NPC-1 (parthenolide and ipriflavone) for Alzheimer's blood biomarkers
Early-phase Biomarker-based Trial of NPC-1 for Alzheimer's Disease Pathology
This trial will test whether taking NPC-1 (a combination of parthenolide and ipriflavone) is safe, well tolerated, and changes blood tests linked to Alzheimer's in adults 55+ with subjective cognitive decline, mild cognitive impairment, or mild Alzheimer's who have biomarker evidence of disease.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 40 (estimated) |
| Ages | 55 Years and up |
| Sex | All |
| Sponsor | Massachusetts General Hospital Academic / other |
| Drugs / interventions | aducanumab, lecanemab |
| Locations | 1 site (Boston, Massachusetts) |
| Trial ID | NCT07236190 on ClinicalTrials.gov |
What this trial studies
This is an early-phase, open-label, single-arm trial at Massachusetts General Hospital in which all participants receive NPC-1, a natural product combination of parthenolide and ipriflavone. Adults aged 55 and older with subjective cognitive decline, MCI, or mild Alzheimer's and biomarker evidence of AD (plasma Aβ42/40 and p-tau217 thresholds or positive amyloid PET) will be enrolled. The study will monitor intraindividual safety, tolerability, and changes in blood-based biomarkers of Alzheimer’s pathology while requiring stable concomitant medications, cognitive and functional assessments, and a study partner for collateral reporting. There is no placebo or randomized control group in this protocol.
Who should consider this trial
Good fit: Ideal candidates are adults 55 or older with subjective cognitive decline, MCI, or mild Alzheimer's who have biomarker evidence of Alzheimer's pathology, meet cognitive and vascular score cutoffs, have stable medications, adequate vision/hearing, and a study partner available.
Not a fit: People without biomarker evidence of Alzheimer's, those with more advanced dementia (MMSE <16), significant vascular brain disease, uncontrolled depression, or who cannot attend in-person visits or provide a study partner are unlikely to benefit from this trial.
Why it matters
Potential benefit: If successful, NPC-1 could provide a safe, widely available supplement approach that lowers Alzheimer's-related blood biomarkers and might help slow disease progression.
How similar studies have performed: Some preclinical data and limited early human work support targeting inflammation and amyloid/tau biology, but the NPC-1 combination is novel and has not been proven effective in larger Alzheimer's trials.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. Age 55 and older, male and female;
2. Subjective Cognitive Impairment or MCI or AD dementia per NIA-AA 2011 criteria;
3. Clinical Dementia Rating \< or = to 2 and Mini Mental Status Exam \> or = to 16;
4. Modified Hachinski Ischemic Score \< or = to 4
5. Geriatric Depression Scale - 15 \< 6 documenting absence from significant depressive syndromes
6. Other medications including non-disease modifying for MCI and AD (e.g., acetylcholine esterase inhibitor, N-methyl D-aspartate receptor antagonist) stable \> or = to 3-months ;
7. Biomarker evidence of AD pathology: Plasma abeta42/40 ratio \< or = to 0.12 AND Plasma p-tau217 \> or = to 0.25 OR Amyloid PET positive (centiloid \> or = to 20) as part of routine clinical care.
8. Sufficient vision and hearing to complete all tests
9. Study partner available with frequent (at least 1 hour/day or 1 day/week) contact with participant to provide collateral information about cognition, daily functioning, adverse events reporting, and support for study drug intake
10. General health status that will not interfere with the ability to complete the prospective study (these conditions are listed below in the study exclusion list)
Exclusion Criteria:
1. CDR \> 2 MMSE \< 16;
2. Significant CNS disease within the last 2 years (i.e., brain tumor, seizure disorder, subdural hematoma, cranial arteritis, cortical stroke);
3. Alcohol or substance abuse according to DSM-IV criteria within the last 2 years
4. Major depressive disorder or anxiety within the last year; Schizophrenia, bipolar disorder or other major psychiatric disorder defined by DSM-IV criteria
5. Abnormal labs indicating potential reversible causes of dementing illness such as vitamin B12 deficiency, thyroid disease, or UTI (documented bacterial colonization is acceptable)
6. Unstable or significantly symptomatic CVD (e.g. CAD with frequent angina, CHF with dyspnea at rest)
7. Hypertension: defined as uncontrolled BP \> 160/100
8. Clinical symptomatic orthostatic hypotension
9. Diabetes mellitus that requires insulin injections
10. Hachinski ischemic score \> or = to 4
11. Cancer within the last 5 years, apart from localized prostate cancer (Gleason Grade \< 3) and non-metastatic skin cancers (melanoma).
12. Illness that requires \>1 visit /month to a clinician
13. Medications and dietary supplements:
* a. AD disease modifying monoclonal antibody treatment e.g., aducanumab or lecanemab
* b. Dietary supplements containing parthenolide or ipriflavone (1-month wash out period prior to enrollment is permitted)
* c. CNS active meds that have not been on stable doses for at least 2 months e.g., cimetidine, beta-blockers, and SSRIs
* d. Neuroleptics, antiparkinsonian agents, systemic corticosteroids, and narcotic analgesics; in the case where these were used for a self-limited time they must have been discounted for a period of five half-lives prior to baseline visit
* e. Over the counter supplements are not by themselves exclusionary, however, participants are asked not to change the dosing regimen over the course of the trial unless medically indicated; the presence and dose of these product are recorded
14. Participation in any Alzheimer's Disease interventional trial. Participation in other non-AD related trials will be evaluated at the discretion of the investigator
15. Currently pregnant. Positive pregnancy tests during the course of the trial will be evaluated at the discretion of the investigator.
Women of Child Bearing Potential (WOCBP)
For the purposes of this study, women of childbearing potential are defined as all women who are capable of becoming pregnant, unless they meet one of the following criteria:
1. 12-months post-menopausal
2. Post-hysterectomy/surgically sterile
If a female Participant does not meet either of these criteria they will be considered of childbearing potential and will have a serum pregnancy test performed at Screening, Visit 3 (2 months), Visit 6 (5 months), and Visit 10 (8 months).
Where this trial is running
Boston, Massachusetts
- Massachusetts General Hospital — Boston, Massachusetts, United States (Recruiting)
Study contacts
- Principal investigator: Gene Bowman, ND, MPH — Harvard/Massachusetts General Hospital
- Study coordinator: Gene Bowman, N.D., M.P.H.
- Email: glbowman@mgh.harvard.edu
- Phone: 857-282-5197
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.