Lomecel-B Effects on Alzheimer's Disease (CLEARMIND)

Lomecel-B Effects on Alzheimer's Disease: A Randomized, Double-Blinded, Placebo-Controlled Phase 2a Trial

Dementia resulting from AD is associated with vascular function decline and involves a pro-inflammatory state. In our Phase 1 trial, Lomecel-B treatment met the primary safety endpoint, with no safety concerns, and showed potential to improve clinical assessments. Mechanistically, Lomecel-B treated subjects had higher serum concentrations of pro-vascular and anti-inflammatory biomarkers relative to placebo. This trial builds upon those preliminary Phase 1 results, and is designed to evaluate the safety profile of multiple infusions of Lomecel-B, and to investigate provisional efficacy of single dosing versus multiple dosing of Lomecel-B on cognitive function and biomarkers in AD subjects.

Study Overview

• Status: Completed
• Conditions: Mild Alzheimer's Disease
• Intervention / Treatment: Other: Placebo; Drug: Allogeneic MSC

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Phase 2

Contacts and Locations

• Study Contact: Name: Kevin N Ramdas, MD, MPH; Phone Number: (786) 543-6793; Email: ALZresearch@longeveron.com
• Study Contact Backup: Name: Nana Yakoubov; Email: Regulatory_Affairs@biorasi.com

Study Locations

• United States
  • Florida
    • Aventura, Florida, United States, 33180
      • Visionary Investigators Network
    • Delray Beach, Florida, United States, 33445
      • Brain Matters Research
    • Doral, Florida, United States, 33178
      • Science Connections - Research Partner Group Multispecialty Group
    • Miami, Florida, United States, 33155
      • Allied Biomedical Research Institute
    • Miami, Florida, United States, 33176
      • Miami Dade Medical Research Institute
    • Miami, Florida, United States, 33176
      • Brainstorm Research
    • Miami, Florida, United States, 33137
      • Miami Jewish Health
    • Miami, Florida, United States, 33155
      • Ivetmar Medical Group
    • Miami, Florida, United States, 33125
      • Bruce W. Carter VA Medical Center
    • Miami, Florida, United States, 33173
      • Fusion Medical Research and Clinic
    • Miami, Florida, United States, 33175
      • First Excellent Research Group, LLC
    • Palmetto Bay, Florida, United States, 33157
      • IMIC Inc.
    • Stuart, Florida, United States, 34997
      • Brain Matters Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Provide written informed consent.
• Be 60 - 85 years of age at signing of the Informed Consent Form.
• Clinical diagnosis of mild Alzheimer's disease in accordance with the NIA-AA criteria at the time of enrollment.
• MMSE score of 19 - 23.
• Body weight of 40 - 150 kg.

• Has an adult caregiver who meets all of the following criteria.

  1. Provides written informed consent to participate on the trial (reporting on patient observations).
  2. Either lives with the patient, or sees the patient for at least 2 hours/day for at least 3 days/week.
  3. Is willing and able to participate in the study, and agrees to accompany the patient to each study visit.
  4. Is able to read, understand, and speak the designated language at the study site.
• Brain MRI consistent with AD.
• A PET scan using an FDA-approved tracer (e.g., AMYViD, Vizamyl, or Neuraceq) consistent with the diagnosis of AD. A prior positive PET scan will be allowed with Sponsor approval.
• Living in the community, includes assisted living facilities (but excluding long-term care nursing facilities).

Exclusion Criteria:

• Diagnosed with frontotemporal dementia (FTD), dementia due to Acquired Immunodeficiency Syndrome (AIDS), Creutzfeldt-Jakob disease (CJD), Lewy Bodies dementia (LBD), Progressive Supranuclear Palsy (PSP), multiple cerebral infarctions, or normal pressure hydrocephalus.
• Any other neurodegenerative disease.
• History of a seizure disorder.
• Evidence of: a prior macrohemorrhage; at least 4 cerebral microhemorrhages (regardless of anatomical location or diagnostic characterization as "possible" or "definite"); or at least 1 area of superficial siderosis.
• Unwillingness or inability to have MRIs scans (no contrasting agent will be used), or condition that contraindicates MRI, such as the presence metallic objects in the eyes, skin, or heart.
• Any conditions that contraindicates PET with a beta-amyloid tracer.
• Significant intestinal malabsorption surgery, e.g., gastric bypass.
• Serum B12 and/or folate levels below normal range.
• Clinically abnormal free T4 or thyroid-stimulating hormone (TSH).
• Resting blood oxygen saturation <93%.
• Resting systolic blood pressure >180 mm Hg, or diastolic blood pressure >110 mm Hg.
• Regularly (> 4 weeks) using high-doses of corticosteroids or other steroidal anti-inflammatory medication (e.g., Prednisone) on a regular basis, with the exception of steroidal nasal sprays, asthma inhalers, topical steroids, and hormonal-replacement therapy.
• Regularly (> 4 weeks) using anti-cytokine antibody or targeting therapy, e.g., anti-TNF-α.
• Be an organ transplant recipient, or have active or expected future listing for any organ/tissue transplant while scheduled to be on trial, except for corneal, bone, skin, ligament, or tendon.
• Diagnosed with malignancy within the past 2 years, with the exception of curatively treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ, or cervical carcinoma.
• Known hypersensitivity to dimethyl sulfoxide (DMSO).
• Test positive for hepatitis B virus surface antigen, viremic hepatitis C virus, HIV, or syphilis.
• Any condition that is projected to limited life expectancy to < 12 months.
• Be pregnant, nursing, or of childbearing potential while not practicing effective contraception.
• Be currently participating in any other investigational therapeutic or device trial, or have participated within one within the previous 30 days to screening, or in the opinion of the investigator, the patient should be excluded for such participation within the past 5 years.
• In the opinion of the investigator, the patient has any other illness or condition that: may compromise the participant's safety, compliance, or ability to successfully complete the study; may compromise the validity of the study; or otherwise should exclude the participant from enrollment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo; Group 1 will receive four infusions of Placebo on Day 0, Week 4, Week 8, and Week 12.	Other: Placebo; Placebo
Experimental: Lomecel-B Dose 1; Group 2 will receive an infusion of Lomecel-B at a dose of 25 x 10^6 cells (25M) on Day 0, followed by Placebo infusions at Week 4, Week 8, and Week 12.	Drug: Allogeneic MSC; An allogeneic bone marrow-derived medicinal signaling cell (MSC) formulation
Experimental: Lomecel-B Dose 2; Group 3 will receive four infusions of 25M Lomecel-B on Day 0, Week 4, Week 8, and Week 12.	Drug: Allogeneic MSC; An allogeneic bone marrow-derived medicinal signaling cell (MSC) formulation
Experimental: Lomecel-B Dose 3; Group 4 will receive four infusions of Lomecel-B at a dose of 100 x 10^6 cells (100M) on Day 0, Week 4, Week 8, and Week 12.	Drug: Allogeneic MSC; An allogeneic bone marrow-derived medicinal signaling cell (MSC) formulation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Primary Endpoint 1: Safety - SAEs and AEs	To demonstrate that Lomecel-B infusions do not trigger the pre-specified stopping rules. Additional safety will be acquired throughout the study as follows: Incidence of all AEs and SAEs over the course of the trial.	41 weeks
Primary Endpoint 2: Safety - Imaging	To demonstrate that Lomecel-B infusions do not trigger the pre-specified stopping rules. Additional safety will be acquired throughout the study as follows: Alzheimer's disease-related imaging abnormalities (ARIA) or clinically asymptomatic microhemorrhages as revealed by MRI.	41 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Secondary Endpoint 2: Efficacy- Change in the ADAS-cog-13	Change from baseline in the ADAS-cog-13 in Lomecel-B-treated arms versus change in placebo.	41 weeks
Secondary Endpoint 3: Efficacy- Change in the MMSE	Change from baseline in the MMSE in Lomecel-B-treated arms versus change in placebo.	41 weeks

Collaborators and Investigators

• Sponsor: Longeveron Inc.
• Collaborators: bioRASI, LLC

Study record dates

Study Major Dates

• Study Start (Actual): December 28, 2021
• Primary Completion (Actual): September 29, 2023
• Study Completion (Actual): September 29, 2023

Study Registration Dates

• First Submitted: December 16, 2021
• First Submitted That Met QC Criteria: January 31, 2022
• First Posted (Actual): February 10, 2022

Study Record Updates

• Last Update Posted (Actual): February 20, 2024
• Last Update Submitted That Met QC Criteria: February 16, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Neurodegenerative Diseases; Dementia; Tauopathies; Alzheimer Disease
• Other Study ID Numbers: 00-007-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No