Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
CMK-0301 is a multi-site, randomized clinical trial to evaluate the safety and efficacy of [F-18]Flornaptitril-PET (F-18 FNT-PET) for the prediction of clinical progression of Mild Cognitive Impairment (MCI) with either Suspected Chronic Traumatic Encephalopathy (CTE) or Alzheimer's Disease (AD).
The primary objectives of the study are to: (1) To determine the accuracy of F-18 FNT-PET in prediction of clinical decline and (2) To assess the safety and tolerability of F-18 FNT.
The secondary objectives include: (1) To demonstrate the feasibility of F-18 FNT-PET in differentiation of participants with suspected chronic traumatic encephalopathy (CTE) from those with suspected Alzheimer's disease (AD) by trained image readers, (2) To evaluate disease progression in participants with suspected CTE or AD and (3) To evaluate the correlation between F-18 FNT-PET regional and summary visual reads scan and other assessments.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part A - Lead in | Other | Part A plans to enroll 50 participants (approximately 20 participants with mild cognitive impairment [MCI] due to suspected CTE, 20 participants with MCI due to suspected AD, and 10 age-matched healthy volunteers, whose age is within 3 years of any participants with MCI due to suspected CTE or AD in Part A). |
|
| Part B - AD | Experimental | Part B plans to enroll 90 participants with MCI due to suspected AD for primary accuracy assessments of F-18 FNT-PET imaging. |
|
| Part B - CTE | Experimental | Part B plans to enroll 90 participants with MCI due to suspected CTE from concussive and percussive injuries in approximately 1:1 ratio for primary accuracy assessments of F-18 FNT-PET imaging. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| [F-18]Flornaptitril | Drug | All participants will receive a single dose of F-18 FNT during an imaging visit. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of F-18 FNT-PET in prediction of clinical decline | The correlation between predictive development of neurodegeneration as made from F-18 FNT-PET and score change from baseline on the Clinical Dementia Rating-Sum of Boxes (CDR-SB) at the 2-year Follow-up Visit | 2 years |
| Assessment of the safety of F-18 FNT using adverse events and serious adverse events. | Adverse events and serious adverse events will be monitored in patients following F-18 FNT administration. | 2 years |
| Assessment of the safety of F-18 FNT using vital signs. | A patients body temperature, respiratory rate, sitting radial pulse rate, and sitting systolic and diastolic blood pressures will be monitored in patients following F-18 FNT administration. | 2 years |
| Assessment of the safety of F-18 FNT using clinical laboratory assessments. | A patients complete blood count with differential, free T4 Index, Vitamin B12 serum, chemistry panel (glucose, calcium, sodium, potassium, carbon dioxide, chlorine, albumin and total protein, ALP, ALT, AST, bilirubin, BUN, creatinine), benzodiazepines, uric acid, thyroid-stimulating hormone, and cholesterol will be monitored in patients following F-18 FNT administration. | 2 years |
| Assessment of the safety of F-18 FNT using electrocardiograms | 12-Lead electrocardiograms (ECGs) will be performed for all participants at Screening and in-person Follow-up Visit(s). Triplicate 12-lead ECG measurements will be obtained approximately 2 minutes apart. A repeat 12-lead ECG recording may be obtained to confirm ECG findings at the discretion of the Investigator. A full assessment of the ECG will be performed including P Wave, QRS Complex, and QT Interval. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of F-18 FNT-PET to differentiate suspected CTE from suspected AD. | The binding patterns of F-18 FNT-PET will be assed in each patient to differentiate those patients with suspected chronic traumatic encephalopathy (CTE) from those with suspected Alzheimer's disease (AD) by trained image readers using pattern determination (for presence versus no presence of CTE or AD type pattern). | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation of F-18 FNT binding patterns neuropathology at autopsy. | To determine the correlation between regional F-18 FNT binding and regional neuropathology (concentration of tau tangles and amyloid-beta (Aβ) plaques) at autopsy. | 2 years |
Inclusion Criteria:
Participants with MCI enrolling in the trial must meet all the following criteria:
1. Diagnosis of MCI due to suspected CTE, and with age >45 years, or AD, and with age >50 years at the time of the Screening Visit (see Inclusion Criteria 9) 2. Participants must have a trial partner who has frequent interaction with them (approximately >3-4 times per week), will be present for all clinic visits, and can assist in compliance with trial procedures 3. Participants, or in the Investigator's opinion, participant's legally acceptable representative, and a trial partner provide informed consent as required by IRB 4. Female participants must be either surgically sterilized or post-menopausal, defined as at least 1 year without menses as reported by the participant or have a negative serum pregnancy test 5. Willing to comply with trial procedures 6. Willing to communicate with trial personnel 7. Willing to undergo longitudinal follow-up visits at 1 and 2 years after the Imaging Visit (only for Part B) 8. CDR global score of 0.5 9. Participants with MCI due to suspected CTE must meet the diagnostic standards of possible traumatic encephalopathy syndrome as all the following criteria:
a. All of the following features are required: i) Persistence of symptoms for longer than 2 years; no other neurologic disorder that is more likely to account for all the clinical features; history of head trauma exposure, progressive course; and at least 1 supportive feature ii) History of head trauma exposure, typically associated with history of concussion, although may be limited to subconcussive trauma iii) Head trauma exposure is repetitive in nature iv) Demonstrated progressive course v) Delayed symptom onset vi) Self-report or observer report of cognitive dysfunction, confirmed with objective cognitive decline documented by results of formal neuropsychological testing. Cognitive decline typically affects more than 1 domain (neuropsychological tests, visuospatial, memory, and language) b. Only 1 of the following supportive features is required: i) Emotional dysregulation: including depression, anxiety, agitation, aggression, paranoid ideation, deterioration of interpersonal relationships, or suicidality ii) Behavioral change: including violence, poor impulse control, socially inappropriate behavior, avolition, apathy, change in personality, or comorbid substance abuse iii) Motor disturbance: including bradykinesia, tremor, rigidity, gait instability, dysarthria, dysphagia, or ataxia 9. Participants with MCI due to suspected AD must meet all the following criteria:
