Experimental drug aims to boost brain function in fragile x syndrome
NCT ID NCT05358886
First seen Jul 10, 2026 · Last updated Jul 10, 2026
Summary
This study tests an experimental drug called BPN14770 (zatolmilast) in men aged 18 to 45 with Fragile X syndrome, a genetic condition that causes intellectual disability and behavioral challenges. The trial compares the drug against a placebo to see if it improves cognitive abilities, such as vocabulary and reading, as well as daily functioning and language skills. Participants take the drug twice daily for several months, and researchers measure changes using standard cognitive tests and caregiver reports.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- BPN14770 (zatolmilast)
- What this could lead to
- If successful, this could become the first approved treatment to improve cognitive and daily functioning in adults with Fragile X syndrome.
- What could go wrong
- This is a phase 3 trial, but previous experimental treatments for Fragile X have failed. The drug may not show significant benefit over placebo, and side effects are possible.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 3
Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.
- Participants
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171 people
The number who actually took part.
- Started
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Nov 2022
- Finished
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Jul 2025
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 to 45 years
- Sex
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Male participants only
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: 1. Male subject aged 18 to 45 years at screening visit. 2. Subject has FXS with a molecular genetic confirmation of the full fragile X mental retardation-1 (FMR1)mutation (≥200 CGG repetitions). 3. Subject is able to swallow capsules. 4. Current treatment with ≤3 prescribed psychotropic medications. Anti-epileptic medications are permitted and are not counted as psychotropic medications if they are used for the treatment of seizures. Anti-epileptics for other indications, such as the treatment of mood disorders, count towards the limit of permitted medications. 5. Permitted concomitant psychotropic medications must be at a stable dose and dosing regimen for at least 4 weeks prior to screening and must remain stable during the period between screening and the commencement of the study treatment. 6. Anti-epileptic medications must be at a stable dose and dosing regimen for 12 weeks prior to screening and must remain stable during the period between screening and commencement of the study treatment. 7. Subjects with a history of seizure disorder who are currently receiving treatment with anti-epileptics must have been seizure free for 3 months preceding screening or must be seizure free for 2 years if not currently receiving anti-epileptics. 8. Behavioral and other non-pharmacological treatments/interventions must be stable for 4 weeks prior to screening and must remain stable during the period between screening and first dose of study treatment and throughout the study. Minor changes in hours or times of therapy that are not considered clinically significant will not be exclusionary. Changes in therapies provided through a program (eg, due to a vacation) are allowed. 9. Subject must be willing to practice barrier methods of contraception while on the study if sexually active. Abstinence is also considered a reasonable form of birth control in this study population. 10. Subject has a parent, legal authorized guardian, or consistent caregiver. 11. Subject and caregiver are able to attend the clinic regularly and reliably. 12. If subject is his own legal guardian, he is able to understand and sign informed consent to participate in the study. 13. For subjects who are not their own legal guardian, subject's parent/legally authorized guardian is able to understand and sign an informed consent form for their child to participate in the study. 14. If subject is not his own legal guardian, subject must provide assent for participation in the study if he has the cognitive ability to do so. Exclusion Criteria: 1. Inability to successfully complete the NIH-TCB picture vocabulary and oral reading assessments at screening and baseline. The ability to complete the NIH-TBC oral reading and picture vocabulary subtest at baseline is defined as the ability to complete both subtests, with (1) confirmation from the clinician administering that the test administrations are valid (noted on the administration form) and (2) generation of valid test scores for each test. 2. History of or current cardiovascular, renal, hepatic, respiratory, gastrointestinal, psychiatric, neurologic, cerebrovascular, or other systemic disease that would place the subject at risk or potentially interfere with the interpretation of the safety, tolerability, or efficacy of the study treatment. a. Common conditions such as mild hypertension, etc. are allowed per the principal investigator's judgement as long as they are stable and controlled by medical therapy that is constant for at least 4 weeks before randomization. 3. Renal impairment, defined as serum creatinine \> 1.25 × ULN at screening 4. Hepatic impairment, defined as ALT or AST elevation \> 2 × ULN at screening. Note: LFTs may be repeated after 1 week to evaluate return to acceptable limits; if LFTs remain elevated, the subject is ineligible to participate. 5. Clinically significant abnormalities, in the investigator's judgement, in safety laboratory tests, vital signs, or ECG, as measured during screening. 6. History of substance abuse within the past year, according to investigator assessment. 7. Positive COVID-19 test during screening. 8. Significant hearing or visual impairment that may affect the subject's ability to complete the test procedures. 9. Concurrent major psychiatric condition (eg, major depressive disorder, schizophrenia, or bipolar disorder) as diagnosed by the investigator. Subjects with the additional diagnosis of autism spectrum disorder or anxiety disorder will be allowed. 10. Subject has active diseases that would interfere with participation, such as acquired immunodeficiency disorder, hepatitis C, hepatitis B, or tuberculosis. 11. Subject is planning to commence psychotherapy or cognitive behavior therapy during the period of the study or had begun psychotherapy or cognitive behavior therapy within 4 weeks prior to screening. 12. Subject is an immediate family member of anyone employed by the sponsor, investigator, or study staff. 13. Subject has a body mass index of less than 18 kg/m2 or greater than 36 kg/m2. 14. Subject has participated in another clinical trial within the 30 days preceding Screening
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Amnova Clinical Research
Irvine, California, 92604, United States
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Boston Children's Hospital
Boston, Massachusetts, 02115, United States
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Children's Hospital Colorado
Aurora, Colorado, 80045, United States
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Cincinnati Childrens Hospital Medical Center
Cincinnati, Ohio, 45229, United States
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Clinic for Special Children
Strasburg, Pennsylvania, 17579, United States
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Emory University School of Medicine
Atlanta, Georgia, 30322, United States
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Greenwood Genetic Center
Greenville, South Carolina, 29605, United States
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Icahn School of Medicine at Mount Sinai Hospital
New York, New York, 10029, United States
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Kennedy Krieger Institute
Baltimore, Maryland, 21205, United States
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Rush University Medical Center
Chicago, Illinois, 60612, United States
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Suburban Research Associates
Media, Pennsylvania, 19063, United States
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Thompson Autism & Neurodevelopment Center - CHOC
Orange, California, 92868, United States
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UC Davis Health System
Sacramento, California, 95817, United States
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University of Kansas Medical Center
Kansas City, Kansas, 66160, United States
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University of Massachusetts Medical School
Worcester, Massachusetts, 01655, United States
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University of Miami
Miami, Florida, 33136, United States
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University of Utah and Primary Childrens Hospital
Salt Lake City, Utah, 84113, United States
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