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Peer-reviewedCC BY-NC-NDNature communications

Preclinical and clinical investigation of VES001, an oral small molecule sortilin receptor inhibitor for the treatment of frontotemporal dementia: a first-in-human randomized placebo-controlled phase 1 trial.

7 more authors
6 affiliations
  1. 1Vesper Bio Aps, Copenhagen, Denmark.
  2. 2Centre for Human Drug Research, Leiden, The Netherlands.
  3. 3Leiden University Medical Center, LUMC, Leiden, The Netherlands.
  4. 4PROMEMO, Department of Biomedicine, Aarhus University, Aarhus, Denmark.
  5. 5Vesper Bio Aps, Copenhagen, Denmark. [email protected].
  6. 6Department of Biomedicine, Aarhus University, Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark. [email protected].

Abstract

GRN haploinsufficiency reduces progranulin and causes frontotemporal dementia (FTD-GRN). VES001, an oral small-molecule sortilin inhibitor, increases progranulin without downregulating sortilin. Preclinically, VES001 bound sortilin selectively and elevated progranulin in plasma, cerebrospinal fluid (CSF), and hippocampal interstitial fluid of male rats. In a randomized, double-blind, placebo-controlled first-in-human phase 1 A study, 79 healthy adults (63/37% male/female; mean age 28 years) received VES001 or placebo as single ascending doses (10-990 mg) or multiple ascending doses for 7 days (180 mg once or twice daily, or 450 mg twice daily). Safety and tolerability, the primary endpoints, were met: no deaths, serious adverse events or treatment-related discontinuations; headache and fatigue were mild and not dose-related. Pharmacokinetics were dose-proportional, with blood-brain barrier penetration. Prespecified pharmacodynamic endpoints were met as single dosing increased plasma progranulin, and twice-daily dosing produced greater, sustained increases versus placebo in plasma (peak 49% change from baseline) and CSF (18% change from baseline). Although cohorts were small, dosing lasted 7 days, and participants were healthy, these findings establish pharmacological proof of mechanism for oral sortilin inhibition and support further development of VES001 as a potential disease-modifying therapy for FTD-GRN. EU CTR 2023-505847-38-00; ClinicalTrials.gov NCT06226064.

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BibTeX
@article{klem2026preclinical,
  title = {{Preclinical and clinical investigation of VES001, an oral small molecule sortilin receptor inhibitor for the treatment of frontotemporal dementia: a first-in-human randomized placebo-controlled phase 1 trial.}},
  author = {Louise Klem and Daniel Dumas and Imogen J Swift and Sofie L Frandsen and Ditte Nedergaard Mikkelsen and Laerke Fensbaek and Yalçin Yavuz and Okke Merton and Jesminne Castricum and Simone Prichardt and Graham M Wynne and Anders Riisager and Nina Schultz and Paul B Little and Ove Pedersen and Eva Thijssen and Anders Nykjaer and Philip Kremer and Mads Kjolby},
  journal = {Nature communications},
  year = {2026},
  month = sep,
  doi = {10.1038/s41467-026-77638-2},
  url = {https://europepmc.org/article/MED/42875454},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Preclinical and clinical investigation of VES001, an oral small molecule sortilin receptor inhibitor for the treatment of frontotemporal dementia: a first-in-human randomized placebo-controlled phase 1 trial.
AU  - Louise Klem
AU  - Daniel Dumas
AU  - Imogen J Swift
AU  - Sofie L Frandsen
AU  - Ditte Nedergaard Mikkelsen
AU  - Laerke Fensbaek
AU  - Yalçin Yavuz
AU  - Okke Merton
AU  - Jesminne Castricum
AU  - Simone Prichardt
AU  - Graham M Wynne
AU  - Anders Riisager
AU  - Nina Schultz
AU  - Paul B Little
AU  - Ove Pedersen
AU  - Eva Thijssen
AU  - Anders Nykjaer
AU  - Philip Kremer
AU  - Mads Kjolby
PY  - 2026
DA  - 2026/09/14
JO  - Nature communications
DO  - 10.1038/s41467-026-77638-2
UR  - https://europepmc.org/article/MED/42875454
AB  - GRN haploinsufficiency reduces progranulin and causes frontotemporal dementia (FTD-GRN). VES001, an oral small-molecule sortilin inhibitor, increases progranulin without downregulating sortilin. Preclinically, VES001 bound sortilin selectively and elevated progranulin in plasma, cerebrospinal fluid (CSF), and hippocampal interstitial fluid of male rats. In a randomized, double-blind, placebo-controlled first-in-human phase 1 A study, 79 healthy adults (63/37% male/female; mean age 28 years) received VES001 or placebo as single ascending doses (10-990 mg) or multiple ascending doses for 7 days (180 mg once or twice daily, or 450 mg twice daily). Safety and tolerability, the primary endpoints, were met: no deaths, serious adverse events or treatment-related discontinuations; headache and fatigue were mild and not dose-related. Pharmacokinetics were dose-proportional, with blood-brain barrier penetration. Prespecified pharmacodynamic endpoints were met as single dosing increased plasma progranulin, and twice-daily dosing produced greater, sustained increases versus placebo in plasma (peak 49% change from baseline) and CSF (18% change from baseline). Although cohorts were small, dosing lasted 7 days, and participants were healthy, these findings establish pharmacological proof of mechanism for oral sortilin inhibition and support further development of VES001 as a potential disease-modifying therapy for FTD-GRN. EU CTR 2023-505847-38-00; ClinicalTrials.gov NCT06226064.
SN  - 2041-1723
ER  -