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Alzheimer DiseasePhase 2ExPlasNCT05068830

Safety and Efficacy of Plasma Transfusion From Exercise-trained Donors in Patients With Early Alzheimer's Disease

A Phase 2 study testing ExPlas, Octaplasma and Saline in people with Alzheimer Disease, run by Norwegian University of Science and Technology at 1 site in Norway.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Introduction Given that exercise training reduces the risk of developing Alzheimer's disease (AD), induces changes in the blood composition and has widespread systemic benefits, it is reasonable to hypothesize that exercised plasma may have rejuvenative properties. Read more about this study

Who is it for?
Ages 50 to 75 years
Conditions the study is for
Alzheimer Disease
What is being tested?
ExPlas, Octaplasma and Saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteNorway
Study dates
17 Sep 2021to 1 Mar 2031
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Patient inclusion criteria:

  • Diagnosis AD in early phase according to the IWG-2 criteria.
  • Mini-Mental State Examination (MMSE) Score ≥20.
  • In-vivo evidence of Alzheimer´s pathology (one of the following):
  • Decreased Aβ42 together with increased t-tau or p-tau in CSF.
  • Increased tracer retention on amyloid PET.
  • Availability of a next of kin who knows the patient well and is willing to accompany the subject to all trial visits and give information about the patients functional level.
  • Signed informed consent.
  • The patient is judged fitted for the study and capable to cooperate in treatment and follow-up.
  • Ability to communicate in Norwegian or another Scandinavian language.

Patient exclusion criteria:

  • Pregnancy or unwilling to use adequate birth control for the duration of and 6 months beyond study participation. Defined according to Clinical Trial Facilitation Group document "Recommendations related to contraception and pregnancy testing in clinical trials".
  • Positive for Hepatitis B, Hepatitis C or HIV at screening.
  • Not qualified to give consent at inclusion.
  • Any other condition judged to interfere with the safety of the patient or the intent and conduct of the study.

Related to medical history:

  • Stroke
  • Anaphylaxis
  • Prior adverse reaction to any human blood product
  • Any history of a blood coagulation disorder or hypercoagulability
  • Congestive heart failure, defined as any previous heart failure hospitalization, or current symptomatic heart failure in New York heart Association class ≥II with reduced, mid-range or preserved ejection fraction.
  • Coagulation defect or hypercoagulopathy
  • Uncontrolled hypertension
  • Renal failure
  • Prior intolerance to intravenous fluids
  • Recent history of uncontrolled atrial fibrillation
  • Bone marrow transplant
  • IgA deficiency
  • Severe protein S deficiency
  • Thrombocytopenia (platelets < 40 x 10 to the power of 9/L)
  • Contraindication for Octaplasma

Related to medications or other treatments:

  • Any concurrent use of anticoagulant therapy, clopidogrel or acetylsalicylic acid/Dipyridamol in combination.
  • Initiation or change in the dosage of a acetylcholine esterase inhibitor (AChEI) or memantine during the trial (week 0-52). Participants will be urged to start on AChEI when diagnosis is communicated, and must be on a stable dose for at least one month prior to screening.
  • Concurrent participation in another treatment trial for AD. If there was prior participation, the last dose of the investigational agent must have been given at least 6 months prior to screening, except if the patient received placebo medication.
  • Treatment with any human blood product, including intravenous immunoglobulin, during the 6 months prior to screening or during the trial.
  • Concurrent daily treatment with benzodiazepines, typical or atypical antipsychotics, long-acting opioids, or other medications that is judged to interfere with cognition. Intermittent treatment with short-acting benzodiazepines or atypical antipsychotics may be permitted, provided that no dose is administered within 72 hours prior to cognitive assessment.

Related to magnetic resonance imaging:

  • Claustrophobia
  • Any metallic surgical implant, like a pacemaker or clip that is incompatible with MRI.

