Trial Review

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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT05904717




Registration number
NCT05904717
Ethics application status
Date submitted
6/06/2023
Date registered
15/06/2023
Date last updated
18/11/2023

Titles & IDs
Public title
Effect of PXS-4728A on Microglia Activation in Participants With Isolated Rapid Eye Movement Sleep Behaviour Disorder
Scientific title
A Phase 2a, Multi Centre, Double-blind, Randomized, Placebo-controlled, Parallel-group Study to Assess the Effect of 12 Weeks Treatment With Oral PXS-4728A on Microglia Activation, as Measured by Positron Emission Tomography, in Participants With Isolated Rapid Eye Movement Sleep Behavior Disorder
Secondary ID [1] 0 0
PXS4728A-IRBD-201
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
REM Sleep Behavior Disorder 0 0
Condition category
Condition code
Neurological 0 0 0 0
Other neurological disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - PXS-4728 (A)
Treatment: Drugs - Matching Placebo (B)

Experimental: A (PXS-4728) - IP Name: PXS-4728 Dosage: 15 mg Mode: oral administration (PO)

Placebo Comparator: B (Matching Placebo) - Matching placebo to PXS-4728


Treatment: Drugs: PXS-4728 (A)
Participants will receive once daily (QD) for period of 12 weeks

Treatment: Drugs: Matching Placebo (B)
Participants will receive once daily (QD) for period of 12 weeks
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
To assess the reduction of microglial activation across striato-cortical regions
Timepoint [1] 0 0
Up to Week 12
Primary outcome [2] 0 0
To assess the safety and tolerability of PXS-4728A as determined by adverse events (AEs)
Timepoint [2] 0 0
Up to Week 24
Secondary outcome [1] 0 0
To assess the reduction of microglial activation across the whole brain and cortical and subcortical regions of interest (ROIs)
Timepoint [1] 0 0
Up to Week 12

Eligibility
Key inclusion criteria
1. Ability to provide written informed consent in accordance with GCP, International
Council for Harmonisation (ICH) and local regulations.

2. Male or female aged 50 to 80 (inclusive) as of the date of Baseline visit.

3. Clinical diagnosis of iRBD according to International Classification of Sleep
Disorders (ICSD)-3 criteria.

4. Objective evidence of 1 or more features of parkinsonism, impaired olfaction and/or
impaired color vision discrimination, which have been associated with an increased
risk for transitioning to a synucleinopathy in the opinion of the Investigator.

5. Screening PET scan demonstrates robust PK11195 signal in striato-cortical region of
interest in the opinion of the Investigator.

6. Liver Function Tests (LFTs): alanine aminotransferase (ALT) and aspartate
aminotransferase (AST) = 3 × upper limit of normal (ULN); total bilirubin = 1.5 × ULN;
serum albumin = 2.8 g/dL.

7. Women of childbearing potential (WOCBP) must have a negative serum pregnancy test
(human chorionic gonadotropin [hCG]) at Screening. WOCBP who engage in heterosexual
intercourse and men whose sexual partners are WOCBP must agree to use highly
effective, double barrier contraception during the study and for a period of 90 days
following final dosing. Double barrier contraception is defined as a condom and 1
other form of the following:

1. Contraceptive pill

2. Depot or injectable birth control

3. Intrauterine Device (IUD)

4. Contraceptive skin implant, (eg, Implanon NXT®)

5. Hormonal vaginal ring, (eg, NuvaRing®)

6. Documented evidence of surgical sterilization at least 6 months prior to the
Screening visit, (ie, bilateral tubal ligation, oophorectomy, salpingectomy, or
total hysterectomy for women or vasectomy for men).

Must be willing to remain on their current form of contraception for the duration of
the study.

Note: For participants with same-sex partners or who are otherwise abstinent from
heterosexual intercourse, total abstinence (defined as abstinence from penile-vaginal
intercourse), when this is the preferred and usual lifestyle of participants, may be
considered an acceptable form of contraception.

8. Women not of childbearing potential must be postmenopausal for = 12 months.
Postmenopausal status will be confirmed through testing of follicle-stimulating
hormone (FSH) levels = 40 IU/L at Screening for amenorrheic female participants.
Willing and able to have the types of diagnostic procedures required by the protocol,
such as neuroimaging, phlebotomy, and other testing.

9. Willing and able to take oral drug therapy according to the study protocol.

10. Willing and able to undertake radiological scans (PET, MRI) and utilize smartphone
apps / devices to complete assessments.
Minimum age
50 Years
Maximum age
80 Years
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. Meets diagnostic criteria for a degenerative neurologic disorder such as Parkinson's
disease, Multiple System Atrophy, Dementia with Lewy Bodies, etc.

2. Screening PET scan does not demonstrate robust PK11195 signal in striato-cortical
region of interest in the opinion of the Investigator.

3. RBD associated with narcolepsy.

4. Dementia (Mild Cognitive Impairment permitted).

5. Unstable medications (stable use [minimum 4 weeks] allowed for treatment of affective
symptoms [mood disorders] and dream enactment [eg, melatonin, clonazepam, etc]).

6. Untreated or uncontrolled severe obstructive sleep apnea (OSA).

7. Females who are pregnant or breastfeeding.

8. Body mass index (BMI) > 35.0 kg/m2.

9. Any known hypersensitivity to the IP, radioligand or their constituents.

10. Serious neurological disorder, such as uncontrolled epilepsy or stroke.

11. History of psychotic symptoms requiring antipsychotic treatment or exposure to typical
or atypical antipsychotics or other dopamine blocking agents within 6 months prior to
Screening.

