A Trial to Evaluate the Safety and Efficacy of Benfotiamine in Patients With Early Alzheimer's Disease (BenfoTeam)

Purpose

The purpose of this study is to learn more about the safety, effectiveness and tolerability of the study drug called Benfotiamine which may delay or slow the progression of the symptoms of early Alzheimer's disease.

Condition

  • Alzheimer Disease

Eligibility

Eligible Ages
Between 50 Years and 89 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Aged 50 to 89 (inclusive) at screening - Mild Cognitive Impairment (MCI) due to AD or Mild dementia due to AD according to workgroups of the Diagnostic Guidelines of the National Institute on Aging and Alzheimer's Association (NIA-AA) - Mini-Mental State Examination (MMSE) score 20-30 inclusive at screening-. Montreal Cognitive Assessment score (MoCA) < 26 at screening - Clinical Dementia Rating (CDR) global score of 0.5 or 1 with memory score of greater or equal to 0.5 at screening - Positive plasma AD biomarker signature - Participants who are treated with FDA-approved acetylcholinesterase inhibitors (AchEI)and/or memantine will have to be on a stable dosage regimen for at least 3 months prior to screening. - Participants must have a study partner who has frequent interaction with them (approximately >3-4 times per week), will be available for all clinic visits in person or remotely, and can assist in compliance with study procedures. - Female participants must be post-menopausal for at least one year or surgically sterile(bilateral tubal ligation, hysterectomy, or bilateral oophorectomy) for at least 6 months prior to screening. - Fluent in English or Spanish to ensure compliance with cognitive testing and study visit procedures. - Ambulatory, or able to walk with an assistive device. - Provision of informed consent from the participant (or the participant's legally authorized representative (LAR) if unable to provide consent) and the study partner.

Exclusion Criteria

  • Significant neurological disorder other than AD (e.g. hypoxia, stroke, traumatic brain injury - Significant neurodegenerative diseases, other than AD, and causes of dementias, Parkinson's disease and Huntington's disease, vascular dementia, CJD (Creutzfeldt-Jakob disease), LBD (Lewy Body dementia), PSP (Progressive Supranuclear Palsy), AIDS (Acquired Immunodeficiency Syndrome), or NPH (normal pressure hydrocephalus). - Meeting Diagnostic Criteria for Possible AD according to workgroups of the Diagnostic Guidelines of the NIA-AA. - A current diagnosis of uncontrolled Type I or Type II diabetes mellitus, as defined by Hemoglobin A1C (Hb A1C ≥ 8). - A current active, uncontrolled seizure disorder. - Diagnosis of cancer, except for those participants who have undergone potentially curative therapy with no evidence of recurrence for > 5 years. - History of alcoholism or substance abuse, current or within past 5 years. - Previous exposure to Benfotiamine within past 3 months. - Contraindication to MRI. - Participation in another clinical trial for an investigational agent and having taken at least one dose of study drug, unless confirmed as having been on placebo, within 4 weeks prior to the baseline visit. The end of a previous investigational trial is defined as the date of the last dose of an investigational agent. - Initiation of a monoclonal antibody treatment targeting brain amyloid within 6 months prior to the baseline visit. - A disability that may prevent the patient from completing all study requirements e.g.,blindness, deafness, severe language difficulty).

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Triple (Participant, Care Provider, Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Low Dose Benfotiamine
Participants will take 300mg benfotiamine capsules twice a day (BID; once in the morning and once in the evening).
  • Drug: Low Dose Benfotiamine
    300mg benfotiamine capsules (BID, twice a day)
Experimental
High Dose Benfotiamine
Participants will take 600mg benfotiamine capsules twice a day (BID; once in the morning and once in the evening).
  • Drug: High Dose Benfotiamine
    600mg benfotiamine capsules (BID, twice a day)
Placebo Comparator
Placebo
Participants will take placebo capsules twice a day (BID; once in the morning and once in the evening). In the placebo group, capsules will be filled with inactive microcrystalline cellulose. The other capsule components, shape and color are identical between benfotiamine and placebo arms.
  • Drug: Placebo
    Placebo capsules to mimic benfotiamine capsules (BID, twice a day)

Recruiting Locations

St. Joseph's Hospital and Medical Center/Barrow Neurological Institute
Phoenix, Arizona 85013

Banner Sun Health Research Institute
Sun City, Arizona 85351

University of California, Irvine
Irvine, California 92697

University of Southern California
Los Angeles, California 90033

Cedars Sinai, Los Angeles
Los Angeles, California 90048

Syrentis Clinical Research
Santa Ana, California 92705

JEM Research Institute
Atlantis, Florida 33462

Brain Matters Research
Delray Beach, Florida 33445

Neuropsychiatric Research Center of Southwest Florida
Fort Myers, Florida 33912

CCM Clinical Research Group, LLC
Miami, Florida 33133

Miami Jewish Health
Miami, Florida 33137

Blue Medical Research Inc.
Miami, Florida 33144

Brain Matters Research (Kane Center)
Stuart, Florida 34997

Emory University Goizueta Alzheimer's Disease Research Center(GADRC)
Atlanta, Georgia 30329

Rush University Medical Center
Chicago, Illinois 60612

Southern Illinois University
Springfield, Illinois 62702

University of Iowa
Iowa City, Iowa 52242

University of Kentucky
Lexington, Kentucky 40504

MedVadis Research
Waltham, Massachusetts 02451

University of Michigan, Ann Arbor
Ann Arbor, Michigan 48109

Albany Medical College
Albany, New York 12208

Dent Neurologic Institute
Amherst, New York 14226

Integrative Clinical Trials
Brooklyn, New York 11229

Weill Cornell Medical College
New York, New York 10021

Mount Sinai School of Medicine
New York, New York 10029

Nathan Kline Institute for Psychiatric Research
New York, New York 10962

SUNY Upstate Medical University
Syracuse, New York 13210

Case Western Reserve University
Cleveland, Ohio 44106

Ohio State University
Columbus, Ohio 43221

Oregon Health & Science University (OHSU)
Portland, Oregon 97239

Rhode Island Hospital
Providence, Rhode Island 02903

Ralph H. Johnson VA Health Care System
Charleston, South Carolina 29401

KCA Neurology
Tennessee, Tennessee 37067

University of North Texas Health Science Center
Fort Worth, Texas 76107

More Details

NCT ID
NCT06223360
Status
Recruiting
Sponsor
Alzheimer's Disease Cooperative Study (ADCS)

Study Contact

ADCS Recruitment Team
877-807-1290
adcs-recruitment@health.ucsd.edu

Detailed Description

This is a randomized, double-blind, placebo-controlled 18-month clinical trial of benfotiamine in early AD. This trial will include a seamless phase 2A-2B design with a randomized total sample of 406 participants. Participants who are randomized but drop out prior to study drug exposure will be replaced. Phase 2A of the trial will randomize approximately 150 participants total, in a 1:1:1 to treatment with 1200 mg/day benfotiamine, 600 mg/day benfotiamine or placebo. The primary objective of phase 2A is to determine the highest safe and well tolerated dose of benfotiamine (600 mg or 1200 mg), as evaluated by the rate of tolerability events (TEs), for advancement to long-term 72 week exposure. The highest tolerated dose of benfotiamine will be carried forward from phase 2A to phase 2B. At the start of phase 2B, all participants enrolled in the two phase 2A active dose arms will receive a new supply of benfotiamine at the selected phase 2B dose. All phase 2A participants will be included in the phase 2 intent-to-treat efficacy population, as assigned to active or placebo treatment. The primary objective of phase 2B is to assess efficacy of benfotiamine on global function and cognition over 72 weeks. In phase 2B, a composite cognitive and functional measure as well as PD biomarkers will be used to evaluate efficacy during the extended treatment period. Phase 2B will also evaluate longer-term safety and tolerability of benfotiamine treatment over 72 weeks.