Trial Outcomes & Findings for Simufilam (PTI-125), 100 mg, for Mild-to-moderate Alzheimer's Disease Patients (NCT NCT04388254)
NCT ID: NCT04388254
Last Updated: 2025-04-22
Results Overview
Alzheimer's Disease Assessment Scale-Cognitive Subscale 11-item: Change from baseline in cognition over the course of 24 months Possible range in score: 0-70; Subscales are summed; Higher values represent a more cognitively impaired participant Decrease in mean value represents improvement in cognition from one timepoint to the next.
COMPLETED
PHASE2
220 participants
Day 1 to Month 24
2025-04-22
Participant Flow
Participant milestones
| Measure |
Simufilam 100 mg Oral Tablets w/ Mild Alzheimer's Disease
Simufilam 100 mg oral tablets administered twice daily (BID); Subjects with a Mini Mental State Examination (MMSE) score of \>=21 are included in Mild group
|
Simufilam 100 mg Oral Tablets/Placebo/Simufilam 100 mg Oral Tablets w/ Mild Alzheimer's Disease
Subjects with a Mini Mental State Examination (MMSE) score of \>=21 are included in Mild group;
The placebo arm is only from Month 12 to Month 18. Day 1 to Month 12, as well as Month 18 to Month 24 are open-label treatment periods of simufilam 100 mg b.i.d.
Simufilam 100 mg oral tablet: Simufilam 100 mg oral tablet for b.i.d. administration;
Placebo: Matching placebo oral tablets
|
Simufilam 100 mg Oral Tablets w/ Moderate Alzheimer's Disease
Simufilam 100 mg oral tablets administered twice daily (BID); Subjects with a Mini Mental State Examination (MMSE) score of \<=20 are included in Moderate group
|
Simufilam 100 mg Oral Tablets/Placebo/Simufilam 100 mg Oral Tablets w/ Moderate Alzheimer's Disease
Subjects with a Mini Mental State Examination (MMSE) score of \<=20 are included in Moderate group;
The placebo arm is only from Month 12 to Month 18. Day 1 to Month 12, as well as Month 18 to Month 24 are open-label treatment periods of simufilam 100 mg b.i.d.
Simufilam 100 mg oral tablet: Simufilam 100 mg oral tablet for b.i.d. administration
Placebo: Matching placebo oral tablets
|
|---|---|---|---|---|
|
Open Label Period 1 (Mth 1 to Mth 12)
STARTED
|
134
|
0
|
85
|
0
|
|
Open Label Period 1 (Mth 1 to Mth 12)
Completed 12 Months and Chose Not to Continue
|
15
|
0
|
5
|
0
|
|
Open Label Period 1 (Mth 1 to Mth 12)
Discontinued Before Completing 12 Months
|
30
|
0
|
13
|
0
|
|
Open Label Period 1 (Mth 1 to Mth 12)
Completed 12 Months and Chose to Continue
|
104
|
0
|
72
|
0
|
|
Open Label Period 1 (Mth 1 to Mth 12)
COMPLETED
|
104
|
0
|
72
|
0
|
|
Open Label Period 1 (Mth 1 to Mth 12)
NOT COMPLETED
|
30
|
0
|
13
|
0
|
|
Double Blind Treatment (Mth12 to Mth18)
STARTED
|
48
|
41
|
32
|
35
|
|
Double Blind Treatment (Mth12 to Mth18)
Discontinued During Double Blind Treatment Period
|
5
|
7
|
6
|
6
|
|
Double Blind Treatment (Mth12 to Mth18)
COMPLETED
|
43
|
34
|
26
|
29
|
|
Double Blind Treatment (Mth12 to Mth18)
NOT COMPLETED
|
5
|
7
|
6
|
6
|
|
Open Label Period 3 (Mth 18 to Mth 24)
STARTED
|
43
|
34
|
26
|
29
|
|
Open Label Period 3 (Mth 18 to Mth 24)
Discontinued During Period 3
|
4
|
0
|
4
|
3
|
|
Open Label Period 3 (Mth 18 to Mth 24)
COMPLETED
|
39
|
34
|
22
|
26
|
|
Open Label Period 3 (Mth 18 to Mth 24)
NOT COMPLETED
|
4
|
0
|
4
|
3
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
One moderate subject had their baseline MMSE collected after day 1 dose administration.
