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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05522387
Registration number
NCT05522387
Ethics application status
Date submitted
18/08/2022
Date registered
31/08/2022
Titles & IDs
Public title
An Open-Label Extension of XPro1595 in Patients With Alzheimer's Disease
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Scientific title
An Open Label Extension of XPro1595 in Patients With Alzheimer's Disease That Have Completed a Phase 1 or Phase 2 Study With XPro1595
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Secondary ID [1]
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XPro1595-AD-OLE
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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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Dementia
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Brain Diseases
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Central Nervous System Diseases
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Nervous System Diseases
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0
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Tauopathies
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0
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Neurodegenerative Diseases
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Neurocognitive Disorders
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0
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Mental Disorders
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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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Neurological
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Neurodegenerative diseases
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Neurological
0
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Other neurological disorders
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Mental Health
0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - XPro1595
Experimental: Experimental: 1.0 mg/kg XPro1595 - Patients will receive XPro1595.
Treatment: Drugs: XPro1595
Each enrolled patient will be treated with 1.0 mg/kg of XPro1595 as a subcutaneous injection once a week for 55, or 74 weeks, for a total exposure to XPro1595 of up to 78 weeks (18 months), depending on their previous study.
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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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Number of participants who experience adverse events and serious adverse events
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Assessment method [1]
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Change from Baseline to Weeks 55, or 74 in the OLE Study
Clinically significant abnormalities of laboratory values, physical findings, electrocardiogram (ECG) findings and other safety assessments will be recorded as adverse events if the findings meet the defined criteria for adverse events.
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Timepoint [1]
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Weeks 55, or 74 in the OLE Study
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Secondary outcome [1]
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To evaluate the change in cognitive performance following administration of open-label XPro1595
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Assessment method [1]
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Change from Baseline on the Early and Mild Alzheimer's Cognitive Composite (EMACC) (Jaeger 2017) made up of the following tests:
* The Grocery List Test- Immediate recall (Word List Learning Test-Immediate recall)
* Trail Making Test Part A and B
* Digit Symbol Coding Test
* Digit Span Forward and Backward
* Category Fluency Test (DKEFS) Letter Fluency Test (DKEFS)
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Timepoint [1]
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Week 55 in the OLE Study
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Secondary outcome [2]
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To evaluate the change in cognition and global function following administration of open-label XPro1595
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Assessment method [2]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Week 55 in the OLE study for the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB)
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Timepoint [2]
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0
Week 55 in the OLE Study
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Secondary outcome [3]
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To evaluate the change in non-cognitive behavioral symptoms following open-label administration of XPro1595
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Assessment method [3]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Week 55 in the OLE study on the Neuropsychiatric Inventory (NPI-12) study partner items.
The NPI-12 total score is calculated by adding the scores of the domains (each domain score ranges from 0 to 12). The NPI-12 total score is based upon the first 10 items and ranges from (0 to 10) with higher scores indicating greater behavioral impairment.
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Timepoint [3]
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Week 55 in the OLE Study
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Secondary outcome [4]
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To evaluate the change Change from Baseline on the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS- MCI- ADL)
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Assessment method [4]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Week 55 in the OLE study on the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS- MCI- ADL)
The 23-item Alzheimer's Disease Cooperative Study - Mild Cognitive Impairment Activities of Daily Living (ADCS-MCI-ADL) Scale has good test-retest reliability, will be utilized to assess performance functioning in MCI patients (Galasko et al., 1997; Douglas Galasko et al., 2006; Pedrosa et al., 2010).
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Timepoint [4]
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Week 55 in the OLE Study
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Secondary outcome [5]
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To evaluate the change on blood inflammatory and neurodegeneration biomarkers following open-label administration of XPro1595 (on blood inflammatory and neurodegeneration biomarker amyloid)
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Assessment method [5]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study or for those in the PK Lead-In Study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Weeks 55, or 74 in the OLE study on blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker amyloid).
