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CompletedNCT04524351Updated Feb 28, 2023Results posted

Posiphen® Dose-Finding, Biomarker Study in Early Alzheimer's and Parkinson's Patients

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

Phase
Phase 1/2
Study type
Interventional
Enrollment
75
Allocation
Randomized
Ages
45 Years and older
Sex
All
01

Study summary

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.

Read the detailed description

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.

02

Conditions studied

  • Alzheimer Disease
  • Parkinson Disease

Keywords

  • Safety
  • Tolerability
  • Pharmacokinetics
  • Pharmacodynamics
  • Neurotoxic proteins
  • Neurotransmitters
  • Amyloid Precursor Proteins
  • Inflammatory factors
  • Synaptic factors
  • CSF
03

In context

Parkinson Disease

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 →

Lead sponsor

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.

04

Who can participate

Ages eligible
45 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Subjects must meet the following criteria:

  1. Male or female aged 45 years and over.
  2. Female participants must be of non-childbearing potential or post-menopausal for at least 2 consecutive years or surgically sterile (bilateral tubal ligation, hysterectomy or bilateral oophorectomy) for at least 6 months prior to screening.
  3. Female participants will be given a urine pregnancy test at the screening visit for which they should test negative.
  4. A) AD - CDR = 0.5 or 1. B) PD - Hoehn \& Yahr ≤ 4; PD criteria by MDS-UPDRS.
  5. A) AD MMSE score between the range of 18 to 28. B) PD MMSE score between the range of 18 to 30.
  6. General cognition and functional performance sufficiently preserved that the subject can provide written informed consent.
  7. No evidence of current suicidal ideation or previous suicide attempt in the past month as evaluated in the Columbia Suicide Severity Rating Scale.
  8. MRI scan within the 12 months prior to screening without evidence of infection, infarction, or other focal lesions and without clinical symptoms suggestive of intervening neurological disease. Lacunes that are not believed to contribute to the subject's cognitive impairment are permissible. If there is no MRI available within a 12-month timeframe, then an MRI must be performed as part of the screening procedures for eligibility.
  9. Stability of permitted medications prior to screening.

    1. Stable for at least 12 weeks: Cholinesterase inhibitors and/or memantine medication
    2. Stable for at least 4 weeks:

    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.

  10. Adequate visual and hearing ability (physical ability to perform all the study assessments).
  11. Good general health with no disease expected to interfere with the study.
  12. Subjects previously exposed to Posiphen may be included in the study.

Exclusion criteria

Exclusion Criteria

Subjects meeting any of the following criteria must not be included in the study:

  1. Has a history of a psychiatric disorder such as schizophrenia, bipolar disorder or major depression according to the criteria of the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Mild depression or history of depression that is stable on treatment with a SSRI or SNRI medication at a stable dose is acceptable.
  2. History of a seizure disorder.
  3. Has a history or current evidence of long QT syndrome, Fridericia's formula corrected QT (QTcF) interval ≥ 450ms, or torsades de pointes.
  4. Has bradycardia (\<50 bpm) or tachycardia (>100 bpm) on the ECG at screening.
  5. Has uncontrolled Type-1 or Type-2 diabetes . A Subject with HbA1c levels up to 7.5% can be enrolled if the investigator believes the subject's diabetes is under control.
  6. Has clinically significant renal or hepatic impairment.
  7. Has any clinically significant abnormal laboratory values. Subjects with liver function tests (aspartate aminotransferase [AST] or alanine aminotransferase [ALT]) greater than twice the upper limit of normal will be excluded.
  8. Is at imminent risk of self-harm, based on clinical interview and responses on the C SSRS, or of harm to others in the opinion of the Investigators. Subjects must be excluded if they report suicidal ideation with intent, with or without a plan or method (e.g. positive response to Items 4 or 5 in assessment of suicidal ideation on the C SSRS) in the past 2 months, or suicidal behavior in the past 6 months.
  9. Has four or more signal hypointensities on T2*-weighted gradient recalled echo magnetic resonance sequences that are thought to represent hemosiderin deposits including microhemorrhages and superficial siderosis or evidence of acute or sub-acute micro or microhemorrhage as noted on the MRI scan.
  10. Has cancer or has had a malignant tumor within the past year, except patients who underwent potentially curative therapy with no evidence of recurrence. (Patients with stable untreated prostate cancer or skin cancers are not excluded).
  11. Alcohol / Substance use disorder, moderate to severe, in the last 5 years according to the most current version DSM.
  12. Participation in another clinical trial with an investigational agent and have taken at least one dose of study medication, unless unblinded on placebo, within 60 days prior to the start of screening. (The end of a previous investigational trial is the date the last dose of an investigational agent was taken), or five half-lives of the investigational drug, whichever is greater.
  13. Subjects with infection or inflammation of the skin or skin disease at or in proximity to the lumbar puncture site.
  14. History of lumbar spine surgery or chronic low back pain (CLBP).
  15. Subjects with learning disability or developmental delay.
  16. Subjects whom the site PI deems to be otherwise ineligible.
05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
75 participants (actual)

Study arms

  • Active comparator
    Posiphen, 80mg (Parkinson's Participants)

    Posiphen Oral Capsule, 80mg, taken once per day for 25±2 days.

    Drug: Posiphen

  • Active comparator
    Posiphen, 40mg (Parkinson's Participants)

    Posiphen Oral Capsule, 40mg, taken once per day for 25±2 days.

    Drug: Posiphen

  • Active comparator
    Posiphen, 20mg (Parkinson's Participants)

    Posiphen Oral Capsule, 20mg, taken once per day for 25±2 days.

    Drug: Posiphen

  • Active comparator
    Posiphen, 10mg (Parkinson's Participants)

    Posiphen Oral Capsule, 10mg, taken once per day for 25±2 days.

    Drug: Posiphen

  • Active comparator
    Posiphen, 5mg (Parkinson's Participants)

    Posiphen Oral Capsule, 5mg, taken once per day for 25±2 days.

    Drug: Posiphen

  • Placebo comparator
    Placebo (Parkinson's Participants)

    Placebo Oral Capsule, taken once per day for 25±2 days.

    Drug: Placebo

  • Placebo comparator
    Placebo (Alzheimer's Participants)

    Placebo Oral Capsule, taken once per day for 25±2 days.

    Drug: Placebo

  • Active comparator
    Posiphen, 80mg (Alzheimer's Participants)

    Posiphen Oral Capsule, 80mg, taken once per day for 25±2 days.

    Drug: Posiphen

Interventions

  • DrugPosiphen

    Solid oral dosage form, capsule

  • DrugPlacebo

    Solid oral dosage form, capsule

06

What researchers measure

Primary outcomes

  1. 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

Secondary outcomes

  1. Concentration of Posiphen in Plasma

    Maximum Plasma Concentration (Cmax) of Posiphen reported as ng/mL.

    Time frame: Samples collected over a 6 hour timeframe

Other outcomes

  1. Change in Abeta42/Abeta40 Ratio

    Biomarker related to neurotoxic protein cascade measured in patient sample

    Time frame: Baseline to 25±2 days

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

07

Results

Posted Feb 28, 2023

Participant flow

Participant flow — Overall Study
MilestonePosiphen, 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)
Started10101110125610
Completed99119115510
Not completed11011010

Outcome measures

PrimaryPercentage 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
Reported as:
Count of participants · Participants
Percentage of Participants With Treatment-Emergent Adverse Events
ParticipantsPosiphen, 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 Events35461335
SecondaryConcentration of Posiphen in Plasma

Maximum Plasma Concentration (Cmax) of Posiphen reported as ng/mL.