Certain metallic implants like joint replacements may be permitted, provided that specific manufacturer specifications are available, and that the device is known to be safe for 7T MRI. In case a patient is not eligible for the 7T scanner, the 3T scanner will be used.

Trial locations and contacts

1 site in 1 country.

Norway1 site
  • Department of Neurology and Clinical Neurophysiology, St Olavs Hospital

    Trondheim

Other trials in Norway

About this study

Official title: Safety and Efficacy of Plasma Transfusion From Exercise-trained Donors in Patients With Early Alzheimer's Disease: The ExPlas Study

Introduction Given that exercise training reduces the risk of developing Alzheimer's disease (AD), induces changes in the blood composition and has widespread systemic benefits, it is reasonable to hypothesize that exercised plasma may have rejuvenative properties. The main objective is to test safety and tolerability of transfusing exercised plasma (ExPlas) from young, healthy, fit adults to patients with early AD. The study is a pilot for a future efficacy study. The key secondary objectives are examining the effect of plasma transfusions on cognitive function, fitness level, vascular risk profile, assessment of cerebral blood flow and hippocampal volume, quality of life, functional connectivity assessed by resting state functional MRI and biomarkers in blood and cerebrospinal fluid.

Methods and analysis ExPlas is a double-blinded, randomized controlled clinical single center trial. Patients aged 50-75 years with diagnosis mild cognitive impairment or early AD will be recruited from two Norwegian hospitals. ExPlas is plasma drawn by plasmapheresis once a month for 4 months, from a total of 30 donors (aged 18-40, BMI ≤27 kg/m2 and VO2max >50 mL/kg/min). All units will be virus inactivated by the Intercept method in accordance with procedures at St. Olavs Hospital. Comparison with isotonic saline allows differentiation from a non-blood product. The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions divided over three 4-weeks periods during study year-1. Follow-up examinations after 2 and 5 years after baseline is also planned.

Ethics and dissemination Written informed consent will be obtained from all participants and participation is voluntary. All participants have a next of kin who will follow them throughout the study and represent the patient's interest. The study is approved by the Regional Committee for Medical and Health Research Ethics (REK 2018/702) and the Norwegian Medicines Agency (EudraCT No. 2018-000148-24).

Being tested
ExPlas, Octaplasma, Saline
Keywords
Exercise therapy, Blood transfusion, Plasma
Medical subject headings
Alzheimer Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ExPlasDrug

    ExPlas (plasma from fit donors) is a Investigational Medicinal Product. ExPlas is plasma drawn by plasmapheresis once a month for 4 months, from a total of 30 donors (aged 18-40, BMI ≤27 kg/m2 and VO2max >50 mL/kg/min) at the Blood Bank at St. Olavs Hospital. All unites will be virus inactivated by the Intercept method (Cerus corporation, US) in accordance with the procedures at Blood Bank at St. Olavs Hospital.

    The transfusion volume will be 200 mL at every time point.

    The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions during the time span of one year (weekly transfusions in 3 four-week periods) and one round of examinations 2 years after baseline. A follow-up visit is also planned 5 years after baseline.

  • OctaplasmaDrug

    Octaplasma is defined as a Investigational Medicinal Product. Octaplasma is human pooled plasma produced by Octapharma (Lachen, Switzerland). The transfusion volume will be 200 mL at every time point .

    The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions during the time span of one year (weekly transfusions in 3 four-week periods) and one round of examinations 2 years after baseline. A follow-up visit is also planned 5 years after baseline.

  • SalineDrug

    Saline is provided by the hospital pharmacies in Central Norway. The infusion volume will be 200 mL at every time point.

    The main study consists of 6 rounds of examinations in addition to 12 saline infusions during the time span of one year (weekly transfusions in 3 four-week periods) and one round of examinations 2 years after baseline. A follow-up visit is also planned 5 years after baseline.

