Skip to main content
Delfa

← Trials/Trial dossier/NCT03402659

REVERSE-SD

CompletedPhase 2Results posted

Proof-of-Concept Study of a Selective p38 MAPK Alpha Inhibitor, Neflamapimod, in Subjects With Mild Alzheimer's Disease

A Double-Blind, Placebo-Controlled Proof-of-Concept Study of a Selective p38 MAP Kinase Alpha Inhibitor, Neflamapimod, Administered for 24 Weeks in Subjects With Mild Alzheimer's Disease

Lead sponsor

EIP Pharma Inc

Asset

Neflamapimod

Listed sites

38

Recruiting sites

-

Enrollment

161

actual

Study population

Alzheimer’s disease

Key I/E criteria

Tau biomarker required (CSF)MMSE 20-28Study partner/caregiver requiredAD symptomatic therapy: stable ≥2 months

Primary endpoint

Total and Delayed Recall on the Hopkins Verbal Learning Test - Revised (HVLT-R)

Footprint

Where this trial recruits

Site locations as reported to ClinicalTrials.gov. Site count is not enrollment count; per-site enrollment is not available from source.

Identifiers

Registered as

Org study IDEIP-VX17-745-304
NCT IDNCT03402659

Timeline

Milestones

Study start2017-12-29actual
Study first posted2018-01-18actual
Primary completion2019-06-30actual
Study completion2019-07-31actual
Last update posted2021-10-27actual
Results first posted2021-10-27actual

Assets

Drug assets

Study populations

Who this study enrolls

Alzheimer’s disease

Eligibility

Who can enroll

Minimum age55 Years
Maximum age85 Years
SexAll
Healthy volunteersNot accepted

Inclusion criteria

1. Men and women age 55 to 85 years, inclusive.

2. Willing and able to provide informed consent.

3. Must have mild cognitive impairment (MCI) or mild AD with evidence of progression ("Mild-AD"), as defined by the following:

1. CDR-Global Score of 0.5 or 1.0, with CDR memory subscore of at least 0.5.

2. MMSE score ranging from 20 to 28, inclusive.

3. Positive biomarker for AD, as defined by a CSF Aβ1-42R below the threshold and phospho-tau above the threshold for the assay utilized in the study and assessed by the central laboratory.

4. Computed tomography (CT) or magnetic resonance imaging (MRI) findings within 2 years of Screening that are compatible with AD and no other pathologic processes that might potentially account for the subject's cognitive impairment.

5. If the subject is taking a single drug for AD (e.g., donepezil or other cholinesterase inhibitors or memantine; dual therapy is excluded), he/she has been on a stable dose for at least 2 months prior to baseline, and the dose must remain unchanged during the study unless required for management of adverse events (AEs).

6. Adequate visual and auditory abilities to perform all aspects of the cognitive and functional assessments.

7. Must have reliable informant or caregiver

Exclusion criteria

1. Evidence that the primary basis for cognitive impairment is neurodegenerative disease other than AD, including, but not limited to, vascular dementia, dementia with Lewy bodies, and Parkinson's disease.

2. Suicidality, defined as active suicidal thoughts within 6 months before Screening or at Baseline, defined as answering yes to items 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS), or history of suicide attempt in previous 2 years, or, in the Investigator's opinion, at serious risk of suicide.

3. History of major and active psychiatric disorder, moderate to severe depressive symptoms, and or other concurrent medical condition that, EIP-VX17-745-304, Version 1.0, 17 November, 2017 Page 7 of 46 EIP Pharma, LLC Confidential in the opinion of the Investigator, might compromise safety and/or compliance with study requirements.

4. Diagnosis of alcohol or drug abuse within the previous 2 years.

5. History of cancer within the last 5 years, except basal cell carcinoma, squamous skin carcinoma, prostate cancer or carcinoma in situ with no significant progression over the past 2 years.

6. Poorly controlled clinically significant medical illness.

7. History of serum B12 abnormality, anemia with hemoglobin ≤10 g/dL, thyroid function abnormality, electrolyte abnormality, or positive syphilis serology that have not been corrected and/or otherwise addressed.

8. History of epilepsy or unexplained seizure within the past 5 years.

9. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >3 × the upper limit of normal (ULN), total bilirubin >2 × ULN, and/or International Normalized Ratio (INR) >1.5

10. Known human immunodeficiency virus, hepatitis B, or active hepatitis C virus infection.

11. Subject participated in a study of an investigational drug less than 3 months or 5 half-lives of the investigation drug, whichever is longer, before enrollment in this study.

