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Alzheimer DiseasePhase 1NCT03943264

A Biomarker-directed Study of XPro1595 in Patients With Alzheimer's

A Phase 1 study testing XPro1595 in people with Alzheimer Disease, run by Inmune Bio, Inc. at 5 sites in Australia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to evaluate safety and target engagement of XPro1595 in Alzheimer's patients with biomarkers of inflammation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Alzheimer Disease
What is being tested?
XPro1595
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
5 sitesAustralia
Study dates
20 Nov 2019to 1 Sep 2021
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 18 years and above at screening;
  • Diagnosed with probable AD defined by the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria;
  • 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);
  • Female of childbearing potential (FCBP) must have confirmed negative urine pregnancy test at Screening;
  • 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.
  • Consents to having lumbar punctures;
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  • Consents to apolipoprotein E (APOE) genotyping(if status unknown);
  • Provide written informed consent prior to any study procedures being performed;
  • 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.

Who cannot join

  • 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);
  • Have taken within the last 45 days from Day 1; corticosteroids or other immunosuppressive drugs, thalidomide or other TNF active drugs, minocycline.
  • 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;
  • Unable to tolerate lumbar puncture or taking medicine where lumber punctures are contraindicated (anti-coagulants besides daily 100mg of aspirin);
  • A prior organ or stem cell transplant;
  • A major adverse cardiac event within 6 months before screening;
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  • 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;
  • Jaundice, active hepatitis, or known hepatobiliary disease (except asymptomatic cholelithiasis);
  • 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;
  • Seated blood pressure of ≥ 165/105 mmHg at screening;
  • Unable to comply with the study procedures and assessments;12.Known hypersensitivity to investigational product or its excipients;

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

Australia5 sites
  • Mater Medical Research Institute

    Brisbane, Queensland, 4101

  • KaRa MINDS

    Macquarie Park, New South Wales, 2113

  • Alfred Heath

    Melbourne, Victoria, 3004

  • Eastern Clinical Research Unit

    Melbourne, Victoria, 3128

  • Central Adelaide Local Health Network

    Woodville, South Australia, 5011

Other trials in Australia

About this study

Official title: Phase 1b Open-Label, Dose-Identification Study of XPro1595 in Patients With Alzheimer's Disease and Biomarkers of Inflammation.

The purpose of this study is to evaluate safety and target engagement of XPro1595 in Alzheimer's patients with biomarkers of inflammation.

Read the detailed description

The study is designed as a multicentre, phase 1b open-label study. The objectives of this study are to determine the safety, tolerability, and efficacy of XPro1595 in patients with Alzheimer's disease and at least one of the following inflammatory biomarkers: high sensitivity c-reactive protein (hs-CRP), hemoglobin A1c, erythrocyte sedimentation rate (ESR), or one Apolipoprotein E4 allele.

XPro1595 is a second-generation inhibitor of tumor necrosis factor (TNF) that selectively neutralizes soluble TNF, an inflammatory factor implicated in Alzheimer's pathology.

A key element of this study is to identify Alzheimer's patients that are most likely to benefit from XPro1595 treatment. Enrollment is limited to patients with evidence of inflammation. For instance, hs-CRP is an inflammatory biomarker elevated in the blood of some Alzheimer's patients and elevated CRP has been shown to predict response to TNF inhibitors in multiple other diseases.

Alzheimer's patients with elevated inflammatory biomarkers will be enrolled in a 12-week study to determine the safety and the ability of XPro1595 to reduce neuroinflammation using a combination of invasive and non-invasive biomarkers of inflammation. The study will identify the dose of XPro1595 to be used in a larger Phase II disease modification study.

Being tested
XPro1595
Keywords
inflammation, Biomarker, TNF
Medical subject headings
Alzheimer Disease, Inflammation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • XPro1595Drug

    Also called INB03, DN-TNF, XENP345

    XPro1595 will be delivered by subcutaneous injection once a week

Study groups in NCT03943264
Study groupRoleWhat they receive
0.3 mg/kg XPro1595Experimental0.3 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 12 weeks.
Receives: Drug: XPro1595
0.6 mg/kg XPro1595Experimental0.6 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 12 weeks.
Receives: Drug: XPro1595
1.0 mg/kg XPro1595Experimental1.0 mg/kg of XPro1595 will be administered via subcutaneous injection once a week for 12 weeks.
Receives: Drug: XPro1595

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The number of patients with a treatment-emergent adverse event throughout 12 weeks of treatment with XPro1595

    Adverse events will be assessed by clinical and laboratory measures

    Measured: 12 weeks

  2. The percentage of patients with a treatment-emergent adverse event throughout 12 weeks of treatment with XPro1595

    Adverse events will be assessed by clinical and laboratory measures

    Measured: 12 weeks

Secondary outcomes (12)
  1. Changes from baseline in high sensitivity C-reactive protein in the blood and cerebral spinal fluid following 12 weeks of treatment with XPro1595

    To compare changes in high sensitivity C-reactive protein

    Measured: 12 weeks

  2. Changes from baseline in inflammatory cytokines in the blood and cerebral following 12 weeks of treatment with XPro1595 spinal fluid

    To compare changes in Inflammatory cytokines; including but not limited to tumor necrosis factor, interleukin-1, and interleukin-6

    Measured: 12 weeks

  3. Changes from baseline in blood and cerebral spinal fluid levels of amyloid beta following 12 weeks of treatment with XPro1595

    To compare changes in amyloid in cerebral spinal fluid

    Measured: 12 weeks

  4. Changes from baseline in cerebral spinal fluid levels of tau following 12 weeks of treatment with XPro1595

    To compare changes in tau in cerebral spinal fluid

    Measured: 12 weeks

  5. Change from baseline in FreeWater content (edema) using magnetic resonance imaging following 12 weeks of treatment with XPro1595

    To compare changes in FreeWater content as a proxy of neuroinflammation following 12 weeks of treatment with XPro1595

    Measured: 12 weeks

  6. Change from baseline in the Mini-Mental State Examination (MMSE) following 12 weeks of treatment with XPro1595

    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).

    Measured: 12 weeks

  7. Change from baseline in the Digit Symbol Substitution Test (DSST) following 12 weeks of treatment with XPro1595

    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.

    Measured: 12 weeks

  8. Change from baseline in the Verbal Fluency Test following 12 weeks of treatment with XPro1595

    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.

    Measured: 12 weeks

  9. Change from baseline in the Neuropsychiatric Inventory (NPI) following 12 weeks of treatment with XPro1595

    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.

    Measured: 12 weeks

  10. Change from baseline in the Bristol Activities of Daily Living Scale (BALDS) following 12 weeks of treatment with XPro1595

    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.

    Measured: 12 weeks

  11. 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

    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.

    Measured: 12 weeks

  12. 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

    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).

    Measured: 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 May 2019
  2. Study start20 Nov 2019
  3. Primary completion30 Jun 2021
  4. Study completion1 Sep 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03943264
Sponsor's protocol ID
XPRO1595-AD
Other IDs
18PTC-R-592167
Status last verified
Jun 2023
First submitted
26 Apr 2019
Last updated
15 Jun 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

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.

    PubMed 19320056
  • 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.

    PubMed 27552480
  • 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.

    PubMed 22666474
  • 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.

    PubMed 28237313

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing XPro1595 in people with Alzheimer Disease, run by Inmune Bio, Inc. at 5 sites in Australia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The number of patients with a treatment-emergent adverse event throughout 12 weeks of treatment with XPro1595 (time frame: 12 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03943264, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2023.

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