A Phase 1/2 interventional study of Posiphen and Placebo in Alzheimer Disease and Parkinson Disease, sponsored by Annovis Bio Inc.. Completed at 13 sites in United States. Open to participants aged 45 Years and older. Per ClinicalTrials.gov, last updated 2023-02-28.
Sponsored by Annovis Bio Inc. · Phase 1/2, Interventional, and Treatment
Annovis is conducting a clinical study to investigate Posiphen in patients with Early Alzheimer's Disease (AD) and Early Parkinson's Disease (PD). Investigators are looking to recruit 68 patients in two parts of the study. In Part one of the study Investigators will recruit 14 AD and 14 PD patients who will either receive placebo (an inert pill which looks like the study drug) or the study drug Posiphen, both taken daily. In Part two of the study Investigators will recruit 40 PD patients who will receive different strengths of the study drug Posiphen taken daily. Patients will be required to come to the site for 3 face to face visits and have 4 phone calls, tests include but are not limited to, blood and CSF (spinal fluid) sampling, cognitive assessments, clinical examinations and laboratory safety tests. Primarily the Investigators are looking for the safety and tolerability of Posiphen, although Investigators will also evaluate the activity of Posiphen by a number of different biomarkers measuring pathway and target engagements.
Part 1 is a study with 14 Early AD and 14 Early PD patients who are randomized to 80 mg of Posiphen or placebo. Participants will undergo a Screening Visit, provide informed consent and be evaluated for eligibility per the inclusion and exclusion criteria. If enrolled, participants will proceed to the randomized treatment portions of the study. Period 1 consists of first-time dosing in clinic with administration of 80 mg of Posiphen or Placebo. Period 2 consists of an at home dosing period of 25±2 days, with daily administration of 80 mg of Posiphen or Placebo. Period 3 will be comprised of a stay at the clinical research unit where the subject will undergo study procedures that include safety assessments (AE and concomitant medication monitoring, 12-lead ECGs, clinical laboratory testing, vital signs assessments, and physical examinations), the last dose of Posiphen or Placebo, and 6 hours of blood and CSF sampling. At the end of blood/CSF sampling, the subjects will need to stay for a minimum of 1 hour of observation but may stay if necessary for observation until the following day (e.g., if the subject has blood/CSF sampling on Day 25, he/she may stay for observation until Day 26). After all end-of-study procedures are complete, the subject will be discharged to home. A 24-hour follow-up call will occur to assess the participants current condition and if there are any additional adverse events to report.
After completion of Part 1 of the study, the plasma and CSF samples will be analyzed for the biomarkers to determine if changes are needed to the biomarkers to be measured in Part 2. Since the conduct of the study in Part 2 will be identical to the conduct of the study in Part 1, recruitment will continue uninterrupted. The only potential change between Part 1 and Part 2 are the biomarkers to be measured.
Part 2 is a study with 40 Early PD patients, 10 patients each who are randomized to one of 4 treatment conditions of Posiphen (5 mg, 10 mg, 20 mg, or 40 mg). Participants will undergo a Screening Visit, provide informed consent and be evaluated for eligibility per the inclusion and exclusion criteria. If enrolled, participants will proceed to the randomized treatment portions of the study. Period 1 consists of first-time dosing in clinic with administration of 5, 10, 20, or 40mg of Posiphen. Period 2 consists of an at home dosing period of 25±2 days, with daily administration of 5, 10, 20, or 40mg of Posiphen. Period 3 will be comprised of a stay at the clinical research unit where the subject will undergo study procedures that include safety assessments (AE and concomitant medication monitoring, 12-lead ECGs, clinical laboratory testing, vital signs assessments, and physical examinations), the last dose of Posiphen or Placebo, and 6 hours of blood and CSF sampling. At the end of blood/CSF sampling, the subject will need to stay for a minimum of 1 hour of observation but may stay if necessary for observation until the following day (e.g., if the subject has blood/CSF sampling on Day 25, he/she may stay for observation until Day 26). After all end-of-study procedures are complete, the subject will be discharged to home. A 24-hour follow-up call will occur to assess the participant's current condition and if there are any additional adverse events to report.
4,487 studies on the registry are indexed under Parkinson Disease; 1,082 are open to participants now.
This study's enrollment of 75 is above the median of 40 across 3,294 interventional studies indexed under Parkinson Disease.
Browse Parkinson Disease studies →Annovis Bio Inc. is the lead sponsor of 8 studies on the registry; 2 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Subjects must meet the following criteria:
Stability of permitted medications prior to screening.
i. Anti-parkinsonian medication ii. Anticonvulsant medications used for epilepsy or mood stabilization; neuropathic pain indications iii. Mood-stabilizing psychotropic agents, including, but not limited to, lithium.
