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Simufilam

Phase 3

Alzheimer Disease | Small molecule | Neurology |Cassava Sciences, Inc.|Last Updated: May 25, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment1,088
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04994483Simufilam 100 mg for Mild-to-Moderate Alzheimer's DiseasePHASE3 COMPLETED 804Nov 3, 2021Oct 2, 2024May 25, 202588 United States, Australia +1
NCT04388254Simufilam (PTI-125), 100 mg, for Mild-to-moderate Alzheimer's Disease PatientsPHASE2 COMPLETED 220Mar 24, 2020Nov 9, 2023Apr 22, 202517 United States, Canada
NCT04079803PTI-125 for Mild-to-moderate Alzheimer's Disease PatientsPHASE2 COMPLETED 64Sep 9, 2019Mar 31, 2020Sep 29, 20219 United States
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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.

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

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 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)
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.
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
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Eligibility Criteria
Age Range50 Years — 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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