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| Name | Class |
|---|---|
| Rio pharmaceuticals Inc. | UNKNOWN |
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This is a first in human study that will assess the safety and diagnostic performance of [18F]RP-115 (fluorine-18 labeled RP115), a positron emission tomography (PET) agent. This agent has the potential to identify the early changes that occur in the brains of patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD).
AD and FTD are the two leading causes of dementia with tremendous impact on patients and their families. Early diagnosis of both AD and FTD is essential to increase patients' quality of life, identify and treat reversible causes, and enhance the development and effectiveness of treatments. However, no single diagnostic agent is currently available for either AD or FTD; instead, clinicians must rely on the patient's history and cognitive testing which often leads to delayed or incorrect diagnosis. Importantly AD and FTD have distinct regional patterns of neuronal loss and dysfunction in the brain; an agent that could detect these regionally specific changes early in the course of the disease process could revolutionize diagnosis and treatment development for these conditions.
This study aims to develop a novel radiotracer to fill this unmet need. The excitatory amino acid transporter 2 (EAAT2) is the main transporter for glutamate in the brain and has been shown to be downregulated in the context of AD and other neurodegenerative conditions. EAAT2 is responsible for over 90% of glutamate uptake in the brain where it is primarily located on astrocytes and plays a key role in maintaining the homeostasis of the tripartite synapse. The goal of this study is to test the EAAT2 targeted positron emitting agent, [18F]RP-115, to evaluate early changes in astrocytes in healthy controls versus patients with AD and FTD by quantitative PET imaging of EAAT2. We have preclinical data that demonstrates that this agent is a good predictor of EAAT2 levels in animal models, hence, can potentially detect early signs of neurodegeneration. We now wish to test this agent in humans.
In summary, the primary objective of this study is to demonstrate human safety and measure the biodistribution of [18F]RP-115 in healthy controls as well as in age-matched patients with AD and FTD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 - dosimetry of [18F]RP-115 in healthy volunteers | Experimental | Establish [18F]RP-115 safety in the clinic with male and female PET imaging. |
|
| Cohort 2B - [18F]RP-115 in patients with AD | Experimental | Comparison of [18F]RP-115 PET binding between AD patients and age-matched cognitively normal controls and between AD and FTD |
|
| Cohort 2C - [18F]RP-115 in patients with FTD | Experimental | Comparison of [18F]RP-115 PET binding between AD patients and age-matched cognitively normal controls and between AD and FTD |
|
| Cohort 2A - [18F]RP-115 in age-matched controls | Experimental | Comparison of [18F]RP-115 PET binding between AD patients and age-matched cognitively normal controls and between AD and FTD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| [18F]RP-115 PET/MRI or PET/CT and MRI | Drug | An I.V. bolus injection of up to 10 millicurie (mCi) [18F]RP-115 will be administered, followed by a PET/MRI scan or by a combination of PET/CT and MRI |
| Measure | Description | Time Frame |
|---|---|---|
| Safety of Administered dose | Each study participant will undergo a physical examination, vital signs, and ECGs prior to and after the scan and will also be monitored during the scan for adverse events. Additionally, a follow-up with the subject will be conducted 24-48 hours after [18F]RP-115 administration. Outcome Measure: Any adverse events will be recorded and graded according to Common Terminology Criteria for Adverse Events. | A year |
| Dosimetry of [18F]RP-115 | Whole-body PET/MRI scan will be conducted immediately after an [18F]RP-115 injection and last about 3.5 hours (including breaks) in 8 healthy volunteers (male and female). Equivalent organ radiation doses will be calculated in selected organs using the dynamic PET/MRI data in order to calculate the dosimetry of the tracer. Outcome Measure: Radiation exposure per organ as milliSievert/kg | A year |
| Biodistribution of [18F]RP-115 | Whole-body PET/MRI scan will be conducted immediately after an [18F]RP-115 injection and last about 3.5 hours (including breaks) in 8 healthy volunteers (male and female). Percent injected activity (%IA) will be calculated in selected organs using the dynamic PET/MRI data in order to calculate the biodistribution of the tracer. Outcome Measure: Percent injected activity (%Injected radioactivity) in selected organs. | A year |
| Measure | Description | Time Frame |
|---|---|---|
| [18F]RP-115 diagnostic performance | Utilize RP-115 to quantitatively assess regional cerebral RP-115 binding differences in healthy volunteers compared to cognitively-defined AD and FTD. Outcome Measure: Radioactivity distribution volume across cerebral cortex, Becquerel/mL or standardized uptake value. | Three years |
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Inclusion Criteria:
Age 40-75
Age-suitable BMI
Ability to provide written informed consent and willingly comply with protocol requirements or has a legal authorized representative/guardian who provides surrogate informed consent.