Exclusion Criteria
Subjects meeting any of the following criteria must not be included in the study:
Posiphen Oral Capsule, 80mg, taken once per day for 25±2 days.
Drug: Posiphen
Posiphen Oral Capsule, 40mg, taken once per day for 25±2 days.
Drug: Posiphen
Posiphen Oral Capsule, 20mg, taken once per day for 25±2 days.
Drug: Posiphen
Posiphen Oral Capsule, 10mg, taken once per day for 25±2 days.
Drug: Posiphen
Posiphen Oral Capsule, 5mg, taken once per day for 25±2 days.
Drug: Posiphen
Placebo Oral Capsule, taken once per day for 25±2 days.
Drug: Placebo
Placebo Oral Capsule, taken once per day for 25±2 days.
Drug: Placebo
Posiphen Oral Capsule, 80mg, taken once per day for 25±2 days.
Drug: Posiphen
Solid oral dosage form, capsule
Solid oral dosage form, capsule
Percentage of Participants With Treatment-Emergent Adverse Events
Percent of patients with AEs in the Posiphen treatment arms compared to the Placebo group
Time frame: 25±2 days
Concentration of Posiphen in Plasma
Maximum Plasma Concentration (Cmax) of Posiphen reported as ng/mL.
Time frame: Samples collected over a 6 hour timeframe
Change in Abeta42/Abeta40 Ratio
Biomarker related to neurotoxic protein cascade measured in patient sample
Time frame: Baseline to 25±2 days
Changes in Functional Impairment
Functional impairment will be evaluated using the Clinical Dementia Rating (CDR) scale (Berg1988) for AD.
Time frame: Baseline to 25±2 days
Changes in Functional Impairment
Functional impairment will be evaluated using the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scale (Goetz 2008) for those with PD.
Time frame: Baseline to 25±2 days
Changes in Cognition
For both populations, the Mini-Mental State Examination (MMSE) scale (Folstein 1975) will be administered as a global measure of cognition.
Time frame: Baseline to 25±2 days
Changes in Cognition
For both populations, the Coding subtest from the Weschler Adult Intelligence Scales, 4th edition (WAIS-IV) will serve as a sensitive measure of CNS dysfunction.
Time frame: Baseline to 25±2 days
Changes in Cognition
The subjects with AD will also be administered the The Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) Subscale (Schafer 2012).
Time frame: Baseline to 25±2 days
| Milestone | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) |
|---|---|---|---|---|---|---|---|---|
| Started | 10 | 10 | 11 | 10 | 12 | 5 | 6 | 10 |
| Completed | 9 | 9 | 11 | 9 | 11 | 5 | 5 | 10 |
| Not completed | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 0 |
Percent of patients with AEs in the Posiphen treatment arms compared to the Placebo group
| Participants | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) |
|---|---|---|---|---|---|---|---|---|
| Percentage of Participants With Treatment-Emergent Adverse Events | 3 | 5 | 4 | 6 | 1 | 3 | 3 | 5 |
Maximum Plasma Concentration (Cmax) of Posiphen reported as ng/mL.
| ng/mL | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) |
|---|---|---|---|---|---|---|---|---|
| Concentration of Posiphen in Plasma | 94.9 ± 33.4 | 40.2 ± 19.7 | 15.3 ± 21.6 | 2.0 ± 1.4 | 0.4 ± 0.3 | — | — | 112.3 ± 49.3 |
Biomarker related to neurotoxic protein cascade measured in patient sample
Results for this outcome have not been posted.
Functional impairment will be evaluated using the Clinical Dementia Rating (CDR) scale (Berg1988) for AD.
Results for this outcome have not been posted.
Functional impairment will be evaluated using the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scale (Goetz 2008) for those with PD.
Results for this outcome have not been posted.
For both populations, the Mini-Mental State Examination (MMSE) scale (Folstein 1975) will be administered as a global measure of cognition.
Results for this outcome have not been posted.
For both populations, the Coding subtest from the Weschler Adult Intelligence Scales, 4th edition (WAIS-IV) will serve as a sensitive measure of CNS dysfunction.
Results for this outcome have not been posted.
The subjects with AD will also be administered the The Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) Subscale (Schafer 2012).
Results for this outcome have not been posted.
