E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Mild Cognitive Impairment |
Deficit cognitivo lieve |
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E.1.1.1 | Medical condition in easily understood language |
Mild impairment of the cognitive system |
Lieve compromissione del sistema cognitivo |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10029205 |
E.1.2 | Term | Nervous system disorders |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the safety and tolerability of ascending oral doses (200, 400, or 600 mg/day) of CHF 5074 administered once per day for up to 12 weeks to patients with mild cognitive impairment |
Valutare la sicurezza e tollerabilita' di dosi orali crescenti (200, 400 o 600 mg/die) di CHF 5074 somministrate una volta al giorno per un periodo di 12 settimane a pazienti con deficit cognitivo lieve |
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E.2.2 | Secondary objectives of the trial |
The secondary objective of this study is to evaluate the pharmacokinetics of CHF 5074 in patients with mild cognitive impairment. |
L'obbiettivo secondario di questo studio e' valutare la farmacocinetica del CHF 5074 in pazienti con deficit cognitivo lieve. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Patientâs written informed consent is obtained prior to any study-related procedures. 2. Patient is younger than 80 years of age. 3. Patient has a diagnosis of amnestic or non-amnestic Mild Cognitive Impairment according to modified Petersen, et al`s criteria. 4. Patient has a Mini-Mental State Examination (MMSE) score higher than 24 at screening. 5. MRI scan of the brain at screening with fluid-attenuation inversion recovery (FLAIR) and T2*-weighted gradient-recalled-echo (GRE) sequences. 6. Patientâs informant is available. |
1. Il consenso informato del paziente e' stato ottenuto per iscritto prima di qualsiasi procedura relativa allo studio. 2. Il paziente e' di eta' inferiore a 80 anni. 3. Il paziente ha una diagnosi di deficit cognitivo lieve amnesico o non amnesico in base ai criteri modificati di Petersen et al. 4. Il paziente ha un punteggio superiore a 24 nel Mini-Mental State Examination (MMSE). 5. Risonanza magnetica del cervello allo screening con le sequenze FLAIR (Fluid-attenuated Inversion Recovery) e GRE (Gradient-recalled-echo) pesate in T2*. 6. Disponibilita' di una persona a dare informazioni sul paziente |
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E.4 | Principal exclusion criteria |
A diagnosis of Alzheimerâs disease according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision (DSM-IV-TR) or National Institute of Neurological and Communicative Disorders and Stroke-AD and Related Disorders (NINCDS-ADRDA) criteria. 2. Any medical condition that could explain the patients cognitive deficits CT or MRI brain imaging results obtained within 12-months prior to baseline showing evidence of infection, infarction, or focal lesions of clinical significance. 4. MRI scan at screening showing more than 4 cerebral microhemorrhages (lesions with diameter ⤠10 mm), regardless of their anatomical location or diagnostic characterization as `possible` or âdefinite`. 5. MRI scan at screening showing single area of superficial siderosis, or evidence of a prior macrohemorrhage (lesion with diameter > 10 mm). 6. A Geriatric Depression Scale (30-point scale) score > 9 at screening. 7. History of stroke. Patients with a history of transient ischemic attack may be enrolled, if occurred at least three months prior to screening. 8. A modified Hachinski ischemic scale score > 4 at screening. 9. Women of childbearing potential. Women of childbearing potential include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation, or bilateral oophorectomy) or is not postmenopausal. 10. Women who are breastfeeding or pregnant. 11. Women with a positive pregnancy test within 72 hours prior to administration of first dose of study medication. 12. Sexually active fertile men not using effective birth control if their partners are women of childbearing potential. 13. Patient has vitamin B12 or folate deficiency. Patients with a B12 deficiency may participate in the study if they are on stable vitamin B12 replacement for at least three months prior to screening. 14. All skin cancers and any cancer that is being actively treated, as well as a history of cancers that are considered to have a high probability of recurrence (with supporting documentation of this from the treating oncologist, if necessary). 15. Clinically significant abnormal coagulations tests. 16. Unstable cardiovascular (includes uncontrolled hypertension), pulmonary, gastrointestinal or hepatic disease one month prior to screening. 17. Diagnosis of schizophrenia or recurrent mood disorder (including unipolar and bipolar disorders) within 3 years of screening. 18. Current diagnosis of peptic ulcer or gastrointestinal bleeding within the last year and/or chronic inflammatory bowel disease. 19. History of neurosyphilis as indicated by positive fluorescent treponemal antibody absorption (FTA-ABS), or microhemagglutination assay (MHA-TP), or treponema pallidum particle agglutination assay (TPPA) tests. 20. Concomitant use of donepezil at doses > 5 mg/day or other cholinesterase inhibitors (rivastigmine or galantamine) at any dose. 21. Concomitant use of memantine at doses > 20 mg/day. 22. Concomitant use of psychoactive drugs (sedatives, hypnotics, etc.). Stable doses of sedatives for conditions such as mild to moderate anxiety or insomnia may be permitted if they have been stable for at least 30 days prior to randomization. |
1.Una diagnosi di morbo di Alzheimer secondo il Manuale diagnostico e statistico dei disturbi mentali IV edizione, revisione del testo (DSM-IV-TR) o i criteri del NINCDS-ADRD. 2.Qualsiasi condizione medica che possa spiegare i deficit cognitivi del paziente 3.Risultati di diagnostica per immagini (TAC o RM) ottenuti nei 12 mesi precedenti la visita basale indicanti evidenza di infezione, infarto o lesioni focali clinicamente significative. 4. RM allo screening indicante piu` di 4 microemorragie cerebrali indipendentemente dalla loro localizzazione anatomica o caratterizzazione diagnostica come `possibili` o `accertate`(lesioni con diametro superiore a 10 mm). 5. RM allo screening indicante singola area di siderosi superficiale o evidenza di precedente macroemorragia (lesioni con diametro superiore a 10 mm).. 6. Punteggio > 9 nella Geriatric Depression Scale (scala a 30 punti) allo screening. 7. Anamnesi di ictus. Si possono arruolare pazienti con anamnesi di attacco ischemico transitorio se si e` verificato almeno tre mesi prima dello screening. 8. Punteggio > 4 nella scala ischemica di Hachinski modificata. 9. Donne potenzialmente fertili. Per donne potenzialmente fertili si intendono donne che hanno raggiunto il menarca e non hanno subito interventi di sterilizzazione chirurgica (isterectomia, legatura bilaterale delle tube oppure ooforectomia bilaterale) o non sono in menopausa. 10. Donne in allattamento o gravidanza. 11. Donne con un risultato positivo al test di gravidanza nelle 72 ore de precedenti la somministrazione della prima dose del farmaco in studio. 12. Uomini fertili e sessualmente attivi che non usano metodi efficaci di contraccezione se le loro partner sono donne potenzialmente fertili. 13. Pazienti con carenza di vitamina B12 o di acido folico. I pazienti con carenza di B12 possono partecipare allo studio se assumono stabilmente integratori di vitamina B12 da almeno tre mesi prima dello screening. 14. Qualsiasi tipo di cancro della pelle e qualsiasi cancro che sia in trattamento attivo,cosi` come una precedente storia clinica di qualsiasi cancro la cui probabilita` di recidiva sia ritenuta alta (con documentazione a supporto fornita dall`oncologo che ha in cura il paziente, se necessario). 15. Anomalie clinicamente significative nei test di coagulazione. 16. Malattia cardiovascolare instabile (inclusa ipertensione non controllata), malattia polmonare, gastrointestinale o epatica nel mese precedente lo screening. 17. Diagnosi di schizofrenia o disturbo dell`umore ricorrente (inclusi disturbi unipolari e bipolari) entro 3 anni dallo screening. 18. Attuale diagnosi di ulcera peptica o sanguinamento gastrointestinale nel corso dell`ultimo anno e/o malattia infiammatoria cronica intestinale. 19. Anamnesi di neurosifilide come indicato da positivita` al test di assorbimento (FTA-ABS) o di microemoagglutinazione (MHA-TP) degli anticorpi contro Treponema fluorescenti, o al test di agglutinazione di particelle di Treponema Pallidum (TPPA) . 20. Uso concomitante di donepezil a dosi > 5 mg/die o altri inibitori delle colinesterasi (rivastigmina o galantamina) a qualsiasi dosaggio. 21. Uso concomitante di memantina a dosi > 20 mg/die. 22. Uso concomitante di farmaci psicoattivi (sedativi, ipnotici, ecc.) Dosi stabili di sedativi per condizioni quali ansia o insonnia da lieve a moderata potrebbero essere consentite se stabili da almeno 30 giorni prima della randomizzazione. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of the study is to determine the maximum tolerated dose (MTD) of CHF 5074 after multiple oral once-daily administrations (up to 12 weeks) to patients with mild cognitive impairment. The MTD of CHF 5074 is defined as the highest dose of the drug that does not, in the opinion of the Data Safety and Monitoring Board (DSMB), cause an intolerable adverse event that is related or possibly related to CHF 5074. |
L'endpoint primario dello studio e' determinare la massima dose tollerabile (MTD) di CHF 5074 dopo somministrazioni multiple per via orale una volta al giorno (per 12 settimane)in pazienti con deficit cognitivo lieve. La MTD del CHF 5074 e' definita come la dose massima di farmaco che, secondo il Data Safety e il Monitoring Board (DSMB), non causa eventi avversi intollerabili correlati o presumibilmente correlati con il CHF 5074. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
The secondary objective of this study is to evaluate the pharmacokinetics of CHF 5074 in patients with mild cognitive impairment |
L`endpoint secondario è di valutare la farmacocinetica del CHF 5074 in pazienti con deficit cognitivo lieve |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.3.1 | Comparator description |
Placebo nella stessa forma del farmaco in studio |
Placebo in the same form of study drug |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 13 |
E.8.5 | The trial involves multiple Member States | No |
E.8.5.1 | Number of sites anticipated in the EEA | 13 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 16 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 16 |
E.8.9.2 | In all countries concerned by the trial days | 0 |