Sikkerhet og immunogenisitet av gjentatte doser av ABvac40 hos pasienter med a-MCI eller Vm-AD
En multisenter, randomisert, dobbeltblind, placebokontrollert, 24 måneders studie i pasienter med amnestisk mild kognitiv svikt eller svært mild Alzheimers sykdom for å undersøke sikkerhet, tolerabilitet og immunrespons ved gjentatte subkutane injeksjoner av ABvac40
Alzheimers sykdom (AD) er den vanligste typen demens, og utgjør 50-75 % av de anslåtte 47 millioner menneskene med demens over hele verden. Amyloidkaskadehypotesen til AD foreslår at amyloid-β (Aβ) peptidakkumulering i hjernen, forårsaket av en ubalanse mellom Aβ-produksjon og clearance, er den initierende faktoren for en kaskade som til slutt fører til demens.
Aβ-peptider genereres fra sekvensiell spaltning av amyloid-forløperproteinet (APP), inkludert Aβ40 og Aβ42. Aβ40 er den dominerende varianten (90 %) blant de utskilte Aβ-formene, og selv om Aβ42 er mer hydrofob og utsatt for aggregering, og Aβ42-oligomerer anses å være den mest nevrotoksiske arten, kan Aβ40 også produsere svært giftige diffusible aggregater, som kan forhindres in vitro av spesifikke anti-Aβ40-antistoffer.
Flere studier har foreslått at en høy konsentrasjon av Aβ40 i hjernen skiller pasienter med AD fra de som har senile plakk, men er kognitivt normale, noe som peker på viktigheten av Aβ40 i begynnelsen av demens. I tråd med dette har tidligere studier vist at spesifikke anti-Aβ40-antistoffer merker NFT-er i entorhinal cortex og hippocampus av AD-hjerner, og at disse ikke samlokaliseres med tau NFT-er, noe som tyder på tilstedeværelsen av degenererende nevronpopulasjoner fylt med C -terminale fragmenter av Aβx-40. I tillegg er Aβ40 hovedkomponenten i amyloidavsetning rundt cerebrale arterier som forårsaker cerebral amyloid angiopati (CAA), som har en prevalens på rundt 80-90 % hos pasienter med AD (for mer informasjon se Lacosta et al. Alzheimers Research & Therapy (2018) 10:12 DOI 10.1186/s13195-018-0340-8).
Tatt i betraktning de tidligere resultatene som antyder at strategier rettet mot Aβ40 kan representere nye sykdomsmodifiserende terapier, har vi utviklet ABvac40, den første aktive vaksinen rettet mot den C-terminale enden av Aβ40-peptidet.
Hensikten med denne fase II-studien er å bekrefte hos pasienter med a-MCI eller vm-AD nivået av sikkerhet og tolerabilitet oppnådd i ABvac40 fase I klinisk studie hos pasienter med mm-AD. I tillegg er studien rettet mot å bedre karakterisere immunresponsen fremkalt av ABvac40 og å utforske dens effekter på AD-biomarkører.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Registrering (Faktiske)
Registrering
Fase
Fase
- Fase 2
Kontakter og plasseringer
Studiesteder
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Montpellier, Frankrike, 34295
- CHU de Montpellier
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Toulouse, Frankrike, 31059
- Centre de Recherche Clinique du Gérontopôle
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Bourgogne-Franche-Comté
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Dijon, Bourgogne-Franche-Comté, Frankrike, 21000
- Hôpital François Mitterrand
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Brescia, Italia, 25125
- San Giovanni di Dio - Fatebenefratelli
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Alicante
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Alicante, Alicante, Spania, 03010
- Hospital General Universitario de Alicante
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Barcelona
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Barcelona, Barcelona, Spania, 08025
- Hospital de La Santa Creu i Sant Pau
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Barcelona, Barcelona, Spania
- Hospital Del Mar
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Barcelona, Barcelona, Spania, 08035
- Hospital Vall d'hebrón
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Barcelona, Barcelona, Spania, 08005
- Barcelona Beta Brain Research Center (BBRC)
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Barcelona, Barcelona, Spania, 08028
- Fundació ACE
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Terrassa, Barcelona, Spania, 08221
- Hospital Mutua De Terrasa
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Burgos
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Burgos, Burgos, Spania, 09006
- Hospital U. de Burgos
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Guipuzcoa
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Donostia / San Sebastian, Guipuzcoa, Spania, 20014
- Hospital Universitario Donosti
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La Rioja
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Logroño, La Rioja, Spania, 26006
- Hospital San Pedro
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Lleida
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Lleida, Lleida, Spania, 25198
- Hospital Santa Maria de Lleida
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Madrid
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Colmenar Viejo, Madrid, Spania, 28034
- Hospital Ramon y Cajal
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Madrid, Madrid, Spania, 28040
- Hospital Clinico San Carlos
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Madrid, Madrid, Spania, 28006
- Complejo Hospitalario Ruber Juan Bravo
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Madrid, Madrid, Spania, 28010
- Hospital Universitario 12 Octubre
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Navarre
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Pamplona, Navarre, Spania, 31008
- CUN - Clínica Universidad de Navarra
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Vizcaya
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Algorta, Vizcaya, Spania, 48993
- CAE Oroitu
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Zaragoza
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Zaragoza, Zaragoza, Spania, 50009
- Hospital Clínico Universitario Lozano Blesa
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Stockholm, Sverige, 141 86
- Karolinska Universitetssjukhuset
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Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Beskrivelse
Inklusjonskriterier:
Et emne må oppfylle alle følgende inklusjonskriterier:
- Mann eller kvinne mellom 55 og 80 år, begge inkludert, på tidspunktet for undertegning av informert samtykke.
- Pasienten (eller juridisk representant, hvis aktuelt) og en nær slektning/omsorgsperson må lese faginformasjonsarket, samtykke i å delta i den kliniske utprøvingen og signere skjemaet for informert samtykke (pasienten og en nær slektning/omsorgsperson).
- Tilstedeværelse av en stabil omsorgsperson for å delta på pasientstudiebesøkene.
- Mini-Mental Status Examination (MMSE) score mellom 24 og 30 poeng (inklusive), i henhold til alder og utdanningsnivå.
- Clinical Dementia Rating (CDR) skala skårer 0,5.
- Repeterbart batteri for vurdering av nevropsykologisk status (RBANS)-score på Delayed Memory Index (DMI) på 85 eller lavere.
- Resultatene av pasientens MR-hjerneskanning må stemme overens med diagnosen klinisk a-MCI eller vm-AD i henhold til følgende kriterier: Scheltens skala, og måling av hvit substans og tidligere blødninger.
- Dersom pasienten får behandling for AD, må ha vært stabil i løpet av de to månedene før seleksjonsbesøket.
- Behandling for samtidige sykdommer må være stabil i løpet av forrige måned før behandlingen av studien.
- Positiv vurdering av kandidaten av etterforskeren for å oppfylle kravene og prosedyrene for studien.
Ekskluderingskriterier:
Et emne som oppfyller noen av følgende eksklusjonskriterier er IKKE kvalifisert for deltakelse i studien.
- Kjent allergi mot komponenter i vaksinen eller tidligere anafylaksi, en alvorlig allergisk reaksjon eller en historie med overfølsomhet overfor en hvilken som helst komponent i formuleringen. Allergi mot fisk eller skalldyr.
- Aktiv infeksjonssykdom (dvs. hepatitt B, C). Positiv syfilis serologi.
- Anamnese eller tilstedeværelse av autoimmun sykdom, bortsett fra mild eksem, rhinitt eller psoriasis.
- Tilstedeværelse eller historie med immunsvikt (dvs. HIV).
- Betydelig nyre- og/eller leversykdom.
- Anamnese med astma eller reaktiv luftveissykdom med bronkospasme i løpet av de siste 6 månedene, eller for tiden på vanlig behandling.
- Større ukontrollert systemisk tilstand (f.eks. diabetes, kongestiv hjertesvikt, hypertensjon).
- Anamnese med kreft (≤5 år siden siste spesifikke behandling). Unntak: basocellulært karsinom.
- Betydelige endringer i hematologiske, biokjemiske eller urinanalytiske parametere, spesielt de som er relatert til nivåer av vitamin B12, folsyre eller skjoldbruskprøver.
- Anamnese med andre forstyrrelser i sentralnervesystemet, degenerative eller ikke-degenerative nevrologiske eller psykiatriske tilstander som etter etterforskerens mening kan være årsaken til demensen, eller kan forklare den kognitive svikten, eller som kan forstyrre kognitiv funksjon direkte eller ved dens behandling.
- Geriatrisk depresjonsskala (GDS; forkortet versjon), score >5
- Har et "ja" svar på C-SSRS selvmordstanker punkt 4 eller 5, eller enhver selvmordsatferd innen 6 måneder før screening, eller har vært innlagt på sykehus eller behandlet for suicidal atferd de siste 5 årene før screening.
- Anamnese eller tegn på cerebrovaskulær sykdom (iskemisk eller hemorragisk hjerneslag, forbigående iskemisk angrep), eller diagnose av mulig, sannsynlig eller klar vaskulær demens i henhold til NINDS-AIREN-kriteriene.
- Tilstedeværelse på MR av et relevant mønster av mikrovaskulær sykdom (Leukoaraiose, Fazekas skåre ≥2 i skalaen for dyp hvit substans eller ≥4 i den globale skåren) eller mer enn ett lakunære eller territorielle infarkter. Ethvert annet MR-funn som, etter utrederens oppfatning, kan være en relevant medvirkende årsak til forsøkspersonens kognitive svikt. Tilstedeværelse av opptil 3 mikroblødninger vil være akseptabelt.
- Anamnese med blødningsforstyrrelser eller disponerende tilstander, blodpropp eller klinisk signifikante unormale resultater på koagulasjonsprofilen ved screening, som bestemt av etterforskeren.
- Pasienter som behandles med antikoagulantia eller antiaggregerende terapi (aspirin i en profylaktisk dose ≤ 325 mg daglig eller klopidogrel i en dose ≤75 mg daglig er tillatt) bør ikke rekrutteres i studien.
- Modifisert Hachinski iskemisk skala, score høyere enn 4.
- Kirurgi (med generell anestesi) innen de foregående tre månedene som skal inkluderes i forsøket, eller programmeres i løpet av studieperioden.
- Behandling innen 30 dager før besøk 0 med systemiske kortikosteroider eller andre immundempende midler.
- Vaksinasjon mot influensa eller annen vaksinasjon innen 2 måneder før første IMP-dose.
- Pasienter som tidligere har blitt randomisert i denne studien.
- Deltakelse i en annen klinisk utprøving i løpet av den siste 1 måneden til screeningbesøket, eller innen de foregående 12 månedene etter siste dose til screeningbesøket når det gjelder forsøkspersoner som deltok i studier med et studiemedikament som hadde til hensikt å modifisere progresjonen AD med mindre dokumentasjon på mottak av placebo er tilgjengelig. Pasienten kan ikke inkluderes i studien dersom det eksperimentelle medikamentet var et immunterapeutisk legemiddel, inkludert IVIG eller en vaksine mot Alzheimers sykdom med mindre dokumentasjon på mottak av placebo er tilgjengelig.
- Pasienter med alkohol- eller narkotikamisbruk eller avhengighet.
- Absolutte (har pacemaker eller implanterbar defibrillator) eller slektning (barmetallstent eller stent implantert de siste seks månedene) kontraindikasjoner for MR-undersøkelse. Følelse av klaustrofobisk ikke la utføre MR eller PET-skanning.
- Pasienter som sannsynligvis ikke vil overholde protokollen (f.eks. ute av stand til å komme tilbake for oppfølgingsbesøk).
- Kvinner i fertil alder, gravide eller ammende.
- Betydelige endringer i EKG som er forbundet med økt risiko for pasienten.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Crossover-oppdrag
- Masking: Trippel
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
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Eksperimentell: ABvac40
Seks administreringer av ABvac40; de første fem administrert en gang hver 4. uke og den sjette i uke 42.
Hver administrering består av 1 ml subkutan injeksjon av ABvac40.
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ABVAC40 består i et konjugat av AβX-40 med et bærerprotein (KLH) kjøretøy i fosfatbuffer som inneholder 0,35% aluminiumhydroksid som adjuvans.
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Placebo komparator: Placebo
Seks administreringer av placebo; de første fem administrert en gang hver 4. uke og den sjette i uke 42.
Hver administrering består av 1 ml subkutan injeksjon av vaksinens bærerbuffer uten den aktive komponenten.
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Placebo består i vaksinens kjøretøy (fosfatbuffer som inneholder 0,35% aluminiumhydroksyd) uten konjugatet.
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Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Gjennomsnittlig maksimal økning av anti-Aβ40 antistoffsignal (optisk tetthet [OD] i ELISA)
Tidsramme: Del A (Baseline, og besøk etter baseline på uke 2A, uke 6A, uke 10A, uke 14A, uke 18A, uke 24A, uke 40A, uke 44a, uke 50A, uke 77A, og uke 104a)
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Gjennomsnittlig maksimal økning (Mδ) av plasma-anti-Aβ40 antistoffsignal (optisk tetthet [OD] i ELISA) i hvert emne med hensyn til baselinebesøk.
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Del A (Baseline, og besøk etter baseline på uke 2A, uke 6A, uke 10A, uke 14A, uke 18A, uke 24A, uke 40A, uke 44a, uke 50A, uke 77A, og uke 104a)
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Emneavvik på grunn av tea
Tidsramme: Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Antall tilbaketrukne forsøkspersoner på grunn av bivirkninger av behandlingsoppførende hendelser (TEAEs) under hele studien.
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Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Antall personer med klinisk signifikante avvik i fysisk undersøkelse
Tidsramme: Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Klinisk signifikante (CS) abnormiteter i fysisk undersøkelse rapportert under studien.
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Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Antall personer med klinisk signifikante avvik i nevrologisk undersøkelse
Tidsramme: Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Klinisk signifikante (CS) abnormiteter i nevrologisk undersøkelse rapportert under studien.
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Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Antall personer med klinisk signifikante avvik i analytisk hematologi
Tidsramme: Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Klinisk signifikante (CS) abnormiteter i hematologiparametere rapportert under studien.
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Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Antall personer med klinisk signifikante avvik i analytisk biokjemi
Tidsramme: Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Klinisk signifikante (CS) abnormiteter i biokjemi -parametere rapportert under studien.
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Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Antall personer med klinisk signifikante avvik i koagulasjon
Tidsramme: Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Klinisk signifikante (CS) abnormiteter i koagulasjonsparametere rapportert under studien.
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Hele studiens varighet (uke 0 til uke 104 i del A, og uke 0 til uke 77 i del B)
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Columbia selvmords alvorlighetsgradskala
Tidsramme: Del A (uke 24A, uke 50A, uke 77A og uke 104A)
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Emner med selvmordstanker eller selvmordsatferd siden forrige besøk.
