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This study is testing a new investigational drug called 8M2D to learn whether it is safe and well-tolerated in humans. 8M2D has not previously been given to people.
Hypothesis: Researchers believe that 8M2D can be administered safely to healthy adults and to people with early Alzheimer's disease, and that it may reduce levels of amyloid beta. Amyloid beta is a protein that builds up in the brains of people with Alzheimer's disease and is thought to contribute to its progression.
The study will be conducted in three parts. In the first two parts, healthy volunteers will receive either a single dose or multiple doses of 8M2D so researchers can understand how the drug moves through the body and whether it causes any side effects. In the third part, a small group of people with early Alzheimer's disease will receive multiple doses so researchers can also begin to assess whether the drug has any effect on amyloid beta levels.
Doses will be increased gradually and carefully. An independent safety board will review safety information before any dose increase is allowed. The information gathered in this study will be used to identify the appropriate dose of 8M2D and to help design future studies in people with Alzheimer's disease.
Trial Rationale: This is a three-part Phase 1a/b clinical trial. Phase Ia is a first-in-human (FIH), 2-part (Part I [SAD] and Part II [MAD]) clinical trial designed to evaluate the safety, tolerability, pharmacokinetics (PK), and exploratory immunogenicity of single and multiple doses of 8M2D in healthy participants. Phase Ib will consist of Part III (Alzheimer's Disease [AD]), designed to evaluate the safety, tolerability, PK, exploratory immunogenicity, and pharmacodynamics (PD) of multiple doses of 8M2D in participants with early AD.
Data from this trial will be used to identify doses of 8M2D that show safety and tolerability and PD effects on amyloid beta (Aβ), to aid in the design of future trials in patients with AD. Prior to this trial, 8M2D has not been administered to humans. Safety and tolerability evaluations will be conducted over a range of single and multiple doses of 8M2D and dose escalation will not proceed until safety and tolerability data and PK parameters from previous doses have been reviewed by an independent Data and Safety Monitoring Board (DSMB).
This trial will aim to assess a maximum-tolerated dose (MTD), or a maximum feasible dose (based on tolerability of the subcutaneous [SC] injections), or a maximum pharmacologically active dose, based on safety, tolerability and PK data as well as on model-based prediction of the anticipated Aβ lowering. The data generated in this trial will be used to help design subsequent clinical trials in participants with early AD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 8M2D Single Ascending Dose (SAD) - healthy participants, Part I | Experimental | Part I (SAD) is a Phase Ia, First-in-Human, single-center, randomized, double-blind, placebo-controlled, dose escalating, SAD part of the clinical trial designed to evaluate the safety, tolerability, PK, and exploratory immunogenicity of single doses of 8M2D in healthy adult participants. Part I (SAD) will evaluate up to 5 dose levels of 8M2D. Approximately 30 eligible participants will be enrolled and assigned to 1 of 5 cohorts, with 6 participants per SAD cohort. In each of the SAD cohorts, 6 participants will be randomized in a 4:2 ratio (4 active: 2 placebo) to receive a single SC dose of 8M2D or matching placebo on Day 1. The intervention will be administered by subcutaneous injection. |
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| 8M2D Multiple Ascending Dose (MAD) - healthy participants, Part II | Experimental | Part II (MAD) is a Phase Ia, single-center, randomized, double-blind, placebo-controlled, dose escalating, MAD part of the clinical trial designed to evaluate the safety, tolerability, PK, and exploratory immunogenicity of multiple doses of 8M2D in healthy adult participants. Part II (MAD) will evaluate up to 3 dose levels of 8M2D. Approximately 18 eligible participants will be enrolled and assigned to 1 of 3 cohorts, with 6 participants per MAD cohort. In each of the MAD cohorts, 6 participants will be randomized in a 4:2 ratio (4 active: 2 placebo) to receive once-daily (QD) SC doses of 8M2D or matching placebo on Days 1 to 7. The intervention will be administered by subcutaneous injection. |
