Status and phase
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About
This study is a Phase 2b/3 clinical trial of a new candidate drug (T3D-959) to treat patients with mild-to-moderate Alzheimer's. The aims of the trial are to affirm potential therapeutic efficacy and safety observed in earlier clinical trials and assess the potential to modify the course of disease. The drug will be compared to placebo and administered orally to patients once a day for 78 weeks.
Full description
This study is a randomized, double-blind, placebo-controlled study of T3D-959 30mg in subjects with clinical mild-to-moderate Alzheimer's Disease and a biological diagnosis of AD pathology, as defined by a validated plasma biomarker (presently %p-tau217 plasma biomarker). This study is designed as a seamless group sequential design where estimates of treatment effect on cognitive and functional scales will be evaluated in an interim analysis by independent statisticians. The sample size will be re-estimated to ensure the study is sufficiently powered to demonstrate efficacy of T3D-959 in cognition and function.
Subjects will be assigned to one of two treatment arms (1:1 ratio) in a randomized, double-blind fashion, stratified by sex and ApoE4 genotype. Study medication will be taken once daily for 78 weeks. Safety/tolerability, efficacy and exploratory assessments will be evaluated for changes from baseline to end of treatment (78 weeks). Subjects will be followed for four weeks after the end of treatment.
Enrollment
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Inclusion criteria
Exclusion criteria
Subject has a current diagnosis of a significant psychiatric illness per the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) including but not limited to major depressive disorder, anxiety disorders and is in an acute phase/episode; or the subject has a current diagnosis or history of schizophrenia or bipolar disorder; or has current signs of suicidality or history of suicide attempt
Subject with untreated clinical depression at screening; Geriatric Depression Scale (GDS) Short Form > 9
Evidence of clinically significant lesion(s) on brain MRI at Screening that could indicate a dementia diagnosis other than Alzheimer's disease
Other significant pathological findings on brain MRI at screening, including but not limited to: more than 4 microhemorrhages (defined as 10 millimeter [mm] or less at the greatest diameter); a single macrohemorrhage >10 mm at greatest diameter; an area of superficial siderosis; evidence of vasogenic edema; evidence of cerebral contusion, encephalomalacia, aneurysms, vascular malformations, or infective lesions; evidence of multiple lacunar infarcts or stroke involving a major vascular territory, severe small vessel, or white matter disease; space occupying lesions; or brain tumors (however, lesions diagnosed as meningiomas or arachnoid cysts and <1 centimeter [cm] at their greatest diameter need not be exclusionary)
Subject has a current diagnosis of a neurological disease other than AD, which has or could result in cognitive impairment, including, but not limited to, any of the following:
With glycosylated hemoglobin (HbA1c) ≥ 10 at screening
Subject with a diagnosis of unstable diabetes
Subject with clinically significant thyroid disease at screening TSH >5 and abnormal T3/T4
Subject has any evidence of hepatic impairment or renal insufficiency, including any of the following values at the screening visit:
Subject is positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibodies at the screening visit
Subject has a history of moderate or severe congestive heart failure, NYHA class III or IV, within 12 months prior to baseline
Subject has experienced a previous cardiovascular event (myocardial infarct, by-pass surgery, or PTCA) within the past 6 months prior to the baseline (visit 2)
Subject has blood pressure reading at screening that is greater than 160/100 mmHg. Subjects with elevated BP will be allowed at the discretion of the principal investigator. Blood pressure will be measured after the subject has been supine for at least 5 minutes followed by repeat measurement after standing for at least 3 minutes. Subjects will be excluded if a significant diastolic (15 mmHg) drop in blood pressure or symptomatic presyncope occurred
Subject has a clinically significant unstable illness, for example hepatic impairment or renal insufficiency, or cardiovascular, pulmonary, gastrointestinal, endocrine, rheumatological, immunological, infection, skin and subcutaneous tissue disorder or metabolic disturbance
Subject has a history of HIV infection
Subject has a history of marijuana abuse or dependence (except topical CBD) within 1 year of the screening visit
Subject has a history of alcohol, drug abuse or dependence (except nicotine dependence) within 2 years of the screening visit
Subject has a history of cancer within 5 years of the screening visit (other than non-melanoma skin cancer, stable non-progressive prostate cancer not requiring treatment or in situ cervical cancer)
Subject has any surgical or medical condition which may significantly alter the absorption of any drug substance including, but not limited to, any of the following:
Female subject who is pregnant, nursing or of childbearing potential and not practicing effective contraception
Subject is required to take excluded medications as specified in the Excluded Medications section below.
Subject has a known or suspected intolerance or hypersensitivity to the study drug, closely related compounds, or any of their stated ingredients
Subject resides in hospital or moderate to high dependency continuous care facility
Evidence of clinically relevant pathology that in the investigator's opinion could interfere with the study results or put the subject's safety at risk
Primary purpose
Allocation
Interventional model
Masking
376 participants in 2 patient groups, including a placebo group
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Central trial contact
Blake E Swearingen, MS; John Didsbury, Ph.D., Chief Executive Officer
Data sourced from clinicaltrials.gov
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