Study groups in NCT05068830
Study groupRoleWhat they receive
Exercised plasma (ExPlas)ExperimentalDosage: 200 mL at every time point Dosage form: Solution for intravenous infusion Frequency of administration: 12 ExPlas transfusions during the time span of one year (weekly transfusions in 3 four-week periods)
Receives: Drug: ExPlas
OctaplasmaActive comparatorDosage: 200 mL at every time point Dosage form: Solution for intravenous infusion Frequency of administration: 12 Octaplasma transfusions during the time span of one year (weekly transfusions in 3 four-week periods)
Receives: Drug: Octaplasma
SalinePlacebo comparatorDosage: 200 mL at every time point Dosage form: Solution for intravenous infusion Frequency of administration: 12 saline infusions during the time span of one year (weekly transfusions in 3 four-week periods)
Receives: Drug: Saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of patients with adverse events

    as a measure for safety and tolerability of the treatment

    Measured: 1 year

  2. Number of subjects who comply with the research protocol

    as a measure for feasibility

    Measured: 1 year

Secondary outcomes (22)
  1. CERAD-test

    Change in performance in the CERAD (The Consortium to Establish a Registry for Alzheimer's Disease) Ten word Test. CERAD Word List consists of three test parts; immediate recall, delayed recall and recognition. The scoring range for immediate recall is 0-30, for delayed recall 0-10 and for recognition 0-20. Higher scores indicate better learning performance, memory performance and recognition performance.

    Measured: 1, 2 and 5 years

  2. MMSE

    Change in the Mini-Mental State Examination Score. An MMSE score of ≥20 is criteria for inclusion. Higher scores >28 indicate normal cognitive function. Scores in the middle range 25-27 may indicate cognitive impairment. Lower scores <24 indicate cognitive impairment.

    Measured: 1, 2, and 5 years

  3. Trail-Making test A and B

    Change in performance in Trail-Making test A and B. The Trail Making Tests are scored by how long it takes to complete the tests. Norms for completion time variate with age and educational level. Longer completion time indicates impaired visual attention, processing speed and executive function.

    Measured: 1, 2, and 5 years

  4. Clock Drawing Test

    Change in scores in the Clock Drawing Test. The Clock Drawing Test has a scoring range 0-5. Higher scores indicate normal cognitive function. Lower scores <4 may indicate cognitive impairment, spatial dysfunction or neglect.

    Measured: 1, 2, and 5 years

  5. Controlled Oral Word Association Test (COWAT)-FAS

    Change in scores in Controlled Oral Word Association Test (COWAT)-FAS. Scoring is based on how many words the person produces within 1 minute. The minimum score is 0, and there is no maximum score. Higher scores indicate better verbal fluency. Scoring norms are based on the persons age and education level.

    Measured: 1, 2, and 5 years

  6. Visual Object and Space Perception (VOSP) Silhouettes

    Change in scores in Visual Object and Space Perception (VOSP) Silhouettes. Visual Object and Space Perception (VOSP) Silhouettes has a scoring range 0-30. Higher scores > 20 indicate normal visuospatial function, and lower scores < 20 indicate visuospatial dysfunction.

    Measured: 1, 2, and 5 years

  7. Clinical Dementia Rating Scale Global score and Sum of Boxes

    Change in Clinical Dementia Rating Scale Global score and Sum of Boxes. Clinical Dementia Rating Scale (CDR) is a clinical scale for the staging of dementia. The Global Score ranges dementia severity from 0-3. The Sum of Boxes ranges dementia severity from 0-18. Higher scores indicate more severe disease.

    Measured: 1, 2, and 5 years

  8. The Lawton Instrumental Activities of Daily Living Scale (IADL)

    Change in The Lawton Instrumental Activities of Daily Living Scale (IADL). The Lawton Instrumental Activities of Daily Living Scale (IADL) evaluates the person's ability to perform complex everyday activities. The score ranges from 8-31. Higher scores indicate lower functional level.