Endpoints (22)

What's being measured

Protocol endpoints and posted registry outcome measures, grouped into outcome categories. Composite endpoints show their component event types. Standard codes (LOINC, SNOMED CT) are shown where available.

Coverage by outcome category

Amyloid biomarkers
6
Global cognition
4
Memory
4
Neurodegeneration biomarkers
4
Tau biomarkers
2
Fluid / digital biomarkers
2

Global cognition

4 endpoints
Secondary/protocol endpoint

Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB)

Time frame:Baseline and 24 weeks

Clinical Dementia Rating-Sum of Boxes (CDR-SB)

change from baseline, improvement

Secondary/protocol endpoint

Mini-Mental State Examination (MMSE)

Time frame:Baseline and 26 Weeks (Follow-up visit, 2 weeks from end of dosing)

Mini-Mental State Examination (MMSE)

descriptive

Secondary/registry result

Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB)

Time frame:Baseline and 24 weeks

Clinical Dementia Rating-Sum of Boxes (CDR-SB)

change from baseline, improvement

Posted result

GroupValue (mean), Scores on a scaleStandard error
Placebo Armn=78 Participants1.00.20
Neflamapimod Armn=74 Participants1.10.21
Mean Difference (Final Values)0.195% CI-0.4 - 0.6p0.806Mixed Models Analysis

Mean change from baseline neflamapimod vs placebo

Secondary/registry result

Mini-Mental State Examination (MMSE)

Time frame:Baseline and 26 Weeks (Follow-up visit, 2 weeks from end of dosing)

Mini-Mental State Examination (MMSE)

descriptive

Posted result

GroupValue (mean), Scores on a scaleStandard error
Placebo Armn=79 Participants-0.50.31
Neflamapimod Armn=70 Participants-0.80.33
Mean Difference (Final Values)-0.395% CI-1.0 - 0.5p0.489ANCOVA

Mean change from baseline neflamapimod vs placebo

Memory

4 endpoints
Primary/protocol endpoint

Total and Delayed Recall on the Hopkins Verbal Learning Test - Revised (HVLT-R)

Time frame:Baseline and 24 weeks

change from baseline, improvement

Primary/registry result

Total and Delayed Recall on the Hopkins Verbal Learning Test - Revised (HVLT-R)

Time frame:Baseline and 24 weeks

change from baseline, improvement

Posted result

GroupValue (mean), Z-scoreStandard error
Placebo Armn=72 Participants-0.096790.074840
Neflamapimod Armn=71 Participants-0.157760.085805
Mean Difference (Final Values)-0.0609895% CI-0.26973 - 0.14777p0.564Mixed Models Analysis

Mean change from baseline neflamapimod vs placebo

Secondary/protocol endpoint

Wechsler Memory Scale (WMS) Immediate and Delayed Recall

Time frame:Baseline and 24 weeks

change from baseline, improvement

Secondary/registry result

Wechsler Memory Scale (WMS) Immediate and Delayed Recall

Time frame:Baseline and 24 weeks

change from baseline, improvement

Posted result

GroupValue (mean), Scores on a scaleStandard error
Placebo Armn=77 Participants16.62.09
Neflamapimod Armn=71 Participants16.02.07
Mean Difference (Final Values)-0.695% CI-6.0 - 4.8p0.823Mixed Models Analysis

Mean change from baseline neflamapimod vs placebo

Amyloid biomarkers

6 endpoints
Secondary/protocol endpoint

Cerebrospinal Fluid Amyloid Beta 1-40

Time frame:Baseline and 24 weeks

change from baseline, improvement

Secondary/protocol endpoint

Cerebrospinal Fluid Amyloid Beta 1-42

Time frame:Baseline and 24 weeks

change from baseline, improvement

Secondary/protocol endpoint

Cerebrospinal Fluid P-tau/AB1-42 Ratio

Time frame:Baseline and 24 weeks

Phosphorylated tau 181 (p-tau181)

ratio, descriptive

Secondary/registry result

Cerebrospinal Fluid Amyloid Beta 1-40

Time frame:Baseline and 24 weeks

change from baseline, improvement

Posted result

GroupValue (mean), pg/mLStandard error
Placebo Armn=68 Participants399.7249.18
Neflamapimod Armn=62 Participants282.3268.58
Mean Difference (Final Values)-117.495% CI-738.9 - 504.2p0.709ANCOVA