Baseline characteristics by cohort
| Measure |
Moderate Alzheimer's Disease
n=85 Participants
Subjects with a Mini Mental State Examination (MMSE) score of \<=20 are included in Moderate group
|
Mild Alzheimer's Disease
n=134 Participants
Subjects with a Mini Mental State Examination (MMSE) score of \>=21 are included in Mild group
|
Total
n=219 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Categorical
<=18 years
|
0 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Age, Categorical
Between 18 and 65 years
|
22 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
26 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
48 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Age, Categorical
>=65 years
|
63 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
108 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
171 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Age, Continuous
|
70.5 years
STANDARD_DEVIATION 8.7 • n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
70.8 years
STANDARD_DEVIATION 7.93 • n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
70.7 years
STANDARD_DEVIATION 8.21 • n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Sex: Female, Male
Female
|
55 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
68 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
123 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Sex: Female, Male
Male
|
30 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
66 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
96 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
9 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
39 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
48 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
76 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
95 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
171 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
Asian
|
6 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
6 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
1 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
1 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
Black or African American
|
2 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
4 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
6 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
White
|
76 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
129 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
205 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
0 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
1 Participants
n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
1 Participants
n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
|
Body Mass Index (kg/m^2)
|
25.52 kg/m2
STANDARD_DEVIATION 4.046 • n=99 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
28.44 kg/m2
STANDARD_DEVIATION 5.740 • n=107 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
27.33 kg/m2
STANDARD_DEVIATION 5.333 • n=206 Participants • One moderate subject had their baseline MMSE collected after day 1 dose administration.
|
PRIMARY outcome
Timeframe: Day 1 to Month 24Population: Full Analysis set; Overall number of participants is the number for each arm that completed a ADAS-Cog-11 assessment at baseline and month 24.
Alzheimer's Disease Assessment Scale-Cognitive Subscale 11-item: Change from baseline in cognition over the course of 24 months Possible range in score: 0-70; Subscales are summed; Higher values represent a more cognitively impaired participant Decrease in mean value represents improvement in cognition from one timepoint to the next.
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=20 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
n=39 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
n=24 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
n=33 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline in ADAS-Cog-11
|
11.05 Change in scale units
Standard Error 1.19
|
0.07 Change in scale units
Standard Error 1.15
|
14.26 Change in scale units
Standard Error 1.79
|
1.04 Change in scale units
Standard Error 1.65
|
PRIMARY outcome
Timeframe: Month 12 to Month 24Population: Full Analysis set; Overall number of participants is the number for each arm/group that completed a ADAS-Cog-11 assessment at month 12 and month 24.
Alzheimer's Disease Assessment Scale-Cognitive Subscale 11-item: Change from baseline in cognition Starting at month 12 through month 24; Possible range in score: 0-70; Higher values represent a more cognitively impaired participant; Decrease in mean value represents improvement in cognition from one timepoint to the next.
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=19 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
n=35 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
n=23 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
n=30 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline in ADAS-Cog-11 (Month 12 to Month 24)
|
7.39 Change in scale units
Standard Error 1.447
|
1.93 Change in scale units
Standard Error 1.128
|
6.97 Change in scale units
Standard Error 1.404
|
2.45 Change in scale units
Standard Error 1.225
|
PRIMARY outcome
Timeframe: Day 1 to Month 12 and month 18 to month 24The most frequently reported Treatment Emergent Adverse Events indicative of abnormal vital signs (hypertension/worsening of hypertension and blood pressure increase) of simufilam (PTI-125) during the open label portion of the study: Open-label period 1 (Day 1 to Month 12) and open-label period 2 (Month 18 to Month 24)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=171 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Open Label Abnormal Vital Signs)
Blood pressure increase
|
6 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Vital Signs)
The number of subjects that did not report hypertension or did not have worsening of hypertension
|
152 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Vital Signs)
Hypertension/worsening hypertension
|
13 Participants
|
—
|
—
|
—
|
PRIMARY outcome
Timeframe: Month 12 to month 18The most frequently reported Treatment Emergent Adverse Event indicative of abnormal vital signs (hypotension) of simufilam (PTI-125) or placebo during the randomized withdraw portion of the study : Month 12 to Month 18
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=45 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
n=37 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Randomize Withdraw Abnormal Vital Signs)
Number of subjects that reported hypotension
|
2 Participants
|
0 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Abnormal Vital Signs)
Number of subjects that did not report hypotension
|
43 Participants
|
37 Participants
|
—
|
—
|
PRIMARY outcome
Timeframe: Day 1 to Month 12 and month 18 to month 24The number of subjects that had Treatment Emergent Adverse Events indicative of abnormal Electrocardiogram results while on simufilam (PTI-125) during the open label portion of the study: Open-label period 1 (Day 1 to Month 12) and open-label period 2 (Month 18 to Month 24)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=171 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Coronary artery disease
|
2 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Mitral valve incompetence
|
2 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Subjects that reported TEAEs that were not related to Electrocardiogram results
|
150 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Acute left ventricular failure
|
1 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Acute myocardial infarction
|
3 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Angina pectoris
|
2 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Aortic valve incompetence
|
1 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Atrial fibrillation
|
4 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Atrial tachycardia
|
1 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Bradycardia
|
3 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Cardiogenic shock
|
1 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Electrocardiogram Results)
Sinus tachycardia
|
1 Participants
|
—
|
—
|
—
|
PRIMARY outcome
Timeframe: Month 12 to Month 18The number of subjects that had Treatment Emergent Adverse Events indicative of abnormal Electrocardiogram results while on simufilam (PTI-125) or placebo during the randomized withdraw portion of the study: Month 12 to Month 18
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=45 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
n=37 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
Acute Myocardial Infarction
|
1 Participants
|
0 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
Arrhymia
|
0 Participants
|
1 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
Atrial Fibrillation
|
1 Participants
|
1 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
Atrioventricular block first degree
|
0 Participants
|
1 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
Cardiomegaly
|
0 Participants
|
1 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
Subjects that had TEAEs that were not related Electrocadiogram results
|
43 Participants
|
33 Participants
|
—
|
—
|
PRIMARY outcome
Timeframe: Day 1 to Month 12 and month 18 to month 24The most frequently reported Treatment Emergent Adverse Events indicative of abnormal physical examination (weight increase or weight decrease) while administered simufilam (PTI-125) during the open label portion of the study: Open-label period 1 (Day 1 to Month 12) and open-label period 2 (Month 18 to Month 24)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=171 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Open Label Abnormal Physical Examination)
Weight decrease
|
4 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Physical Examination)
Weight increase
|
2 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Physical Examination)
Number of subjects that reported TEAEs not indicative of weight change
|
165 Participants
|
—
|
—
|
—
|
PRIMARY outcome
Timeframe: Month 12 to Month 18The number of subjects that had Treatment Emergent Adverse Events of indicative of abnormal physical examination while on simufilam (PTI-125) or placebo during the randomized withdraw portion of the study: Month 12 to Month 18
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=45 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
n=37 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Randomize Withdraw Abnormal Physical Examination Findings)
Subjects that did not report TEAEs of abnormal weight decrease
|
45 Participants
|
35 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Abnormal Physical Examination Findings)
Weight decrease
|
0 Participants
|
2 Participants
|
—
|
—
|
PRIMARY outcome
Timeframe: Day 1 to Month 12 and month 18 to month 24Treatment Emergent Adverse Events when three or more subjects reported abnormal clinical laboratory results while on simufilam (PTI-125) during the open label portion of the study: Open-label period 1 (Day 1 to Month 12) and open-label period 2 (Month 18 to Month 24)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=171 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Open Label Abnormal Clinical Laboratory Results)
Hyperlipidaemia
|
3 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Clinical Laboratory Results)
Hypophosphataemia
|
3 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Clinical Laboratory Results)
Subjects that reported 2 or less TEAEs indicative of clinical laboratory results
|
162 Participants
|
—
|
—
|
—
|
|
Safety and Tolerability (Open Label Abnormal Clinical Laboratory Results)
Hyperkalaemia
|
3 Participants
|
—
|
—
|
—
|
PRIMARY outcome
Timeframe: Month 12 to Month 18Treatment Emergent Adverse Events when two or more subjects reported abnormal clinical laboratory results while on simufilam (PTI-125) or placebo during the randomized withdraw portion of the study: Month 12 to Month 18
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=45 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
n=37 Participants
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Safety and Tolerability (Randomize Withdraw Abnormal Clinical Laboratory Results)
Leukocytosis
|
0 Participants
|
2 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Abnormal Clinical Laboratory Results)
Haematuria
|
2 Participants
|
1 Participants
|
—
|
—
|
|
Safety and Tolerability (Randomize Withdraw Abnormal Clinical Laboratory Results)
Two subjects or less that report TEAEs of abnormal clinical laboratory results or none at all.
|
43 Participants
|
34 Participants
|
—
|
—
|
SECONDARY outcome
Timeframe: Day 1 to Month 12Change from baseline to month 12 in Cerebral Spinal Fluid for Triggering Receptor Expressed on Myeloid Cells 2 (TREM2) Mean Concentration (pg/mL) (samples stored at -70 degrees Celsius; assays performed at Abilene Christian University Bioanalytics Laboratory)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=13 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline to Month 12 in Cerebral Spinal Fluid for Triggering Receptor Expressed on Myeloid Cells 2 (TREM2) Mean Concentration (pg/mL)
|
-4093.31 pg/mL
Standard Deviation 4730.736
|
—
|
—
|
—
|
SECONDARY outcome
Timeframe: Day 1 to Month 12Change from baseline to month 12 in Cerebral Spinal Fluid for Tau Protein Mean Concentration (pg/mL) (samples stored at -70 degrees Celsius; assays performed at Abilene Christian University Bioanalytics Laboratory)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=18 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline to Month 12 in Cerebral Spinal Fluid for Tau Protein Mean Concentration (pg/mL)
|
-12.26 pg/mL
Standard Deviation 96.238
|
—
|
—
|
—
|
SECONDARY outcome
Timeframe: Day 1 to Month 12Change from baseline to month 12 in Cerebral Spinal Fluid for Neurogranin Mean Concentration (pg/mL) (samples stored at -70 degrees Celsius; assays performed at Abilene Christian University Bioanalytics Laboratory)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=18 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline to Month 12 in Cerebral Spinal Fluid for Neurogranin Mean Concentration (pg/mL)
|
-115.15 pg/mL
Standard Deviation 237.256
|
—
|
—
|
—
|
SECONDARY outcome
Timeframe: Day 1 to Month 12Change from baseline to month 12 in Cerebral Spinal Fluid for Neurofilament Light Chain Protein Mean Concentration (pg/mL) (samples stored at -70 degrees Celsius; assays performed at Abilene Christian University Bioanalytics Laboratory)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=18 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline to Month 12 in Cerebral Spinal Fluid for Neurofilament Light Chain Protein Mean Concentration (pg/mL)
|
-10.00 pg/mL
Standard Deviation 95.504
|
—
|
—
|
—
|
SECONDARY outcome
Timeframe: Day 1 to Month 12Change from baseline to month 12 in Cerebral Spinal Fluid for Glial Fibrillary Acidic Protein Mean Concentration (pg/mL) (samples stored at -70 degrees Celsius; assays performed at Abilene Christian University Bioanalytics Laboratory)
Outcome measures
| Measure |
Moderate Alzheimer's Disease, 24 Months of Simufilam
n=18 Participants
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Mild Alzheimer's Disease, 24 Months of Simufilam
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects were administered Simufilam over the course of the whole trial (from day 1 to month 24)
|
Moderate Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Moderate subjects: Mini Mental State Examination (MMSE) score of \<=20
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
Mild Alzheimer's Disease, Interrupted Simufilam Placebo Administration From Month 12 to Month 18
* Mild Subjects with a Mini Mental State Examination (MMSE) score of \>=21
* Subjects that were administered Simufilam from day 1 to month 12 and month 18 to 24 with 6 month simufilam interruption (placebo administration from month 12 to month 18)
|
|---|---|---|---|---|
|
Change From Baseline to Month 12 in Cerebral Spinal Fluid for Glial Fibrillary Acidic Protein Mean Concentration (pg/mL)
|
-84.946 pg/mL
Standard Deviation 118.736
|
—
|
—
|
—
|
Adverse Events
Placebo
Simufilam
Serious adverse events
| Measure |
Placebo
n=77 participants at risk
Subjects from Month 12 to Month 18 that were taking placebo.
Placebo: Matching placebo oral tablets administered b.i.d.
|
Simufilam
n=220 participants at risk
All subjects during day 1 to month 12 (Open-label simufilam), all subjects during month 18 to month 24 (Open-label simufilam), and subjects that were taking simufilam from month 12 to month 18.
Simufilam 100 mg oral tablet: Simufilam 100 mg oral tablet for b.i.d. administration
|
|---|---|---|
|
Cardiac disorders
Acute myocardial infarction
|
0.00%
0/77 • 2 years
|
1.8%
4/220 • Number of events 4 • 2 years
|
|
Cardiac disorders
Atrial fibrillation
|
1.3%
1/77 • Number of events 1 • 2 years
|
0.00%
0/220 • 2 years
|
|
Infections and infestations
COVID-19
|
1.3%
1/77 • Number of events 1 • 2 years
|
0.91%
2/220 • Number of events 2 • 2 years
|
|
Injury, poisoning and procedural complications
Femoral neck fracture
|
1.3%
1/77 • Number of events 1 • 2 years
|
0.00%
0/220 • 2 years
|
|
Injury, poisoning and procedural complications
Rib fracture
|
1.3%
1/77 • Number of events 1 • 2 years
|
0.00%
0/220 • 2 years
|
|
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
|
1.3%
1/77 • Number of events 1 • 2 years
|
0.00%
0/220 • 2 years
|
|
Respiratory, thoracic and mediastinal disorders
Interstitial lung disease
|
1.3%
1/77 • Number of events 1 • 2 years
|
0.00%
0/220 • 2 years
|
|
Cardiac disorders
Acute left ventricular failure
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Cardiac disorders
Angina pectoris
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Gastrointestinal disorders
Gastrointestinal haemorrhage
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Gastrointestinal disorders
Intestinal obstruction
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
General disorders
Asthenia
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Hepatobiliary disorders
Cholecystitis acute
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Appendicitis
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Bursitis infective staphylococcal
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
COVID-19 pneumonia
|
0.00%
0/77 • 2 years
|
0.91%
2/220 • Number of events 2 • 2 years
|
|
Infections and infestations
Cystitis
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Diverticulitis
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Diverticulitis intestinal perforated
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Peritonitis
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Pneumonia bacterial
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Pneumonia respiratory syncytial viral
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Urinary tract infection
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Injury, poisoning and procedural complications
Fall
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Injury, poisoning and procedural complications
Head injury
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Injury, poisoning and procedural complications
Hip fracture
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Metabolism and nutrition disorders
Hypokalaemia
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Metabolism and nutrition disorders
Hyponatraemia
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Nervous system disorders
Cerebral infarction
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
|
Infections and infestations
Pneumonia
|
0.00%
0/77 • 2 years
|
0.45%
1/220 • Number of events 1 • 2 years
|
Other adverse events
| Measure |
Placebo
n=77 participants at risk
Subjects from Month 12 to Month 18 that were taking placebo.
Placebo: Matching placebo oral tablets administered b.i.d.
|
Simufilam
n=220 participants at risk
All subjects during day 1 to month 12 (Open-label simufilam), all subjects during month 18 to month 24 (Open-label simufilam), and subjects that were taking simufilam from month 12 to month 18.
Simufilam 100 mg oral tablet: Simufilam 100 mg oral tablet for b.i.d. administration
|
|---|---|---|
|
Infections and infestations
COVID-19
|
5.2%
4/77 • Number of events 4 • 2 years
|
11.8%
26/220 • Number of events 26 • 2 years
|
|
Infections and infestations
Urinary tract infection
|
3.9%
3/77 • Number of events 3 • 2 years
|
10.0%
22/220 • Number of events 22 • 2 years
|
|
Nervous system disorders
Headache
|
1.3%
1/77 • Number of events 1 • 2 years
|
8.6%
19/220 • Number of events 19 • 2 years
|
|
Gastrointestinal disorders
Diarrhoea
|
0.00%
0/77 • 2 years
|
6.4%
14/220 • Number of events 14 • 2 years
|
|
Vascular disorders
Hypertension
|
1.3%
1/77 • Number of events 1 • 2 years
|
5.9%
13/220 • Number of events 13 • 2 years
|
|
Psychiatric disorders
Anxiety
|
1.3%
1/77 • Number of events 1 • 2 years
|
5.9%
13/220 • Number of events 13 • 2 years
|
|
Psychiatric disorders
Insomnia
|
2.6%
2/77 • Number of events 2 • 2 years
|
5.0%
11/220 • Number of events 11 • 2 years
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place