A Study to Evaluate the Effects of JNJ-54861911 on Amyloid Beta Processing in Cerebrospinal Fluid and Plasma in Patients With Prodromal Alzheimer's Disease
Primary Purpose
Alzheimer Disease
Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
JNJ-54861911 10 mg
JNJ-54861911 50 mg
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease focused on measuring Alzheimer Disease, Prodromal Alzheimer Disease, Safety, Tolerability, Pharmacokinetic, Proof of Mechanism, JNJ-54861911
Eligibility Criteria
Inclusion Criteria:
- Patients must have had sufficient education or work experience to exclude mental retardation
- Patients must have an abnormal cognitive performance consistent with mild cognitive impairment based on the computerized neuropsychological test battery (CANTAB Elect) that can effectively screen patients and identify cognitive deficits consistent with mild cognitive impairment
- Patients must have evidence of amyloid deposition by means of either 1) low cerebrospinal fluid amyloid beta 1-42 (CSF amyloid beta 1-42) levels and elevated CSF p-Tau and/or total tau levels at screening (cut off values for CSF amyloid beta 1-42 and CSF p-tau and/or total tau will be based on the values established by the Clinical Neurochemistry Lab, Sahlgrenska University Hospital, Mölndal, Sweden and specified in a separate lab manual) or 2) a positive 18F-flutematol amyloid positron emission tomography (PET) amyloid scan at screening (optional depending on the site's PET capability) or both
- Patients must have a body mass index (BMI=weight/height²) between 18 and 35 kg/m2, inclusive, at screening
- Women must be postmenopausal, permanently sterilized or otherwise be incapable of pregnancy
- Must adhere to required contraception during and for 3 months after study
- Patients must be otherwise healthy for their age group or medically stable with or without medication
- Patients must be able to be compliant with self-administration of medication
- Patients must be able to swallow drug as a whole
Exclusion Criteria:
- Patient has evidence of brain disease, other than Alzheimer's Disease (AD), or any other abnormality (e.g. folic acid/Vitamin B12 deficiency) that could explain the cognitive deficit (including, but not limited to vascular encephalopathy or strokes, as imaged by cerebral MRI and Major Depression, as defined by DSM-IV criteria)
- Patient has been diagnosed with dementia due to AD, due to other diseases, or with AD and contribution of other disorders (mixed dementia)
- Patient has evidence of familial autosomal dominant AD
- Patient has a history of substance or alcohol abuse
- Relevant history of lower back pain or scoliosis and/or major (lumbar) back surgery
- Patient is allergic to local anesthetics and/or iodine or chlorhexidine
- Patient has taken aspirin (even low dose) within 5 days prior to lumbar puncture (screening or Day 1)
- Patient has taken Low Molecular Weight Heparin (LMWH) within 12 hours prior to lumbar puncture (screening or Day 1)
- Patient has taken any anticoagulant treatment (e.g. warfarin; besides LMWH described above) within 1 week prior to lumbar puncture (screening or Day 1)
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Placebo Comparator
Arm Label
JNJ-54861911 10 mg
JNJ-54861911 50 mg
Placebo
Arm Description
From Day 1 to Day 28 inclusive, patients will self-administer once daily study drug (JNJ-54861911 or placebo) with a glass of non-carbonated water (approximately 200 mL).
Patients will receive matching placebo.
