31P-MRS Imaging to Assess the Effects of CNM-Au8 on Impaired Neuronal Redox State in Parkinson's Disease
Condition: Parkinson's Disease
MeSH terms: Parkinson Disease
Study type: Interventional
Phase: Phase 2

Summary: 
      REPAIR-PD is a single-center open label pilot, sequential group, investigator and patient
      blinded study to assess the CNS metabolic effects, safety, pharmacokinetics, and
      pharmacodynamics of CNM-Au8 in patients who have been diagnosed with Parkinson's Disease (PD)
      within three (3) years of Screening. The primary endpoint is the ratio of the oxidized to
      reduced form of nicotinamide adenine dinucleotide (NAD+:NADH) measured non-invasively by
      31phosphorous magnetic resonance spectroscopy (31P-MRS).
    

Detailed description: 
      This is a single-center open label pilot, sequential group, investigator blinded study of the
      CNS metabolic effects, safety, pharmacokinetics, and pharmacodynamics of CNM-Au8 in patients
      who have been diagnosed with Parkinson's Disease within three years of Screening. The Sponsor
      will select a starting treatment dose of CNM-Au8 for the initial treatment. Investigators and
      patients will be blinded to each cohort's study dose. Upon completion of the first treatment
      cohort, the Sponsor will select a single dose or two different doses for the subsequent
      second cohort from a pre-specified dosing selection plan based on the evaluation of the
      31P-Magnetic Resonance Spectroscopy (31P-MRS) changes versus baseline in the first cohort. Up
      to a total of two treatment cohorts may be studied (n=15 patients/cohort, total n=30
      patients). All patients will receive daily oral treatment over twelve consecutive weeks
      during each cohort's Treatment Period.

      There will be three study periods per treatment cohort:

        1. A six-week screening period (Screening Period);

        2. A twelve-week treatment period (Treatment Period);

        3. A four-week follow-up period (End-of-Study Assessment).

      The primary study outcome, CNS metabolic changes, will be assessed based upon each patient's
      Week 12 study visit versus the pre-treatment baseline. The primary endpoint is the brain
      metabolic effects of treatment with CNM-Au8 as assessed by an improvement of 31P-MRS
      assessment of Brain Tissue Cellular Redox Potential defined by the measured tissue ratio of
      NAD+:NADH concentrations following 12 weeks of once daily treatment.
    

Intervention name(s): Gold Nanocrystals
Intervention type(s): Drug
Intervention description(s): CNM-Au8 is a dark red/purple-colored liquid formulation consisting of a stable suspension of faceted clean surfaced elemental gold nanocrystals in buffered deionized water with a concentration of up to 0.5 mg/mL of gold. The formulation is buffered by sodium bicarbonate present at a concentration of 0.546 mg/mL. There are no other excipients. The drug product is formulated to be taken orally and will be provided in single dose HDPE containers. The study doses vary by the concentration of gold nanocrystals per milliliter in a volume of 60 mL.
Other intervention name(s): CNM-Au8
Allocation: Non-Randomized
Intervention model: Sequential Assignment
Intervention model description: Open Label, Investigator Blinded, Sequential Cohort (max of 2 cohorts amongst the possible 4 interventions)
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: neurodegeneration; gold; nanocrystal; NAD+; redox; 31P-MRS; Parkinson's Disease; magnetic resonance spectroscopy; nanoparticle; nanomedicine; NADH