A Phase 2 interventional study of SUVN-502 and Placebo in Alzheimer's Disease, sponsored by Suven Life Sciences Limited. Completed at 71 sites in United States. Open to participants aged 50 Years to 85 Years. Per ClinicalTrials.gov, last updated 2023-06-09.
Sponsored by Suven Life Sciences Limited · Phase 2, Interventional, and Treatment
This is a phase 2a, proof-of-concept, 26-week, double-blind, multicenter, randomized, parallel group, placebo-controlled study to compare the efficacy and safety of treatment with SUVN-502 to placebo treatment in subjects with moderate Alzheimer's disease receiving stable doses of donepezil HCl and memantine HCl.
This is a phase 2a, proof-of-concept, 26-week, double-blind, multicenter, randomized, parallel group, placebo-controlled study to compare the efficacy and safety of treatment with SUVN-502 to placebo treatment in subjects with moderate Alzheimer's disease receiving donepezil HCl (10 mg qd) and either memantine HCl (10 mg twice daily [bid]) or Namenda XR® (Extended Release, 28 mg qd) or the combination therapy, Namzaric™
The primary objective of the study is to evaluate the efficacy of a serotonin receptor subtype 6 (5-HT6) antagonist, SUVN-502, compared to placebo, as adjunct treatment in subjects with moderate Alzheimer's disease (Mini-Mental State Examination [MMSE] score of 12 to 20) currently treated with the acetylcholinesterase inhibitor, donepezil hydrochloride (HCl), and the N-methyl-D-aspartic acid (NMDA) antagonist, memantine HCl. Efficacy will be assessed by the 11-item Alzheimer's Disease Assessment Scale for Cognitive Behavior (ADAScog-11) after 26 weeks of treatment.
3,678 studies on the registry are indexed under Alzheimer Disease; 872 are open to participants now.
This study's enrollment of 564 is above the median of 70 across 2,808 interventional studies indexed under Alzheimer Disease.
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Of its 7 completed or terminated interventional studies of FDA-regulated products, 2 (29%) have results posted.
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SUVN-502 Low dose adjunct to base treatment with Donepezil and Memantine
Drug: SUVN-502 · Drug: Donepezil · Drug: Memantine
SUVN-502 High dose adjunct to base treatment with Donepezil and Memantine
Drug: SUVN-502 · Drug: Donepezil · Drug: Memantine
Placebo adjunct to base treatment with Donepezil and Memantine
Drug: Placebo · Drug: Donepezil · Drug: Memantine
Once-daily, tablets, orally
Also known as: Masupirdine
Once-daily, tablets, orally
Donepezil HCl (10 mg, once a day)
Also known as: Namzaric
Memantine HCl (10 mg, twice a day or 28 mg extended-release, once a day).
Also known as: Namenda XR®
Change From Baseline to Week-26 in Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog 11)
Mean change from baseline at week 26 is assessed for ADAS-Cog11 score. The ADAS-Cog11 is a structured scale that evaluates memory, orientation, attention, reasoning, language, and constructional praxis. ADAS-Cog11 measures cognition by assessing 11 metrics impaired in AD: word recall; commands; constructional praxis; naming objects and fingers; ideational praxis; orientation; word recognition; remembering test instructions; spoken language ability; word-finding difficulty; and comprehension of spoken language. The scale ranges from 0 to 70, with higher scores indicate greater impairment.
Time frame: Baseline to Week 26
Change From Baseline to Week-26 in Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB)
Clinical Dementia Rating-Sum of Boxes (CDR-SB) - Sum of Boxes CDR-SB is a semi-structured interview of participants and their caregivers. Participant's cognitive status is rated across 6 domains of functioning, including memory, orientation, judgment/problem solving, community affairs, home/hobbies, and personal care. Severity score assigned for each of 6 domains; total score (SB) ranges from 0 to 18. Higher scores indicate greater disease severity.
Time frame: Baseline to Week 26
Change From Baseline to Week-26 in Alzheimer's Disease Cooperative Study Group-Activities of Daily Living (ADCS-ADL)
The Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score is a 23-item inventory. The ADCS-ADL measures both basic and instrumental activities of daily living The total ADCS-ADL score ranges from 0 to 78, with lower scores indicating greater disease severity.
Time frame: Baseline to Week 26
Change From Baseline to Week-26 in Neuropsychiatric Inventory (NPI)
Neuropsychiatric Inventory (NPI) 12 item - Total Score NPI assesses psychopathology in participants with dementia and other neurologic disorders. Total score ranges from 12 to 144; higher scores indicate greater disease severity.
Time frame: Baseline to Week 26
Change From Baseline to Week-26 in Change in Mini Mental State Examination (MMSE)
Change in Mini-Mental State Examination (MMSE) - Total Score Minimum Score - 0, Maximum Score - 30. Higher score means better outcome.
Time frame: Baseline to Week 26
Study centers located in the United States of America (USA) participated in the study
| Milestone | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Started | 190 | 185 | 189 |
| Safety population | 187 | 181 | 188 |
| Modified intent-to-treat (mitt) population | 184 | 176 | 183 |
| Completed | 147 | 136 | 157 |
| Not completed | 43 | 49 | 32 |
| Withdrew: Adverse event | 15 | 19 | 10 |
| Withdrew: Lack of efficacy | 5 | 0 | 2 |
| Withdrew: Protocol violation | 4 | 9 | 6 |
| Withdrew: Lost to follow-up | 4 | 4 | 2 |
| Withdrew: Withdrawal by subject | 11 | 9 | 7 |
| Withdrew: Randomized in error and never treated | 4 | 8 | 5 |
Mean change from baseline at week 26 is assessed for ADAS-Cog11 score. The ADAS-Cog11 is a structured scale that evaluates memory, orientation, attention, reasoning, language, and constructional praxis. ADAS-Cog11 measures cognition by assessing 11 metrics impaired in AD: word recall; commands; constructional praxis; naming objects and fingers; ideational praxis; orientation; word recognition; remembering test instructions; spoken language ability; word-finding difficulty; and comprehension of spoken language. The scale ranges from 0 to 70, with higher scores indicate greater impairment.
| score on a scale | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Change From Baseline to Week-26 in Alzheimer's Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog 11) | 2.0 ± 0.5 | 2.5 ± 0.5 | 2.6 ± 0.5 |
Clinical Dementia Rating-Sum of Boxes (CDR-SB) - Sum of Boxes CDR-SB is a semi-structured interview of participants and their caregivers. Participant's cognitive status is rated across 6 domains of functioning, including memory, orientation, judgment/problem solving, community affairs, home/hobbies, and personal care. Severity score assigned for each of 6 domains; total score (SB) ranges from 0 to 18. Higher scores indicate greater disease severity.
| score on a scale | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Change From Baseline to Week-26 in Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) | 1.3 ± 0.2 | 1.0 ± 0.2 | 1.2 ± 0.2 |
The Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score is a 23-item inventory. The ADCS-ADL measures both basic and instrumental activities of daily living The total ADCS-ADL score ranges from 0 to 78, with lower scores indicating greater disease severity.
| score on a scale | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Change From Baseline to Week-26 in Alzheimer's Disease Cooperative Study Group-Activities of Daily Living (ADCS-ADL) | -4.6 ± 0.6 | -3.4 ± 0.6 | -4.4 ± 0.6 |
Neuropsychiatric Inventory (NPI) 12 item - Total Score NPI assesses psychopathology in participants with dementia and other neurologic disorders. Total score ranges from 12 to 144; higher scores indicate greater disease severity.
| score on a scale | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Change From Baseline to Week-26 in Neuropsychiatric Inventory (NPI) | 0.5 ± 0.8 | 0.4 ± 0.9 | 2.1 ± 0.8 |
Change in Mini-Mental State Examination (MMSE) - Total Score Minimum Score - 0, Maximum Score - 30. Higher score means better outcome.