Outcomes
Primary Outcome Measures
Levels of amyloid beta 1-40 in cerebrospinal (CSF) after treatment at the intended target dose range
Levels of amyloid beta 1-40 in plasma after treatment at the intended target dose range
Maximum observed plasma concentration (Cmax) of JNJ-54861911
Cmax is the observed maximum plasma concentration of study drug, taken directly from the plasma concentration-time profile
Time to reach maximum observed plasma concentration of JNJ-54861911
Time when Cmax is observed, taken directly from the plasma concentration-time profile
Area under the plasma concentration time curve (AUC) from 0 to t hours of JNJ-54861911
Area under the plasma concentration-time curve from 0 to t hours post dosing (time t is the dosing interval)
Half-life of JNJ-54861911
Elimination half-life associated with the terminal slope of the semi-logarithmic drug concentration-time curve, calculated as 0.693/terminal slope
Cerebrospinal fluid exposure of JNJ-54861911
The number of volunteers who experience adverse events as a measure of safety and tolerability of JNJ-54861911 after multiple-dose administration in the anticipated target dose range
Secondary Outcome Measures
Levels of amyloid beta fragments (amyloid beta 1-37, 1-38, and 1-42) in cerebrospinal fluid after treatment at the intended target dose range
Levels of amyloid beta fragments (amyloid beta 1-37, 1-38, and 1-42) in plasma after treatment at the intended target dose range
Levels of amyloid precursor protein (APP) fragments (soluble amyloid precursor protein α [sAPPalpha], sAPPbeta, totalAPP) in CSF after treatment at the intended target dose range
Compare the relationship of amyloid beta 1-40 levels in plasma and cerebrospinal fluid after treatment at the intended target dose range
Full Information
NCT ID
NCT01978548
First Posted
October 31, 2013
Last Updated
June 24, 2015
Sponsor
Janssen Research & Development, LLC
1. Study Identification
Unique Protocol Identification Number
NCT01978548
Brief Title
A Study to Evaluate the Effects of JNJ-54861911 on Amyloid Beta Processing in Cerebrospinal Fluid and Plasma in Patients With Prodromal Alzheimer's Disease
Official Title
A Double-blind, Placebo-Controlled, Randomized, 4-Week, Multiple-Dose, Proof-of-Mechanism Study in Subjects With Prodromal Alzheimer's Disease Investigating the Effects of JNJ-54861911 on Aβ Processing in CSF and Plasma
Study Type
Interventional
2. Study Status
Record Verification Date
June 2015
Overall Recruitment Status
Completed
Study Start Date
December 2013 (undefined)
Primary Completion Date
April 2015 (Actual)
Study Completion Date
April 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of JNJ-54861911 in patients with prodromal Alzheimer's disease (pAD).
Detailed Description
This will be a multicenter, double-blind (neither investigator nor patient knows which treatment the patient receives), placebo-controlled (placebo is an inactive substance that is compared with a drug to test whether the drug has a real effect in a clinical trial), randomized (patients are assigned different treatments based on chance), multiple-dose, proof-of-mechanism (POM) study in pAD. Approximately 24 outpatients (n=8/treatment group) diagnosed with pAD, according to the inclusion and exclusion criteria, will participate in this 4-week treatment study. For all enrolled patients, this study will consist of an 8-week eligibility screening period, a 4-week double-blind treatment period, and a follow-up examination (7-14 days after the last dose). Patients will be assigned randomly to 1 of 3 treatment groups: placebo, JNJ-54861911 10 mg once daily, or JNJ-54861911 50 mg once daily. Safety assessments will be performed throughout the study. The maximal study duration for a patient will be 14 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
Keywords
Alzheimer Disease, Prodromal Alzheimer Disease, Safety, Tolerability, Pharmacokinetic, Proof of Mechanism, JNJ-54861911
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
45 (Actual)
8. Arms, Groups, and Interventions
Arm Title
JNJ-54861911 10 mg
Arm Type
Experimental
Arm Description
From Day 1 to Day 28 inclusive, patients will self-administer once daily study drug (JNJ-54861911 or placebo) with a glass of non-carbonated water (approximately 200 mL).
Arm Title
JNJ-54861911 50 mg
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients will receive matching placebo.
Intervention Type
Drug
Intervention Name(s)
JNJ-54861911 10 mg
Intervention Description
JNJ-54861911 10 mg will be administered as two 5 mg oral tablets once daily.
Intervention Type
Drug
Intervention Name(s)
JNJ-54861911 50 mg
Intervention Description
JNJ-54861911 50 mg will be administered as two 25 mg oral tablets once daily.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo will be administered as 2 oral tablets once daily.
