Alzheimer's Disease
Conditions
Keywords
Alzheimer's Disease, Synapses, Cognition, Neuroprotection, Neurons, mGluR5
Brief summary
A Phase 1b Multiple Ascending Dose Study of the Safety and Tolerability of BMS-984923 in Healthy Older Adults and Patients with Alzheimer's Disease
Detailed description
This double-blind placebo-controlled study will be completed in 2 stages. The first stage will evaluate 10-days of BID dosing in four ascending dose cohorts in healthy older adults and Stage 2 will examine BMS-984923 dosed BID for 28 days at two dose levels in comparison to Placebo in participants with early AD. This research study will assess the safety and tolerability of multiple doses of BMS-984923 for the treatment of early Alzheimer's Disease (AD) and investigate the use of synaptic density, measured with positron emission tomography (PET), as an early marker of therapeutic response to treatments that target synapse restoration.
Interventions
DRUGBMS-984923
Capsules
DRUGPlacebo
Capsules
Sponsors
Yale University
National Institute on Aging (NIA)
Allyx Therapeutics
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
TRIPLE (Subject, Caregiver, Investigator)
Masking description
Placebo capsules
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Stage 1: 1. Men or women between the ages of 50 and 80 years, inclusive 2. No history of cognitive impairment 3. Capable of providing written informed consent and willing to comply with all study requirements and procedures 4. Participant is not pregnant, lactating, or of childbearing potential 1. Non-childbearing potential for women is defined as postmenopausal (last natural menses greater than 24 months prior; menopausal status will be documented with serum follicle-stimulating hormone (FSH) or documentation of bilateral tubal ligation or hysterectomy 2. Male participants who are sexually active with a woman of childbearing potential must agree to use condoms during the trial and for 3 months after the last dose unless the woman is using an acceptable means of birth control. Acceptable forms of birth control include abstinence, birth control pills, or any double combination of intrauterine device (IUD), male or female condom, diaphragm, sponge, and cervical cap. 3. Male participants must also agree not to donate sperm for 90 days after the last dose. 5. Montreal Cognitive Assessment (MOCA) \>25
Exclusion criteria
Stage 1: 1. Body mass index (BMI) \>38 kg/m2 or body weight \<50 kg. 2. Any significant neurologic disease, such as AD, Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities. 3. A current Diagnostic and Statistical Manual of Mental Disorders, Fifth revision (DSM V) diagnosis of active major depression, schizophrenia or bipolar disorder. Participants with depressive symptoms successfully managed by a stable dose of an antidepressant are allowed entry. 4. Positive urine drug screen for amphetamines, barbiturates, benzodiazepines, cocaine, opiates, tetrahydrocannabinol (THC), ethanol or cotinine (stable prescribed amphetamines or benzodiazepines for a non-exclusionary medical condition are permitted) or positive alcohol breathalyzer test 5. Current nicotine use or positive urine cotinine test. 6. History of alcohol or substance abuse or dependence within the past 2 years (DSM IV criteria). 7. Clinically significant or unstable medical condition, including uncontrolled hypertension, uncontrolled diabetes, or significant cardiac, pulmonary, renal, hepatic, endocrine, or other systemic disease in the opinion of the PI, may either put the participant at risk because of participation in the study, or influence the results, or the participant's ability to participate in the study. 8. Any disorder that could interfere with the absorption, distribution, metabolism or excretion of drugs (e.g., small bowel disease, Crohn's disease, celiac disease, or liver disease.) 9. Seropositive for human immunodeficiency virus (HIV). 10. History of acute/chronic hepatitis B or C and/or carriers of hepatitis B (seropositive for hepatitis B surface antigen \[HbsAg\] or anti-hepatitis C \[HCV\] antibody). 11. Use of psychoactive medications (typical neuroleptics, narcotic analgesics, antiparkinsonian medications, systemic corticosteroids, or medications with significant central anticholinergic activity) within 2 weeks or 5 half-lives (whichever is greater) prior to study drug administration and for the duration of the trial. 