Alzheimer's Disease
Conditions
Keywords
anti-PD-L1 monoclonal antibody, IBC-Ab002, early Alzheimer's Disease
Brief summary
This is a randomized, double-blind, placebo-controlled first-in-human, Phase 1, safety, tolerability, pharmacokinetic (PK) and preliminary exploratory activity study of escalating multiple intravenous (IV) doses of IBC-Ab002 in persons with early Alzheimer's disease. The study will have both Single- and Multiple-Ascending Dose components.
Detailed description
Subjects in 5 sequential cohorts of 8 subjects each will be assigned in a 3:1 ratio to receive either IBC-Ab002 or matching placebo 4 times. Part A will be a single-ascending dose study and Part B will be a multiple ascending dose study. The two parts of the study will be intercalated such that subjects will be dosed once every 12 weeks. However, repeated dosing at any dose level will not begin until the anticipated cumulative dose for that cohort has been equaled or exceeded in Part A and/or B of the study, and appropriate safety review of data from all preceding doses in prior subjects has taken place. All subjects randomized into Part A of the study will automatically continue into Part B unless dosing is halted at the individual or group level due to safety or other concerns.
Interventions
BIOLOGICALIBC-Ab002
An anti-PD-L1 monoclonal antibody
OTHERPlacebo
Normal Saline
Sponsors
Immunobrain Checkpoint
National Institute on Aging (NIA)
Alzheimer's Association
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
Within each cohort subjects are randomized to either active investigational product or placebo in a ratio 3:1
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Diagnosis of early Alzheimer's disease based on the National Institute on Aging and Alzheimer's Association) (NIA-AA Research Framework criteria, regardless of apolipoprotein E (APOE) gene status. 2. Able to speak, read and write the local language fluently. 3. With respect to symptomatic treatment for Alzheimer's disease, subjects should either be not treated with any approved treatments for AD or stabilized on approved medication(s) other than anti-Ab antibodies for the treatment of AD for at least 3 months prior to Baseline. 4. Subject has a study partner who spends at least 10 hours/week with the subject, and can attend all visits with the subject, report accurately on the subject's status, and ensure compliance with all study requirements 5. Subject and study partner must each independently be able to understand the study requirements and provide informed consent
Exclusion criteria
1. Females who are not postmenopausal at Screening as defined by amenorrhea for at least 12 consecutive months or who have not been sterilized surgically (i.e. bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all with surgery at least 1 month before Screening) 2. Other than Alzheimer's disease, any neurologic or medical disorder which may impair cognition. 3. Any contra-indication to undergo magnetic resonance imaging (MRI). 4. Severe vision or hearing impairment that would prevent the subject from performing psychometric tests or otherwise complying with requirements for study participation and activities. 5. History of certain neurological, psychiatric or medical conditions including autoimmune diseases. 6. Clinically significant laboratory or electrocardiogram (ECG) abnormalities 7. Presence of contraindication to lumbar puncture (LP) including taking anticoagulant or antiplatelet medications other than aspirin at a dose of ≤ 100 mg/day or clopidogrel. 8. Taking any of the following medications. 1. Immunosuppressant medications, including chronic systemic corticosteroids (chronic use of topical steroids is allowed) 2. Injected or infused antibody therapies, including but not limited to antibodies directed against tumor necrosis factor (TNF), anti-interleukin-6 (anti-IL-6), natalizumab, rituximab and similar agents 3. Aducanumab, (aducanumab-avwa) intravenous injection (brand name: Aduhelm™), or any other experimental or approved anti-amyloid antibody 4. Insulin 5. Anticoagulant or anti-platelet medications including warfarin, heparinoids and direct coagulation factor inhibitors (e.g. apixaban, dabigatran, rivaroxaban) within 90 days of the planned first dose of study drug; either aspirin at a dose of \< 100 mg/day or clopidogrel at a dose of 75 mg/day, but not both in combination is permitted 9. Participation in any other interventional clinical trial, or treatment with any investigational drug or investigational use of an approved therapy, within 30 days or 5 half-lives of such agent, whichever is longer, prior to the first Screening visit 10. Subject currently smokes more than 5 cigarettes or equivalent tobacco consumption daily 11. Regular nonmedical use of cannabis or cannabis products unless such products are documented by the manufacturer's label not to contain tetrahydrocannabinol or its derivatives or analogs 12. History of drug (including cannabis) or alcohol abuse within the last 5 years 13. Positive urine drug test for drugs of abuse at Screening. Subjects who test positive for benzodiazepines or opioids in urine drug testing need not be excluded if in the clinical opinion of the investigator, this is due to the subject taking prior/concomitant medications containing benzodiazepines or opioids for a medical condition and not due to drug abuse 14. Subjects who answer "yes" to Columbia Suicidality Rating Scale (C-SSRS) suicidal ideation Type 4 or 5, or any suicidal behavior assessment within 6 months before Screening, at Screening, or has been hospitalized or treated for suicidal behavior in the past 5 years before Screening 15. Unwillingness to comply with study requirements or history of noncompliance in prior clinical trials
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Subjects With Adverse Events, Serious Adverse Events | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome |
| Number of Subjects With Clinically Significant Changes in Hematology Parameters | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome - complete blood count, white blood cells, red blood cells, platelets, hematocrit, mean corpuscular hemoglobin (MCH), neutrophiles percent, neutrophiles absolute, lymphocytes percent, lymphocytes absolute, monocytes percent, monocytes absolute, eosinophils percent, eosinophils absolute, basophils percent, basophils absolute, mean platelet volume. |