| score on a scale | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Change From Baseline to Week-26 in Change in Mini Mental State Examination (MMSE) | -1.1 ± 0.3 | -1.1 ± 0.3 | -1.0 ± 0.3 |
Collected over 26 Weeks. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| SUVN-502 Low Dose (50 mg) | 3/187 (1.6%) | 10/187 (5.3%) | 50/187 (26.7%) |
| SUVN-502 High Dose (100 mg) | 2/181 (1.1%) | 14/181 (7.7%) | 44/181 (24.3%) |
| Placebo | 1/188 (0.5%) | 12/188 (6.4%) | 40/188 (21.3%) |
| Event | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| SyncopeNervous system disorders | 3/187 | 1/181 | 0/188 |
| PneumoniaInfections and infestations | 0/187 | 2/181 | 2/188 |
| Acute kidney injuryRenal and urinary disorders | 0/187 | 2/181 | 0/188 |
| DehydrationMetabolism and nutrition disorders | 2/187 | 0/181 | 0/188 |
| SepsisInfections and infestations | 0/187 | 1/181 | 2/188 |
| Urinary tract infectionInfections and infestations | 0/187 | 1/181 | 0/188 |
| UrosepsisInfections and infestations | 0/187 | 1/181 | 0/188 |
| Haemorrhage intracranialNervous system disorders | 0/187 | 1/181 | 0/188 |
| Acute myocardial infarctionCardiac disorders | 0/187 | 1/181 | 0/188 |
| BradycardiaCardiac disorders | 0/187 | 1/181 | 0/188 |
| Event | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo |
|---|---|---|---|
| Urinary tract infectionInfections and infestations | 15/187 | 21/181 | 19/188 |
| HeadacheNervous system disorders | 12/187 | 4/181 | 7/188 |
| DiarrhoeaGastrointestinal disorders | 12/187 | 9/181 | 3/188 |
| FallInjury, poisoning and procedural complications | 11/187 | 10/181 | 11/188 |
A total of 564 patients were randomized as per the planned ratio to receive masupirdine 50 mg (190 patients), masupirdine 100 mg (185 patients), or placebo (189 patients). A total of 543 (96.3%) patients who were randomized to specific treatment sequence were included in the modified intent to treat (mITT) population and this mITT population is considered for baseline analysis.
| Age, Continuous(years) | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo | Total |
|---|---|---|---|---|
| Mean | 73.4 ± 8.08 | 74.4 ± 6.97 | 72.9 ± 7.23 | 73.6 ± 7.46 |
| Age, Customized(Participants) | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo | Total |
|---|---|---|---|---|
| Age group greater than or equal to 65 years | 159 | 155 | 157 | 471 |
| Sex: Female, Male(Participants) | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo | Total |
|---|---|---|---|---|
| Female | 95 | 96 | 106 | 297 |
| Male | 89 | 80 | 77 | 246 |
| Race (NIH/OMB)(Participants) | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 1 | 2 | 0 | 3 |
| Asian | 3 | 1 | 1 | 5 |
| Native Hawaiian or Other Pacific Islander | 0 | 1 | 0 | 1 |
| Black or African American | 6 | 8 | 10 | 24 |
| White | 171 | 162 | 168 | 501 |
| More than one race | 3 | 2 | 4 | 9 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 |
| APO-E4 Carrier Status(Participants) | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo | Total |
|---|---|---|---|---|
| Carrier one allele | 77 | 79 | 84 | 240 |
| Carrier two allele | 24 | 31 | 35 | 90 |
| Mini-Mental State Examination(units on a scale) | SUVN-502 Low Dose (50 mg) | SUVN-502 High Dose (100 mg) | Placebo | Total |
|---|---|---|---|---|
| Mean | 16.9 ± 2.21 | 17.0 ± 2.47 | 16.5 ± 2.48 | 16.8 ± 2.39 |
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Suven Life Sciences Limited