a 500Hz sound, and the oddball stimulus is a 2000Hz sound. Stimuli are presented through calibrated headphone in a pseudo randomized order. The inter-stimulus interval is randomized between 1200 and 1900ms to avoid anticipation. Oddball makes up 15% of presentations.
Time frame: Baseline and Day 28
Change in Plasma biomarkers in treated participants
High-sensitivity C-Reactive Protein (hsCRP), HbA1, erythrocyte sedimentation rate (ESR), TNF-a, IL-1b, IL-6, IL-2, YKL- 40, sTREM2, Abeta40, Abeta42, ptau217
Time frame: Baseline and Day 28
Change in CSF biomarkers in treated participants
TNF-a, IL-1b, IL-6, IL-2, YKL- 40, sTREM2, Abeta40, Abeta42, ptau217, Neurogranin, synaptotagmin-1, NfL, GFAP
Time frame: Baseline and Day 28
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