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| Placebo - healthy participants (Parts I & II combined) | Placebo Comparator | Study Parts I and II each include a placebo arm. Part I (SAD) will evaluate up to 5 dose levels of 8M2D. Approximately 30 eligible participants will be enrolled and assigned to 1 of 5 cohorts, with 6 participants per SAD cohort. In each of the SAD cohorts, 6 participants will be randomized in a 4:2 ratio (4 active: 2 placebo) to receive a single SC dose of 8M2D or matching placebo on Day 1. Part II (MAD) will evaluate up to 3 dose levels of 8M2D. Approximately 18 eligible participants will be enrolled and assigned to 1 of 3 cohorts, with 6 participants per MAD cohort. In each of the MAD cohorts, 6 participants will be randomized in a 4:2 ratio (4 active: 2 placebo) to receive once-daily (QD) SC doses of 8M2D or matching placebo on Days 1 to 7. Placebo will be administered by subcutaneous injection. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 8M2D | Drug | 8M2D administered by subcutaneous injection. Evaluated across single ascending doses (Part I) and multiple ascending doses (Part II) in healthy participants, and as multiple doses in participants with early Alzheimer's disease (Part III). |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants reporting treatment-emergent adverse events | A treatment-emergent adverse event is defined as any adverse event that has an onset on or after the first dose of the trial medication, or any pre-existing condition that has worsened on or after the first dose of the trial intervention. | Baseline to Day 44 |
| Number of participants reporting treatment-emergent adverse events that require discontinuation of therapy due to intolerable side effects | Evaluation of the number of participants withdrawn from study medication due to treatment-emergent adverse events. | Baseline to Day 14 |
| Number of participants reporting injection site reactions | Evaluation of skin reactions at the injection site, including pain, itching, and swelling or redness around the injection site. | Baseline to Day 22 |
| Number of participants demonstrating abnormal laboratory findings | Evaluation of laboratory results outside the documented normal range as defined by the clinical laboratory. | Baseline to Day 14 |
| Number of participants demonstrating abnormal vital signs | Evaluation of absolute vital sign value and the changes from baseline that are outside the normal range. | Baseline to Day 22 |
| Number of participants demonstrating abnormal vital electrocardiogram (ECG) parameters | Evaluation of 12-lead ECG parameters. | Baseline to Day 15 |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of the presence of anti-8M2D antibody in participants of all cohorts. | Evaluation of anti-8M2D antibody presence in blood samples collected from all participants. | Baseline to Day 22 |
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Inclusion Criteria:
Part I (Single Ascending Dose) and Part II (Multiple Ascending Dose):
Voluntarily consents to participate in this trial and provides written informed consent before the start of any trial assessments.
Healthy male and female adults, 18 and 55 years of age (inclusive).
Participants with a body mass index (BMI) ≥ 18 and ≤ 32 kg/m2 (inclusive) and weigh a minimum of 50 kg.
Participants with a normal 12-lead ECG at Screening.
Participant has normal renal function.
Females participants must meet one of the following criteria:
a. Females must either be of non-childbearing potential, or if of childbearing potential, must agree to use contraceptives throughout the study period and have a negative pregnancy test at both Screening and Check-in (Day -1).
Males with a sexual partner who is a female of childbearing potential must be surgically sterile, or agree to use condoms with spermicide or abstain from sexual intercourse, starting from Screening until 90 days after the last dose of the trial medication.
Participant is willing and able to complete all trial assessments in compliance with the protocol and is able to remain in the inpatient treatment unit for the entire duration of the confinement period and return for outpatient visits.
Part III Alzheimer's Disease:
Participant is able to provide written informed consent prior to the performance of any trial -specific procedures.
Male or female participants with early Alzheimer's disease between 55 and 80 years of age (inclusive) in good health as determined by the Investigator.
Participants with a BMI of ≥ 18.0 and ≤ 32.0 kg/m2 (inclusive) and weigh a minimum of 50 kg.
Participants with a 12-lead ECG at screening which, in the opinion of the Investigator, has no abnormalities that compromise participant's safety in this study.