12. History of suicidal attempt/s within the prior 6 months.

13. Gastrointestinal conditions that may affect the absorption of IP (eg, ulcerative
colitis, gastric bypass).

14. History of significant medical event/s within 6 months prior to the Screening visit,
at the discretion of the PI. This includes, but is not limited to, a cerebrovascular
event or a myocardial infarction.

15. Any significant uncontrolled cardiac arrhythmia, including but not limited to second
and third degree atrioventricular (AV) block.

16. History of head trauma with loss of consciousness for more than 5 minutes within the
past 6 months.

17. Use of drugs historically associated with liver injury, hepatic steatosis, or
steatohepatitis in the 4 weeks prior to Screening.

18. History of liver cirrhosis (fibrosis stage 4), or hepatic decompensation (eg, ascites,
hepatic encephalopathy, variceal bleeding, etc.) or history of other forms of chronic
liver disease (for example Hepatitis B, Hepatitis C, autoimmune liver disease, primary
biliary sclerosis, primary sclerosing cholangitis, Wilsons disease, hemochromatosis,
A1At deficiency, history of liver transplantation).

19. Active known chronic or relevant acute infections, such as HIV (Human Immunodeficiency
Virus), viral hepatitis, or tuberculosis. Participants with a positive test result may
participate in the study, at the discretion of the Investigator, if further diagnostic
analysis (according to local practice/guidelines) establishes conclusively that the
participant has no evidence of active infection.

20. Solid liver lesions other than hemangiomas.

21. Suspicion or diagnosis or history of hepatocellular carcinoma (HCC).

22. Sustained supine hypertension = 180 mmHg systolic or 110 mmHg diastolic. Sustained is
defined as the average of 3 observations, each at least 10 minutes apart, with the
participant having been supine and at rest for at least 5 minutes prior to each
measurement.

23. History of symptomatic orthostatic hypotension (OH) which interferes with the
participant's day-to-day level of functioning. OH is defined as a decrease of = 20
mmHg systolic or = 10 mmHg diastolic when changing from supine to standing position,
after having been in supine position for at least 5 minutes.

24. Current unstable angina.

25. Congestive heart failure (New York Heart Association [NYHA] Class 3 or 4).

26. Heart rate = 50 beats per minute (bpm) as tested on 3 occasions, 10 minutes apart.

27. Abnormal 12-lead ECG results, which in the opinion of the Investigator will prevent
participation in the study.

28. Uncontrolled diabetes defined as an HbA1c = 9.5% in the 3 months prior to or at
Screening.

29. Prior diagnosis of cancer and evidence of continued malignancy within the past 3 years
(with the exception of adequately treated basal cell or squamous cell skin cancer, in
situ cervical cancer or in situ prostate cancer with normal prostate-specific antigens
post resection).

30. Any major surgical procedure within 30 days prior to the Screening visit. Minor
surgery is per the discretion of the Investigator.

31. Severely impaired renal function with creatinine clearance < 30 mL/min.

32. Active alcohol or substance use disorder within the past 12 months, at the discretion
of the Investigator.

33. Depression of moderate severity or more on the Patient Health Questionnaire (PHQ-9) =
10 at Screening.

34. Participants with clinically significant abnormalities (as determined by the
Investigator) in clinical laboratory tests at Screening, as assessed by the
study-specific clinical laboratory. A single repeat test may be conducted if deemed
necessary.

35. Participation in any trial of a device (including, but not limited to transcranial
magnetic stimulation [TMS], near-infrared [NIR], and red-light therapy [? = 600-1070
nm]), investigational medicinal product, supplement, surgical treatment,
cognitive/behavioral therapy, physiotherapy, or active exercise study within 30 days
prior to Screening.

36. Any reason which would impede the ability to safely undertake radiological scans (PET,
MRI) such as metal implants, claustrophobia, inability to lie still in the scanner for
the scanning period etc.

37. Chronic inflammatory or autoimmune disorder.

38. Receipt of any live vaccine within 4 weeks or any vaccine within 2 weeks prior to
Screening.

39. Regular use of anti-inflammatory/immunomodulating medications including prednisolone
or other oral steroids (within 3 months of Screening), non-steroidal
anti-inflammatories including high dose aspirin (> 75 mg), diclofenac, and meloxicam
(within 2 weeks of Screening), and immunosuppressant drugs including mycophenolate,
methotrexate, rituximab, cyclophosphamide, and alemtuzumab (within 6 months of
Screening).

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 2
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
8/11/2023
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
31/01/2025
Actual
Sample size
Target
40
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Sydne
Recruitment hospital [1] 0 0
Cognitive Neuroscience Brain & Mind Centre - Camperdown
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment outside Australia
Country [1] 0 0
United Kingdom
State/province [1] 0 0
Oxford

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Syntara
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This study is to investigate the safety and efficacy of PXS-4728A as an intervention therapy
in participants with iRBD. This study will be conducted in participants aged 50 to 80 years
of age and will investigate a single dose level.
Trial website
https://clinicaltrials.gov/ct2/show/NCT05904717
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Jennifer Maschmann
Address 0 0
Country 0 0
Phone 0 0
+61 3 9960 7940
Fax 0 0
Email 0 0
Jennifer.Maschmann@novotech-cro.com
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT05904717