Collected over 25±2 days. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Posiphen, 80mg (Parkinson's Participants) | 0/10 (0%) | 0/10 (0%) | 3/10 (30%) |
| Posiphen, 40mg (Parkinson's Participants) | 0/10 (0%) | 0/10 (0%) | 5/10 (50%) |
| Posiphen, 20mg (Parkinson's Participants) | 0/11 (0%) | 0/11 (0%) | 4/11 (36.4%) |
| Posiphen, 10mg (Parkinson's Participants) | 0/10 (0%) | 0/10 (0%) | 6/10 (60%) |
| Posiphen, 5mg (Parkinson's Participants) | 0/12 (0%) | 0/12 (0%) | 1/12 (8.3%) |
| Placebo (Parkinson's Participants) | 0/5 (0%) | 0/5 (0%) | 3/5 (60%) |
| Placebo (Alzheimer's Participants) | 0/6 (0%) | 0/6 (0%) | 3/6 (50%) |
| Posiphen, 80mg (Alzheimer's Participants) | 0/10 (0%) | 0/10 (0%) | 5/10 (50%) |
| Event | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) |
|---|---|---|---|---|---|---|---|---|
| back painMusculoskeletal and connective tissue disorders | 0/10 | 1/10 | 0/11 | 1/10 | 0/12 | 2/5 | 1/6 | 1/10 |
| headacheNervous system disorders | 0/10 | 1/10 | 3/11 | 4/10 | 0/12 | 1/5 | 0/6 | 2/10 |
| puncture site painGeneral disorders | 0/10 | 0/10 | 0/11 | 1/10 | 0/12 | 0/5 | 2/6 | 1/10 |
| dizzinessNervous system disorders | 0/10 | 0/10 | 0/11 | 0/10 | 1/12 | 1/5 | 0/6 | 0/10 |
| pain in extremityMusculoskeletal and connective tissue disorders | 0/10 | 0/10 | 0/11 | 1/10 | 0/12 | 1/5 | 0/6 | 0/10 |
| fatigueGeneral disorders | 0/10 | 0/10 | 2/11 | 1/10 | 0/12 | 0/5 | 0/6 | 0/10 |
| aspartate aminotransferase increasedInvestigations | 0/10 | 0/10 | 0/11 | 0/10 | 0/12 | 0/5 | 1/6 | 0/10 |
| electrocardiogram QT prolongationInvestigations | 0/10 | 0/10 | 0/11 | 0/10 | 0/12 | 0/5 | 0/6 | 1/10 |
| liver function test abnormalInvestigations | 0/10 | 0/10 | 0/11 | 0/10 | 0/12 | 0/5 | 0/6 | 1/10 |
| cystitisInfections and infestations | 0/10 | 0/10 | 0/11 | 0/10 | 0/12 | 0/5 | 0/6 | 1/10 |
| Age, Continuous(years) | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) | Total |
|---|---|---|---|---|---|---|---|---|---|
| Mean | 65.0 ± 9.31 | 62.5 ± 6.74 | 69.8 ± 10.93 | 62.0 ± 9.93 | 67.2 ± 6.94 | 75.4 ± 3.13 | 68.0 ± 6.87 | 72.8 ± 6.34 | 67.3 ± 8.84 |
| Sex: Female, Male(Participants) | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) | Total |
|---|---|---|---|---|---|---|---|---|---|
| Female | 2 | 2 | 3 | 3 | 2 | 2 | 3 | 8 | 25 |
| Male | 8 | 8 | 8 | 7 | 10 | 3 | 3 | 2 | 49 |
| Ethnicity (NIH/OMB)(Participants) | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) | Total |
|---|---|---|---|---|---|---|---|---|---|
| Hispanic or Latino | 0 | 0 | 5 | 2 | 3 | 2 | 4 | 5 | 21 |
| Not Hispanic or Latino | 10 | 10 | 6 | 8 | 9 | 3 | 2 | 5 | 53 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) | Total |
|---|---|---|---|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Asian | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 1 | 3 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 |
| Black or African American | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 2 |
| White | 10 | 10 | 9 | 10 | 12 | 5 | 4 | 8 | 68 |
| More than one race | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Region of Enrollment(participants) | Posiphen, 80mg (Parkinson's Participants) | Posiphen, 40mg (Parkinson's Participants) | Posiphen, 20mg (Parkinson's Participants) | Posiphen, 10mg (Parkinson's Participants) | Posiphen, 5mg (Parkinson's Participants) | Placebo (Parkinson's Participants) | Placebo (Alzheimer's Participants) | Posiphen, 80mg (Alzheimer's Participants) | Total |
|---|---|---|---|---|---|---|---|---|---|
| United States | 10 | 10 | 11 | 10 | 12 | 5 | 6 | 10 | 74 |
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