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A Dose Titration Study of CPC-201 in Patients With Dementia of Alzheimer's Type (CPC-12)

Primary Purpose

Dementia of Alzheimer's Type

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Donepezil
Solifenacin
Sponsored by
Chase Pharmaceuticals Corporation, an affiliate of Allergan plc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dementia of Alzheimer's Type

Eligibility Criteria

50 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed an Institutional Review Board (IRB) approved informed consent document
  2. Aged 50 - 89 years inclusive.
  3. Meeting the diagnosis of probable AD consistent with:

    • Revised National Institute on Aging-Alzheimer's Disease Association (NIA-ADA) criteria and
    • Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria.
  4. Mild to severe severity (Mini-Mental Status Exam [MMSE] scores 7 - 24 inclusive).
  5. Rosen-Modified Hachinski Ischemia Score of ≤4.
  6. Have a suitable caregiver to supervise the at-home administration of study drugs and observe for AEs.
  7. Patients treated with donepezil 5 or 10 mg/day (given once daily) for at least 4 weeks just prior to Day1 for Population (group) 1 or;
  8. Patients never been treated with donepezil before (donepezil naïve) or who have not received any other AChEI for the past 6 months for Population (group) 2.
  9. Patients in generally good health as indicated by their medical history and physical examination, vital signs, electrocardiogram (ECG), and standard laboratory tests.

Exclusion Criteria:

  1. Women of child bearing potential.
  2. History or presence of a seizure disorder.
  3. Current unstable peptic ulcer disease, urinary or gastric retention; asthma or obstructive pulmonary disease.
  4. History or presence of bladder outflow obstruction, gastrointestinal obstructive disorder or reduced GI motility, or narrow-angle glaucoma.
  5. History or presence of gastrointestinal, hepatic, or renal disease, or other condition known to interfere with the absorption, distribution, metabolism or excretion of drugs.
  6. Renal and hepatic dysfunction with:

    • Total Bilirubin: >1.5 x UNL
    • AST: >2.5 x UNL
    • ALT: >2.5 x UNL
    • Serum Creatinine: >1.5 x UNL
    • Creatinine Clearance: <30 mL/min (calculated by Cockcroft and Gault equation)
  7. History or presence of myasthenia.
  8. History or family history of Prolonged QT Syndrome.
  9. History of unexplained syncope or family history of unexplained syncope or sudden death.
  10. Myocardial infarction or hospitalization for congestive heart failure within 6 months.
  11. ECG findings of:

    • Complete Left Bundle Branch Block;
    • Ventricular pacing;
    • 2nd degree or 3rd degree AV block;
    • Atrial fibrillation or atrial flutter;
    • HR <45 or >100;
    • PR >220 msec; or
    • QTcF >450 msec in male, >470 msec in female
  12. Known hypersensitivity to donepezil, solifenacin or related drugs.
  13. History of drug significant allergy.
  14. History of substance abuse, known drug addiction, or positive test for drugs of abuse or alcohol.
  15. Patients treated with the following medications within 8 weeks of screening

    • AChEIs (other than donepezil),
    • Peripherally acting anticholinergics (such as drugs for the treatment of overactive bladder disorder),
    • Psychoactive medications (including antipsychotics, antidepressants, anxiolytics or sedative hypnotics) having significant anticholinergic effects and/or believed to affect cognitive function.

    Other medications are acceptable, at the investigators discretion, if dosage is held stable for at least 4 weeks prior to screening and throughout the study.

  16. Patients considered unlikely to co-operate in the study, and/or poor compliance anticipated by the investigator.
  17. Patients hospitalized within 4 weeks of screening.
  18. Any other clinically relevant acute or chronic diseases which could interfere with patients' safety during the trial, or expose them to undue risk, or which could interfere with study objectives.
  19. Patients who have participated in another clinical trial with an investigational drug within previous 30 days.

Sites / Locations

  • Quantum Laboratories
  • Miami Jewish Health Systems
  • Premiere Research Institute
  • PMG Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort 1

Cohort 2

Cohort 1b

Cohort 3c

Arm Description

Donepezil 20mg/day upward dose titration of 10mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 60mg/day with solifenacin 15 or 20mg/day.

Donepezil 20mg/day upward dose titration of 20mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 60mg/day with solifenacin 15 or 20mg/day.

Donepezil 10mg/day upward dose titration of 10mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 60mg/day with solifenacin 15 or 20mg/day.

