Alzheimer’s & Dementia: Translational Research & Clinical Interventions (Jan 2022)

A phase 1b/2a multicenter study of the safety and preliminary pharmacodynamic effects of selective muscarinic M1 receptor agonist HTL0018318 in patients with mild‐to‐moderate Alzheimer's disease

  • Pradeep J. Nathan,
  • S. Babli Millais,
  • Alex Godwood,
  • Odile Dewit,
  • David M. Cross,
  • Janet Liptrot,
  • Bharat Ruparelia,
  • Stephen Paul Jones,
  • Geor Bakker,
  • Paul T. Maruff,
  • Gregory A. Light,
  • Alastair J.H. Brown,
  • Malcolm Peter Weir,
  • Miles Congreve,
  • Tim Tasker

DOI
https://doi.org/10.1002/trc2.12273
Journal volume & issue
Vol. 8, no. 1
pp. n/a – n/a

Abstract

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Abstract Introduction This study examined the safety and pharmacodynamic effects of selective muscarinic M1 receptor orthosteric agonist HTL0018318 in 60 patients with mild‐to‐moderate Alzheimer's disease (AD) on background donepezil 10 mg/day. Methods A randomized, double‐blind, placebo‐controlled 4‐week safety study of HTL0018318 with up‐titration and maintenance phases, observing exploratory effects on electrophysiological biomarkers and cognition. Results Treatment‐emergent adverse events (TEAEs) were mild and less frequently reported during maintenance versus titration. Headache was most commonly reported (7–21%); 0 to 13% reported cholinergic TEAEs (abdominal pain, diarrhea, fatigue, nausea) and two patients discontinued due to TEAEs. At 1 to 2 hours post‐dose, HTL0018318‐related mean maximum elevations in systolic and diastolic blood pressure of 5 to 10 mmHg above placebo were observed during up‐titration but not maintenance. Postive effects of HTL0018318 were found on specific attention and memory endpoints. Discussion HTL0018318 was well tolerated in mild‐to‐moderate AD patients and showed positive effects on attention and episodic memory on top of therapeutic doses of donepezil.

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