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Xanamem

Phase 2

Dementia, Alzheimer Type | Small molecule | Neurology |Icon Plc|Last Updated: Feb 3, 2025

Success Probability

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment185

FDA Designations

No designations recorded

Clinical trial landscape

Xanamem · 2 trials · 10 indications

Phase 2 1Phase 1 1
NCT02727699A Phase II Study to Assess the Safety, Tolerability and Efficacy of Xanamem™ in Subjects With Mild Dementia Due to AD (XanADu)Dementia, Alzheimer Type
COMPLETED185 Analytics
PHASE2COMPLETED
A Phase II Study to Assess the Safety, Tolerability and Efficacy of Xanamem™ in Subjects With Mild Dementia Due to AD (XanADu)
Dementia, Alzheimer TypeUnlock trial analytics

Study Endpoints

Primary Endpoints

ADAS-Cog v14
Baseline, Week 12

Change in Alzheimer's Disease Assessment Scales - Cognitive Subscale Score, version 14 (ADAS-Cog v14) Total scores of ADAS Cog 14 range from 0 to 90, with higher scores indicating greater disease severity.

AD COMposite Scores
Baseline, Week 12

Change in AD COMposite Scores (ADCOMs- ADCOMs, composite score is derived from a weighted linear combination of items from commonly used outcome scales Cognitive Subscale Version 14 \[ADAS-Cog v14\], Clinical Dementia Rating Scale - Sum of Boxes \[CDR-SOB\], and Mini-Mental Status Examination \[MMSE\]. Th ADCOMs range: 0 - 1.97, whereas a lover score is interpreted as a better result. Included scales: ADAS-Cog v14 (range: 0-90): A lower score is indicative of better cognition, a higher score indicates higher cognitive impairment. CDR-SOB (range: 0-18): A lower score is indicative of better cognition, a higher score indicates higher cognitive impairment. MMSE (range: 0-30): A higher score is indicative of better cognition, a lower score indicates higher cognitive impairment.

Incidence of Treatment-Emergent Adverse Events (AEs)
20 Weeks (Screening up to Week 16 Follow-Up [4 Weeks Post Last Dose of Study Drug ± 4 Days])

The number, type, and severity of treatment-emergent adverse events (AEs) that are reported from Screening Visit to Follow-up Visit will be collected and evaluated.

Incidence of Clinically Significant Changes in Serum Biomarker Levels in a Standard Serum Chemistry Panel
Screening up to Week 16 (Follow-Up [4 Weeks Post Last Dose of Study Drug ± 4 Days])

Collection of blood samples for clinical laboratory testing to assess any clinically significant changes in standard serum chemistry measures.

Incidence of Clinically Significant Laboratory Haematological Biomarker Levels in a Standard Haematology Panel.
Screening up to Week 16 (Follow-Up [4 Weeks Post Last Dose of Study Drug ± 4 Days])

Collection of blood samples for clinical laboratory testing to assess any clinically significant changes in standard haematology measures.

Incidence of Clinically Significant Changes or Abnormalities Following Physical Examination
Screening up to Week 16 (Follow-Up) and Unscheduled Safety Visit throughout duration of study up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])

Evaluation of any clinically significant changes or abnormalities reported following a standard Physical Examination.

Nerve Conduction Assessments
Screening up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])

Nerve Conduction assessments will be used to detect presence and severity of nerve damage.

Neuropathy Total Symptom Score-6 (NTSS-6)
Screening, Week 2, Week 4, Week 8, Week 12 (End of Treatment), Week 16 (Follow-Up) and Telephone Contact (Ad Hoc)

Changes in the Neuropathy Total Symptom Score (NTSS-6) administered by a physician to assess a subjects' medical history. Each item will also be graded for its frequency and intensity, adding up to a total score from "0" to "21.96" points. A total score of \> 6 would exclude the subject from the study.

Toronto Clinical Neuropathy Score (TCNS)
Screening, Week 2, Week 4, Week 8, Week 12 (End of Treatment), Week 16 (Follow-Up) and Telephone Contact (Ad Hoc)

Changes in Toronto Clinical Neuropathy Score (TCNS) to detect for neuropathy out of a total score of 19; scales are defined as follows: 0-5 = no neuropathy; 6-8 = mild neuropathy; 9-11 = moderate neuropathy; ≥ 12 = severe neuropathy.

Skin Biopsy
At Baseline and Week 12 (End of Treatment)

A 3mm skin sample will be taken via skin punch biopsy to detect intra-epidermal nerve fiber density; this allows for the objectification and quantification of a small-fiber neuropathy.

Quantitative Sensory Testing (QST)
Screening up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])

Thermal sensory testing using Quantitative Sensory Testing (QST) for cold, warm and heat pain to detect peripheral nerve disorders.

Columbia Suicide Severity Rating Scale (CSSRS)
Screening, Baseline, Week 2, Week 4, Week 8, Week 12 (End of Treatment), Week 16 (Follow-Up)

Any change in Columbia Suicide Severity Rating Scale (CSSRS) will assess suicidal ideation and behaviour. * Suicidal ideation score: Any score greater than 0 is important and may indicate the need for mental health intervention. * Suicidal ideation intensity rating: The five intensity item scores create a total score (range 0 to 25) to represent the intensity rating, if the patient did not endorse any suicidal ideation the intensity rating is 0.

Electrocardiogram (ECG)
Screening up to Week 16 (Follow-Up Visit [4 Weeks Post Last Dose of Study Drug ± 4 Days])

Any clinically significant electrocardiogram (ECG) abnormalities will be recorded, including corrected QT interval (QTc) of \> 500 msec.

Secondary Endpoints

RAVLT
Baseline, Week 12
CDR-SOB
Baseline, Week 12
MMSE
Baseline, Week 12
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Xanamem™EXPERIMENTALOral Xanamem™ capsules 10mg, to be administered once daily
PlaceboPLACEBO_COMPARATORMatching placebo which is identical in appearance to the test product except that it contains no active ingredient, to be administered once daily
Cohort 1 / Cohort 2 (Active)EXPERIMENTAL20mg or 30mg capsules of Xanamem respectively, to be administered PO once daily.
Cohort 1 / Cohort 2 (Placebo)PLACEBO_COMPARATORMatching placebo which is identical in appearance to the test product except that it contains no active ingredient, to be administered once daily.

Interventions

NameTypeDescription
Xanamem™DRUGXanamem™ is formulated in green and cream coloured size 3, Coni-Snap shaped gelatin capsules as an excipient blend at a dose of 10mg. It contains active pharmaceutical ingredient of UE2343
Placebo (for Xanamem™)DRUGExcipient blend capsules manufactured to mimic Xanamem™ capsules
XanamemDRUGOral Xanamem capsules 20mg or 30mg, administered PO once daily. Xanamem is formulated in green and cream coloured size 3, Coni-Snap shaped gelatin capsules as an excipient blend at a dose of 10mg. It contains active pharmaceutical ingredient of UE2343.
Matching PlaceboDRUGMatching placebo which is identical in appearance to the test product (20mg, 30mg Xanamem™ QD) except that it contains no active ingredient.
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Eligibility Criteria

Age Range50 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites25

Inclusion Criteria: 1. Males and females aged 50 years or older at the time of informed consent. 2. Female Subjects: 1. Post menopausal women, defined as no menses for 12 months without an alternative medical cause. If there is any concern about the menopausal status of a prospective female sub...

Countries:United StatesAustraliaUnited Kingdom
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Frequently asked questions about Xanamem

What is Xanamem used for in Alzheimer's disease?

Xanamem is an investigational small molecule being studied for the treatment of mild dementia due to Alzheimer's disease. It is currently in Phase 2 clinical development and has not been approved by regulatory authorities. The drug is being evaluated for its safety, tolerability, and efficacy in patients with this condition.

How does Xanamem work?

Xanamem is a small molecule designed to inhibit the enzyme 11β-HSD1, which is involved in the production of cortisol within the brain. By reducing local cortisol levels, Xanamem aims to address cognitive decline associated with Alzheimer's disease. This mechanism is being investigated in clinical trials for its potential to improve cognitive function.

Who is developing Xanamem?

Xanamem is being developed by Icon Plc, a biopharmaceutical company listed on the NASDAQ under the ticker symbol ICLR. The company is conducting clinical trials to evaluate the drug's safety and efficacy for Alzheimer's disease and related conditions.

What phase is Xanamem in?

Xanamem is currently in Phase 2 clinical development. It has completed a Phase 2 study in patients with mild dementia due to Alzheimer's disease and a Phase 1 study in healthy elderly subjects. The drug remains investigational and is not yet approved for any use.

What clinical trials has Xanamem been in?

Xanamem has been studied in two completed clinical trials. The Phase 2 trial NCT02727699, known as XanADu, enrolled 185 patients with mild dementia due to Alzheimer's disease across the United States, Australia, and the United Kingdom. The Phase 1 trial NCT03830762 enrolled 42 healthy elderly subjects in Australia to assess safety and cognitive effects.

Is Xanamem the same as any other drug?

Xanamem is a distinct investigational drug and is not known to be the same as any other marketed medication. It is being developed under its own name by Icon Plc and is not a repurposed version of an existing approved drug.