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Mild Cognitive Impairment (MCI)Phase 1SONATASNCT07210528

Safety Of Nrtis for Alzheimer's Therapeutic Advancement in Singapore Study

A Phase 1 study testing Emtricitabine (FTC) and Descovy® (TAF/FTC) in people with Mild Cognitive Impairment (MCI) and Alzheimer Dementia (AD), run by National University Hospital, Singapore at 1 site in Singapore.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Recent studies have identified an association between Alzheimer's Disease (AD) and an expansion of DNA content in the brain (prefrontal cortex). This additional DNA content appears to be derived from reverse transcriptase (RT) activity that incorporates genomic cDNAs (gencDNAs) into chromosomes, resulting in multiple… Read more about this study

Who is it for?
Ages 50 to 85 years
What is being tested?
Emtricitabine (FTC) and Descovy® (TAF/FTC)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
48 participants
Where
1 siteSingapore
Study dates
30 Jun 2025to Sep 2026
Phase
Phase 1
Are there results?
Not yet: the study is under way

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 50 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • CDR-GS of 0 or 0.5 (calculated by the QDRS)
  • Diagnosed with MCI, determined by impairment in at least one domain of the neuropsychological test battery without significant dysfunction in activities of daily living OR MCI consistent with the NIA/AA diagnostic criteria; OR presenting with SCD and a CDR-GS of 0.5.
  • Does not have any medical condition (e.g. cardiac, respiratory, gastrointestinal, renal disease) which are not stably and adequately controlled, or which in the opinion of the investigator(s) could affect the subject's safety or interfere with the study assessments.
  • Willingness to provide blood sample and neuropsychological testing for the study.
  • Ability for the patient to provide informed consent.

Who cannot join

  • Patient who is receiving a prescription of acetylcholinesterase inhibitor (AChEI) and/or Memantine at screening or baseline.
  • Patients with a history of HIV or HBV infection, or that test positive for HIV or HBV on screening.
  • Pre-existing comorbidities such as Hepatits, cardiovascular disease, or renal insufficiency.
  • History of Moderate to severe hepatic impairment indicated by screening AST or ALT > 3x the upper limit of normal (ULN) or total bilirubin > 2x ULN.
  • Patients with severe renal impairment, or creatinine clearance ≤ 30 mL/min (calculated by Cockcroft-Gault formulae at screening).
  • Co administration of nephrotoxic drugs.
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  • Current or previous RTi use within the last 2 years.
  • Malignant neoplasm, and are undergoing active treatment.
  • Participating in other interventional clinical trials during the course of the study.
  • Documented history of lactic acidosis and severe hepatomegaly with steatosis.

Trial locations and contacts

1 site in 1 country.

Singapore1 site
  • National University Hospital

    Singapore

Other trials in Singapore

About this study

Official title: A Phase 1b, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety of Emtricitabine and Descovy in Patients With Mild Cognitive Impairment.

Recent studies have identified an association between Alzheimer's Disease (AD) and an expansion of DNA content in the brain (prefrontal cortex). This additional DNA content appears to be derived from reverse transcriptase (RT) activity that incorporates genomic cDNAs (gencDNAs) into chromosomes, resulting in multiple copies of full length and shorter cDNAs involving many genes - including the causal AD gene amyloid precursor protein (APP). Accumulation of these APP gencDNAs is associated with AD.

This identifies RT as a promising therapeutic target for the attenuation of AD progression through existing reverse transcriptase inhibitors (RTi's) that have been widely used for treating HIV and hepatitis B. Since this class of drugs has been in the clinic for over 3 decades, there are significant data supporting their post-approval safety for long-term use. However, this has not been specifically addressed in the target population - patients with mild cognitive impairment (MCI), particularly women - who are underrepresented in HIV datasets.

Read more

This proposed Phase I safety trial will perform a Special Population Study in a cohort of MCI patients who may benefit from the intervention.

This study aims to (1) evaluate the safety and tolerability of standard dose FTC or Descovy for 3 months in MCI patients; (2) as secondary aims, collect preliminary data on clinical effects of standard dose FTC or Descovy compared to placebo for 3 months on cogntiive function in MCI patients; and (3) collect preliminary data on clinical effects of standard dose FTC or Descovy compared with placebo on AD-associated inflammatory markers.

Participants will be randomized into either Descovy or FTC arms in equal numbers, and receive either active drug or placebo. Participants will orally ingest 1 capsule or tablet (depending on drug arm) daily for the 3 month participation period.

The investigators hypothesise that MCI are not at increased risk of adverse effects due to administration of standard dose FTC or Descovy.

Being tested
Emtricitabine (FTC), Descovy® (TAF/FTC), Placebo to Match Emtricitabine 200mg/Tenofovir Alafenamide 25 mg., Placebo Capsules to Match Emtricitabine Capsules, 200mg.
Keywords
Reverse Transcriptase Inhibitors, Mild Cognitive Impairment (MCI), Descovy, Emtricitabine, Alzheimer's Disease (AD)
Medical subject headings
Cognitive Dysfunction, Alzheimer Disease

What participants receive

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

  • Emtricitabine (FTC)Drug

    Also called Emtriva

    Capsule, 200mg FTC. White Opaque Body / Light Blue Opaque Cap with "GILEAD" and Gilead logo on body. "200 mg" on cap printed in black.

  • Descovy® (TAF/FTC)Drug

    Emtricitabine (FTC) 200 mg / Tenofovir Alafenamide (TAF) 25 mg. Tablets, Rectangular-Shaped, Debossed, Film-coated blue.

  • Placebo to Match Emtricitabine 200mg/Tenofovir Alafenamide 25 mg.Drug

    Placebo to Match Emtricitabine 200mg/Tenofovir Alafenamide 25mg. Tablets, Rectangular-Shaped, Debossed, Film-Coated Blue.

  • Placebo Capsules to Match Emtricitabine Capsules, 200mg.Drug

    White Opaque Body/Light Blue Opaque Cap with "GILEAD" and Gilead logo on body, "200 mg" on cap printed in black.

Study groups in NCT07210528
Study groupRoleWhat they receive
DescovyExperimentalEqual numbers of male and female participants will be recruited in all arms. Descovy, Tablet, 200/25 mg, ct, Bottle, Britestock.
Receives: Drug: Descovy® (TAF/FTC)
Placebo to Match DescovyPlacebo comparatorEqual numbers of male and female participants will be recruited in all arms. Placebo to match Descovy. Tablets, Rectangular-Shaped, Debossed, Film-Coated Blue, 30ct per bottle.
Receives: Drug: Placebo to Match Emtricitabine 200mg/Tenofovir Alafenamide 25 mg.
Emtricitabine (Emtriva)ExperimentalEqual numbers of male and female participants will be recruited in all arms. Emtriva, Capsule, 200 mg, 30 ct, Bottle, Britestock.
Receives: Drug: Emtricitabine (FTC)
Placebo to match Emtricitabine (Emtriva)Placebo comparatorEqual numbers of male and female participants will be recruited in all arms. Placebo Capsules to Match Emtricitabine Capsules, 200 mg, White Opaque Body/Light Blue Opaque Cap with "GILEAD" and Gilead Logo on body, "200 mg" on cap printed in black, 30 ct per bottle.
Receives: Drug: Placebo Capsules to Match Emtricitabine Capsules, 200mg.

What is being measured

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

  1. Number of participants with treatment-related Adverse/Serious Adverse Events (AE/SAE)

    Number of participants with treatment-related AE/SAEs as assessed on the CTCAE Version 4.0. Incidence rate (n = x, and %), cause, and type of AE/SAE will be compared across the active drug and placebo groups.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

Secondary outcomes (10)
  1. Change in circulating Beta-Amyloid 40 (Aβ40), Beta-Amyloid 42 (Aβ42) and Aβ-40: Aβ-42 ratio from baseline.

    Changes in plasma Aβ-40 and Aβ-42 levels; and Aβ40:Aβ42 ratio from baseline visit to week 12 visit, as assessed on Single Molecular Array (SIMOA). Units: pg/mL. No reference range is reported as significant variation exists across cohorts.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  2. Change in Phospho-Tau217 (Ptau217) from baseline.

    Change in total plasma Ptau217 levels from baseline visit to week 12 visit, as assessed on Single Molecular Array (SIMOA). Units: pg/mL. No reference range is reported as significant variation exists across cohorts.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  3. Change in Interleukin-6 (IL-6) levels from baseline.

    Change in serum IL-6 levels from baseline to week 12 visit, as assessed on Luminex Multiplex Analyser. Units: pg/mL. No reference range is reported as significant variation exists across cohorts.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  4. Change in Interleukin-8 (IL-8) levels from baseline.

    Change in serum IL-8 levels from baseline to week 12 visit, as assessed on Luminex Multiplex Analyser. Units: pg/mL. No reference range is reported as significant variation exists across cohorts.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  5. Change in Tumor Necrosis Factor-alpha (TNFα) levels from baseline.

    Change in serum TNFα levels from baseline to week 12 visit, as assessed on Luminex Multiplex Analyser. Units: pg/mL. No reference range is reported as significant variation exists across cohorts.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  6. Change in Mini Mental State Exam scores (MMSE).

    Change in MMSE total scores from baseline visit to week 12 visit, to assess changes in cognitive function. Scores range from 0 - 30, with higher scores indicating better cognitive function.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  7. Change in Quick Dementia Rating Scores (QDRS) from baseline.

    Change in QDRS total scores from baseline visit to week 12 visit, to assess changes in cognitive function. Scores range from 0 - 30, with higher scores indicating greater cognitive and functional impairment.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  8. Change in Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) scores from baseline.

    Change in RBANS total and index scores from baseline to week 12 visit to assess changes in cognitive function. The battery consists of 5 indexes: 1) Immediate Memory, 2) Visuospatial/Constructional, 3) Language, 4) Attention, and 5) Delayed Memory and 12 subtests which are indexed and scored according to standardized RBANS criteria - adjusting for age and education):

    Immediate Memory: List Learning, Story Memory; Visuospatial/Constructional: Figure Copy, Line Orientation; Language: Picture Naming, Semantic Fluency; Attention: Digit Span, Coding; Delayed Memory: List Recall, List Recognition, Story Recall, Figure Recall.

    Raw scores of all 12 subtests will be converted to age- and education-adjusted scaled scores before calculating an index score for each domain. Sum of index scores will then be converted to a Total Scale score. Scaled scores range from 40 - 160, with higher scores indicating higher overall cognitive function.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  9. Change in Colour Trials Test (CTT) scores from baseline.

    Change in CTT (Trial 1 \& 2) completion times from baseline to week 12 visit, to assess changes in attention and sequencing. Units: Time-to-completion (seconds) for each Trial. A range of time-to-completion of 3-8 minutes is reported in the CTT manual, with longer completion times indicative of impaired attention and sequencing.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

  10. Change in Activities of Daily Living (ADL) scores from baseline.

    Change in Independent ADL scores from baseline to week 12 visit, as assessed on the Activities of Daily Living Preventative Instrument (ADCS-ADL-PI) - comprising 15 ADL and 5 physical function questions covering complex activities typically conducted by most during independent living (e.g. handling money, shopping, remembering plans and appointments).

    ADLs are scored on a 5-point Likert scale. Total scores range from 0 - 45, with higher scores indicating less functional impairment.

    Measured: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).

Timeline

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

  1. First posted7 Oct 2025
  2. Study start30 Jun 2025
  3. Primary completionSep 2026 (estimated)
  4. Study completionSep 2026 (estimated)

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
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07210528
Sponsor's protocol ID
RTi-EmtriDes-2022
Acronym
SONATAS
Status last verified
Jul 2026
First submitted
30 Jul 2025
Last updated
10 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Sensitive health information will be collected as part of this study. Only de-indentified data will be used for study purposes.

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Emtricitabine (FTC) and Descovy® (TAF/FTC) in people with Mild Cognitive Impairment (MCI) and Alzheimer Dementia (AD), run by National University Hospital, Singapore at 1 site in Singapore.

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 5 inclusion and 10 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: under way, not looking for participants, as of the sponsor's last update on 10 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Singapore. 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. Some participants in this study may receive a placebo. 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?

This study is still under way. Results are not available in the source record yet.

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?

Number of participants with treatment-related Adverse/Serious Adverse Events (AE/SAE) (time frame: From enrollment to the end of treatment at 12 weeks (measured from participant's baseline visit).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 10 Aug 2026.

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