Time frame:
Samples collected over a 6 hour timeframe
Reported as:
Mean · ng/mL
Concentration of Posiphen in Plasma
ng/mLPosiphen, 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 Plasma94.9 ± 33.440.2 ± 19.715.3 ± 21.62.0 ± 1.40.4 ± 0.3——112.3 ± 49.3
Other pre-specifiedChange in Abeta42/Abeta40 Ratio

Biomarker related to neurotoxic protein cascade measured in patient sample

Time frame:
Baseline to 25±2 days

Results for this outcome have not been posted.

Other pre-specifiedChanges 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

Results for this outcome have not been posted.

Other pre-specifiedChanges 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

Results for this outcome have not been posted.

Other pre-specifiedChanges 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

Results for this outcome have not been posted.

Other pre-specifiedChanges 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

Results for this outcome have not been posted.

Other pre-specifiedChanges 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

Results for this outcome have not been posted.

Adverse events

Collected over 25±2 days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
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%)
Most frequent other events
Showing 10 of 29
Most frequent other events
EventPosiphen, 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 disorders0/101/100/111/100/122/51/61/10
headacheNervous system disorders0/101/103/114/100/121/50/62/10
puncture site painGeneral disorders0/100/100/111/100/120/52/61/10
dizzinessNervous system disorders0/100/100/110/101/121/50/60/10
pain in extremityMusculoskeletal and connective tissue disorders0/100/100/111/100/121/50/60/10
fatigueGeneral disorders0/100/102/111/100/120/50/60/10
aspartate aminotransferase increasedInvestigations0/100/100/110/100/120/51/60/10
electrocardiogram QT prolongationInvestigations0/100/100/110/100/120/50/61/10
liver function test abnormalInvestigations0/100/100/110/100/120/50/61/10
cystitisInfections and infestations0/100/100/110/100/120/50/61/10

Baseline characteristics

Age, Continuous
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
Mean65.0 ± 9.3162.5 ± 6.7469.8 ± 10.9362.0 ± 9.9367.2 ± 6.9475.4 ± 3.1368.0 ± 6.8772.8 ± 6.3467.3 ± 8.84
Sex: Female, Male
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
Female2233223825
Male88871033249
Ethnicity (NIH/OMB)
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 Latino0052324521
Not Hispanic or Latino101068932553
Unknown or Not Reported000000000
Race (NIH/OMB)
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 Native000000000
Asian001000113
Native Hawaiian or Other Pacific Islander000000011
Black or African American001000102
White10109101254868
More than one race000000000
Unknown or Not Reported000000000
Region of Enrollment
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 States1010111012561074
08

Study locations

13 sites
  • New England Institute for Clinical Research
    Stamford, Connecticut 06905, United States
  • DeLand Clinical Research Unit
    DeLand, Florida 32720, United States
  • MD Clinical
    Hallandale Beach, Florida 33009, United States
  • Homestead Associates in Research
    Miami, Florida 33032, United States
  • Ezy Medical Research Co.
    Miami, Florida 33175, United States
  • Conquest Research LLC
    Winter Park, Florida 32789, United States
  • iResearch Atlanta, LLC
    Decatur, Georgia 30030, United States
  • Hawaii Pacific Neuroscience
    Honolulu, Hawaii 96817, United States
  • Quest Research Institute
    Farmington Hills, Michigan 48334, United States
  • North Suffolk Neurology, PC
    Port Jefferson Station, New York 11776, United States
  • Penn Medicine, Department of Neurology, U of PA
    Philadelphia, Pennsylvania 19107, United States
  • University of Texas Health Science Center
    San Antonio, Texas 78229, United States
  • Aspen Clinical Research LLC
    Orem, Utah 84058, United States
09

References and documents

Study documents

  • Study protocol · Aug 21, 2020
  • Statistical analysis plan · Feb 26, 2021

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 28, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04524351
Lead sponsor
Annovis Bio Inc.
Collaborators
Parexel
Responsible party
Sponsor
First posted
Aug 24, 2020
Start date
Aug 14, 2020
Primary completion
Aug 16, 2021
Completion
Jan 31, 2022
Results posted
Feb 28, 2023
Last update
Feb 28, 2023

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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