Primary Outcome Measure Information:
Title
Levels of amyloid beta 1-40 in cerebrospinal (CSF) after treatment at the intended target dose range
Time Frame
Up to 4 weeks
Title
Levels of amyloid beta 1-40 in plasma after treatment at the intended target dose range
Time Frame
Up to 4 weeks
Title
Maximum observed plasma concentration (Cmax) of JNJ-54861911
Description
Cmax is the observed maximum plasma concentration of study drug, taken directly from the plasma concentration-time profile
Time Frame
Up to 4 weeks
Title
Time to reach maximum observed plasma concentration of JNJ-54861911
Description
Time when Cmax is observed, taken directly from the plasma concentration-time profile
Time Frame
Up to 4 weeks
Title
Area under the plasma concentration time curve (AUC) from 0 to t hours of JNJ-54861911
Description
Area under the plasma concentration-time curve from 0 to t hours post dosing (time t is the dosing interval)
Time Frame
Up to 4 weeks
Title
Half-life of JNJ-54861911
Description
Elimination half-life associated with the terminal slope of the semi-logarithmic drug concentration-time curve, calculated as 0.693/terminal slope
Time Frame
Up to 4 weeks
Title
Cerebrospinal fluid exposure of JNJ-54861911
Time Frame
Up to 4 weeks
Title
The number of volunteers who experience adverse events as a measure of safety and tolerability of JNJ-54861911 after multiple-dose administration in the anticipated target dose range
Time Frame
Up to 4 weeks
Secondary Outcome Measure Information:
Title
Levels of amyloid beta fragments (amyloid beta 1-37, 1-38, and 1-42) in cerebrospinal fluid after treatment at the intended target dose range
Time Frame
Up to 4 weeks
Title
Levels of amyloid beta fragments (amyloid beta 1-37, 1-38, and 1-42) in plasma after treatment at the intended target dose range
Time Frame
Up to 4 weeks
Title
Levels of amyloid precursor protein (APP) fragments (soluble amyloid precursor protein α [sAPPalpha], sAPPbeta, totalAPP) in CSF after treatment at the intended target dose range
Time Frame
Up to 4 weeks
Title
Compare the relationship of amyloid beta 1-40 levels in plasma and cerebrospinal fluid after treatment at the intended target dose range
Time Frame
Up to 4 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients must have had sufficient education or work experience to exclude mental retardation
Patients must have an abnormal cognitive performance consistent with mild cognitive impairment based on the computerized neuropsychological test battery (CANTAB Elect) that can effectively screen patients and identify cognitive deficits consistent with mild cognitive impairment
Patients must have evidence of amyloid deposition by means of either 1) low cerebrospinal fluid amyloid beta 1-42 (CSF amyloid beta 1-42) levels and elevated CSF p-Tau and/or total tau levels at screening (cut off values for CSF amyloid beta 1-42 and CSF p-tau and/or total tau will be based on the values established by the Clinical Neurochemistry Lab, Sahlgrenska University Hospital, Mölndal, Sweden and specified in a separate lab manual) or 2) a positive 18F-flutematol amyloid positron emission tomography (PET) amyloid scan at screening (optional depending on the site's PET capability) or both
Patients must have a body mass index (BMI=weight/height²) between 18 and 35 kg/m2, inclusive, at screening
Women must be postmenopausal, permanently sterilized or otherwise be incapable of pregnancy
Must adhere to required contraception during and for 3 months after study
Patients must be otherwise healthy for their age group or medically stable with or without medication
Patients must be able to be compliant with self-administration of medication
Patients must be able to swallow drug as a whole
Exclusion Criteria:
Patient has evidence of brain disease, other than Alzheimer's Disease (AD), or any other abnormality (e.g. folic acid/Vitamin B12 deficiency) that could explain the cognitive deficit (including, but not limited to vascular encephalopathy or strokes, as imaged by cerebral MRI and Major Depression, as defined by DSM-IV criteria)
Patient has been diagnosed with dementia due to AD, due to other diseases, or with AD and contribution of other disorders (mixed dementia)
Patient has evidence of familial autosomal dominant AD
Patient has a history of substance or alcohol abuse
Relevant history of lower back pain or scoliosis and/or major (lumbar) back surgery
Patient is allergic to local anesthetics and/or iodine or chlorhexidine
Patient has taken aspirin (even low dose) within 5 days prior to lumbar puncture (screening or Day 1)
Patient has taken Low Molecular Weight Heparin (LMWH) within 12 hours prior to lumbar puncture (screening or Day 1)
Patient has taken any anticoagulant treatment (e.g. warfarin; besides LMWH described above) within 1 week prior to lumbar puncture (screening or Day 1)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
City
Antwerp
Country
Belgium
City
Gent
Country
Belgium
City
Hoboken
Country
Belgium
City
Amsterdam
Country
Netherlands
City
Barcelona
Country
Spain
City
Madrid N/A
Country
Spain
City
Madrid
Country
Spain
City
Terrassa
Country
Spain
City
Valencia
Country
Spain
City
Mölndal
Country
Sweden
City
Stockholm
Country
Sweden
12. IPD Sharing Statement
Citations:
PubMed Identifier
30134967
Citation
Timmers M, Streffer JR, Russu A, Tominaga Y, Shimizu H, Shiraishi A, Tatikola K, Smekens P, Borjesson-Hanson A, Andreasen N, Matias-Guiu J, Baquero M, Boada M, Tesseur I, Tritsmans L, Van Nueten L, Engelborghs S. Pharmacodynamics of atabecestat (JNJ-54861911), an oral BACE1 inhibitor in patients with early Alzheimer's disease: randomized, double-blind, placebo-controlled study. Alzheimers Res Ther. 2018 Aug 23;10(1):85. doi: 10.1186/s13195-018-0415-6.
Results Reference
derived
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A Study to Evaluate the Effects of JNJ-54861911 on Amyloid Beta Processing in Cerebrospinal Fluid and Plasma in Patients With Prodromal Alzheimer's Disease
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