Inclusion Criteria for Healthy Volunteers (Part A):
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Henry M Chilton, PharmD | Contact | 8654069859 | hmchilton@ceremarkpharma.com |
| Name | Affiliation | Role |
|---|---|---|
| Chad Yucus, MD | Endeavor Health System | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Endeavor Health Systems | Recruiting | Evanston | Illinois | 60201 | United States |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Assessment of the safety of F-18 FNT using the Suicide Behavior Questionnaire-Revised | The Suicide Behavior Questionnaire-Revised will be given and assessed in patients following F-18 FNT administration. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the CDR-SB at the 2-year follow-up visit. | The change from baseline in scores on the Clinical Dementia Rating Scale Sum of Box Scores (CDR-SB) at the 2-year follow-up visit will be used to assess the disease progression in participants with suspected CTE or AD. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the 36-Item Short Form Survey (SF-36). | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of 36-Item Short Form Survey (SF-36). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the STOP-BANG Questionnaire for Sleep Apnea. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the STOP-BANG Questionnaire for Sleep Apnea. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Pittsburgh Sleep Quality Index. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Pittsburgh Sleep Quality Index. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Mini Mental State Examination (the 2nd edition). | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Mini Mental State Examination (the 2nd edition). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Modified Balance Error Scoring System. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Modified Balance Error Scoring System. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Modified Balance Error Scoring System.. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Modified Balance Error Scoring System. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the quality of life in neurological disorders (Neuro-QOL). | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the quality of life in neurological disorders (Neuro-QOL). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Hamilton Rating Scale for Depression (17 items). | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Hamilton Rating Scale for Depression (17 items). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Hamilton Anxiety Scale. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Hamilton Anxiety Scale | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Pfeffer Functional Activities Questionnaire. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Pfeffer Functional Activities Questionnaire | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Geriatric Depression Scale. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Geriatric Depression Scale. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Cognitive Function Instrument. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Cognitive Function Instrument. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Modified Overt Aggression Scale. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Modified Overt Aggression Scale. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Wechsler Memory Scale. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Wechsler Memory Scale. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Logical Memory Immediate/Delayed Recall score. | Wechsler Memory To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the 4th edition (WMS-IV) Logical Memory Immediate/Delayed Recall score. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Visual Memory Index score. | Wechsler Memory To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Visual Memory Index score. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Multilingual Naming Test- 32 item version. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Multilingual Naming Test- 32 item version (20 minutes). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Wechsler Adult Intelligence Scale. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Wechsler Adult Intelligence Scale. | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Digit Span test. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the 4th edition (WAIS-IV) Digit Span (7 minutes). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Animal Naming Test. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Animal Naming Test (3 minutes). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using Trail Making Test. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Trail Making Test: Trails A and Trails B (6 minutes). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Test of Memory Malingering. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Test of Memory Malingering (20 minutes). | 2 years |
| Evaluation of disease progression in participants with suspected CTE or AD using the Peabody Picture Vocabulary Test. | To evaluate disease progression in participants with suspected CTE or AD using change from baseline of the Peabody Picture Vocabulary Test (15 minutes). | 2 years |
| Evaluation of the correlation between F-18 FNT-PET and baseline clinical and demographic data. | To evaluate the correlation between F-18 FNT-PET images and a patient's baseline clinical and demographic data. The evaluation of the correlation between F-18 FNT-PET and baseline clinical and demographic data does not explicitly include the baseline clinical and demographic data. | 2 years |
| Evaluation of the correlation between F-18 FNT-PET and conversion to dementia | To evaluate the correlation between F-18 FNT-PET images and a patient's conversion to dementia. The evaluation of the correlation between F-18 FNT-PET and conversion to dementia does not explicitly include the conversion to dementia data. | 2 years |
| Evaluation of the correlation between F-18 FNT-PET and decline in executive function. | To evaluate the correlation between F-18 FNT-PET images and a patient's decline in executive functioning domain score of a trial specific assessment battery (neuropsychiatric and neuropsychological examinations). The evaluation of the correlation between F-18 FNT-PET and decline in executive function does not explicitly include the decline in executive function data. | 2 years |
| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D000070627 | Chronic Traumatic Encephalopathy |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D024801 | Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D000070642 | Brain Injuries, Traumatic |
| D001930 | Brain Injuries |
| D020208 | Brain Injury, Chronic |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D001925 | Brain Damage, Chronic |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D014947 | Wounds and Injuries |
Not provided
Not provided