Females participants must meet one of the following criteria:
a. Females must either be of non-childbearing potential, or if of childbearing potential, must agree to use contraceptives throughout the study period and have a negative pregnancy test at both Screening and Check-in (Day -1).
Males with a sexual partner who is a female of childbearing potential must be surgically sterile, or agree to use condoms with spermicide or abstain from sexual intercourse, starting from Screening until 90 days after the last dose of the trial medication.
Participant is willing and able to complete all trial assessments in compliance with the protocol and is able to remain in the inpatient treatment unit for the entire duration of the confinement period and return for outpatient visits.
Participant meets the diagnostic criteria of mild cognitive impairment (MCI) of probable Alzheimer's disease consistent with National Institute On Aging - Alzheimer's Association (NIA-AA) research framework.
Participant with a qualifying amyloid score.
Participant with a Mini-Mental State Examination (MMSE) score between 20 and 28 inclusive at screening and baseline.
Exclusion Criteria:
Part I (Single Ascending Dose) and Part II (Multiple Ascending Dose):
Part III Alzheimer's Disease:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kimberly Schafer, MS | Contact | 619-912-7475 | kims@cennabiosciences.com |
| Name | Affiliation | Role |
|---|---|---|
| Nazneen Dewji, PhD | Cenna Biosciences | Principal Investigator |
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D058225 | Plaque, Amyloid |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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Phase Ia is a first-in-human, 2-part (Part I single ascending dose and Part II multiple-ascending dose) clinical trial designed to evaluate the safety, tolerability, pharmacokinetics, and exploratory immunogenicity of single and multiple doses of 8M2D in healthy participants. Phase Ib will consist of Part III (Alzheimer's Disease [AD]), designed to evaluate the safety, tolerability, PK, exploratory immunogenicity, and pharmacodynamics of multiple doses of 8M2D in participants with early AD.
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| 8M2D Multiple Dose (Open-Label) - Early Alzheimer's Disease - Part III | Experimental | Part III (AD) will consist of a single cohort of participants with early AD. Approximately 6 eligible participants with early AD will be enrolled into a single cohort and will receive QD SC doses of 8M2D from Days 1 to 14. The intervention will be administered by subcutaneous injection. |
|
| Placebo | Drug | Matching placebo administered by subcutaneous injection in healthy participants across the single ascending dose (Part I) and multiple ascending dose (Part II) parts of the study. |
|
| Number of participants demonstrating adverse changes in physical and/or neurologic examinations |
Evaluation of the physical and/or neurological examinations conducted by site clinicians during the study period. |
| Baseline to Day 22 |
| Number of participants reporting changes in Columbia-Suicide Severity Rating Scale (C-SSRS) from baseline | The C-SSRS is a suicidal ideation and behavior rating scale to evaluate suicide risk. The total score ranges from 0 (no ideation is present) to 5 (active suicidal ideation with specific plan and intent). | Baseline to Day 22 |
| Maximum observed concentration (Cmax) of 8M2D | Maximum concentration of 8M2D, determined directly from individual concentration-time data determined through plasma and CSF analysis. | Baseline to Day 14 |
| Time to maximum observed concentration (tmax) of 8M2D | Time of the maximum concentration of 8M2D determined through plasma and CSF analysis. | Baseline to Day 14 |
| Area under the concentration-time curve from time 0 to the last quantifiable concentration (AUC-last) of 8M2D | Evaluated from time-zero to the time of the last quantifiable concentration of 8M2D determined through plasma and CSF analysis. | Baseline to Day 14 |
| Terminal phase half-life (t1/2) | The observed terminal half-life of 8M2D determined through plasma and CSF analysis. | Baseline to Day 14 |
| Area under the concentration-time curve from time 0 to infinity (AUC-inf) | Area under the concentration-time curve from time-zero extrapolated to infinity. | Baseline to Day 14 |
| Assessment of changes from baseline after 14 days of dosing in plasma and CSF biomarkers of AD [such as Aβ42, Aβ40, p-tau217, and np-tau217 | Evaluation of biomarkers of AD through plasma and CSF collected from all participants in Part III (AD) of the study. | Baseline to Day 14 |
| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |