Psychosis Associated With Alzheimer's Disease
Conditions
Keywords
Alzheimer Disease, Brain Diseases, Central Nervous System Diseases, Delusions, Dementia, Hallucinations, Mental Disorders, Nervous System Diseases, Neurocognitive Disorders, Neurodegenerative Diseases, Psychotic Disorders, Schizophrenia Spectrum and Other Psychotic Disorders, Tauopathies, Muscarinic Antagonists, Muscarinic Agonists, Cholinergic Agents
Brief summary
ML-007C-MA-221 is a Phase 2, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of ML-007C-MA in male and female participants aged 55 to 90 years with hallucinations and delusions associated with Alzheimer's Disease Psychosis (ADP). The primary objective is to evaluate the efficacy of ML-007C-MA compared with placebo for the treatment of hallucinations and delusions associated with ADP as measured by the Neuropsychiatric Inventory-Clinician (NPI-C): Hallucinations and Delusions (H+D) score.
Interventions
DRUGML-007C-MA
ML-007C-MA dosed as 105/1.5 mg BID, or 210/3 mg BID
DRUGPlacebo
Placebo Tablets
Sponsors
MapLight Therapeutics
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
55 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Key Inclusion Criteria: 1. Willing and able to provide written informed consent, or, if deemed lacking in the capacity to provide informed consent, the following requirements for consent must be met: 1. The participant's LAR must provide written informed consent AND 2. The participant will provide informed assent. 2. Meets clinical criteria for Possible AD or Probable AD. 3. Presence of psychotic symptoms (meeting International Psychogeriatric Association criteria) (Cummings 2020) for at least 2 months before Screening. 4. Has resided at the same home, residential assisted living, or nursing home facility for a minimum of 6 weeks before Screening. 5. Has a designated care partner who is in contact with the participant frequently enough to accurately report on the participant's symptoms and adherence to study drug. 6. Has a NPI-C H+D score of ≥ 6 AND meet at least 1 of the following criteria: 1. Moderate to severe delusions, defined as NPI-C Delusions domain score of ≥ 2 on at least 2 of the 8 items OR 2. Moderate to severe hallucinations, defined as NPI-C Hallucinations domain score of ≥ 2 on at least 2 of the 7 items. 7. Has a (CGI)-S hallucinations and delusions domain-specific score ≥4 8. Has an Mini-mental State Examination (MMSE) score of 6 to 26, inclusive. Key
Exclusion criteria
1. Under the care of hospice, bed-bound, or receiving end-of-life palliative care. 2. Psychotic symptoms that are primarily attributable to substance abuse or a medical, neurological or psychiatric condition other than Alzheimer's disease. 3. Evidence of a CNS disorder other than Alzheimer's disease that is the primary cause of, or a significant contributor to the participant's dementia. 4. Moderate or severe major depressive episode within 3 months of Screening, according to DSM-5 criteria. 5. Has an elevated risk of suicidal behavior 6. Has had an amyloid PET brain scan or CSF Alzheimer's disease biomarker test in the past 3 years with results inconsistent with a diagnosis of AD. 7. Evidence of a clinically significant and/or unstable medical condition that, in the opinion of the investigator or medical monitor, could substantially impair cognition, compromise participant safety, interfere with the participant's ability to comply with study procedures or substantially impair the evaluation of efficacy or safety assessments. 8. Gastric retention, urinary retention or narrow-angle (angle-closure) glaucoma 9. Meets or has met DSM-5 criteria for alcohol or substance use disorder within the past 12 months (excluding caffeine and nicotine). 10. Has previously participated in any clinical study with ML-007 or ML-007C-MA. 11. Has developed an allergy or other intolerance to ML-007C-MA, its active ingredients or their excipients. 12. Received or may have received an investigational drug, biological product or device within 90 days before Baseline (or 6 months for investigational Alzheimer's disease-modifying therapies).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline to End of Treatment in the Neuropsychiatric Inventory-Clinician: Hallucinations and Delusions (NPI-C H+D) score | Baseline and End of Treatment (7 weeks) | NPI-C H+D scale includes 2 domains from the NPI-C scale, namely, hallucinations and delusions. These 2 domains include the following number of items to be rated by the clinician: Hallucinations, 7 items (maximum score = 21) and Delusions, 8 items (maximum score = 24). The maximum score for the NPI-C: H+D scale is 45. Higher scores on this scale indicate worse outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline to End of Treatment in the Clinical Global Impressions-Severity (CGI-S) hallucinations and delusions domain-specific score | Baseline and End of Treatment (7 weeks) | The CGI-S scale is a clinician-rated, 7-point scale that is designed to rate the severity of the participant's hallucinations and delusions using the investigator's judgment and past experience with participants who have Alzheimer's disease psychosis. Higher scores on this scale indicate worse outcomes. |
| Change from Baseline to End of Treatment in the Neuropsychiatric Inventory - Clinician Agitation and Aggression (NPI-C A+A) score in participants who have a CGI-S agitation/aggression domain-specific score of ≥4 at Baseline | Baseline and End of Treatment (7 weeks) | NPI-C A+A scale includes 2 domains from the NPI-C scale, namely, agitation and aggression. These 2 domains include the following number of items to be rated by the clinician: Agitation, 13 items (maximum score = 39), and Aggression, 8 items (maximum score = 24). The maximum score for the NPI-C A+A scale is 63. Higher scores on this scale indicate more severe symptoms of agitation and aggression. |
Countries
Argentina, Bulgaria, Canada, Czechia, France, Hungary, Italy, Poland, Portugal, Romania, Serbia, Slovakia, South Korea, United States
Contacts
CONTACTClinical Trials Contact Center
STUDY_DIRECTORMapLight Therapeutics
MapLight Therapeutics
Outcome results
None listed