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Del A (uke 24A, uke 50A, uke 77A og uke 104A)
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Level of Anti-Aβ40 Antibodies in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of anti-Aβ40 antibodies in cerebrospinal fluid (CSF) from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included the recorded outcome value as the dependent variable; treatment, protocol specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Level of Anti-Aβ40 Antibodies in Plasma
Tidsramme: Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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The change in levels of anti-Aβ40 antibodies in plasma from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included the recorded outcome value as the dependent variable; treatment, protocol specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline age as covariates; and measures within-patient at each visit as a repeated measure. A compound symmetric variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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Level of Antibody-secreting Cells
Tidsramme: Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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The change in levels of antibody-secreting cells from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included the recorded outcome value as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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Level of Aβ40 Peptides in Plasma - ABtest-IA
Tidsramme: Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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The change in levels of anti-Aβ40 peptides in plasma (ABtest-IA) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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Level of Aβ42 Peptides in Plasma - ABtest-IA
Tidsramme: Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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The change in levels of anti-Aβ42 peptides in plasma (ABtest-IA) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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Level of Aβ40 Peptides in Plasma - ABtest-MS
Tidsramme: Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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The change in levels of anti-Aβ40 peptides in plasma (ABtest-MS) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. A compound symmetric variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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Level of Aβ42 Peptides in Plasma - ABtest-MS
Tidsramme: Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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The change in levels of anti-Aβ42 peptides in plasma (ABtest-MS) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 2A, Week 6A, Week 10A, Week 14A, Week 18A, Week 24A, Week 40A, Week 44A, Week 50A, Week 77A, and Week 104A)
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Cortical Fibrillary Amyloid Deposition Assessed by a-PET Scans
Tidsramme: Part A (Week 50A and Week 104A)
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The change in amyloid-PET (a-PET) standard centiloid global cortical area (reference Pons) from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Percentage of Change in Brain Volume
Tidsramme: Part A (Week 24A, Week 50A, and Week 104A)
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The percent change in brain volume from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, and Week 104A)
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Percentage of Change in Hippocampal Volume
Tidsramme: Part A (Week 24A, Week 50A, Week 104A)
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The percent change in right and left hippocampal volume from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, Week 104A)
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Percentage of Change in Ventricular Volume
Tidsramme: Part A (Week 24A, Week 50A, and Week 104A)
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The percent change in ventricular volume from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, and Week 104A)
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Level of Aβ42 Peptides in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of Aβ42 peptides in cerebrospinal fluid (CSF) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Level of Aβ40 Peptides in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of Aβ40 peptides in cerebrospinal fluid (CSF) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Aβ42/Aβ40 Ratio in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in Aβ42/Aβ40 ratio in cerebrospinal fluid (CSF) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Level of Total Tau in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of total Tau in cerebrospinal fluid (CSF) from baseline to each applicable postbaseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Level of p-Tau 181 in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of p-Tau 181 in cerebrospinal fluid (CSF) from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Level of Neurofilament Light in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of neurofilament light in cerebrospinal fluid (CSF) from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Level of Neurogranin in CSF
Tidsramme: Part A (Week 50A and Week 104A)
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The change in levels of neurogranin in cerebrospinal fluid (CSF) from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Mini Mental State Examination (MMSE) Score
Tidsramme: Part A (baseline, and post-baseline at Week 24A, Week 50A, Week 77A, and Week 104A)
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The change in MMSE score from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a MMRM and the ITT analysis set. MMSE is an 11-question measure that tests 5 areas of cognitive function: orientation, registration, attention and calculation, recall, and language. MMSE score ranges: 0-30, with lower scores indicating worst cognition. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (baseline, and post-baseline at Week 24A, Week 50A, Week 77A, and Week 104A)
