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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03943264
Registration number
NCT03943264
Ethics application status
Date submitted
26/04/2019
Date registered
9/05/2019
Titles & IDs
Public title
A Biomarker-directed Study of XPro1595 in Patients With Alzheimer's
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Scientific title
Phase 1b Open-Label, Dose-Identification Study of XPro1595 in Patients With Alzheimer's Disease and Biomarkers of Inflammation.
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Secondary ID [1]
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18PTC-R-592167
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Secondary ID [2]
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XPRO1595-AD
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Alzheimer Disease
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Condition category
Condition code
Neurological
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Alzheimer's disease
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Neurological
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Dementias
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - XPro1595
Experimental: 0.3 mg/kg XPro1595 - 0.3 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 12 weeks.
Experimental: 0.6 mg/kg XPro1595 - 0.6 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 12 weeks.
Experimental: 1.0 mg/kg XPro1595 - 1.0 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 12 weeks.
Treatment: Drugs: XPro1595
XPro1595 will be delivered by subcutaneous injection once a week
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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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The number of patients with a treatment-emergent adverse event throughout 12 weeks of treatment with XPro1595
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Assessment method [1]
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Adverse events will be assessed by clinical and laboratory measures
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Timepoint [1]
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12 weeks
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Primary outcome [2]
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The percentage of patients with a treatment-emergent adverse event throughout 12 weeks of treatment with XPro1595
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Assessment method [2]
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Adverse events will be assessed by clinical and laboratory measures
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Timepoint [2]
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12 weeks
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Secondary outcome [1]
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Changes from baseline in high sensitivity C-reactive protein in the blood and cerebral spinal fluid following 12 weeks of treatment with XPro1595
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Assessment method [1]
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To compare changes in high sensitivity C-reactive protein
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Timepoint [1]
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12 weeks
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Secondary outcome [2]
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Changes from baseline in inflammatory cytokines in the blood and cerebral following 12 weeks of treatment with XPro1595 spinal fluid
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Assessment method [2]
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To compare changes in Inflammatory cytokines; including but not limited to tumor necrosis factor, interleukin-1, and interleukin-6
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Timepoint [2]
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12 weeks
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Secondary outcome [3]
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Changes from baseline in blood and cerebral spinal fluid levels of amyloid beta following 12 weeks of treatment with XPro1595
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Assessment method [3]
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To compare changes in amyloid in cerebral spinal fluid
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Timepoint [3]
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12 weeks
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Secondary outcome [4]
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Changes from baseline in cerebral spinal fluid levels of tau following 12 weeks of treatment with XPro1595
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Assessment method [4]
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To compare changes in tau in cerebral spinal fluid
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Timepoint [4]
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12 weeks
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Secondary outcome [5]
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Change from baseline in FreeWater content (edema) using magnetic resonance imaging following 12 weeks of treatment with XPro1595
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Assessment method [5]
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To compare changes in FreeWater content as a proxy of neuroinflammation following 12 weeks of treatment with XPro1595
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Timepoint [5]
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12 weeks
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Secondary outcome [6]
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Change from baseline in the Mini-Mental State Examination (MMSE) following 12 weeks of treatment with XPro1595
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Assessment method [6]
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The Mini-Mental State Examination (MMSE) provides a comprehensive measure of cognitive function. The maximum possible score is 30 and patients scoring below 23 are classified as having cognitive impairment as follows, mild (19 to 23), moderate (10 to 18), severe (below 9).
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Timepoint [6]
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12 weeks
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Secondary outcome [7]
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Change from baseline in the Digit Symbol Substitution Test (DSST) following 12 weeks of treatment with XPro1595
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Assessment method [7]
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The Digit Symbol Substitution Test (DSST) is a cognitive test that consists of digit-symbol pairs. The patient records the corresponding symbol to each presented digit in 90 seconds. The total number of correct symbols is counted to provide a score between 0 and 133. Higher scores indicate better cognitive functioning.
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Timepoint [7]
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12 weeks
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Secondary outcome [8]
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Change from baseline in the Verbal Fluency Test following 12 weeks of treatment with XPro1595
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Assessment method [8]
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In the Verbal Fluency Test, patients are given a letter and asked to name as many words as they can that begin with that letter in 60 seconds. The number of correct responses is counted. A higher number of responses indicates better cognitive functioning.
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Timepoint [8]
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12 weeks
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Secondary outcome [9]
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Change from baseline in the Neuropsychiatric Inventory (NPI) following 12 weeks of treatment with XPro1595
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Assessment method [9]
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Neuropsychiatric Inventory (NPI) is a measure of frequency and severity of common psychiatric symptoms related to dementia using a 12-question measure. For each question, a score is given for frequency, severity and caregiver distress. Total scores range from 0 to 144. A higher score means greater neuropsychiatric disturbance.
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Timepoint [9]
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12 weeks
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Secondary outcome [10]
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Change from baseline in the Bristol Activities of Daily Living Scale (BALDS) following 12 weeks of treatment with XPro1595
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Assessment method [10]
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Bristol Activities of Daily Living Scale (BADLS) is a questionnaire that measures the impact of Alzheimer's disease on daily activities using a 20-item questionnaire. Total scores range from 0 to 60. A higher score indicates a greater disturbance in daily living.
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Timepoint [10]
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12 weeks
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Secondary outcome [11]
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Change from baseline in the Memory-Enhanced Retrospective Evaluation of Treatment Observer Reported Global Impression of Improvement (MERET OBSRO-C) following 12 weeks of treatment with XPro1595
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Assessment method [11]
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Memory-Enhanced Retrospective Evaluation of Treatment Observer Reported Global Impression of Improvement (MERET OBSRO-C) evaluates caregivers' self-reports of treatment efficacy with self-prompted memory aids regarding their clinical experiences obtained prior to treatment initiation.
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Timepoint [11]
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12 weeks
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Secondary outcome [12]
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Evaluate changes in the Memory-Enhanced Retrospective Evaluation of Change from baseline Global Impression of Improvement (MERET PGI-C) following 12 weeks of treatment with XPro1595
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Assessment method [12]
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Memory-Enhanced Retrospective Evaluation of Treatment Patient Global Impression of Improvement (MERET PGI-C) evaluates patients self-reports of treatment efficacy with self-prompted memory aids regarding their clinical experience obtained prior to treatment initiation. Patient's global impression of (PGI-I) ratings will be obtained using a web-based interface prior to and following playback of impromptu patient recordings obtained prior to the start of treatment (MERET).
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Timepoint [12]
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12 weeks
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Eligibility
Key inclusion criteria
1. Aged 18 years and above at screening;
2. Diagnosed with probable AD defined by the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria;
3. Has hsCRP levels =1.5mg/L,OR HbA1c = 6DCCT %, OR Erythrocyte Sedimentation Rate (ESR) =10 mm/h, OR APOE4 positive (at least one APOE4 allele);
4. Female of childbearing potential (FCBP) must have confirmed negative urine pregnancy test at Screening;
5. All female of childbearing potential (FCBP) and male patients who are sexually active with a female of childbearing potential must agree to use a highly effective contraception during the treatment period and until 90 days after the last dose of treatment for sexually active males whose partners are FCBP or until 30 days after the last dose of treatment for FCBP.
6. Consents to having lumbar punctures;
7. Consents to apolipoprotein E (APOE) genotyping(if status unknown);
8. Provide written informed consent prior to any study procedures being performed;
9. Has a caregiver who either lives in the same household or interacts withthe patient at least 4 hours per day and at least 4 days per week, who is knowledgeable about the participant's daytime and night-time behaviours and who canbe available to attend all clinic visits in personat which caregiver assessments are performed.Patients with caregivers that do not meet this criterionbut are determined by the investigator as able to provide an adequate assessment of the patient may also participate with prior approval from the sponsor.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Patients taking cholinesterase inhibitors, memantine, or antidepressant medication for less than 45 days from Day 1 (i.e. must be on stable dose for at least 45 days prior to Day 1);
2. Have taken within the last 45 days from Day 1; corticosteroids or other immunosuppressive drugs, thalidomide or other TNF active drugs, minocycline.
3. Enrolled in another clinical trial where patients receive treatment with investigational drug or device or have received treatment on another AD clinical trial within the last 60 days from Day 1;
4. Unable to tolerate lumbar puncture or taking medicine where lumber punctures are contraindicated (anti-coagulants besides daily 100mg of aspirin);
5. A prior organ or stem cell transplant;
6. A major adverse cardiac event within 6 months before screening;
7. Lymphoma, leukaemia, or any malignancy within the past 5 years with the exception of malignancies with negligible risk of metastasis or death, such as basal cell or squamous cell carcinomas of the skin or cervical carcinoma in situ that have been resected with no evidence of metastatic disease for 3 years;
8. Jaundice, active hepatitis, or known hepatobiliary disease (except asymptomatic cholelithiasis);
9. Positive screening assessment for viral hepatitis B surface antigen or hepatitis C virus (HCV) antibody and positive HCV ribonucleic acid or human immunodeficiency virus, or a history of illicit drug injecting;
10. Seated blood pressure of = 165/105 mmHg at screening;
11. Unable to comply with the study procedures and assessments;12.Known hypersensitivity to investigational product or its excipients;
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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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
20/11/2019
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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
1/09/2021
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Sample size
Target
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC
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Recruitment hospital [1]
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KaRa MINDS - Macquarie Park
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Recruitment hospital [2]
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Mater Medical Research Institute - Brisbane
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Recruitment hospital [3]
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Central Adelaide Local Health Network - Woodville
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Recruitment hospital [4]
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Alfred Heath - Melbourne
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Recruitment hospital [5]
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Eastern Clinical Research Unit - Melbourne
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Recruitment postcode(s) [1]
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2113 - Macquarie Park
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Recruitment postcode(s) [2]
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4101 - Brisbane
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Recruitment postcode(s) [3]
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5011 - Woodville
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Recruitment postcode(s) [4]
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3004 - Melbourne
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Recruitment postcode(s) [5]
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3128 - Melbourne
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Inmune Bio, Inc.
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Alzheimer's Association
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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
The purpose of this study is to evaluate safety and target engagement of XPro1595 in Alzheimer's patients with biomarkers of inflammation.
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Trial website
https://clinicaltrials.gov/study/NCT03943264
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Trial related presentations / publications
McAlpine FE, Lee JK, Harms AS, Ruhn KA, Blurton-Jones M, Hong J, Das P, Golde TE, LaFerla FM, Oddo S, Blesch A, Tansey MG. Inhibition of soluble TNF signaling in a mouse model of Alzheimer's disease prevents pre-plaque amyloid-associated neuropathology. Neurobiol Dis. 2009 Apr;34(1):163-77. doi: 10.1016/j.nbd.2009.01.006. Cavanagh C, Tse YC, Nguyen HB, Krantic S, Breitner JC, Quirion R, Wong TP. Inhibiting tumor necrosis factor-alpha before amyloidosis prevents synaptic deficits in an Alzheimer's disease model. Neurobiol Aging. 2016 Nov;47:41-49. doi: 10.1016/j.neurobiolaging.2016.07.009. Epub 2016 Jul 25. Sama DM, Mohmmad Abdul H, Furman JL, Artiushin IA, Szymkowski DE, Scheff SW, Norris CM. Inhibition of soluble tumor necrosis factor ameliorates synaptic alterations and Ca2+ dysregulation in aged rats. PLoS One. 2012;7(5):e38170. doi: 10.1371/journal.pone.0038170. Epub 2012 May 29. MacPherson KP, Sompol P, Kannarkat GT, Chang J, Sniffen L, Wildner ME, Norris CM, Tansey MG. Peripheral administration of the soluble TNF inhibitor XPro1595 modifies brain immune cell profiles, decreases beta-amyloid plaque load, and rescues impaired long-term potentiation in 5xFAD mice. Neurobiol Dis. 2017 Jun;102:81-95. doi: 10.1016/j.nbd.2017.02.010. Epub 2017 Feb 24.
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Public notes
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Contacts
Principal investigator
Name
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Terrence O'Brien, MD
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Address
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The Alfred
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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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Fax
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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)?
Undecided
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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
Type
Citations or Other Details
Journal
McAlpine FE, Lee JK, Harms AS, Ruhn KA, Blurton-Jo...
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Journal
Cavanagh C, Tse YC, Nguyen HB, Krantic S, Breitner...
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Sama DM, Mohmmad Abdul H, Furman JL, Artiushin IA,...
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MacPherson KP, Sompol P, Kannarkat GT, Chang J, Sn...
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Results not provided in
https://clinicaltrials.gov/study/NCT03943264