Senolytic Therapy to Modulate Progression of Alzheimer's Disease

Alzheimer Disease Clinical Trial

— SToMP-AD  

Official title:

Pilot Study to Investigate the Safety and Feasibility of Senolytic Therapy to Modulate Progression of Alzheimer's Disease (SToMP-AD)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04063124
• Other study ID #: HSC20190222H
• Status: Completed
• Phase: Phase 1/Phase 2
• Start date: February 14, 2020
• Est. completion date: January 30, 2023

Study information

• Verified date: February 2023
• Source: The University of Texas Health Science Center at San Antonio
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this pilot study is to evaluate whether a combination of two drugs, dasatinib (D) and quercetin (Q) [D+Q], penetrate the brain using cerebrospinal fluid (CSF) in older adults with early Alzheimer's disease (AD). This combination of drug therapy has been shown to affect dying cells in humans with other chronic illnesses and in Alzheimer's mice models. The study team want to know if this combination of medications will reach the brain in order to evaluate if this intervention may be effective for treating AD symptoms in future studies. This is also known as a "proof of concept" study.

Description:

Up to 40 potential candidates will be pre-screened to identify eligible men and women ages 65 years and over with a clinical diagnosis of early AD on a stable dose of cholinesterase inhibitors for at least 3 months (for example, Aricept).

Eligible participants will undergo laboratory assessments of blood and urine, receive study medications over a twelve week period, and complete pre- and post-treatment testing including: an MRI for digital imaging of the brain; lumbar puncture to obtain cerebrospinal fluid; memory and thinking assessments; quality of life questionnaires; and tests of walking, balance and strength, all of which will be done for research purposes only.

Participants must be accompanied by a Legally Authorized Representative and have no travel plans for 4-5 months that would interfere with study visits.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 5
• Est. completion date: January 30, 2023
• Est. primary completion date: December 10, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

1. Age 65 years or above.

2. Clinical diagnosis of AD (MoCA 10-20 and Clinical Dementia Rating Scale/CDR = 1) on a stable dose of cholinesterase inhibitors for at least three months

3. Body Mass Index (BMI) within range of 19 - 35 kg/ m2

4. Labs: Normal blood cell counts without clinically significant excursions (WBCs:

4,500-10,500 cells/mcL; absolute neutrophil count: 1,800-8,700 cells/mcL; platelets:

140-450 K/uL; hemoglobin 12.0-17.5 grams/dL); liver and renal function (AST 10-40 IU/L, total bilirubin 0.1-1.4 mg/dl); cholesterol (<240 mg/dl), triglycerides (<300 mg/dl), and glucose control (HbA1c < 7%). PT/PTT/INR within normal limits

5. Participants must be accompanied by a Legally Authorized Representative designated to sign informed consent and to provide study partner reported outcomes at all remaining visits

6. Participants must have no plans to travel over the next 4-5 months that interfere with study visits following consent

Exclusion Criteria:

1. Hearing, vision, or motor deficits despite corrective devices;

2. Alcohol or drug abuse;

3. MRI contraindications;

4. Myocardial infarction, angina, stroke or transient ischemic attack in the past 6 months; QT interval >440 on ECG will not be enrolled. Chronic heart failure will be exclusionary;

5. Participants with coagulation disorders;

6. Neurologic, musculoskeletal, or other condition that limits subject's ability to complete study physical assessments;

7. Uncontrolled diabetes (HbA1c > 7% or the current use of insulin);

8. Current or chronic history of liver disease, or known hepatic or biliary abnormalities;

9. Use of anti-arrhythmic medications known to cause QTc prolongation, anti-platelet or anti-coagulant medication;

10. Current use of quinolone antibiotics.

11. Poorly controlled blood pressure (systolic BP>160, diastolic BP>90 mmHg).

12. Active inflammatory, autoimmune, infectious, hepatic, gastrointestinal, malignant, and psychiatric disease.

13. History of or MRI-positive for any space occupying lesion, including mass effect or abnormal intracranial pressure, which would indicate contraindication to lumbar puncture

Related Conditions & MeSH terms

• Alzheimer Disease

Intervention

Drug:
• Dasatinib + Quercetin
Intermittent D+Q administered for 2 days on/14 days off for 12 weeks (6 cycles)

Locations

Country	Name	City	State
United States	Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases	San Antonio	Texas

Sponsors (2)

Lead Sponsor	Collaborator
The University of Texas Health Science Center at San Antonio	Mayo Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Brain Penetrance of Dasatinib (D)	Cerebrospinal Fluid (CSF) collected by lumbar puncture before and after 12 weeks of treatment to determine levels of drug that reach the central nervous system will be measured by high performance liquid chromatography/mass spectrometry (HPLC/MS)	Change from 0 to 12 weeks
Primary	Brain Penetrance of Quercetin (Q)	CSF collected by lumbar puncture before and after 12 weeks of treatment to determine levels of drug that reach the central nervous system using HPLC/MS	Change from 0 to 12 weeks
Secondary	Alzheimer's Disease Marker - CSF Tau	Cerebrospinal Fluid collected by lumbar puncture analyzed for level of tau proteins present in CSF	Change from 0 to 12 weeks
Secondary	Alzheimer's Disease Marker - CSF Amyloid Beta	Cerebrospinal Fluid collected by lumbar puncture analyzed for level of amyloid beta proteins present in CSF	Change from 0 to 12 weeks
Secondary	Senescence Marker IL-6 in CSF	Laboratory measure of level of IL-6 found in CSF collected pre and post treatment	Change from 0 to 12 weeks
Secondary	Senescence Marker P16 in CSF	Laboratory measure of level of P16 found in CSF collected pre and post treatment	Change from 0 to 12 weeks
Secondary	Electronic Gait Mapping Under Single and Dual-task Conditions	Participants walk on a pressure-sensitive walkway to capture data on gait speed	Change from 0 to 12 weeks
Secondary	Montreal Cognitive Assessment (MoCA)	A test which scores the participant with score ranges between 0 and 30. A score of 26 or over is considered normal. Individuals with mild cognitive impairment score lower and individuals with Alzheimer's disease score even lower.	Change from 0 to 12 weeks