No apparent physical disorder.
Radial, ulnar, or brachial artery suitable for catheterization.
Non-smoker, and not taking OTC nicotine cessation - to limit peripheral metabolism events.
Devoid of CNS prescription drugs for three weeks - to limit peripheral metabolism events.
For Cohort 2B and 2C:
Must have a study partner (informant) who spends a minimum average of 5 hours per week with the participant (e.g. family member, significant other, friend, caregiver), is generally aware of the participant's daily activities, can provide information about the participant's cognitive and functional performance, and will accompany the participant in all study procedure.
Recent (within 6 mo.) MME clinical scores.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| David Wilson, MD, PhD | Contact | 415-514-6229 | david.m.wilson@ucsf.edu | |
| Henry Vanbrocklin, PhD | Contact | 415-353-4569 | henry.vanbrocklin@ucsf.edu |
| Name | Affiliation | Role |
|---|---|---|
| David Wilson, MD, PhD | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| China Basin, UCSF | Recruiting | San Francisco | California | 94107 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29653606 | Background | Jack CR Jr, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, Holtzman DM, Jagust W, Jessen F, Karlawish J, Liu E, Molinuevo JL, Montine T, Phelps C, Rankin KP, Rowe CC, Scheltens P, Siemers E, Snyder HM, Sperling R; Contributors. NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018 Apr;14(4):535-562. doi: 10.1016/j.jalz.2018.02.018. | |
| 31396666 |
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All of the individuals participants data collected during the trial, after de-identification.
Immediately following publication. No end date.
Anyone who wishes to access the data
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Nov 8, 2021 | Dec 8, 2021 | ICF_000.pdf |
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D057180 | Frontotemporal Dementia |
| D003704 | Dementia |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D024801 | Tauopathies |
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| ID | Term |
|---|---|
| D009682 | Magnetic Resonance Spectroscopy |
| ID | Term |
|---|---|
| D013057 | Spectrum Analysis |
| D002623 | Chemistry Techniques, Analytical |
| D008919 | Investigative Techniques |
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| Background |
| Boche D, Gerhard A, Rodriguez-Vieitez E; MINC Faculty. Prospects and challenges of imaging neuroinflammation beyond TSPO in Alzheimer's disease. Eur J Nucl Med Mol Imaging. 2019 Dec;46(13):2831-2847. doi: 10.1007/s00259-019-04462-w. Epub 2019 Aug 8. |
| 17519979 | Background | Innis RB, Cunningham VJ, Delforge J, Fujita M, Gjedde A, Gunn RN, Holden J, Houle S, Huang SC, Ichise M, Iida H, Ito H, Kimura Y, Koeppe RA, Knudsen GM, Knuuti J, Lammertsma AA, Laruelle M, Logan J, Maguire RP, Mintun MA, Morris ED, Parsey R, Price JC, Slifstein M, Sossi V, Suhara T, Votaw JR, Wong DF, Carson RE. Consensus nomenclature for in vivo imaging of reversibly binding radioligands. J Cereb Blood Flow Metab. 2007 Sep;27(9):1533-9. doi: 10.1038/sj.jcbfm.9600493. Epub 2007 May 9. |
| 28941755 | Background | Rice L, Bisdas S. The diagnostic value of FDG and amyloid PET in Alzheimer's disease-A systematic review. Eur J Radiol. 2017 Sep;94:16-24. doi: 10.1016/j.ejrad.2017.07.014. Epub 2017 Jul 20. |
