A phase 2 randomized, placebo-controlled study on the efficacy and safety of AR1001, a phosphodiesterase-5 inhibitor, in patients with mild-to-moderate Alzheimer's disease.

IF 7.8 Q2 BUSINESS
David Greeley, Marshall Nash, Brad Herskowitz, Fred Kim, James Rock, Neils Prins, SangYun Kim, Tianyang Xi, Jonathan A Busam, Benoit Tete, Jai Jun Choung, Sharon J Sha
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引用次数: 0

Abstract

Background: AR1001 is a phosphodiesterase-5 inhibitor that produces improved cognitive performance and reduces amyloid-β and phosphorylated tau burdens in preclinical models of Alzheimer's disease (AD).

Objectives: To evaluate the safety and efficacy of AR1001 in participants with mild-to-moderate Alzheimer's disease (AD).

Design: Randomized, double-blind, placebo-controlled phase 2 trial conducted at 21 sites in the United States.

Participants: Adults aged 55-80 years with mild-to-moderate dementia as determined by National Institutes of Aging-Alzheimer's Association (NIA-AA) stage 4 or 5 and Mini-mental State Exam (MMSE) score 16-26.

Intervention: Once daily oral administration of placebo, 10 mg AR1001, or 30 mg AR1001 for 26 weeks followed by 26 weeks optional extension.

Measurements: Co-primary efficacy endpoints were changes from baseline at Week 26 in Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog 13) and Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC). Secondary endpoints included measures of cognition, daily living, and depression. Levels of plasma biomarkers pTau-181, pTau-217, Aβ42/40 ratio, glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) were also examined.

Results: A total of 210 participants were enrolled and 82% completed 26 weeks of treatment. AR1001 10 mg and 30 mg were well-tolerated with a similar safety profile compared to placebo. After 26 weeks, there were no differences in ADAS-Cog13, ADCS-CGIC, or in secondary efficacy endpoints between groups. Levels of plasma biomarkers pTau-181, pTau-217, and GFAP were improved in the 30 mg AR1001 group compared to placebo.

Conclusion: AR1001 was safe and well tolerated. Although primary efficacy endpoints were not met after 26 weeks of treatment, participants receiving 30 mg AR1001 showed favorable changes in AD-related plasma biomarkers compared to placebo.

Trial registration: clinicaltrials.gov; NCT03625622.

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一项关于磷酸二酯酶-5抑制剂AR1001治疗轻至中度阿尔茨海默病的疗效和安全性的2期随机、安慰剂对照研究。
背景:AR1001是一种磷酸二酯酶-5抑制剂,在阿尔茨海默病(AD)的临床前模型中可提高认知能力,减少淀粉样蛋白-β和磷酸化tau负担。目的:评估AR1001在轻度至中度阿尔茨海默病(AD)患者中的安全性和有效性。设计:随机,双盲,安慰剂对照2期试验在美国21个地点进行。参与者:年龄在55-80岁,患有轻度至中度痴呆症的成年人,由美国国家老年痴呆症协会(NIA-AA) 4期或5期和迷你精神状态测试(MMSE)评分16-26分确定。干预措施:每天口服一次安慰剂,10mg AR1001,或30mg AR1001,连续26周,随后26周可选延长。测量:共同的主要疗效终点是第26周阿尔茨海默病评估量表-认知亚量表(ADAS-Cog 13)和阿尔茨海默病合作研究-临床总体印象变化(ADCS-CGIC)的基线变化。次要终点包括认知、日常生活和抑郁的测量。同时检测血浆生物标志物pTau-181、pTau-217、a - β42/40比值、胶质纤维酸性蛋白(GFAP)和神经丝轻链(NfL)水平。结果:共有210名参与者入组,82%完成了26周的治疗。与安慰剂相比,AR1001 10mg和30mg耐受性良好,安全性相似。26周后,两组间ADAS-Cog13、ADCS-CGIC或次要疗效终点均无差异。与安慰剂相比,30mg AR1001组血浆生物标志物pTau-181、pTau-217和GFAP水平均有改善。结论:AR1001是安全且耐受性良好的。虽然治疗26周后未达到主要疗效终点,但与安慰剂相比,接受30mg AR1001治疗的参与者在ad相关血浆生物标志物方面表现出有利的变化。试验注册:clinicaltrials.gov;NCT03625622。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
自引率
0.00%
发文量
0
期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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