Donepezil 10mg/day upward dose titration of 5mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 40mg/day with solifenacin 15mg/day.

Outcomes

Primary Outcome Measures

Number of Participants Who Reached the Maximum Allowed Dose (MAD) in Their Respective Cohort
Of the four cohorts with different dosing schedules for CPC-201, the cohort with the greatest proportion of participants to reach the donepezil MAD was determined to be the optimal administration regimen.

Secondary Outcome Measures

Number of Participants With TEAEs Leading to Study Drug Discontinuation
Number of subjects who experienced any treatment-emergent adverse events (TEAEs) leading to study drug discontinuation

Full Information

First Posted
August 27, 2015
Last Updated
February 12, 2019
Sponsor
Chase Pharmaceuticals Corporation, an affiliate of Allergan plc
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1. Study Identification

Unique Protocol Identification Number
NCT02549196
Brief Title
A Dose Titration Study of CPC-201 in Patients With Dementia of Alzheimer's Type
Acronym
CPC-12
Official Title
A Phase II, Dose Titration Study of CPC-201 in Patients With Dementia of Alzheimer's Type
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
October 7, 2015 (Actual)
Primary Completion Date
September 28, 2017 (Actual)
Study Completion Date
September 28, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chase Pharmaceuticals Corporation, an affiliate of Allergan plc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase II, ascending dose study of CPC-201 in patients with dementia of Alzheimer's type to determine the optimal dose titration schedule.
Detailed Description
This is a Phase II, ascending dose study of CPC-201 in patients with dementia of Alzheimer's type to determine the optimal dose titration schedule. The study involves a step wise cohort design in two different patient populations: Group 1 will comprise of patients who have been treated with low dose of CPC-201(5 or 10 mg/day) (given once daily) for at least 4 weeks just prior to Day1. Group 2 will consist of patients who have never been treated with CPC-201 before or who have not received any other AChEI for the past 6 months. In this study, CPC-201 dose will be increased at weekly intervals, in accordance with the schedules given below, to its first intolerable dose (FID) or maximum allowed dose (MAD) of 60 mg/day (40mg/day for Cohort 3c) together with solifenacin 15 mg/day. Cohort 1 1st week: 20mg 2nd week: 30mg 3rd week: 40mg 4th week: 50mg 5th week: 60mg Cohort 2* 1st week: 20mg 2nd week: 40mg 3rd week: 60mg Cohort 1b 1st - 2nd week: 10mg 3rd week: 20mg 4th week: 30mg 5th week: 40mg 6th week: 50mg 7th week: 60mg Cohort 3c* 1st week: 10mg 2nd week: 15mg 3rd week: 20mg 4th week: 25mg 5th week: 30mg 6th week: 35mg 7th week: 40mg *: The dose titration schedule of Cohort 2 and 3 may be altered based on Cohort 1 result. Patients will be enrolled in Cohort 2 only when patients enrolled in Cohort 1 have safely completed titration. Similary, patients will be enrolled in Cohort 3, only when patients enrolled in Cohort 2 have safely completed titration. Patients reaching their FID or having completed one week treatment with donepezil 40mg/day, have two options. Option 1: Patient will be allowed to immediately enter a long term extension at their Maximum tolerated dose (MTD) or MAD. Option 2: Patients may choose not to enter the long term extension, in which case the Investigator will decide whether the patient should discontinue high dose of donepezil without down-titration, or whether donepezil should be downtitrated to their own standard of donepezil dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dementia of Alzheimer's Type

