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| Name | Class |
|---|---|
| For Drug Consulting | OTHER |
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Study aims at evaluating the therapeutic efficacy and safety of low-dose IL-2 immunomodulatory treatment in patients with early AD, in a phase II, randomized, double blind, placebo-controlled phase II clinical trial. Patients with AD at early stage will be recruited and randomized (2:1) in each treatment group.
The primary endpoint is the rate of decline assessed through CDR change at 18 months between the placebo group and the treated patients.
This study aims to investigate the immunomodulatory therapeutic potential and safety of low-dose (ld) IL-2 in a randomized, double blind, and placebo-controlled phase II clinical trial.
Conservative diagnosis criteria based on clinical and CSF biomarkers have been established to avoid risks of misdiagnosis.
The treatment consist of 21 cures of subcutaneous injections of either placebo or low-dose (1MIU/day) IL-2 (PROLEUKIN ®). Patients will receive 5 consecutive injections during the induction phase which will be followed by a week break. During the maintenance phase a total of 16 injections will be administered weekly. Total duration of treatment for each patient is anticipated to be 18 weeks. Patients will be followed-up for 18 months after the first injection.
At inclusion, in addition to the clinical evaluation, a hybrid PET/MRI (using [18F]-DPA-714) scan will be performed. After randomized patients successfully complete the treatment phases, they will be followed-up through 3 clinical and 1 neuroimaging visits to assess cogitive and functional decline. Clinical visits are scheduled at 6, 12, and 18 months after treatment induction. Another hybrid PET/MRI (using [18F]-DPA-714) scan will be performed at 19 months following induction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental | Patient will be treated with low dose of Interleukin 2 (PROLEUKIN ®) |
|
| Placebo | Placebo Comparator | Patient will receive sodium chloride solution (NaCl) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Proleukin | Drug | Sub-cutaneous injections of Interleukin-2 (PROLEUKIN ®) Induction phase: 5 consecutive days. A week break. Maintenance phase: once a week during 16 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline CDR score at 18 months | The primary endpoint will be evaluated in all patients evaluable for efficacy, i.e. patients who received at least one cure of IL-2 and were evaluated for cognitive and functional status at baseline and 18 months. The response variable will be dichotomized as follows: Responder patient = 1 (end of study CDR score <= baseline CDR score) Non-responder patient = 0 (end of study CDR score > baseline CDR score) | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of cognitive decline between placebo and treatment groups as assessed by changes in MMSE scores at baseline, 6, 12, and 18 months | MMSE total score out of 30 | 6, 12 and 18 months |
| Rate of cognitive decline between placebo and treatment groups as assessed by changes in ADAS-Cog 13 items scores at baseline, 6, 12, and 18 months |
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Inclusion Criteria:
Patients aged > 18
Age of disease onset < 70 years
Clinical and biological diagnosis of AD based on
Brain MRI congruent with the diagnosis, left to the appreciation of the investigator
CDR (Clinical Dementia Rating Scale) = 0.5 or 1
If patients have an antidepressant or acetylcholinesterase inhibitors treatment, patients must be treated with stable doses of treatment for at least 1 month before inclusion.
Have a caregiver who provides a separate written informed consent to participate. If a caregiver/study informant cannot continue, one replacement is allowed.
Have adequate vision and hearing for neuropsychological testing in the opinion of the investigator.
Have given written informed consent approved by the ethical review board (ERB) governing the site.
The patient has to have a French social security number and be fluent and literate in French.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Khaoussou SYLLA, Dr | Contact | 01 45 65 76 78 | k.sylla@ghu-paris.fr | |
| Viviane AWASSI | Contact | 01 45 65 84 86 | v.awassi@ghu-paris.fr |
| Name | Affiliation | Role |
|---|---|---|
| Marie SARAZIN, Prof | GHU Saint Anne | Principal Investigator |
| Guillaume DOROTHEE, PhD | INSERM UMRS 938 | Study Chair |
| Michel BOTTLAENDER, Dr |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| GHU Saint Anne | Recruiting | Paris | 75674 | France |
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D000090862 | Neuroinflammatory Diseases |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| C082598 | aldesleukin |
| D007376 | Interleukin-2 |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D007378 | Interleukins |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
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|
| Placebo | Drug | Sub-cutaneous injections of placebo (NaCl) Induction phase: 5 consecutive days. A week break. Maintenance phase: once a week during 16 weeks. |
|
|
ADAS-Cog total score out of 85 |
| 6, 12 and 18 months |
| Rate of functional decline between placebo and treatment groups as assessed by changes in ADCS-ADL MCI scores at baseline, 6, 12, and 18 months | ADSC-ADL MCI total score out of 53 | 6, 12 and 18 months |
| Rate of functional decline between placebo and treatment groups as assessed by changes in CDR (sum of boxes) scores at baseline, 6, 12, and 18 months | CDR sum of the boxes (CDR-SOB) total score out of 18 | 6, 12 and 18 months |
| Change in neuroimmune reaction as assessed by [18F]-DPA-714 PET global cortical index and regional cortical binding at baseline and 18 months between placebo and treated groups | Global and regional cortical [18F]-DPA-714 PET uptake ratio | 18 months |
| Change in peripheral frequency of Treg and other immune effectors at 18 months compared to baseline between placebo and treated groups | Tregs frequency, total lymphocytes as a biomarker of target engagement | 6, 12 and 18 month |
| Change in hippocampal atrophy at 18 month compared to baseline between placebo and treated groups | Volume of hippocampus measured in T1 MRI | 18 months |
| Number of patients with treatment related adverse events as assessed by clinical safety panel | Clinical safety will be assessed via the following assessments: Vital signs (including blood pressure, weight, BPM, temperature) - each visit ECG - at inclusion and at V22 (M18) Check-list questionnaire to assess clinical adverse events - each visit | 18 months |
| Number of patients with treatment related adverse events as assessed by blood laboratory safety panel | Biological safety will be evaluated and controlled through blood laboratory safety tests which include the following: Thyroid function: T4 and TSH - at inclusion, at V21 Haematology (RBC, WBC, leukocyte formula, platelets) and C reactive protein (CRP) - at inclusion, 8 days before the randomization, each day of the induction phase (day 1 to day 5), before each injection of the maintenance phase until V7, then every fortnight until the last injection of the maintenance phase, and then at M6, M12 and M18. Biochemistry (electrolytes, proteins, albumin, urea, creatinine, glucose, AST, ALT, GGT, bilirubin) and Coagulation tests - at inclusion, 8 days before the randomization, every 2 months for 6 months (V9 and V17), and at M6, M12 and M18 | 18 months |
| Service Hospitalier Frédéric Joliot / CEA |
| Study Chair |
| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000602 |
| Amino Acids, Peptides, and Proteins |
| D008222 | Lymphokines |
| D011506 | Proteins |
| D001685 | Biological Factors |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |