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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03830762
Registration number
NCT03830762
Ethics application status
Date submitted
23/01/2019
Date registered
5/02/2019
Titles & IDs
Public title
Xanamemâ„¢ in Healthy Elderly Subjects
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Scientific title
XanaHES: A Phase I, Single Blinded, Central Reader Blinded, Placebo-Controlled, Dose Escalation Study of Xanamemâ„¢ to Assess Safety and Tolerability in Healthy Elderly Subjects
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Secondary ID [1]
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ACW0003
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Universal Trial Number (UTN)
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Trial acronym
XanaHES
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Safety
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Peripheral Neuropathy
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Cortisol
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Central Nervous System
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Cognitive Function
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Healthy Ageing
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Small Fibre Neuropathy
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Cerebrospinal Fluid
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Electrocardiography
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Condition category
Condition code
Neurological
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Xanamem
Treatment: Drugs - Matching Placebo
Experimental: Cohort 1 / Cohort 2 (Active) - 20mg or 30mg capsules of Xanamem respectively, to be administered PO once daily.
Placebo comparator: Cohort 1 / Cohort 2 (Placebo) - Matching placebo which is identical in appearance to the test product except that it contains no active ingredient, to be administered once daily.
Treatment: Drugs: Xanamem
Oral Xanamem capsules 20mg or 30mg, administered PO once daily. Xanamem is formulated in green and cream coloured size 3, Coni-Snap shaped gelatin capsules as an excipient blend at a dose of 10mg. It contains active pharmaceutical ingredient of UE2343.
Treatment: Drugs: Matching Placebo
Matching placebo which is identical in appearance to the test product (20mg, 30mg Xanamemâ„¢ QD) except that it contains no active ingredient.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Incidence of Treatment-Emergent Adverse Events (AEs)
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Assessment method [1]
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The number, type, and severity of treatment-emergent adverse events (AEs) that are reported from Screening Visit to Follow-up Visit will be collected and evaluated.
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Timepoint [1]
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20 Weeks (Screening up to Week 16 Follow-Up [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Primary outcome [2]
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Incidence of Clinically Significant Changes in Serum Biomarker Levels in a Standard Serum Chemistry Panel
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Assessment method [2]
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Collection of blood samples for clinical laboratory testing to assess any clinically significant changes in standard serum chemistry measures.
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Timepoint [2]
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Screening up to Week 16 (Follow-Up [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Primary outcome [3]
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Incidence of Clinically Significant Laboratory Haematological Biomarker Levels in a Standard Haematology Panel.
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Assessment method [3]
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Collection of blood samples for clinical laboratory testing to assess any clinically significant changes in standard haematology measures.
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Timepoint [3]
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Screening up to Week 16 (Follow-Up [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Primary outcome [4]
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Incidence of Clinically Significant Changes or Abnormalities Following Physical Examination
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Assessment method [4]
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Evaluation of any clinically significant changes or abnormalities reported following a standard Physical Examination.
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Timepoint [4]
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Screening up to Week 16 (Follow-Up) and Unscheduled Safety Visit throughout duration of study up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Primary outcome [5]
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Nerve Conduction Assessments
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Assessment method [5]
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Nerve Conduction assessments will be used to detect presence and severity of nerve damage.
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Timepoint [5]
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Screening up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Primary outcome [6]
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Neuropathy Total Symptom Score-6 (NTSS-6)
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Assessment method [6]
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Changes in the Neuropathy Total Symptom Score (NTSS-6) administered by a physician to assess a subjects' medical history. Each item will also be graded for its frequency and intensity, adding up to a total score from "0" to "21.96" points. A total score of \> 6 would exclude the subject from the study.
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Timepoint [6]
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Screening, Week 2, Week 4, Week 8, Week 12 (End of Treatment), Week 16 (Follow-Up) and Telephone Contact (Ad Hoc)
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Primary outcome [7]
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Toronto Clinical Neuropathy Score (TCNS)
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Assessment method [7]
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Changes in Toronto Clinical Neuropathy Score (TCNS) to detect for neuropathy out of a total score of 19; scales are defined as follows: 0-5 = no neuropathy; 6-8 = mild neuropathy; 9-11 = moderate neuropathy; = 12 = severe neuropathy.
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Timepoint [7]
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Screening, Week 2, Week 4, Week 8, Week 12 (End of Treatment), Week 16 (Follow-Up) and Telephone Contact (Ad Hoc)
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Primary outcome [8]
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Skin Biopsy
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Assessment method [8]
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A 3mm skin sample will be taken via skin punch biopsy to detect intra-epidermal nerve fiber density; this allows for the objectification and quantification of a small-fiber neuropathy.
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Timepoint [8]
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At Baseline and Week 12 (End of Treatment)
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Primary outcome [9]
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Quantitative Sensory Testing (QST)
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Assessment method [9]
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Thermal sensory testing using Quantitative Sensory Testing (QST) for cold, warm and heat pain to detect peripheral nerve disorders.
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Timepoint [9]
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Screening up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Primary outcome [10]
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Columbia Suicide Severity Rating Scale (CSSRS)
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Assessment method [10]
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Any change in Columbia Suicide Severity Rating Scale (CSSRS) will assess suicidal ideation and behaviour.
* Suicidal ideation score: Any score greater than 0 is important and may indicate the need for mental health intervention.
* Suicidal ideation intensity rating: The five intensity item scores create a total score (range 0 to 25) to represent the intensity rating, if the patient did not endorse any suicidal ideation the intensity rating is 0.
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Timepoint [10]
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Screening, Baseline, Week 2, Week 4, Week 8, Week 12 (End of Treatment), Week 16 (Follow-Up)
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Primary outcome [11]
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Electrocardiogram (ECG)
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Assessment method [11]
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Any clinically significant electrocardiogram (ECG) abnormalities will be recorded, including corrected QT interval (QTc) of \> 500 msec.
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Timepoint [11]
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Screening up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])
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Eligibility
Key inclusion criteria
1. Volunteers aged 50 to 75 years.
2. Female subjects:
1. Post-menopausal women, defined as no menses for 12 months without an alternative medical cause. If there is any concern about the menopausal status of a prospective female subject, a follicle stimulating hormone test (FSH) should be requested to confirm post-menopausal status. Post-menopausal women confirmed by FSH level > 40 mIU/mL, will be confirmed by the local laboratory.
2. Women of childbearing potential (WOCBP) must have a negative pregnancy test.
3. Male Subjects:
1. Who are sexually active, fertile men must use highly effective methods of contraception from Day 1 until 3 months after last dose of study drug if their partners are WOCBP
2. Who are permanently sterile or have had bilateral orchiectomy or bilateral vasectomy.
4. No disease which may cause a peripheral neuropathy.
5. No evidence of alcohol abuse (defined as greater than 21 standard units per week for males and greater than 14 standard units per week for females).
6. Must provide written informed consent to participate in the study and be willing and able to participate for the maximum of 12 weeks of treatment and 16 weeks of site visits.
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Minimum age
50
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Clinically significant abnormalities in vital signs (blood pressure, heart rate, respiration rate and oral temperature), as determined by the investigator.
2. Body Mass Index (BMI) > 38 kg/m2
3. Clinically significant abnormal haematology, biochemistry and urine examination values, as determined by the investigator.
4. Participants who have a history of liver disease, including fatty liver, or LFT elevations requiring investigation will not be eligible.
5. Has had a significant systemic illness or infection within the past 4 weeks prior to randomisation, as determined by the investigator.
6. Documented diagnosis of Type I or Type II diabetes.
7. Has a history of disease directly related to the hypothalamus, the pituitary and/or the adrenal glands which affects the hypothalamic-pituitary-adrenal axis function.
8. Has any uncontrolled clinical condition relating to glucose or lipid metabolism.
9. Subjects with clinical evidence of peripheral neuropathy or historical evidence of clinically significant nerve conduction abnormalities. Clinical evidence of neuropathy.
10. Clinically significant electrocardiogram (ECG) abnormalities, including QTc interval > 450 msec (male) and > 470 msec (female), following ECG tracings at Screening.
11. Use of any prohibited medication.
12. Participation in another clinical study of a drug or device whereby the last investigational drug/device administration is within 60 days of Screening.
13. Inability to communicate well with the investigator (i.e. language problem, non-fluent English [as questionnaires and study drug label will be provided in English only], poor mental development or impaired cerebral function).
14. Subject will undergo the Columbia Suicide Severity Rating Scale (CSSRS), Toronto Clinical Neuropathy Score (TCNS), EuroQoL Health Related Quality of Life - 5 Dimensions - 5 Levels (EQ-5D-5L), and Cogstate Test Battery at the indicated time-points to avoid uncontrolled learning effects. Subjects who need to perform these tests externally to and in parallel with this study will be excluded.
15. For subjects that consent, and are subsequently accepted for enrolled into, the CSF optional sub-study, subjects must have no contraindications to the lumbar puncture procedure as assessed by the Principal Investigator. Such contraindications may include uncontrolled bleeding abnormalities or skin or spine abnormalities.
16. Positive testing for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or hepatitis C antibodies (HCV). Subjects returning a positive result will be managed by the site in line with standard care.
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Study design
Purpose of the study
Other
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
21/01/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
7/01/2020
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Sample size
Target
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Accrual to date
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Final
42
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Linear Clinical Research - Perth
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Recruitment postcode(s) [1]
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6009 - Perth
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Actinogen Medical
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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ICON plc
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Xanamemâ„¢ is being developed as a potential drug for Alzheimer's disease. This study drug has been designed to change the cortisol levels in the brain. Cortisol is a naturally occurring hormone in the body. It is believed that reducing the level of cortisol will be a benefit in the treatment of Alzheimer's disease. The XanaHES study is testing the safety and tolerability of Xanamem. It is planned to enrol approximately 84 participants, male and female aged from 50 to 75 who are in good health, in the study at 1 centre in Australia. The XanaHES Phase I study is a single-blind study. Subjects will be randomised to receive either 20mg once daily Xanamem or Placebo in cohort 1. Once all subjects have completed the study treatment of 12 weeks, a dose escalation committee will decide if a new cohort, cohort 2, with 30mg once daily vs placebo is started.
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Trial website
https://clinicaltrials.gov/study/NCT03830762
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Trial related presentations / publications
Webster SP, McBride A, Binnie M, Sooy K, Seckl JR, Andrew R, Pallin TD, Hunt HJ, Perrior TR, Ruffles VS, Ketelbey JW, Boyd A, Walker BR. Selection and early clinical evaluation of the brain-penetrant 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) inhibitor UE2343 (Xanamem). Br J Pharmacol. 2017 Mar;174(5):396-408. doi: 10.1111/bph.13699. Epub 2017 Jan 25.
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Public notes
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Contacts
Principal investigator
Name
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Bill Ketelbey, MD
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Address
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Actinogen Medical
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03830762