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Timepoint [5]
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Weeks 55, or 74 in the OLE Study
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Secondary outcome [6]
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To evaluate the change on blood inflammatory and neurodegeneration biomarkers following open-label administration of XPro1595 (on blood inflammatory and neurodegeneration biomarker pTau)
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Assessment method [6]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study or for those in the PK Lead-In Study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Weeks 55, or 74 in the OLE study on blood inflammatory and neurodegeneration biomarkers (on blood inflammatory and neurodegeneration biomarker pTau).
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Timepoint [6]
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Weeks 55, or 74 in the OLE Study
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Secondary outcome [7]
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To evaluate the change on imaging neuroinflammation following open-label administration of XPro1595
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Assessment method [7]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study or for those in the PK Lead-In Study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Weeks 55, or 74 in the OLE study in Magnetic Resonance Imaging (MRI) neuroinflammation (White matter Free Water).
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Timepoint [7]
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Weeks 55, or 74 in the OLE Study
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Secondary outcome [8]
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To evaluate the change on axonal integrity following open-label administration of XPro1595
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Assessment method [8]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study or for those in the PK Lead-In Study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Weeks 55, or 74 or in the OLE study in MRI Apparent Fiber Density (AFD).
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Timepoint [8]
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Weeks 55, or 74 in the OLE Study
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Secondary outcome [9]
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To evaluate the change in Everyday Cognition (ECog) following open-label administration of XPro1595
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Assessment method [9]
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Change from Baseline in the double-blind study (for those on XPro1595 during the double-blind study) or Change from Baseline in the OLE Study (for those on placebo during the double-blind study) to Week 55 in the OLE study on Everyday Cognition (ECog).
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Timepoint [9]
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Week 55 in the OLE Study
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Eligibility
Key inclusion criteria
Patients are eligible to be included in the study only if all the following criteria apply:
1. Participated and completed the full duration of the study intervention and all procedures at the End of Study (EOS) visit in a previous XPro1595 study.
2. Concomitant medications for the management of MCI/AD and/or behavior symptoms which were ongoing during the double-blind study should remain at a constant dose throughout this study.
3. Patient must be willing and able to provide informed consent prior to any study procedures being performed. If the patient is not competent, a LAR (Legally Authorized Representative) must provide informed consent on their behalf, and the patient must provide assent.
4. Has a study partner willing to participate for the duration of the trial who either lives in the same household or interacts with the patient at least 4 hours per day and on at least 4 days per week, who is knowledgeable about the patient's daytime and night-time behaviors and who can be available to attend all clinic visits in person at which informant assessments are performed. This study partner should agree to monitor and report on concomitant medications, understand the study requirements, and assist the participant in meeting study requirements. Patients with study partners that do not meet this criterion but are determined by the investigator as able to provide an adequate assessment of the patient may also participate with prior approval from the sponsor (However, this is not a requirement for patients coming from the AD-02 PK Lead-In Study).
5. All male subjects who are sexually active with a female of childbearing potential (FCBP) must agree to use a highly effective method of contraception during the treatment period and until 90 days after the last dose of treatment.
6. All females of childbearing potential (FCBP) must have a negative urine pregnancy test and agree to use a highly effective method of contraception during the treatment period and 30 days after the last dose of treatment.
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Minimum age
55
Years
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Maximum age
86
Years
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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. Any clinically significant abnormalities that in the opinion of the Investigator require further investigation or treatment or may interfere with study procedures and assessments or affect patient safety. These include but are not limited to, laboratory tests, electrocardiogram (ECG), physical examination, or vital signs at Screening or other medical conditions (e.g., cardiac, respiratory, gastrointestinal, psychiatric, renal disease) which are not adequately and stably controlled.
2. Unable to comply with the study procedures and assessments.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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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
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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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
21/02/2023
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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
31/12/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
11
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Recruitment in Australia
Recruitment state(s)
NSW,VIC,WA
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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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Neuro Trials Victoria Pty Ltd T/A NeuroCentrix - Carlton
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Recruitment hospital [3]
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Austin Health - Ivanhoe
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Recruitment hospital [4]
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Australian Alzheimer's Research Foundation - Perth
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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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3053 - Carlton
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Recruitment postcode(s) [3]
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3079 - Ivanhoe
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Recruitment postcode(s) [4]
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6009 - Perth
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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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Ethics approval
Ethics application status
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Summary
Brief summary
The goal of this Phase 2 Open Label study is to evaluate long-term safety, tolerability, and efficacy of XPro1595 on measures of cognition, function and brain quality in individuals with Alzheimer's Disease.
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Trial website
https://clinicaltrials.gov/study/NCT05522387
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Trial related presentations / publications
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Tumor necrosis factor-induced cerebral insulin resistance in Alzheimer's disease links numerous treatment rationales. Pharmacol Rev. 2012 Oct;64(4):1004-26. doi: 10.1124/pr.112.005850. Epub 2012 Sep 10. Alvarez A, Cacabelos R, Sanpedro C, Garcia-Fantini M, Aleixandre M. Serum TNF-alpha levels are increased and correlate negatively with free IGF-I in Alzheimer disease. Neurobiol Aging. 2007 Apr;28(4):533-6. doi: 10.1016/j.neurobiolaging.2006.02.012. Epub 2006 Mar 29. Buchhave P, Zetterberg H, Blennow K, Minthon L, Janciauskiene S, Hansson O. Soluble TNF receptors are associated with Abeta metabolism and conversion to dementia in subjects with mild cognitive impairment. Neurobiol Aging. 2010 Nov;31(11):1877-84. doi: 10.1016/j.neurobiolaging.2008.10.012. Epub 2008 Dec 13. Branders S, Bernard G and Pereira A. Leveraging historical data for high-dimensional regression adjustment, a machine learning approach. PSI annual conference, Amsterdam, 3 to 6 June 2018. Arnason et al., Neurology. 53, 457-465 (1999) Bradshaw MJ, Mobley BC, Zwerner JP, Sriram S. Autopsy-proven demyelination associated with infliximab treatment. Neurol Neuroimmunol Neuroinflamm. 2016 Jan 27;3(2):e205. doi: 10.1212/NXI.0000000000000205. eCollection 2016 Apr. No abstract available. Dickson DW. The pathogenesis of senile plaques. J Neuropathol Exp Neurol. 1997 Apr;56(4):321-39. doi: 10.1097/00005072-199704000-00001. Draft FDA Guidance for Industry: Adjusting for covariates in randomized clinical trials for drugs and biologics. Revision 1 May 2021 Biostatistics (https://www.fda.gov/media/148910/download). Finsterwalder S, Vlegels N, Gesierich B, Araque Caballero MA, Weaver NA, Franzmeier N, Georgakis MK, Konieczny MJ, Koek HL; Dominantly Inherited Alzheimer Network (DIAN); Karch CM, Graff-Radford NR, Salloway S, Oh H, Allegri RF, Chhatwal JP; DELCODE study group; Jessen F, Duzel E, Dobisch L, Metzger C, Peters O, Incesoy EI, Priller J, Spruth EJ, Schneider A, Fliessbach K, Buerger K, Janowitz D, Teipel SJ, Kilimann I, Laske C, Buchmann M, Heneka MT, Brosseron F, Spottke A, Roy N, Ertl-Wagner B, Scheffler K; Alzheimer's Disease Neuroimaging Initiative (ADNI); Utrecht VCI study group; Seo SW, Kim Y, Na DL, Kim HJ, Jang H, Ewers M, Levin J, Schmidt R, Pasternak O, Dichgans M, Biessels GJ, Duering M. Small vessel disease more than Alzheimer's disease determines diffusion MRI alterations in memory clinic patients. Alzheimers Dement. 2020 Nov;16(11):1504-1514. doi: 10.1002/alz.12150. Epub 2020 Aug 18. Fillit H, Ding WH, Buee L, Kalman J, Altstiel L, Lawlor B, Wolf-Klein G. 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