12. Use of medications with potential drug-drug interactions (see Appendix A for a list of these medications) within 2 weeks or 5 half-lives (whichever is greater) prior to study drug administration and for the duration of the trial. 13. Use of anticoagulants within 30 days or 5 half-lives (whichever is greater) prior to study drug administration and for the duration of the trial. 14. Use of another investigational agent within 30 days or 5 half-lives (whichever is greater) prior to screening and for the duration of the trial. 15. Neutropenia defined as absolute neutrophils count of \<1,500/microliter. 16. Thrombocytopenia defined as platelet count \<100,000/microliter. 17. Clinically significant abnormalities in screening laboratories, including aspartate aminotransferase (AST) \>1.5 times the upper limit of normal (ULN); alanine aminotransferase (ALT) \>1.5 times ULN; total bilirubin \>1.5 times ULN; serum creatinine \>2.0 times ULN. 18. Geriatric Depression Scale (GDS) score of ≥5 and symptoms consistent with a current episode of major depression. Inclusion Criteria Stage 2 1. Men or women between the ages of 50 and 85 years, inclusive, at the time of first dose of investigational product (IP). 2. Diagnosis of either amnestic mild cognitive impairment (aMCI) or mild dementia due to AD as defined by * Mild dementia due to AD * National Institute on Aging (NIA)-Alzheimer's Association core clinical criteria for dementia due to probable AD (McKhann 2011) and, * Mini Mental Status Exam (MMSE) score between 18 and 26 (inclusive) * Clinical Dementia Rating (CDR) global score of 0.5 or 1 * aMCI due to AD * Subjective memory complaint preferably corroborated by an informant and, * Normal activities of daily living * CDR global score of 0.5 * aMCI (Petersen 2004) as evidenced by abnormal memory function documented by scoring 1.5 SD below the education adjusted cutoff on the Logical Memory II subscale (Delayed Paragraph Recall) from the Wechsler Memory Scale - Revised (the maximum score is 25), and * 8 for 16 or more years of education * 4 for 8 15 years of education * 2 for 0 7 years of education 3. Stable pharmacological treatment of any other chronic conditions for at least 4 weeks prior to baseline. 4. Neuroimaging (MRI) obtained during screening consistent with the clinical diagnosis of AD as defined in Criteria 2 and without findings of significant exclusionary abnormalities (see Section 6.2.2,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stage 2 Incidence of clinically significant changes in safety assessments | Up to 10 days after last dose | Vital signs, physical exam, ECG, NPI Q, GDS, MOCA, and Functional Assessment Questionnaire \[FAQ\]) |
| Stage 1 and Stage 2 Incidence of treatment-emergent adverse events (TEAEs) | Up to 10 days after last dose | Safety |
| Stage 1 and Stage 2 Incidence of clinically significant lab abnormalities | Up to 10 days after last dose | Safety |
| Stage 1 Incidence of clinically significant changes in safety assessments | Up to 10 days after last dose | Vital signs, physical exam, electrocardiogram \[ECG\], Neuropsychiatric Inventory-Questionnaire \[NPI Q\], Geriatric Depression Scale \[GDS\], Glasgow Coma Scale \[GCS\], Montreal Cognitive Assessment \[MOCA\]) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stage 1 and Stage 2 Trough plasma drug concentration at steady state | Up to 10 days after last dose | plasma concentration as determined by pharmacokinetic modeling |
| Stage 1 and Stage 2 Area under the curve for the first 24 hours of dosing (AUC24h) and at steady state as determined by PK modeling | Up to 10 days after last dose | Total plasma concentration as determined by pharmacokinetic modeling |
| Stage 2 Change from baseline in synaptic density PET | Up to 24 hours after last dose | Pharmacodynamics |
| Stage 2 Change from baseline in Alzheimer's Disease Assessment Scale-Cognitive subscale 14 Score range of 0-90, with higher scores indicating greater cognitive impairment. | Up to 7 days after the last dose | Assessment of cognitive impairment. |
Countries
United States
Outcome results
None listed