REBRAnD: Repurposing Bromocriptine for Abeta Metabolism in Alzheimer's Disease
Study Details
Study Description
Brief Summary
To investigate the safety and efficacy of an orally administered dose of TW-012R in patients with Alzheimer's disease bearing PSEN1 (presenilin 1) mutations (PSEN1-AD), using a placebo group as a control. In addition, long-term safety will be examined in an open-label extension trial.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1/Phase 2 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Active Comparator: Active
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Drug: Bromocriptine
TW-012R: Each tablet contains 2.87 mg of bromocriptine mesilate (JP) (2.5 mg of bromocriptine)
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Placebo Comparator: Placebo
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Drug: Placebos
Placebo: Identical tablets which contain no active ingredient
|
Outcome Measures
Primary Outcome Measures
- Safety (Incidence and severity of adverse events and adverse reactions) [Until Week 50 (end of trial)]
- Severe impairment battery-Japanese version (SIB-J) [Until Week 20 and 36]
- Neuropsychiatric Inventory (NPI) [Until Week 20 and 36]
Secondary Outcome Measures
- Mental Function Impairment Scale (MENFIS) [Until Week 20 and 36]
- Mini-Mental State Examination-Japanese (MMSE-J) [Until Week 20 and 36]
- Disability Assessment for Dementia (DAD) [Until Week 20 and 36]
- Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III [Until Week 20 and 36]
- Apathy Scale [Until Week 20 and 36]
- Plasma Aβ protein concentration [Until Week 20 and 36]
- Plasma NfL protein concentration [Until Week 20 and 36]
- Plasma Total Tau, Plasma p-Tau concentration [Until Week 20 and 36]
- Cerebrospinal fluid (CSF) Aβ concentration [Until Week 36]
- CSF Total Tau, CSF p-Tau concentration [Until Week 36]
- Blood bromocriptine concentration [Until Week 20 and 36]
Other Outcome Measures
- Wearable physical activity meter [Until Week 20 and 36]
- Finger tapping sensor readout [Until Week 20 and 36]
- Brain amyloid PET image [Until Week 36]
- Brain tau PET image [Until Week 36]
- Upper motor neuron burden score [Until Week 20 and 36]
- Plasma Aβ-related peptides concentration [Until Week 20 and 36]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Alzheimer's disease patients with PSEN1 mutations
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Patients diagnosed with "probable AD" according to the diagnostic guideline of NIA-AA or "probable Alzheimer-type dementia" according to the diagnostic criteria for Alzheimer's disease specified in DSM-5
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An MMSE-J score of <= 25
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Patients whose cognitive function and everyday function are obviously impaired based on their medical record or information provided by a person who knows the patient well
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Patients for whom intellectual disability and mental disorders other than dementia can be ruled out based on their academic background, work history, and life history.
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Patients with a reliable and close relationship with a partner/caregiver
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Age>=20 years at the time of giving informed consent
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Written informed consent has been obtained from the patient or his/her legally acceptable representative to participate in this trial
Exclusion Criteria:
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Difficulty with the oral intake of tablets
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Patients receiving anti-dementia drugs who have changed the dosing regimen during the 2 months prior to giving informed consent
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Patients with dementia due to pathology other than Alzheimer's disease (e.g., vascular dementia, frontotemporal dementia, Lewy body dementia, progressive supranuclear palsy, corticobasal degeneration, Huntington's disease, and prion disease)
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Presence of clinically relevant or unstable mental disorders. Patients with major depression in remission can be enrolled.
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Imminent risk of self-harm or harm to others
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Body mass index (BMI) of <= 17 or >= 35
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Patients with a history of alcohol dependence, drug dependence, or drug abuse within the 5 years before providing informed consent
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HBs antigen positive
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Anti-HIV antibody positive
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Anti-HTLV-1 antibody positive
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Patients with an active infection, such as hepatitis C and syphilis (STS/TPHA)
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Patients with the following liver function values on the test before enrollment
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AST(GOT) > 4.0 x Upper limit of the institutional reference range or
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ALT (GPT) > 4.0 x Upper limit of the institutional reference range
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Patients who have uncontrolled, clinically significant medical conditions (e.g., diabetes melitus, hypertension, thyroid/endocrine disease, congestive cardiac failure, angina pectoris, cardiac/gastrointestinal disease, dialysis, and abnormal renal function with an estimated CLcr < 30 mL/min)within 3 months prior to giving informed consent in addition to the underlying disease to be investigated in the trial and for whom the investigator or sub-investigator considers that there is a significant medical risk in the patient's participation in the trial
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Patients with long QT syndrome or tendency toward prolonged QTc interval (male: >=470 msec, female: >= 480 msec), or patients with a history/complication of torsades de pointes
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Patients with a history of malignancies within 5 years prior to providing informed consent. However, patients with the following diseases can be enrolled if they are treated appropriately:
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Skin cancer (basal cell, squamous cell)
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Cervical carcinoma in situ
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Localized prostate cancer
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Malignancies that have not recurred for at least 3 years since surgery and the patient's physician has determined that the risk of recurrence is low
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Patients with clinically significant vitamin B1/B12 deficiency or folic acid deficiency within 6 months prior to giving informed consent
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Patients who have participated in other clinical research/trials involving interventions within the 3 months prior to providing informed consent
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Patients who have previously received bromocriptine or TW-012R
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Patients with a history of hypersensitivity to bromocriptine or ergot alkaloids
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Patients with current or a history of thickened heart valve cusps, restricted heart valve motion, and the associated heart valve lesions, such as stenosis, confirmed by echocardiography
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Pregnant females, lactating females, females who may be pregnant, and females who wish to become pregnant
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Other patients who are considered inappropriate to participate in this trial at the discretion of the investigator or sub-investigator
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Nagoya City University Hospital | Nagoya | Aichi | Japan | 467-8602 |
2 | Mie University Hospital | Tsu | Mie | Japan | 514-8507 |
3 | Kawasaki Medical School Hospital | Kurashiki | Okayama | Japan | 701-0192 |
4 | Asakayama Hospital | Sakai | Osaka | Japan | 590-0018 |
5 | Osaka University | Suita | Osaka | Japan | 565-0871 |
6 | Kyoto University Hospital | Kyoto | Japan | 606-8507 | |
7 | Tokushima University Hospital | Tokushima | Japan | 770-8503 | |
8 | Tokyo Metropolitan Geriatric Hospital | Tokyo | Japan | 173-0015 |
Sponsors and Collaborators
- Kyoto University
- Mie University
- Osaka University
- Tokushima University
- Tokyo Metropolitan Geriatric Medical Center
- Asakayama Hospital
- Kawasaki Medical School Hospital
- Nagoya City University Hospital
- Time Therapeutics, Inc.
- Towa Pharmaceutical Co.,Ltd.
Investigators
- Principal Investigator: Haruhisa Inoue, MD, PhD, Kyoto University
- Study Director: Hidekazu Tomimoto, MD, PhD, Mie University Hospital
- Study Director: Haruhiko Banno, MD, PhD, Kyoto University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IACT19029