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
Participant
Allocation
Non-Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
Donepezil 20mg/day upward dose titration of 10mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 60mg/day with solifenacin 15 or 20mg/day.
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
Donepezil 20mg/day upward dose titration of 20mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 60mg/day with solifenacin 15 or 20mg/day.
Arm Title
Cohort 1b
Arm Type
Experimental
Arm Description
Donepezil 10mg/day upward dose titration of 10mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 60mg/day with solifenacin 15 or 20mg/day.
Arm Title
Cohort 3c
Arm Type
Experimental
Arm Description
Donepezil 10mg/day upward dose titration of 5mg at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) of 40mg/day with solifenacin 15mg/day.
Intervention Type
Drug
Intervention Name(s)
Donepezil
Intervention Description
Donepezil dose increased at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) together with solifenacin.
Intervention Type
Drug
Intervention Name(s)
Solifenacin
Intervention Description
Donepezil dose increased at weekly intervals up to first intolerable dose (FID) or to maximum allowed dose (MAD) together with solifenacin.
Primary Outcome Measure Information:
Title
Number of Participants Who Reached the Maximum Allowed Dose (MAD) in Their Respective Cohort
Description
Of the four cohorts with different dosing schedules for CPC-201, the cohort with the greatest proportion of participants to reach the donepezil MAD was determined to be the optimal administration regimen.
Time Frame
1-7 weeks
Secondary Outcome Measure Information:
Title
Number of Participants With TEAEs Leading to Study Drug Discontinuation
Description
Number of subjects who experienced any treatment-emergent adverse events (TEAEs) leading to study drug discontinuation
Time Frame
1-7 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed an Institutional Review Board (IRB) approved informed consent document Aged 50 - 89 years inclusive. Meeting the diagnosis of probable AD consistent with: Revised National Institute on Aging-Alzheimer's Disease Association (NIA-ADA) criteria and Diagnostic and Statistical Manual of Mental Disorders (DSM IV) criteria. Mild to severe severity (Mini-Mental Status Exam [MMSE] scores 7 - 24 inclusive). Rosen-Modified Hachinski Ischemia Score of ≤4. Have a suitable caregiver to supervise the at-home administration of study drugs and observe for AEs. Patients treated with donepezil 5 or 10 mg/day (given once daily) for at least 4 weeks just prior to Day1 for Population (group) 1 or; Patients never been treated with donepezil before (donepezil naïve) or who have not received any other AChEI for the past 6 months for Population (group) 2. Patients in generally good health as indicated by their medical history and physical examination, vital signs, electrocardiogram (ECG), and standard laboratory tests. Exclusion Criteria: Women of child bearing potential. History or presence of a seizure disorder. Current unstable peptic ulcer disease, urinary or gastric retention; asthma or obstructive pulmonary disease. History or presence of bladder outflow obstruction, gastrointestinal obstructive disorder or reduced GI motility, or narrow-angle glaucoma. History or presence of gastrointestinal, hepatic, or renal disease, or other condition known to interfere with the absorption, distribution, metabolism or excretion of drugs. Renal and hepatic dysfunction with: Total Bilirubin: >1.5 x UNL AST: >2.5 x UNL ALT: >2.5 x UNL Serum Creatinine: >1.5 x UNL Creatinine Clearance: <30 mL/min (calculated by Cockcroft and Gault equation) History or presence of myasthenia. History or family history of Prolonged QT Syndrome. History of unexplained syncope or family history of unexplained syncope or sudden death. Myocardial infarction or hospitalization for congestive heart failure within 6 months. ECG findings of: Complete Left Bundle Branch Block; Ventricular pacing; 2nd degree or 3rd degree AV block; Atrial fibrillation or atrial flutter; HR <45 or >100; PR >220 msec; or QTcF >450 msec in male, >470 msec in female Known hypersensitivity to donepezil, solifenacin or related drugs. History of drug significant allergy. History of substance abuse, known drug addiction, or positive test for drugs of abuse or alcohol. Patients treated with the following medications within 8 weeks of screening AChEIs (other than donepezil), Peripherally acting anticholinergics (such as drugs for the treatment of overactive bladder disorder), Psychoactive medications (including antipsychotics, antidepressants, anxiolytics or sedative hypnotics) having significant anticholinergic effects and/or believed to affect cognitive function. Other medications are acceptable, at the investigators discretion, if dosage is held stable for at least 4 weeks prior to screening and throughout the study. Patients considered unlikely to co-operate in the study, and/or poor compliance anticipated by the investigator. Patients hospitalized within 4 weeks of screening. Any other clinically relevant acute or chronic diseases which could interfere with patients' safety during the trial, or expose them to undue risk, or which could interfere with study objectives. Patients who have participated in another clinical trial with an investigational drug within previous 30 days.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lynn James
Organizational Affiliation
Allergan
Official's Role
Study Chair
Facility Information:
Facility Name
Quantum Laboratories
City
Deerfield Beach
State/Province
Florida
ZIP/Postal Code
33064
Country
United States
Facility Name
Miami Jewish Health Systems
City
Miami
State/Province
Florida
ZIP/Postal Code
33137
Country
United States
Facility Name
Premiere Research Institute
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33407
Country
United States
Facility Name
PMG Research
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States

12. IPD Sharing Statement

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A Dose Titration Study of CPC-201 in Patients With Dementia of Alzheimer's Type

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