RecruitingPhase 2NCT06072963

COMMETS- Combination MCI Metabolic Syndrome

Combination of Intranasal Insulin With Oral Semaglutide to Improve Cognition and Cerebral Blood Flow: a Feasibility Study


Sponsor

Rutgers, The State University of New Jersey

Enrollment

80 participants

Start Date

Jan 30, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

The investigators propose a proof of concept RCT (randomized clinical trial), testing the efficacy of intranasal insulin (INI) with semaglutide, a combination therapy with strong biological plausibility to benefit impaired cognition through vascular mechanisms, in older adults with MetS (metabolic syndrome) and MCI (Mild Cognitive Impairment), who are enriched for cerebrovascular disease and at high dementia risk. The study will focus on cognitive and biological outcomes, allowing identification of relevant mechanisms.


Eligibility

Min Age: 60 YearsMax Age: 90 Years

Plain Language Summary

Simplified for easier understanding

This study tests a combined treatment approach for older adults who have both mild cognitive impairment (early memory and thinking problems) AND metabolic syndrome (a cluster of conditions including belly fat, high blood sugar, and high blood pressure). Researchers want to see if treating both conditions together improves brain health. **You may be eligible if...** - You have mild cognitive impairment (based on MoCA score below 27 and a CDR score of 0.5) - You have metabolic syndrome: abdominal obesity PLUS glucose intolerance AND at least one of — high triglycerides/low HDL cholesterol, or elevated blood pressure - You are fluent in Hebrew - You have an active study partner who can participate with you **You may NOT be eligible if...** - You have diabetes (any type) - You take medications that affect blood sugar or insulin - You have severe cognitive impairment or a dementia diagnosis - You live in a care facility Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGSemaglutide

The medication is available in 3, 7, and 14-mg tablets for oral use. Participants will be instructed to start with an initiating dose of 3 mg once daily. If they do not experience adverse events (nausea, vomiting, and abdominal pain) then the dose will be titrated to 7 mg once daily after 30 days. Again, if the participant does not experience adverse events, the dose will be further titrated after 30 days to 14 mg once daily. This does will continue until the end of the study, at 12 months.

DRUGIntranasal insulin

The study will use the ViaNase; Kurve Technology intranasal device to administer insulin intra-nasally. This device has been used in other studies of persons with AD and has shown insulin penetration into the brain via CSF studies. Through sniffing, the medication crosses the blood-brain barrier (BBB) at the top of the nasal cavity. Participants will be instructed to press a switch that will turn on the device, engaging a pump that releases a nebulized stream of insulin through a nose piece into a nostril for 20 seconds (the device includes an electronic timer), after which the device switches off. The process is then repeated in the other nostril. The investigators decided on administration of 20IU of INI twice per day as the literature suggests this as the optimal dosage.

OTHERSemaglutide placebo

Rybelsus semaglutide - this medicine will simulate taking the pill Rybelsus /semaglutide once a day. A pill identical to the medicine pill will be given.

OTHERIntranasal insulin placebo

The placebo used in this study is saline. The investigators will administer saline, with exactly the same methods as the INI insulin (twice per day, 20 seconds each sniff, in each nostril.


Locations(1)

Joseph Sagol Neuroscience center, Sheba Medical Center

Ramat Gan, Israel

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NCT06072963


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