    Measured: 1, 2, and 5 years

  9. 6 minutes' walk test

    Change in 6 minutes' walk-test

    Measured: 1, 2, and 5 years

  10. Functional MRI

    Change in/Reduced hippocampal atrophy and preservation of functional connectivity assessed by resting state functional MRI. A secondary aim is to identify any effect of treatment group on MRI markers of both neurodegenerative and cerebrovascular disease.

    Measured: 1, 2, and 5 years

  11. SF-36

    Quality of Life SF-36 Questionnaire. Computer-based scoring services for the SF-36v2 are available through QualityMetric™ or its licensed certified vendors.

    Measured: 1, 2, and 5 years

  12. Biomarker profile in blood

    Change in biomarkers in blood (APOE). As there exist no single ideal biomarker of AD this endpoint is partly exploratory. Biological material will be stored for future analysis in the search for new biomarkers.

    Measured: 1, 2, and 5 years

  13. Biomarker profile in cerebrospinal fluid

    Change in biomarkers in cerebrospinal fluid (Amyloid Beta 1-42, Amyloid Beta 1-40, phosphor tau and total tau). As there exist no single ideal biomarker of AD this endpoint is partly exploratory. Biological material will be stored for future analysis in the search for new biomarkers.

    Measured: 1, 2, and 5 years

  14. Echocardiography - Cardiac dimensions - Left ventricular end diastolic diameter

    Changes in cardiac dimensions - left ventricular end diastolic diameter (mm).

    Measured: 1, 2, and 5 years

  15. Echocardiography - Cardiac dimensions - Right ventricular dimension

    Changes in cardiac dimensions - right ventricular dimension (mm).

    Measured: 1, 2, and 5 years

  16. Echocardiography - Cardiac volumes - Left ventricular and diastolic volume.

    Changes in cardiac volumes - left ventricular and diastolic volume (mL).

    Measured: 1, 2, and 5 years

  17. Echocardiography - Cardiac volumes - Right ventricular volume

    Changes in cardiac volumes. Right ventricular volume (mL).

    Measured: 1, 2, and 5 years

  18. Echocardiography - Functional indices - Ejection fraction

    Changes in functional indices - ejection fraction (%).

    Measured: 1, 2, and 5 years

  19. Echocardiography - Functional indices - Left ventricular strain

    Changes in functional indices - left ventricular strain (%).

    Measured: 1, 2, and 5 years

  20. Echocardiography - Functional indices - Ventricular velocity

    Changes in functional indices - ventricular velocity (cm/s).

    Measured: 1, 2, and 5 years

  21. Echocardiography - Functional indices - Right ventricular strain

    Changes in functional indices - right ventricular strain (%).

    Measured: 1, 2, and 5 years

  22. Echocardiography - Functional indices - Left ventricular stiffness

    Changes in functional indices - left ventricular stiffness.

    Measured: 1, 2, and 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Oct 2021
  2. Study start17 Sep 2021
  3. Primary completion1 Mar 2027 (estimated)
  4. Study completion1 Mar 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Double blinded, randomized controlled clinical phase II trial
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05068830
Sponsor's protocol ID
2018/702
Other IDs
2018-000148-24, 2018
Acronym
ExPlas
Status last verified
Apr 2026
First submitted
13 Sep 2021
Last updated
15 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: To be decided

Publications

  • Tari AR, Berg HH, Videm V, Brathen G, White LR, Rosbjorgen RN, Scheffler K, Dalen H, Holte E, Haberg AK, Selbaek G, Lydersen S, Duezel E, Bergh S, Logan-Halvorsrud KR, Sando SB, Wisloff U. Safety and efficacy of plasma transfusion from exercise-trained donors in patients with early Alzheimer's disease: protocol for the ExPlas study. BMJ Open. 2022 Sep 6;12(9):e056964. doi: 10.1136/bmjopen-2021-056964.

    PubMed 36538409

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing ExPlas, Octaplasma and Saline in people with Alzheimer Disease, run by Norwegian University of Science and Technology at 1 site in Norway.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 15 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of patients with adverse events (time frame: 1 year). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05068830, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Apr 2026.

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