| 26912447 | Background | Rodriguez-Vieitez E, Carter SF, Chiotis K, Saint-Aubert L, Leuzy A, Scholl M, Almkvist O, Wall A, Langstrom B, Nordberg A. Comparison of Early-Phase 11C-Deuterium-l-Deprenyl and 11C-Pittsburgh Compound B PET for Assessing Brain Perfusion in Alzheimer Disease. J Nucl Med. 2016 Jul;57(7):1071-7. doi: 10.2967/jnumed.115.168732. Epub 2016 Feb 16. |
| 28634836 | Background | Arakawa R, Stenkrona P, Takano A, Nag S, Maior RS, Halldin C. Test-retest reproducibility of [11C]-L-deprenyl-D2 binding to MAO-B in the human brain. EJNMMI Res. 2017 Dec;7(1):54. doi: 10.1186/s13550-017-0301-4. Epub 2017 Jun 20. |
| 2896322 | Background | Cowburn R, Hardy J, Roberts P, Briggs R. Presynaptic and postsynaptic glutamatergic function in Alzheimer's disease. Neurosci Lett. 1988 Mar 21;86(1):109-13. doi: 10.1016/0304-3940(88)90192-9. |
| 7722505 | Background | Scott HL, Tannenberg AE, Dodd PR. Variant forms of neuronal glutamate transporter sites in Alzheimer's disease cerebral cortex. J Neurochem. 1995 May;64(5):2193-202. doi: 10.1046/j.1471-4159.1995.64052193.x. |
| 29405337 | Background | Hoshi A, Tsunoda A, Yamamoto T, Tada M, Kakita A, Ugawa Y. Altered expression of glutamate transporter-1 and water channel protein aquaporin-4 in human temporal cortex with Alzheimer's disease. Neuropathol Appl Neurobiol. 2018 Oct;44(6):628-638. doi: 10.1111/nan.12475. Epub 2018 Mar 4. |
| 9258260 | Background | Li S, Mallory M, Alford M, Tanaka S, Masliah E. Glutamate transporter alterations in Alzheimer disease are possibly associated with abnormal APP expression. J Neuropathol Exp Neurol. 1997 Aug;56(8):901-11. doi: 10.1097/00005072-199708000-00008. |
| 25716012 | Background | Pasqualetti G, Brooks DJ, Edison P. The role of neuroinflammation in dementias. Curr Neurol Neurosci Rep. 2015 Apr;15(4):17. doi: 10.1007/s11910-015-0531-7. |
| 27844039 | Background | Miller ZA, Sturm VE, Camsari GB, Karydas A, Yokoyama JS, Grinberg LT, Boxer AL, Rosen HJ, Rankin KP, Gorno-Tempini ML, Coppola G, Geschwind DH, Rademakers R, Seeley WW, Graff-Radford NR, Miller BL. Increased prevalence of autoimmune disease within C9 and FTD/MND cohorts: Completing the picture. Neurol Neuroimmunol Neuroinflamm. 2016 Oct 28;3(6):e301. doi: 10.1212/NXI.0000000000000301. eCollection 2016 Dec. |
| 11124442 | Background | Arnold SE, Han LY, Clark CM, Grossman M, Trojanowski JQ. Quantitative neurohistological features of frontotemporal degeneration. Neurobiol Aging. 2000 Nov-Dec;21(6):913-9. doi: 10.1016/s0197-4580(00)00173-1. |
| 27114033 | Background | Lui H, Zhang J, Makinson SR, Cahill MK, Kelley KW, Huang HY, Shang Y, Oldham MC, Martens LH, Gao F, Coppola G, Sloan SA, Hsieh CL, Kim CC, Bigio EH, Weintraub S, Mesulam MM, Rademakers R, Mackenzie IR, Seeley WW, Karydas A, Miller BL, Borroni B, Ghidoni R, Farese RV Jr, Paz JT, Barres BA, Huang EJ. Progranulin Deficiency Promotes Circuit-Specific Synaptic Pruning by Microglia via Complement Activation. Cell. 2016 May 5;165(4):921-35. doi: 10.1016/j.cell.2016.04.001. Epub 2016 Apr 21. |
| 20026663 | Background | Yin F, Banerjee R, Thomas B, Zhou P, Qian L, Jia T, Ma X, Ma Y, Iadecola C, Beal MF, Nathan C, Ding A. Exaggerated inflammation, impaired host defense, and neuropathology in progranulin-deficient mice. J Exp Med. 2010 Jan 18;207(1):117-28. doi: 10.1084/jem.20091568. Epub 2009 Dec 21. |
| D019636 |
| Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D057174 | Frontotemporal Lobar Degeneration |
| D057177 | TDP-43 Proteinopathies |
| D057165 | Proteostasis Deficiencies |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |