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The purpose of this study is to assess the safety and efficacy of masitinib for the treatment of mild to moderate Alzheimer's Disease. Masitinib will be administered as add-on therapy in patients who have been treated for a minimum of 6 months with a stable dose of cholinesterase inhibitor (donepezil, rivastigmine or galantamine) and/or memantine.
Actual standard treatment for mild to moderately severe Alzheimer's dementia includes acetylcholinesterase inhibitors (donepezil, rivastigmine and galantamine) and a NMDA receptor antagonist (memantine for moderate to severe Alzheimer's disease). These medications have shown to have an effect on some cognitive and non cognitive symptoms of the pathology. However, their efficacy remains limited and may decrease with time. There is an unmet medical need in this pathology. Masitinib is a selective tyrosine kinase inhibitor that is thought to exert a neuroprotective effect through its activity on mast cells and other non-neuronal cells of the central nervous system, with subsequent modulation of inflammatory and neurodegenerative processes, as well as possibly disruption of the Aβ signaling cascade via inhibition of the Fyn signaling pathway. This is a multicenter, double-blind, randomized, placebo-controlled, parallel-group study of oral masitinib. The objective of this study is to compare the efficacy and safety of masitinib at various doses versus matched placebo in the treatment of patients with mild to moderate Alzheimer's Disease. Masitinib will be administered as add-on therapy in patients who have been treated for a minimum of 6 months with a stable dose of cholinesterase inhibitor (donepezil, rivastigmine or galantamine) and/or memantine. Approximately 675 patients will be randomized into 5 treatment groups. The co-primary outcome measures are the Alzheimer's Disease Cooperative Study Activities of Daily Living score (ADCS-ADL), and Alzheimer's Disease Assessment Scale-Cognitive Subscale score (ADAS-Cog) after 24 weeks of treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Masitinib escalating dose | Experimental | Participants receive masitinib at 4.5 mg/kg/day, given orally twice daily, with a dose escalation to 6 mg/kg/day after 3 months of treatment |
|
| Masitinib fixed dose (4.5 mg/kg/day) | Experimental | Participants receive masitinib at 4.5 mg/kg/day, given orally twice daily. |
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| Masitinib fixed dose (3.0 mg/kg/day) | Experimental | Participants receive masitinib at 3.0 mg/kg/day, given orally twice daily. |
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| Placebo (escalating dose) | Placebo Comparator | Participants receive placebo, given orally twice daily, with a matched dose escalation after 3 months of treatment |
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| Placebo (fixed dose) | Placebo Comparator | Participants receive fixed dose placebo, given orally twice daily |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Masitinib | Drug |
|
| Measure | Description | Time Frame |
|---|---|---|
| ADCS-ADL | Change in the Alzheimer's Disease Cooperative Study Activities of Daily Living score (ADCS-ADL). | 24 weeks |
| ADAS-Cog | Change in the Alzheimer's Disease Assessment Scale-Cognitive Subscale score (ADAS-Cog). | 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| MMSE | Change in Mini Mental State Examination (MMSE) | 24 weeks |
| CIBIC-plus | Clinician's Interview Based Impression of Change-plus (CIBIC-plus) |
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Inclusion criteria include:
Exclusion criteria include:
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| Name | Affiliation | Role |
|---|---|---|
| Bruno DUBOIS, M.D., Ph.D. | Pitié-Salpétrière | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| MHAT Sveta Marina | Varna | 9010 | Bulgaria | |||
| General Hospital of Thessaloniki |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36849969 | Derived | Dubois B, Lopez-Arrieta J, Lipschitz S, Doskas T, Spiru L, Moroz S, Venger O, Vermersch P, Moussy A, Mansfield CD, Hermine O, Tsolaki M; AB09004 Study Group Investigators. Masitinib for mild-to-moderate Alzheimer's disease: results from a randomized, placebo-controlled, phase 3, clinical trial. Alzheimers Res Ther. 2023 Feb 28;15(1):39. doi: 10.1186/s13195-023-01169-x. |
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D003704 | Dementia |
| D003072 | Cognition Disorders |
| D008569 | Memory Disorders |
| D002561 | Cerebrovascular Disorders |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D024801 | Tauopathies |
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| ID | Term |
|---|---|
| C526575 | masitinib |
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| Placebo | Drug |
|
|
| Standard of care | Drug | stable dose of cholinesterase inhibitor (donepezil, rivastigmine or galantamine) and/or memantine, as per standard practice. |
|
| 24 weeks |
| Thessaloniki |
| 570 10 |
| Greece |
| Centrum Zdrowia Stołeczna 7 | Bialystok | 15-879 | Poland |
| Spitalul Universitar de Urgenta Elias | Bucharest | 013686 | Romania |
| Hospital Universitario Ramón y Cajal | Madrid | 28034 | Spain |
| Municipal Institution Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov | Dnipropetrovsk | 49005 | Ukraine |
| D019636 |
| Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |