Title

Study to Evaluate the Preliminary Safety, Efficacy, PK and PD of Bryostatin 1 in Patients With Alzheimer's Disease
A Randomized, Double-Blind, Placebo-Controlled, Study to Evaluate the Preliminary Safety, Efficacy, Pharmacokinetics and Pharmacodynamics of Bryostatin 1 in Patients With Alzheimer's Disease
  • Phase

    Phase 1/Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    bryostatin ...
  • Study Participants

    9
This study is being done to evaluate the safety, tolerability and potential effectiveness of a new investigational drug, bryostatin 1, in patients with Alzheimer's disease (AD).
This study is a single center, randomized, double-blind, placebo-controlled, parallel groups trial in patients with AD. Each subject enrolled in the trial will be randomized to receive a single IV dose of 0 (placebo) or 25 μg/m2 bryostatin. A total of 15 subjects (5 in the placebo arm and 10 in the treatment arm) will be enrolled in the study. The study consists of screening evaluations and on study evaluations divided into two segments, an inpatient segment and an outpatient segment. The four-day inpatient segment will consist of baseline evaluations and a 1-hour IV infusion of study drug followed by evaluations at multiple evaluations over the first 72 hrs post dose. During the outpatient segment, patients will be followed for AEs and have a final evaluation at 2 weeks post dose and a 4-week telephone safety follow up. Evaluations will include safety, efficacy, pharmacokinetics, and pharmacodynamics as assessed by PKC activity
Study Started
Jun 30
2014
Primary Completion
Dec 31
2014
Study Completion
Dec 31
2014
Results Posted
Apr 21
2016
Estimate
Last Update
Nov 06
2017

Drug Bryostatin 1

25 μg/m2 bryostatin 1, single dose via intravenous infusion over 1 hour.

Drug Placebo

Placebo, single dose via intravenous infusion over 1 hour.

Bryostatin 1 Active Comparator

single dose of 25 μg/m2 bryostatin, intravenous infusion over 1 hour

placebo Placebo Comparator

single dose of placebo, intravenous infusion over 1 hour

Criteria

Inclusion Criteria:

Male or female, age 50 - 85 yrs. Females are non-childbearing potential
Patient must have a cognitive deficit present for at least 1 year and meet diagnostic criteria for probable Alzheimer's Disease Dementia by NIA-AA criteria or prodromal Alzheimer's Disease
Mini Mental State Exam score of 16-26
Ability to walk, at least with an assistive device
Vision and hearing sufficient to comply with testing
Normal cognitive and social functioning prior to onset of dementia, with evidence of progressive symptoms from patient or informant
Consistent caregiver to accompany patient to visits
Sufficient basic education to be able to complete the cognitive assessments
Living outside an institution

Exclusion Criteria:

Dementia due to any condition other than AD, including vascular dementia
Significant neuroimaging abnormalities, previously known or discovered on screening MRI scan,
Evidence of clinically significant unstable cardiovascular, renal, hepatic, gastrointestinal, neurological, or metabolic disease within the past 6 months
Use of any drug within 14 days prior to randomization unless the dose of the drug and the condition being treated have been stable for at least 30 days and are expected to remain stable during the study
Use of tobacco products or nicotine-containing products within 3 months before Day 1
Use of high dose vitamin E, or valproic acid
Any medical or psychiatric condition that may require medication or surgical treatment during the study
Life expectancy less than 6 months
Use of an investigational drug within 2 months prior to the screening visit
Clinically significant neurological disease other than AD
Major depression, alcohol or drug dependence or suicidality
Psychotic episodes requiring hospitalization or antipsychotic therapy for more than 2 weeks within the past 10 years, not linked to AD
Agitation sufficient to preclude participation in this trial
Epilepsy or anti-epileptic drug therapy
Abnormal laboratory tests that might point to another etiology for dementia;
Acute or poorly controlled medical illness
Likelihood, according to clinical judgment, of being transferred to a nursing home within 6 months

Summary

Bryostatin 1

Placebo

All Events

Event Type Organ System Event Term Bryostatin 1 Placebo

Number of Participants With Adverse Events as a Measure of Safety and Tolerability

Evaluate the safety and tolerability of bryostatin 1 (hereinafter referred to as bryostatin) in patients with Alzheimer's Disease (AD) following a single intravenous (IV) dose.

Bryostatin 1

Dizziness

Headache

1.0
event

Rash Papular

Placebo

Dizziness

1.0
event

Headache

1.0
event

Rash Papular

1.0
event

Preliminary Efficacy of a Single Dose of Bryostatin in the Treatment of Patients With AD

Hopkins Verbal Learning Test - Revised (HVLT-R) delayed recall; change from baseline. HVLT consists of a 12-item word list drawn from 3 semantic categories, presented in 3 learning trials. Score range = 0-12. The lower the number, the more impaired. Repeatable Battery of Assessments for Neuropsychological Status (RBANS) figure recall; change from baseline. Total Score Range: 0-20. Each portion of the drawing is scored 1 point for correctness and completeness and 1 point for being placed properly in relation to the rest of the drawing. Drawing and placement scores are summed for the item total. To obtain subtest total score, the drawing and placement scores are summed for each item. The lower the number, the more impaired.

Bryostatin 1

HVLT-R at 48hrs (change from baseline)

1.3
units on a scale, change from baseline (Mean)
Standard Deviation: 2.16

RBANS figure recall at 48hrs (CBL)

4.5
units on a scale, change from baseline (Mean)
Standard Deviation: 4.14

Placebo

HVLT-R at 48hrs (change from baseline)

3.7
units on a scale, change from baseline (Mean)
Standard Deviation: 1.15

RBANS figure recall at 48hrs (CBL)

6.7
units on a scale, change from baseline (Mean)
Standard Deviation: 3.06

Preliminary Efficacy of a Single Dose of Bryostatin in the Treatment of Patients With AD

HVLT-R (Hopkins Verbal Learning Test-Revised™) delayed recall (change from baseline). A 12-item word list: 3 learning trials. Score range = 0-12. The lower the number, the more impaired. Repeatable Battery of Assessments for Neuropsychological Status (RBANS) figure recall; change from baseline. Score Range: 0-20. The lower the number, the more impaired. Digit Symbol Coding (observed), Score range: 0-125. The lower the number, the more impaired. Clinical Dementia Rating- Sum of Boxes (CDR-SB, observed). Sum of 6 investigated domains (Memory, Orientation, Judgment and Problem Solving, Community Affairs, Home and Hobbies, Personal Care). Each subtest range is 0-3; Sum of all 6 subtest scores gives total CDR-SB score (range= 0-18).The higher the number, the more impaired. Mini Mental State Exam, version 2 (MMSE-2), change from baseline. The MMSE-2 measures aspects of cognitionon a scale of 0-30. Lower scores indicate greater cognitive impairment.

Bryostatin 1

CDR, CDR-SB 2wks (observed)

1.5
units on a scale (Mean)
Standard Deviation: 1.00

CDR, CDR-SB baseline (observed)

1.3
units on a scale (Mean)
Standard Deviation: 0.98

Digit Symbol Coding 24hrs post start of infusion

36.0
units on a scale (Mean)
Standard Deviation: 10.75

Digit Symbol Coding 2 wks post start of infusion

38.3
units on a scale (Mean)
Standard Deviation: 7.61

Digit Symbol Coding 3hrs post start of inf (observ

32.7
units on a scale (Mean)
Standard Deviation: 6.86

Digit Symbol Coding 48hrs post start of infusion

37.3
units on a scale (Mean)
Standard Deviation: 11.64

Digit Symbol Coding baseline (observed)

32.2
units on a scale (Mean)
Standard Deviation: 9.13

HVLT-R 24hr Delayed Recall (change from baseline)

0.5
units on a scale (Mean)
Standard Deviation: 3.27

HVLT-R 2 Wks Delayed Recall (change from baseline)

0.3
units on a scale (Mean)
Standard Deviation: 1.63

HVLT-R delayed recall of stimuli at 48hr (CBL)

-1.2
units on a scale (Mean)
Standard Deviation: 1.17

MMSE-2 3hrs post start of inf (change)

1.8
units on a scale (Mean)
Standard Deviation: 1.72

MMSE-2 at 2wks (change from Baseline)

3.3
units on a scale (Mean)
Standard Deviation: 1.86

MMSE-2 at 72hrs (change from Baseline)

2.6
units on a scale (Mean)
Standard Deviation: 1.52

RBANS 24hr Figure Recall (change from baseline)

4.7
units on a scale (Mean)
Standard Deviation: 4.76

RBANS 2 Wks Figure Recall (CBL)

4.2
units on a scale (Mean)
Standard Deviation: 5.60

Placebo

CDR, CDR-SB 2wks (observed)

0.7
units on a scale (Mean)
Standard Deviation: 0.29

CDR, CDR-SB baseline (observed)

0.7
units on a scale (Mean)
Standard Deviation: 0.29

Digit Symbol Coding 24hrs post start of infusion

49.0
units on a scale (Mean)
Standard Deviation: 4.58

Digit Symbol Coding 2 wks post start of infusion

52.7
units on a scale (Mean)
Standard Deviation: 6.66

Digit Symbol Coding 3hrs post start of inf (observ

45.3
units on a scale (Mean)
Standard Deviation: 11.50

Digit Symbol Coding 48hrs post start of infusion

53.7
units on a scale (Mean)
Standard Deviation: 4.73

Digit Symbol Coding baseline (observed)

42.3
units on a scale (Mean)
Standard Deviation: 12.50

HVLT-R 24hr Delayed Recall (change from baseline)

1.3
units on a scale (Mean)
Standard Deviation: 2.52

HVLT-R 2 Wks Delayed Recall (change from baseline)

2.3
units on a scale (Mean)
Standard Deviation: 2.52

HVLT-R delayed recall of stimuli at 48hr (CBL)

2.7
units on a scale (Mean)
Standard Deviation: 2.08

MMSE-2 3hrs post start of inf (change)

-1.0
units on a scale (Mean)
Standard Deviation: 2.65

MMSE-2 at 2wks (change from Baseline)

4.7
units on a scale (Mean)
Standard Deviation: 1.15

MMSE-2 at 72hrs (change from Baseline)

3.3
units on a scale (Mean)
Standard Deviation: 2.52

RBANS 24hr Figure Recall (change from baseline)

6.0
units on a scale (Mean)
Standard Deviation: 2.65

RBANS 2 Wks Figure Recall (CBL)

7.3
units on a scale (Mean)
Standard Deviation: 3.06

Pharmacokinetic Parameters of Bryostatin.

Preliminary evaluation of pharmacokinetics and pharmacodynamics (Cmax, Tmax, AUClast).

Bryostatin 1

Cmax (ng/mL)

1.09
bryostatin plasma concentration (ng/mL) (Mean)
Standard Deviation: 0.246

Concentration 1.5 hrs post (ng/mL)

0.181
bryostatin plasma concentration (ng/mL) (Mean)
Standard Deviation: 0.148

Concentration 15 min post (ng/mL)

0.88
bryostatin plasma concentration (ng/mL) (Mean)
Standard Deviation: 0.133

Concentration 1 hr post (ng/mL)

1.04
bryostatin plasma concentration (ng/mL) (Mean)
Standard Deviation: 0.309

Concentration 2 hrs post (ng/mL)

0.0702
bryostatin plasma concentration (ng/mL) (Mean)
Standard Deviation: 0.109

Concentration 30 min post (ng/mL)

0.941
bryostatin plasma concentration (ng/mL) (Mean)
Standard Deviation: 0.168

Concentration 3 hrs post (ng/mL)

Concentration 6 hrs post (ng/mL)

predose Bryostatin Plasma Concentration (ng/mL)

Placebo

Total

9
Participants

Age, Continuous

71.9
years (Mean)
Standard Deviation: 7.37

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Bryostatin 1

Placebo