Cognitive Change Clinical Trial
Official title:
The Use of AVL-3288 to Potentiate the Attention-Enhancing Effects of Low-Dose Nicotine
Single-center, randomized, double-blind, placebo-controlled, proof-of-principle study to evaluate potential cognitive benefits of a single oral dose of AVL-3288 (3 mg) in the presence and absence of transdermal nicotine (7 mg/24 hrs) in healthy non-smokers, while monitoring the safety and tolerability of AVL-3288.
Nicotinic acetylcholine receptor (nAChR) agonists such as nicotine have been shown to enhance
cognitive performance, especially functions in the attention domain. Efforts have been made
to develop similar compounds as therapeutic agents for disorders such as schizophrenia or
Alzheimer's disease. Over the last two decades, drug development has invested into novel
nAChR agonists. Effects have generally been in the expected direction, but tended to be of
small magnitude. A potential way of increasing the effect size ceiling is by co-administering
a nAChR positive allosteric modulator (PAM). PAMs generally do not activate the nAChR on
their own but bind to a second, modulatory site and facilitate agonist-induced responses. The
present study is aimed at testing the effects of AVL-3288, a PAM selective for the α7 nAChR
subtype that is thought to be of particular relevance for cognition in schizophrenia, on
cognitive task performance, and on nicotine-induced improvements in cognitive task
performance, in healthy adult non-smokers.
The aim of the present study is to provide the proof-of-principle that the
attention-enhancing effects of the prototypical nAChR agonist nicotine can be potentiated by
an α7 nAChR PAM (AVL-3288). Potentiation of nAChR agonist effects by PAMs have been shown in
preclinical behavioral assays. The availability of AVL-3288 as a safe pure nAChR PAM for
human research allows testing the hypothesis that nicotine and AVL-3288 will have additive or
synergistic effects, such that the attention-enhancing effects of nicotine and AVL-3288
combined will be greater than the effects of either drug alone.
AVL-3288 has shown preclinical efficacy in rat paradigms of attention and memory, including
models of cognitive dysfunction1-3. A human study in healthy adults reported no adverse
effects associated with AVL-3288, tested at doses of 3, 10, and 30 mg. Some of the
participants tested with 3 mg were smokers, some on nicotine replacement.
The present study will adopt a repeated measures design, in which a single group of 24
healthy non-smokers will complete 4 test sessions, in each of which they perform the same
three cognitive paradigms. In each session, a skin patch will be administered 5 hrs prior to
testing, and a solution (3 mL) will be administered by mouth 1 hr prior to testing. The skin
patch is either a 7 mg/24 hrs nicotine patch or a placebo patch. The solution either contains
AVL-3288 (3 mg) or is inactive diluent only. Over the 4 test sessions, each participant will
be tested with Placebo + Placebo, Nicotine + Placebo, Placebo + AVL-3288, and Nicotine +
AVL-3288, in a 2x2 factorial design. The sequence of test conditions will be only known to
the statistician and pharmacist and counterbalanced across subjects.
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