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A FDG-PET Study of AGN-242071 Added to Standard-of-Care (Donepezil ± Memantine) for the Treatment of Participants With Mild to Moderate Alzheimer's Disease

Primary Purpose

Alzheimer's Disease

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AGN-242071
Placebo
Donepezil
Memantine
Sponsored by
Allergan
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease

Eligibility Criteria

55 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnostic evidence of probable Alzheimer's Disease (AD) per the 2011 National Institutes of Aging-Alzheimer's Association (NIA-AA) criteria
  • Participants receiving donepezil at a stable dose of 10 mg daily with or without stable dose memantine for at least 6 weeks prior to the screening visit.

Exclusion Criteria:

  • Participants with illness apart from AD that could contribute to cognitive dysfunction
  • History of clinically significant suicidal ideation within the past 6 months
  • Thyroid disease unless the participant is euthyroid and stable on treatment for at least 3 months prior to screening
  • Participants with a personal or family history of congenital long QT syndrome or sudden death
  • Clinically significant cardiovascular disease in the past 6 months prior to screening
  • Participants with signs and symptoms of peripheral vascular disease (PVD)
  • A transient ischemic attack or other acute ischemic event affecting the brain, spinal cord, or peripheral circulation in the past 6 months prior to screening
  • Any history of cerebrovascular accident or stroke
  • Any history of a seizure disorder other than a single febrile seizure
  • