AZD3241 PET MSA Trial, Phase 2, Randomized,12 Week Safety and Tolerability Trial With PET in MSA Patients

Study Overview
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Brief Summary
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AZD3241 myeloperoxidase (MPO) inhibitor trial is assessing safety and tolerability, randomized trial, in patients with Multiple System Atrophy.

Official Title
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A 12-Week, Multicenter, Randomized, Parallel-Group Study to Assess the Safety, Tolerability, Pharmacokinetics, Biomarker Effects, Efficacy, and Effect on Microglia Activation, as Measured by Positron Emission Tomography, of AZD3241 in Subjects With Multiple System Atrophy

Conditions
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Multiple System Atrophy, MSA

Intervention / Treatment
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* Drug: AZD3241
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female, age 30-80 years, inclusive, at screen. Meet criteria for diagnosis of probable or possible MSA according to the consensus criteria (Gilman et al. 2008 ). High-affinity binder or mixed-affinity binder for TSPO, as confirmed by prospective genotyping of TSPO polymorphism during screen. Subjects must understand the nature of the study and must provide signed and dated written informed consent in accordance with local regulations before the conduct of any study-related procedures. The informed consent should reflect the protocol stipulations concerning the use of contraception. Medical treatment of MSA and co-morbid medical conditions must be stable for at least 30 days prior to screen and between screen and baseline. Written and oral fluency in the local language. Able and willing to participate in all scheduled evaluations, abide by all study restrictions, and complete all required tests and procedures. In the opinion of the investigator, the subject must be considered likely to comply with the study protocol and to have a high probability of completing the study. Able to swallow tablets whole. Exclusion Criteria: Prior participation in any AZD3241 study. Magnetic resonance imaging (MRI) performed during screen not consistent with diagnosis of MSA. Received a PET scan within the last 12 months. Negative Allen test in both hands, unless the brachial artery is used for arterial cannulation. Subjects determined to be low affinity binders by TSPO genotyping. Claustrophobia that would contraindicate a brain MRI scan or brain PET scan. Pregnancy, lactation, or, if female of childbearing potential, positive serum β-hCG at screen or positive urine β-hCG at baseline (Day -1). Initiation or change in pharmacologic therapy for symptoms of MSA within 30 days prior to screen or between screen and baseline (Day -1). Significant neurological disease affecting the central nervous system (CNS), other than MSA History of brain surgery for parkinsonism. History of stem cell treatment. Seizure disorder, unless well controlled and for which treatment has been stable for at least 30 days prior to screen and between screen and baseline (Day -1). Presence of any clinically significant medical condition History or presence of thyroid disease. Any abnormal TSH or Free T4 test result at screen or baseline (Day -1). History or presence of gastrointestinal disorders or other disease known to interfere with absorption, distribution, metabolism or excretion of drugs History or presence of renal disease or impaired renal function. A QT interval corrected according to the Fridericia procedure (QTcF) interval measurement > 450 msec at screen (single ECG) or baseline (Day -1) (mean of three ECG measurements) or a family history of long-QT syndrome. Uncontrolled hypertension History or presence of diabetes, unless glucose levels have been well controlled and for which treatment has been stable for at least 30 days prior to screen and between screen and baseline (Day -1). History of cancer within the last 5 years, with the exception of nonmetastatic basal cell carcinoma of the skin. Any clinically important abnormality, as determined by the investigator, on physical examination or vital signs, ECG, or clinical laboratory test results other than abnormality due to a stable, well-controlled medical condition; or any abnormality that could be detrimental to the subject or could compromise the study. Use of potent inhibitors of CYP3A4, Use of potent inducers of CYP3A4 and/or Use of drugs mainly metabolized by CYP3A4 Treatment with any investigational drug or device within 60 days or five half-lives prior to screen, whichever is longer, or between screen and baseline (Day -1).

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AZD3241<br>Subjects will be randomized to one of the two doses of AZD3241 or placebo in a 1:1:1 ratio. | Drug: AZD3241<br>* Drug: AZD3241 administered for 12 weeks orally as a tablet.<br>* Other names: AZD3241 to match placebo administered for 12 weeks.;|
| Placebo Comparator: Placebo to match AZD3241<br>Subjects will be randomized to one of the two doses of AZD3241 or placebo in a 1:1:1 ratio. | Drug: Placebo<br>* Placebo to match AZD3241 administered for 12 weeks orally as a tablet.<br>* Other names: Placebo to match AZD3241 administered for 12 weeks.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Striatum Brain Region: Change From Baseline in Microglia Activation Via Positron Emission Tomography(PET) | Striatum Brain region: Change from baseline in microglia activation via PET By [11C]PBR28 binding to translocator protein | Baseline (pre randomization) and Week 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myeloperoxidase (MPO) Inhibition in Plasma (Change From Baseline), Specific Activity | Myeloperoxidase (MPO) inhibition in plasma (change from baseline), on samples collected and analyzed, specific activity (activity/protein) | Baseline (Day -1) and week 12 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multiple System Atrophy (MSA), PET imaging, myeloperoxidase (MPO) inhibitor