Study to Assess the Safety and Biological Activity of AMX0035 for the Treatment of Alzheimer's Disease

The study is a 24-week, randomized, double-blind, multi-site, placebo-controlled study in
volunteers with late mild cognitive impairment (MCI) or early dementia due to Alzheimer's
disease (AD). The study is designed to evaluate the safety, tolerability, drug target
engagement and neurobiological effects of treatment with AMX0035 over 24 weeks. The study is
designed to yield deep phenotyping insight for the purposes of demonstrating the effects of
AMX0035 on mechanistic targets of engagement and disease biology. The study will evaluate
diverse disease-relevant markers and produce an informative dataset that will allow for
evaluation and correlation of imaging-based markers, neurobiological changes, functional
measures, and cognitive outcomes.

Inclusion Criteria:

1. Ages 55-89, inclusive, male or female

2. Diagnosis of "Probable Alzheimer's Disease" or Mild Cognitive Impairment (amnestic or
amnestic plus other) with biomarkers that suggest intermediate or high likelihood that
the syndrome is due to AD, according to 2011 NIA-AA Workgroup criteria

3. MoCA 8 - 26 inclusive

4. Able to read and write in English sufficiently to complete all study procedures

5. Geriatric Depression Scale <7

6. Willing and able to complete all assessments and study procedures

7. Not pregnant, lactating or of child-bearing potential (women must be >2 years
post-menopausal or surgically sterile)

8. Study partner with at least two days per week with contact with patient willing to
accompany patient to visits and complete partner study forms

9. No known hypersensitivity to Tauroursodeoxycholic acid or Phenylbutyrate

10. Must have a previous biomarker supportive of AD as the underlying pathology of
cognitive decline, which could include amyloid PET, CSF AD biomarkers, FDG-PET, or
vMRI scan

11. If on cholinesterase inhibitor and/or memantine, doses are stable for 3 months prior
to baseline

Exclusion Criteria:

1. Any CNS disease other than suspected AD, such as clinical stroke, brain tumor, normal
pressure hydrocephalus, multiple sclerosis, significant head trauma with persistent
neurological cognitive deficits or complaints, Parkinson's disease, frontotemporal
dementia, or other neurodegenerative diseases

2. Abnormal liver function defined as AST and/or ALT > 3 times the upper limit of normal

3. Renal insufficiency as defined by a serum creatinine > 1.5 times the upper limit of
normal

4. History of cholecystectomy or biliary disease

5. Clinically significant unstable medical condition (other than AD) that in the Site
Investigator opinion would pose a risk to the participant if they were to participate
in the study

6. Any contraindication to undergo MRI studies such as:

1. History of a cardiac pacemaker or pacemaker wires

2. Metallic particles in the body

3. Vascular clips in the head

4. Prosthetic heart valves

5. Severe claustrophobia impeding ability to participate in an imaging study

7. Major active or chronic psychiatric illness (e.g. depression, bipolar disorder,
obsessive compulsive disorder, schizophrenia) within the previous year prior to
baseline

8. Any significant neurodevelopmental disability

9. Current suicidal ideation or history of suicide attempt within five years of baseline
or significant change from the screening and baseline C-SSRS at the discretion of the
Site Investigator

10. History of alcohol or other substance abuse or dependence within the past two years

11. Any significant systemic illness or medical condition that could affect safety or
compliance with study at the discretion of the Site Investigator

12. Laboratory abnormalities in B12, TSH, or other common laboratory parameters that might
contribute to cognitive dysfunction

13. Current use of medications with psychoactive properties that may deleteriously affect
cognition (e.g., anticholinergics, centrally-acting antihistamines, antipsychotics,
sedative hypnotics, anxiolytics)

14. Use of any small molecule investigational therapy being used or evaluated for the
treatment of AD is prohibited beginning three months (84 days) prior to the Baseline
Visit and throughout the study.

15. Use of any immunotherapy investigational therapy is prohibited beginning one year (365
days) prior to the Baseline Visit and throughout the study.

16. Use of other investigational agents one month (28 days) prior to the Baseline Visit
and for the duration of the trial.