Mean change from baseline neflamapimod vs placebo

Secondary/registry result

Cerebrospinal Fluid Amyloid Beta 1-42

Time frame:Baseline and 24 weeks

change from baseline, improvement

Posted result

GroupValue (mean), pg/mLStandard error
Placebo Armn=68 Participants31.112.70
Neflamapimod Armn=62 Participants10.013.75
Mean Difference (Final Values)-21.095% CI-52.7 - 10.7p0.192ANCOVA

Mean change from baseline neflamapimod vs placebo

Secondary/registry result

Cerebrospinal Fluid P-tau/AB1-42 Ratio

Time frame:Baseline and 24 weeks

Phosphorylated tau 181 (p-tau181)

ratio, descriptive

Posted result

GroupValue (mean), ratioStandard error
Placebo Armn=68 Participants-0.00
Neflamapimod Armn=62 Participants-0.00
Mean Difference (Final Values)-0.095% CI-0.0 - 0.0p0.590ANCOVA

Mean change from baseline neflamapimod vs placebo

Tau biomarkers

2 endpoints
Secondary/protocol endpoint

Cerebrospinal Fluid Total Tau

Time frame:Baseline and 24 weeks

descriptive

Secondary/registry result

Cerebrospinal Fluid Total Tau

Time frame:Baseline and 24 weeks

descriptive

Posted result

GroupValue (mean), pg/mLStandard error
Placebo Armn=68 Participants10.06.83
Neflamapimod Armn=62 Participants-8.67.36
Mean Difference (Final Values)-18.895% CI-35.8 - -1.8p0.031ANCOVA

Mean change from baseline neflamapimod vs placebo

Neurodegeneration biomarkers

4 endpoints
Secondary/protocol endpoint

Cerebrospinal Fluid Neurogranin

Time frame:Baseline and 24 weeks

change from baseline, improvement

Secondary/protocol endpoint

Cerebrospinal Fluid Neurofilament Light Chain

Time frame:Baseline and 24 weeks

Neurofilament light (NfL)

change from baseline, improvement

Secondary/registry result

Cerebrospinal Fluid Neurogranin

Time frame:Baseline and 24 weeks

change from baseline, improvement

Posted result

GroupValue (mean), pg/mLStandard error
Placebo Armn=68 Participants11.19.16
Neflamapimod Armn=62 Participants-9.99.82
Mean Difference (Final Values)-21.095% CI-43.6 - 1.6p0.068ANCOVA

Mean change from baseline neflamapimod vs placebo

Secondary/registry result

Cerebrospinal Fluid Neurofilament Light Chain

Time frame:Baseline and 24 weeks

Neurofilament light (NfL)

change from baseline, improvement

Posted result

GroupValue (mean), pg/mLStandard error
Placebo Armn=68 Participants231.961.31
Neflamapimod Armn=62 Participants121.766.92
Mean Difference (Final Values)-110.195% CI-262.7 - 42.4p0.156ANCOVA

Mean change from baseline neflamapimod vs placebo

Fluid / digital biomarkers

2 endpoints
Secondary/protocol endpoint

Cerebrospinal Fluid Phospho-tau

Time frame:Baseline and 24 weeks

Phosphorylated tau 181 (p-tau181)

change from baseline, improvement

Secondary/registry result

Cerebrospinal Fluid Phospho-tau

Time frame:Baseline and 24 weeks

Phosphorylated tau 181 (p-tau181)

change from baseline, improvement

Posted result

GroupValue (mean), pg/mLStandard error
Placebo Armn=68 Participants0.90.63
Neflamapimod Armn=62 Participants-1.10.68
Mean Difference (Final Values)-2.095% CI-3.6 - -0.5p0.012ANCOVA

Mean change from baseline neflamapimod vs placebo

Publications (2)

Bibliography

Records linked to this trial through ClinicalTrials.gov references, PubMed NCT search, and curated study seeds. 'Canonical' marks design/result papers; others are registry references or candidates.

Provenance

Sources

Trial identity, design, statusClinicalTrials.gov API v2
Snapshot dateJuly 21, 2026
Endpoint classificationDelfa ADRD endpoint taxonomy
Results tableClinicalTrials.gov results section

Trial facts come from public ClinicalTrials.gov records. Endpoint categories are Delfa's classification of those records, not a ClinicalTrials.gov field. All figures reflect the July 21, 2026 snapshot.