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simufilam

Phase 3

Alzheimer Disease | Small molecule | Neurology |Filana Therapeutics, Inc.|Trials Updated: May 25, 2025

simufilam development status

Highest phase Phase 3
Registered trials 8 across 2 sponsors since Jun 2021

simufilam target and mechanism

Molecular targetFLNA
Target classPositive Modulator
ModalitySmall molecule

Also known as PTI-125

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials7
Total Enrollment1,160

FDA Designations

No designations recorded

simufilam clinical trials

simufilam · 7 trials · 6 indications

Phase 3 1Phase 2 3Phase 1 3
NCT04994483Simufilam 100 mg for Mild-to-Moderate Alzheimer's DiseaseAlzheimer Disease
COMPLETED804 Analytics
PHASE3COMPLETED
Simufilam 100 mg for Mild-to-Moderate Alzheimer's Disease
Alzheimer DiseaseUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in the 12-item Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog12)
Baseline (Study Day 1) to Week 52

The change from baseline to Week 52 in the ADAS-Cog12, a psychometrician-administered battery comprised of several cognitive domains including memory, comprehension, praxis, orientation, and spontaneous speech. Scores range from 0 (best) to 80 (worst).

Change From Baseline in the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL)
Baseline (Study Day 1) to Week 52

The change from baseline to Week 52 in the ADCS-ADL, a 23-item study partner questionnaire that covers both basic activities of daily living (ADL) and more complex ADL or instrumental ADL. Scores range from 0 to 78, with a lower score indicating greater severity of functional loss.

Maximum Plasma Concentration (Cmax)
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose

Blood draws will be done to evaluate levels of PTI-125 in the plasma using non-compartmental methods in WinNonlin.

Time to Maximum Plasma Concentration (Tmax)
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose

Levels of PTI-125 will be assessed to determine how long it takes to reach the Cmax

Last Quantifiable Plasma Concentration (Clast)
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose

Levels of PTI-125 will be assessed to determine the last time point where PTI-125 can be detected.

Time to Last Quantifiable Plasma Concentration (Tlast)
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose

Levels of PTI-125 will be assessed to determine the elapsed time to where PTI-125 can last be detected in the plasma.

Area Under the Curve (AUClast)
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose

AUC for PTI-125 plasma concentration from time zero to the last quantifiable plasma concentration.

Plasma Half-life (T1/2)
Study Day 1 and Day 28 at 20, 40, and 60 min and at 1.5, 2, 2.5, 3, 4, 6, 8, 10 and 12 h post-dose

Assessment of the half-life in plasma of PTI-125

Change From Baseline in ADAS-Cog-11
Day 1 to 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.

Change From Baseline in ADAS-Cog-11 (Month 12 to Month 24)
Month 12 to 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.

Safety and Tolerability (Open Label Abnormal Vital Signs)
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)

Safety and Tolerability (Randomize Withdraw Abnormal Vital Signs)
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

Safety and Tolerability (Open Label Electrocardiogram Results)
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)

Safety and Tolerability (Randomize Withdraw Electrocardiogram Results)
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

Safety and Tolerability (Open Label Abnormal Physical Examination)
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)

Safety and Tolerability (Randomize Withdraw Abnormal Physical Examination Findings)
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

Safety and Tolerability (Open Label Abnormal Clinical Laboratory Results)
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)

Safety and Tolerability (Randomize Withdraw Abnormal Clinical Laboratory Results)
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

Change From Baseline in CSF Abeta42
Screening to Day 28

Change from Baseline (screening sample) to Day 28 in cerebrospinal fluid levels of Amyloid beta42

Change From Baseline in CSF Total Tau.
Screening to Day 28

Change from Baseline (screening sample) to Day 28 in cerebrospinal fluid total tau.

Change From Baseline in CSF P-tau181
Screening to Day 28

Change from Baseline (screening) to Day 28 in cerebrospinal fluid P-tau181

Change From Baseline in CSF Neurogranin
Screening to Day 28

Change from Baseline (screening) to Day 28 in cerebrospinal fluid neurogranin

Change From Baseline in CSF Neurofilament Light Chain
Screening to Day 28

Change from Baseline (screening) to Day 28 in cerebrospinal fluid neurofilament light chain

Change From Baseline in CSF YKL-40
Screening to Day 28

Change from Baseline (screening) in cerebrospinal fluid YKL-40

Time to Maximum Plasma Concentration (Tmax) (Tmax)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The time to peak drug concentration will be obtained directly from the data without interpolation

Elimination Rate Constant (λz)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The elimination rate constant (λz) will be calculated.

Termination Elimination Half-Life (T1/2)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The terminal elimination half-life (T1/2) will be calculated.

Area Under the Curve (AUC)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The AUC from time zero to the time of the last quantifiable concentration (AUClast) will be calculated.

Area Under the Curve to Infinity (AUCinf)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The AUC from time zero extrapolated to infinity (AUCinf) will be calculate.

Percent Extrapolated of Area Under the Curve to Infinity (AUCextrap[%]).
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The percentage of AUCinf based on extrapolation (AUCextrap\[%\]).

Oral Clearance (Cl/F)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

The apparent oral clearance will be calculated.

Volume of Distribution (Vz/F)
Blood samples will be drawn on Day 1 after dosing at 20, 40, and 60 minutes and at 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours.

Vz/F, apparent volume of distribution will be calculated.

Area Under the Curve; moderate vs. normal and mild vs. normal
5 Days

Area Under the Curve of simufilam concentration in plasma in Moderate and Mild Impairment vs. Normal (each separately)

Concentration max; moderate vs. normal and mild vs. normal
5 Days

Maximum simufilam concentration in plasma in Moderate and Mild Impairment vs. Normal (each separately)

Time max; moderate vs. normal and mild vs. normal
5 Days

Time to maximum simufilam concentration in plasma in Moderate and Mild Impairment vs. Normal (each separately)

Half-life; moderate vs. normal and mild vs. normal
5 Days

Half-life of simufilam concentration in plasma in Moderate and Mild Impairment vs. Normal (each separately)

Elimination rate constant; moderate vs. normal and mild vs. normal
5 Days

Elimination rate constant of simufilam concentration in plasma in Moderate and Mild Impairment vs. Normal (each separately)

AUC of total radioactivity, parent drug and metabolite(s) in plasma.
10 days

Area Under the Curve for each total radioactivity, parent drug and metabolite(s) in plasma.

Cmax of total reactivity, parent drug and metabolite(s) in plasma.
10 Days

Maximum concentration for each total radioactivity, parent drug and metabolite(s) in plasma.

Tmax of total reactivity, parent drug and metabolite(s) in plasma.
10 Days

Time to maximum concentration for each total radioactivity, parent drug and metabolite(s) in plasma.

Half-life of total reactivity, parent drug and metabolite(s) in plasma.
10 Days

Half-life for each total reactivity, parent drug and metabolite(s) in plasma.

Elimination rate constant of total reactivity, parent drug and metabolite(s) in plasma.
10 Days

Elimination rate constant for each total reactivity, parent drug and metabolite(s) in plasma.

Secondary Endpoints

Change From Baseline in the Integrated Alzheimer's Disease Rating Scale (iADRS)
Baseline (Study Day 1) to Week 52
Change From Baseline in the Neuropsychiatric Inventory (NPI)
Baseline (Study Day 1) to Week 52
Change From Baseline in the Mini-Mental State Exam (MMSE)
Baseline (Study Day 1) to Week 52
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
PlaceboPLACEBO_COMPARATORMatching placebo, supplied by Cassava as coated tablets, and taken twice daily (b.i.d.) for 52 weeks
Simufilam 100 mgEXPERIMENTALSimufilam 100 mg, supplied by Cassava as coated tablets, and taken b.i.d. for 52 weeks
Simufilam (PTI-125)EXPERIMENTALSimufilam (PTI-125) 100 mg oral tablets administered twice daily (BID)
Simufilam 100 mg oral tablets throughoutEXPERIMENTALSimufilam 100 mg oral tablets administered twice daily (BID) for the full 24 months (including the randomized period Month 12 to Month 18)
Simufilam 100 mg oral tablets / Placebo / Simufilam 100 mg oral tabletsPLACEBO_COMPARATORThis placebo arm is only for 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. for all subjects.
Placebo CohortPLACEBO_COMPARATORSubjects administered placebo oral tablets twice daily (BID)
Simufilam (PTI-125) 100 mg tablets CohortEXPERIMENTALSubjects administered simufilam (PTI-125) 100 mg oral tablets twice daily (BID)
Simufilam (PTI-125) 50 mg tablets CohortEXPERIMENTALSubjects administered simufilam (PTI-125) 50 mg oral tablets twice daily (BID)
50 mg PTI-125ACTIVE_COMPARATORSix (6) subjects will receive a single orally administered dose of 50 mg PTI-125 in this cohort.
50 mg PTI-125 PlaceboPLACEBO_COMPARATORTwo (2) subjects will receive a single orally administered dose of 50 mg Placebo PTI-125 in this cohort.
100 mg PTI-125ACTIVE_COMPARATORSix (6) subjects will receive a single orally administered dose of 100 mg PTI-125 in this cohort.
100 mg PTI-125 PlaceboPLACEBO_COMPARATORTwo (2) subjects will receive a single orally administered dose of 100 mg Placebo PTI-125 in this cohort.
200 mg PTI-125ACTIVE_COMPARATORSix (6) subjects will receive a single orally administered dose of 200 mg PTI-125 in this cohort.
200 mg PTI-125 PlaceboPLACEBO_COMPARATORTwo (2) subjects will receive a single orally administered dose of 200 mg Placebo PTI-125 in this cohort.
Moderate Hepatic ImpairmentEXPERIMENTAL -
Healthy VolunteerEXPERIMENTAL -
Mild Hepatic ImpairmentEXPERIMENTAL -

Interventions

NameTypeDescription
SimufilamDRUGSimufilam is a novel drug candidate designed to treat and slow the progression of AD. Simufilam binds with femtomolar affinity to an altered conformation of filamin A that is present in the brain of patients with AD and critical to the toxicity of Aβ42. In this study, simufilam will be given b.i.d. for 52 weeks at a dose of 100 mg.
PlaceboDRUGMatching placebo given b.i.d. for 52 weeks.
PTI-125, 100 mg tabletsDRUGPTI-125, 100 mg tablets taken twice a day for 28 days
Simufilam 100 mg oral tabletDRUGSimufilam 100 mg oral tablet for b.i.d. administration
Placebo oral tabletDRUGOral placebo tablet
Simufilam 100 mg tabletDRUGSimufilam 100 mg oral tablet
Simufilam 50 mg oral tabletDRUGSimufilam 50 mg oral tablet
50 mg PTI-125DRUGPTI-125 50 mg Oral Solution
100 mg PTI-125DRUGPTI-125 100 mg Oral Solution
200 mg PTI-125DRUGPTI-125 200 mg Oral Solution
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Eligibility Criteria

Age Range50 Years to 87 Years
SexALL
Healthy VolunteersNo
Study Sites88

Key Inclusion Criteria: 1. Meets National Institute on Aging and Alzheimer's Association Research Framework criteria for individuals in clinical Stage 4 or 5 of the Alzheimer's continuum. 2. Evidence for AD pathophysiology, confirmed either prior to or during screening. 3. MMSE score ≥ 16 and ≤ 27 ...

Countries:United StatesAustraliaCanada
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Frequently asked questions about simufilam

What is simufilam?

Simufilam is an investigational small molecule developed by Filana Therapeutics, Inc. (ticker FLNA). It is being studied in clinical trials for Alzheimer disease, hepatic insufficiency, and absorption, metabolism, and excretion. Simufilam is also known as simufilam 100 mg tablet or simufilam 100 mg oral tablet. It has not been approved by the FDA and remains in clinical development.

What does simufilam target?

Simufilam targets FLNA and acts as a positive modulator. By binding to FLNA, simufilam is designed to modulate its activity. This mechanism is being investigated in conditions such as Alzheimer disease and hepatic insufficiency.

Who makes simufilam?

Simufilam is being developed by Filana Therapeutics, Inc., which trades under the ticker symbol FLNA. The company is responsible for the clinical development of simufilam across its studied indications.

What phase is simufilam in?

Simufilam is in Phase 1 development. It has completed three clinical trials, including Phase 1 studies in hepatic insufficiency and absorption, as well as a Phase 2 and a Phase 3 trial in Alzheimer disease. Simufilam is investigational and has not been approved by the FDA.

What clinical trials is simufilam in?

Simufilam has been studied in several completed trials. These include NCT06390410, a Phase 1 pharmacokinetic study in hepatic insufficiency; NCT06195319, a Phase 1 absorption, metabolism, and excretion study; NCT04994483, a Phase 3 trial in mild-to-moderate Alzheimer disease; and NCT04388254, a Phase 2 trial in mild-to-moderate Alzheimer disease.