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.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

220 participants

Primary outcome timeframe

Day 1 to Month 24

Results posted on

2025-04-22

Participant Flow

Participant milestones

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

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 24

Population: 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

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 24

Population: 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

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 24

The 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

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 18

The 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

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 24

The 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

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 18

The 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

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 24

The 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

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 18

The 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

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 24

Treatment 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

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 18

Treatment 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

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 12

Change 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

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 12

Change 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

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 12

Change 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

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 12

Change 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

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 12

Change 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

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

Serious events: 5 serious events
Other events: 12 other events
Deaths: 1 deaths

Simufilam

Serious events: 25 serious events
Other events: 113 other events
Deaths: 1 deaths

Serious adverse events

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

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

Sr. Associate Director

Cassava Sciences

Phone: 5125013180

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place