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Säkerhet och immunogenicitet för upprepade doser av ABvac40 hos patienter med a-MCI eller Vm-AD

15 april 2026 uppdaterad av: Araclon Biotech S.L.

En multicenter, randomiserad, dubbelblind, placebokontrollerad, 24 månader lång studie på patienter med amnestisk lindrig kognitiv funktionsnedsättning eller mycket lindrig Alzheimers sjukdom för att undersöka säkerheten, tolerabiliteten och immunsvaret av upprepade subkutana injektioner av ABvac40

Alzheimers sjukdom (AD) är den vanligaste typen av demens och står för 50-75 % av de uppskattningsvis 47 miljoner människor med demens i världen. Amyloidkaskadhypotesen för AD föreslår att ackumulering av amyloid-β (Aβ)-peptid i hjärnan, orsakad av en obalans mellan Aβ-produktion och clearance, är den initierande faktorn för en kaskad som slutligen leder till demens.

Ap-peptider genereras från sekventiell klyvning av amyloidprekursorproteinet (APP), inklusive Aβ40 och Aβ42. Aβ40 är den dominerande varianten (90 %) bland de utsöndrade Aβ-formerna och även om Aβ42 är mer hydrofobt och benäget att aggregera, och Aβ42-oligomerer anses vara de mest neurotoxiska arterna, kan Aβ40 också producera mycket giftiga diffunderbara aggregat, vilket kan förhindras in vitro av specifika anti-Aβ40-antikroppar.

Flera studier har föreslagit att en hög koncentration av Aβ40 i hjärnan skiljer patienter med AD från de som har senila plack men är kognitivt normala, vilket pekar på vikten av Aβ40 vid uppkomsten av demens. I enlighet med detta har tidigare studier visat att specifika anti-Aβ40-antikroppar märker NFTs i entorhinal cortex och hippocampus av AD-hjärnor, och att dessa inte samlokaliserar med tau NFT, vilket tyder på närvaron av degenererande neuronala populationer fyllda med C -terminala fragment av Aβx-40. Dessutom är Aβ40 huvudkomponenten i amyloidavlagring runt cerebrala artärer som orsakar cerebral amyloidangiopati (CAA), som har en prevalens på cirka 80-90% hos patienter med AD (för mer information se Lacosta et al. Alzheimers Research & Therapy (2018) 10:12 DOI 10.1186/s13195-018-0340-8).

Med tanke på de tidigare resultaten som tyder på att strategier riktade mot Aβ40 kan representera nya sjukdomsmodifierande terapier, har vi utvecklat ABvac40, det första aktiva vaccinet som riktar sig mot den C-terminala änden av Aβ40-peptiden.

Syftet med denna fas II-studie är att hos patienter med a-MCI eller vm-AD bekräfta nivån av säkerhet och tolerabilitet som erhölls i den kliniska fas I-studien ABvac40 på patienter med mm-AD. Dessutom syftar studien till att bättre karakterisera immunsvaret som framkallas av ABvac40 och att utforska dess effekter på AD-biomarkörer.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Faktisk)

134

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Montpellier, Frankrike, 34295
        • CHU de Montpellier
      • Toulouse, Frankrike, 31059
        • Centre de Recherche Clinique du Gérontopôle
    • Bourgogne-Franche-Comté
      • Dijon, Bourgogne-Franche-Comté, Frankrike, 21000
        • Hôpital François Mitterrand
      • Brescia, Italien, 25125
        • San Giovanni di Dio - Fatebenefratelli
    • Alicante
      • Alicante, Alicante, Spanien, 03010
        • Hospital General Universitario de Alicante
    • Barcelona
      • Barcelona, Barcelona, Spanien, 08025
        • Hospital de la Santa Creu i Sant Pau
      • Barcelona, Barcelona, Spanien
        • Hospital del Mar
      • Barcelona, Barcelona, Spanien, 08035
        • Hospital Vall d'Hebrón
      • Barcelona, Barcelona, Spanien, 08005
        • Barcelona Beta Brain Research Center (BBRC)
      • Barcelona, Barcelona, Spanien, 08028
        • Fundacio ACE
      • Terrassa, Barcelona, Spanien, 08221
        • Hospital Mutua De Terrasa
    • Burgos
      • Burgos, Burgos, Spanien, 09006
        • Hospital U. de Burgos
    • Guipuzcoa
      • Donostia / San Sebastian, Guipuzcoa, Spanien, 20014
        • Hospital Universitario Donosti
    • La Rioja
      • Logroño, La Rioja, Spanien, 26006
        • Hospital San Pedro
    • Lleida
      • Lleida, Lleida, Spanien, 25198
        • Hospital Santa Maria de Lleida
    • Madrid
      • Colmenar Viejo, Madrid, Spanien, 28034
        • Hospital Ramón Y Cajal
      • Madrid, Madrid, Spanien, 28040
        • Hospital Clinico San Carlos
      • Madrid, Madrid, Spanien, 28006
        • Complejo Hospitalario Ruber Juan Bravo
      • Madrid, Madrid, Spanien, 28010
        • Hospital Universitario 12 Octubre
    • Navarre
      • Pamplona, Navarre, Spanien, 31008
        • CUN - Clínica Universidad de Navarra
    • Vizcaya
      • Algorta, Vizcaya, Spanien, 48993
        • CAE Oroitu
    • Zaragoza
      • Zaragoza, Zaragoza, Spanien, 50009
        • Hospital Clínico Universitario Lozano Blesa
      • Stockholm, Sverige, 141 86
        • Karolinska Universitetssjukhuset

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

55 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Beskrivning

Inklusionskriterier:

Ett ämne måste uppfylla alla följande inkluderingskriterier:

  1. Man eller kvinna mellan 55 och 80 år, båda inklusive, vid tidpunkten för undertecknandet av informerat samtycke.
  2. Patienten (eller juridiskt ombud, om tillämpligt) och en nära anhörig/vårdgivare måste läsa ämnesinformationsbladet, samtycka till att delta i den kliniska prövningen och underteckna formuläret för informerat samtycke (patienten och en nära anhörig/vårdgivare).
  3. Närvaro av en stabil vårdgivare för att närvara vid patientens studiebesök.
  4. Mini-Mental Status Examination (MMSE) ger mellan 24 och 30 poäng (inklusive), beroende på ålder och utbildningsnivå.
  5. Clinical Dementia Rating (CDR) skala poäng 0,5.
  6. Repeterbart batteri för bedömning av neuropsykologisk status (RBANS) poäng på fördröjt minnesindex (DMI) på 85 eller lägre.
  7. Resultaten av patientens MRT hjärnskanning måste överensstämma med diagnosen klinisk a-MCI eller vm-AD enligt följande kriterier: Scheltens skala och mätning av vit substans och tidigare blödningar.
  8. Om patienten får behandling för AD, ska ha varit stabil under de två månaderna före urvalsbesöket.
  9. Behandling för samtidiga sjukdomar måste vara stabil under föregående månad före behandlingen av studien.
  10. Positiv bedömning av kandidaten av utredaren för att uppfylla kraven och procedurerna för studien.

Exklusions kriterier:

Ett försöksperson som uppfyller något av följande uteslutningskriterier är INTE berättigat att delta i studien.

  1. Känd allergi mot komponenter i vaccinet eller tidigare anafylaxi, en allvarlig allergisk reaktion eller en historia av överkänslighet mot någon komponent i formuleringen. Allergi mot fisk eller skaldjur.
  2. Aktiv infektionssjukdom (dvs. hepatit B, C). Positiv syfilis serologi.
  3. Historik eller förekomst av autoimmun sjukdom, förutom milda eksem, rinit eller psoriasis.
  4. Närvaro eller historia av immunbrist (dvs. HIV).
  5. Betydande njur- och/eller leversjukdom.
  6. Historik med astma eller reaktiv luftvägssjukdom med bronkospasm under de senaste 6 månaderna, eller för närvarande på regelbunden behandling.
  7. Stort okontrollerat systemiskt tillstånd (t.ex. diabetes, kronisk hjärtsvikt, högt blodtryck).
  8. Historik av cancer (≤5 år sedan den senaste specifika behandlingen). Undantag: basocellulärt karcinom.
  9. Betydande förändringar i hematologiska, biokemiska eller urinanalytiska parametrar, särskilt de som hänför sig till nivåer av vitamin B12, folsyra eller sköldkörteltest.
  10. Historik om någon annan störning i centrala nervsystemet, degenerativt eller icke-degenerativt neurologiskt eller psykiatriskt tillstånd som enligt utredarens åsikt kan vara orsaken till demensen, eller kan förklara den kognitiva försämringen, eller som kan störa den kognitiva funktionen direkt eller genom dess behandling.
  11. Geriatric Depression Scale (GDS; förkortad version), poäng >5
  12. Har ett "ja" svar på C-SSRS självmordstankar punkt 4 eller 5, eller något självmordsbeteende inom 6 månader före screening, eller har varit inlagd på sjukhus eller behandlats för suicidalt beteende under de senaste 5 åren före screening.
  13. Historik eller tecken på cerebrovaskulär sjukdom (ischemisk eller hemorragisk stroke, övergående ischemisk attack), eller diagnos av möjlig, trolig eller tydlig vaskulär demens enligt NINDS-AIREN-kriterier.
  14. Närvaro på MRT av ett relevant mönster av mikrovaskulär sjukdom (Leukoaraiosis, Fazekas poäng ≥2 i skalan för djup vit substans eller ≥4 i den globala poängen) eller mer än en lakunär eller territoriell infarkt. Alla andra MRT-fynd som, enligt utredarens uppfattning, kan vara en relevant bidragande orsak till försökspersonens kognitiva funktionsnedsättning. Förekomst av upp till 3 mikroblödningar kommer att vara acceptabelt.
  15. Historik av blödningsrubbningar eller predisponerande tillstånd, blodpropp eller kliniskt signifikanta onormala resultat på koagulationsprofilen vid screening, enligt bedömning av utredaren.
  16. Patienter som behandlas med antikoagulantia eller antiaggregantbehandling (aspirin i en profylaktisk dos ≤ 325 mg dagligen eller klopidogrel i en dos ≤75 mg dagligen är tillåtna) bör inte rekryteras i studien.
  17. Modifierad Hachinski ischemisk skala, poäng högre än 4.
  18. Operation (med narkos) inom de föregående tre månaderna för att inkluderas i försöket, eller programmeras under studieperioden.
  19. Behandling inom 30 dagar före besök 0 med systemiska kortikosteroider eller andra immunsuppressiva medel.
  20. Vaccination mot influensa eller annan vaccination inom 2 månader före första IMP-dosen.
  21. Patienter som tidigare har randomiserats i denna studie.
  22. Deltagande i en annan klinisk prövning under den föregående 1 månaden till screeningbesöket, eller inom de föregående 12 månaderna efter den sista dosen till screeningbesöket när det gäller försökspersoner som deltog i prövningar med ett studieläkemedel vars avsikt var att modifiera progressionen AD om inte dokumentation av mottagandet av placebo finns tillgänglig. Patienten kan inte inkluderas i studien om det experimentella läkemedlet var ett immunterapeutiskt läkemedel, inklusive IVIG eller ett vaccin mot Alzheimers sjukdom om inte dokumentation om mottagande av placebo finns tillgänglig.
  23. Patienter med alkohol- eller drogmissbruk eller beroende.
  24. Absoluta (har en pacemaker eller implanterbar defibrillator) eller släkt (barmetallstent eller stent implanterad under de senaste sex månaderna) kontraindikationer för MRT-undersökning. Känsla av klaustrofobisk låt inte utföra MRT eller PET-skanning.
  25. Patienter som sannolikt inte kommer att följa protokollet (t.ex. oförmögna att återvända för uppföljningsbesök).
  26. Kvinnor i fertil ålder, gravida eller ammande.
  27. Betydande förändringar i EKG som är förknippade med en ökad risk för patienten.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Crossover tilldelning
  • Maskning: Trippel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: ABvac40
Sex administreringar av ABvac40; de första fem administrerade en gång var fjärde vecka och den sjätte vid vecka 42. Varje administrering består av 1 ml subkutan injektion av ABvac40.
ABVAC40 består i ett konjugat av Apx-40 med ett bärarprotein (KLH) som är fordon i fosfatbuffert innehållande 0,35% aluminiumhydroxid som adjuvans.
Placebo-jämförare: Placebo
Sex administreringar av placebo; de första fem administrerade en gång var fjärde vecka och den sjätte vid vecka 42. Varje administrering består av 1 ml subkutan injektion av vaccinets vehikelbuffert utan den aktiva komponenten.
Placebo består i vaccinets fordon (fosfatbuffert som innehåller 0,35% aluminiumhydroxid) utan konjugatet.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Genomsnittlig maximal ökning av anti-Ap40-antikroppssignal (optisk densitet [OD] i ELISA)
Tidsram: Del A (baslinje och besök efter baslinjen vid vecka 2A, vecka 6A, vecka 10A, vecka 14A, vecka 18A, vecka 24A, vecka 40A, vecka 44A, vecka 50A, vecka 77A och vecka 104A)
Genomsnittlig maximal ökning (MΔ) av plasma-anti-Ap40-antikroppssignal (optisk densitet [OD] i ELISA) i varje ämne när det gäller baslinjebesök.
Del A (baslinje och besök efter baslinjen vid vecka 2A, vecka 6A, vecka 10A, vecka 14A, vecka 18A, vecka 24A, vecka 40A, vecka 44A, vecka 50A, vecka 77A och vecka 104A)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Ämnesavbrott på grund av TEAES
Tidsram: Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Antal tillbakadragna personer på grund av biverkningar i behandlingen (TEAE) under hela studien.
Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Antal personer med kliniskt signifikanta avvikelser i fysisk undersökning
Tidsram: Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Kliniskt signifikanta (CS) avvikelser i fysisk undersökning rapporterade under studien.
Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Antal personer med kliniskt signifikanta avvikelser i neurologisk undersökning
Tidsram: Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Kliniskt signifikanta (CS) avvikelser i neurologisk undersökning rapporterade under studien.
Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Antal personer med kliniskt signifikanta avvikelser i analytisk hematologi
Tidsram: Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Kliniskt signifikanta (CS) avvikelser i hematologiparametrar rapporterade under studien.
Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Antal personer med kliniskt signifikanta avvikelser i analytisk biokemi
Tidsram: Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Kliniskt signifikanta (CS) avvikelser i biokemiparametrar rapporterade under studien.
Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Antal personer med kliniskt signifikanta avvikelser vid koagulering
Tidsram: Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Kliniskt signifikanta (CS) avvikelser i koagulationsparametrar rapporterade under studien.
Hela studievaraktigheten (vecka 0 till vecka 104 i del A, och vecka 0 till vecka 77 i del B)
Columbia Suicide Severity Rating Scale
Tidsram: Del A (vecka 24A, vecka 50A, vecka 77A och vecka 104A)
Ämnen med självmordstankar eller självmordsbeteende sedan förra besöket.
Del A (vecka 24A, vecka 50A, vecka 77A och vecka 104A)
Level of Anti-Aβ40 Antibodies in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Level of Anti-Aβ40 Antibodies in Plasma
Tidsram: 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)

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)
Level of Antibody-secreting Cells
Tidsram: 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)

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)
Level of Aβ40 Peptides in Plasma - ABtest-IA
Tidsram: 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)

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)
Level of Aβ42 Peptides in Plasma - ABtest-IA
Tidsram: 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)

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)
Level of Aβ40 Peptides in Plasma - ABtest-MS
Tidsram: 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)

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)
Level of Aβ42 Peptides in Plasma - ABtest-MS
Tidsram: 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)

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)
Cortical Fibrillary Amyloid Deposition Assessed by a-PET Scans
Tidsram: Part A (Week 50A and Week 104A)

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)
Percentage of Change in Brain Volume
Tidsram: Part A (Week 24A, Week 50A, and Week 104A)

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)
Percentage of Change in Hippocampal Volume
Tidsram: Part A (Week 24A, Week 50A, Week 104A)

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)
Percentage of Change in Ventricular Volume
Tidsram: Part A (Week 24A, Week 50A, and Week 104A)

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)
Level of Aβ42 Peptides in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Level of Aβ40 Peptides in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Aβ42/Aβ40 Ratio in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Level of Total Tau in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Level of p-Tau 181 in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Level of Neurofilament Light in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Level of Neurogranin in CSF
Tidsram: Part A (Week 50A and Week 104A)

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)
Mini Mental State Examination (MMSE) Score
Tidsram: Part A (baseline, and post-baseline at Week 24A, Week 50A, Week 77A, and Week 104A)

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)
Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score
Tidsram: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)

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)
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Score
Tidsram: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)

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)
Alzheimer's Disease Cooperative Study - Activities of Daily Living, Mild Cognitive Impairment (ADCS-ADL MCI) Score
Tidsram: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)

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)
Trail Making Test (TMT) Scores
Tidsram: Part A (Week 24A, Week 50A, Week 77A, and Week 104A)

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)
Investigator Global Evaluation (IGE) Score
Tidsram: Part A (Week 24A, Week 50A, and Week 104A)

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)
EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) Overall Severity Index Score
Tidsram: Part A (Week 50A and Week 104A)

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)
EuroQol 5 Dimensions 5 Levels - Visual Analogue Scale (EQ-5D-5L - VAS) Score
Tidsram: Part A (Week 50A and Week 104A)

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)

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Genomsnittlig maximal ökning av anti -Ap40 -antikroppssignal (optisk densitet [OD] i ELISA) - Känslighet
Tidsram: Del A (baslinje och besök efter baslinjen vid vecka 2A, vecka 6A, vecka 10A, vecka 14A, vecka 18A, vecka 24A, vecka 40A, vecka 44A, vecka 50A, vecka 77A och vecka 104A)

Genomsnittlig maximal ökning (MΔ) av plasma-anti-Ap40-antikroppssignal (optisk densitet [OD] i ELISA) i varje ämne när det gäller baslinjebesök.

Känslighetsanalyser i PP (del A) analysuppsättning.

Del A (baslinje och besök efter baslinjen vid vecka 2A, vecka 6A, vecka 10A, vecka 14A, vecka 18A, vecka 24A, vecka 40A, vecka 44A, vecka 50A, vecka 77A och vecka 104A)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Studierektor: Manuel Sarasa, Araclon Biotech Ltd

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

13 december 2017

Primärt slutförande (Faktisk)

23 mars 2023

Avslutad studie (Faktisk)

23 mars 2023

Studieregistreringsdatum

Först inskickad

2 mars 2018

Först inskickad som uppfyllde QC-kriterierna

8 mars 2018

Första postat (Faktisk)

12 mars 2018

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

5 maj 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

15 april 2026

Senast verifierad

1 april 2026

Mer information

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Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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