Presenter of 1 Presentation
SAFETY, TARGET ENGAGEMENT AND EFFECTS OF BOSUITNIB IN DEMENTIA WITH LEWY BODIES
Abstract
Aims
Aim- To investigated the safety, biomarkers effects and determine the lowest effective dose of Bosutinib in Dementia with Lewy Bodies (DLB)
Methods
A single center, Phase 2, randomized, double-blind, placebo-controlled study primarily investigated the safety and pharmacokinetics of 12-week oral treatment of bosutinib,100mg. Biomarkers and clinical outcomes were exploratory.
Results
Approximately 120 subjects were approached, 39 were screened, 13 did not meet inclusion criteria and 26 were randomized and included male and female (12:1) in bosutinib and male (13) in placebo with average age 72.94±8.8 (year±SD). There was no serious adverse events (SAEs) and no difference in AEs and no dropouts. Bosutinib, 100mg, was detected in the cerebrospinal fluid (CSF) and inhibited both Abl and Src in plasma. Bosutinib significantly reduced CSF alpha-synuclein (p=0.023) and the ratio of oligomeric/total alpha-synuclein (p=0.045) compared to placebo. There was also significant decrease in plasma oligomeric alpha-synuclein (p=0.04) and ptau181/Aβ42 (p=0.03). Bosutinib significantly (p=0.034) improved activities of daily living (ADCS-ADL-MCI) compared to placebo.
Conclusions
Bosutinib is safe and enters the brain. Bosutinib, 100mg, inhibited Abl/Src indicting dual target engagement, reduced brain alpha-synuclein and improved activities of daily living, suggesting that this is lowest effective dose (100mg) in DLB. This study is underpowered (by design) but the data will guide adequately powered future studies of a higher dose range of bosutinib over longer time (6 months) in DLB.