| Number of Subjects With Clinically Significant Changes in Biochemistry Parameters | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome - sodium, potassium, calcium, phosphorus, glucose, alanine aminotransferase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), bilirubin, creatine, albumin, total protein, amylase, total cholesterol, triglycerides, thyroid function tests (T3, T4, TSH), coagulation panel International normalized ratio (INR) and partial thromboplastin time (PTT). |
| Number of Subjects With Clinically Significant Changes in Urinalysis Parameters | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome - protein, nitrates, glucose, specific gravity, ketones, urobilinogen, bilirubin, pH, hemoglobin. |
| Number of Subjects With Clinically Significant Changes in Vital Signs | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety outcome - weight, heart rate, respiratory rate, body temperature, systolic and diastolic blood pressure. |
| Number of Subjects With Clinically Significant Changes in Physical Examination | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome |
| Number of Subjects With Clinically Significant Changes in Electrocardiogram (ECG) | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome |
| Number of Subjects With Development of New Abnormalities on Brain MRI | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome - lacunar infarcts, territorial infarct, macroscopic hemorrhage, deep white matter lesions, cerebral contusion, encephalomalacia, infective lesion, aneurysm or vascular malformation, intraparenchymal tumor, meningioma or arachnoid cyst, inflammation, edema. |
| Number of Subjects With Increased Suicidality (C-SSRS) | From first dose (Day 1) through end of follow-up visit (Week 48) | Safety Outcome - measured using Columbia Suicidality Rating Scale. Part 1 of the scale (Suicidal Ideation) is comprised of 5 yes/no questions with "yes" indicating suicidal ideation and "no" indicating no suicidal ideation. Part 2 of the scale (Intensity of Ideation) is comprised of 5 items which should be rated with respect to the most severe type if ideation (with 5 being the most severe intensity and 1 being the least intensity). Part 3 of thee scale (Suicidal Behavior) is comprised of 5 yes/no items with "yes" indicating suicidal behavior and "no" indicating no suicidal behavior. Part 4 of the scale (Actual Attempts) is comprised of 2 items which should be rated with respect to the most severe outcome of the suicide attempt (with the highest score indicating the most severe outcome and 0 indicating no harm). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| IBC-Ab002 Levels in Serum (PK Parameters: Cmax) | Pre-dose and up to Day 84 post-dose | Pharmacokinetic Outcome - Area under the concentration-time curve from time zero to infinity, area under the concentration-time curve from time zero to the time of the last measurable sample, maximum observed concentration, time to reach maximum observed concentration, terminal elimination half-life, clearance, volume of distribution. |
| IBC-Ab002 Levels in Serum (PK Parameters: CL) | Pre-dose and up to Day 84 post-dose | Pharmacokinetic Outcome - Area under the concentration-time curve from time zero to infinity, area under the concentration-time curve from time zero to the time of the last measurable sample, maximum observed concentration, time to reach maximum observed concentration, terminal elimination half-life, clearance, volume of distribution. |
| IBC-Ab002 Levels in Serum (PK Parameters: AUC) | Pre-dose and up to Day 84 post-dose | Pharmacokinetic Outcome - Area under the concentration-time curve from time zero to infinity, area under the concentration-time curve from time zero to the time of the last measurable sample, maximum observed concentration, time to reach maximum observed concentration, terminal elimination half-life, clearance, volume of distribution. |
| IBC-Ab002 Levels in Serum (PK Parameters: Vd) | Pre-dose and up to Day 84 post-dose | Pharmacokinetic Outcome - Area under the concentration-time curve from time zero to infinity, area under the concentration-time curve from time zero to the time of the last measurable sample, maximum observed concentration, time to reach maximum observed concentration, terminal elimination half-life, clearance, volume of distribution. |
| Number of Subjects With Positive Serum Anti-IBC-Ab002 Antibodies (ADA) | From first dose (Day 1) through end of follow-up visit (Week 48) | Serological Outcome - Number of participants with positive serum anti-IBC-Ab002 antibodies (ADA), summarized by arm. |
Countries
Israel, Netherlands, United Kingdom
Contacts
STUDY_DIRECTORTommaso Croese, MD
Immunobrain Checkpoint
PRINCIPAL_INVESTIGATORCatherine Mummery, MD
Dementia Research Centre, UCL, London
Participant flow
Recruitment details
Participants were enrolled at 10 of 11 study centers across the United Kingdom, Netherlands, and Israel. The first participant was screened on March 02, 2023 and the last participant's last visit was on December 16, 2025.
Pre-assignment details
Of the 75 screened participants, 40 participants were treated after being randomly assigned (3:1) to receive either IBC-Ab002 or matching placebo 4 times in one of the 5 dose level cohorts (Cohorts 1 to 5). IBC-Ab002/placebo was administered IV, with an interval of 12 weeks (once every 12 weeks \[Q12W\]) between doses.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 69.1 years STANDARD_DEVIATION 7.6 |
| Body Mass Index (BMI) | 22.44 kg/m^2 STANDARD_DEVIATION 1.27 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 39 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 37 Participants |
| Sex: Female, Male Female | 4 Participants |
| Sex: Female, Male Male | 2 Participants |
| Weight | 69.57 kg STANDARD_DEVIATION 14.05 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk |
|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 6 | 0 / 6 | 0 / 6 | 0 / 6 | 0 / 6 | 0 / 10 |
| other Total, other adverse events | 6 / 6 | 6 / 6 | 6 / 6 | 6 / 6 | 6 / 6 | 10 / 10 |
| serious Total, serious adverse events | 0 / 6 | 0 / 6 | 0 / 6 | 1 / 6 | 0 / 6 | 2 / 10 |
Outcome results
None listed