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Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score
Tidsramme: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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The change in CDR-SB score from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a MMRM and the ITT analysis set. CDR-SB assesses 6 cognitive and functional domains: Memory, Orientation, Judgment & Problem Solving, Community Affairs, Home & Hobbies, Personal Care. CDR-SB score ranges: 0-18. The higher scores mean a worst outcome. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Score
Tidsramme: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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The change in RBANS total score from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a MMRM and the ITT analysis set. RBANS assesses 5 cognitive domains: Immediate Memory, Visuospatial/constructional, Language, Attention, Delayed Memory. Total score (range 40-160) sums the 5 domain scores. The higher scores mean a better outcome. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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Alzheimer's Disease Cooperative Study - Activities of Daily Living, Mild Cognitive Impairment (ADCS-ADL MCI) Score
Tidsramme: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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The change in ADCS-ADL MCI total score from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a MMRM and the ITT analysis set. ADCS-ADL MCI is a 24-item scale that includes 6 basic activities of daily living (ADL) items and 16 instrumental ADL items that provide a total score: 0-78, with a lower score indicating greater severity. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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Trail Making Test (TMT) Scores
Tidsramme: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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Change in TMT score from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a MMRM and the ITT analysis set. TMT has 2 parts in which the patient connects 25 dots in order as quickly as possible. In TMT-A, targets are numbers 1-25; in TMT-B, targets are numbers 1-13 interleaved with letters A-L. Lower timings indicate better outcome. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 24A, Week 50A, Week 77A, and Week 104A)
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Investigator Global Evaluation (IGE) Score
Tidsramme: Part A (Week 24A, Week 50A, and Week 104A)
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Change in IGE from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using MMRM and ITT analysis set. IGE at baseline:1-Good general status;2-Slight deterioration;3-Moderate deterioration;4-Bad general status. IGE after baseline:1-Marked improvement;2-Moderate improvement;3-Slight improvement;4-No change;5-Slight worsening;6-Moderate worsening;7-Marked worsening. MMRM included IGE after baseline as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix is used. Following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly significantly associated with response measure (p < 0.15). |
Part A (Week 24A, Week 50A, and Week 104A)
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EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) Overall Severity Index Score
Tidsramme: Part A (Week 50A and Week 104A)
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Change in EQ-5D-5L overall severity index from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using MMRM and ITT analysis set. EQ-5D-5L has 5 dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression; rated: 1=no problems, 2=slight problems, 3=moderate problems, 4=severe problems, and 5=extreme problems. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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EuroQol 5 Dimensions 5 Levels - Visual Analogue Scale (EQ-5D-5L - VAS) Score
Tidsramme: Part A (Week 50A and Week 104A)
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The change in EQ-5D-5L - VAS score from baseline to each applicable post-baseline efficacy visit (Part A) was analyzed using a Mixed-Model Repeated Measures (MMRM), and the ITT analysis set. VAS records the patient's self-rated health on a vertical scale, ranging from 100 = 'Best imaginable health state' down to 0 = 'Worst imaginable health state'. The MMRM included change from baseline in the efficacy parameter as the dependent variable; treatment, protocol-specified visits, treatment-by-visit interaction, and amyloid positivity as the fixed effects; baseline efficacy parameter and baseline age as covariates; and measures within-patient at each visit as a repeated measure. An unstructured variance-covariance matrix was used. The following factors may also have been included in the model: ApoE carrier status, baseline use of AD symptomatic medication and clinical subgroup - MCI or vmAD, if found to be significantly associated with the response measure (p < 0.15). |
Part A (Week 50A and Week 104A)
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Andre resultatmål
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Gjennomsnittlig maksimal økning av anti -Aβ40 antistoffsignal (optisk tetthet [OD] i ELISA) - Følsomhet
Tidsramme: Del A (Baseline, og besøk etter baseline på uke 2A, uke 6A, uke 10A, uke 14A, uke 18A, uke 24A, uke 40A, uke 44a, uke 50A, uke 77A, og uke 104a)
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Gjennomsnittlig maksimal økning (Mδ) av plasma-anti-Aβ40 antistoffsignal (optisk tetthet [OD] i ELISA) i hvert emne med hensyn til baselinebesøk. Følsomhetsanalyser i PP (del A) analysesettet. |
Del A (Baseline, og besøk etter baseline på uke 2A, uke 6A, uke 10A, uke 14A, uke 18A, uke 24A, uke 40A, uke 44a, uke 50A, uke 77A, og uke 104a)
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Etterforskere
Etterforskere
- Studieleder: Manuel Sarasa, Araclon Biotech Ltd
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Studiestart
Primær fullføring (Faktiske)
Primær fullføring
Studiet fullført (Faktiske)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
Andre studie-ID-numre
- AB1601
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
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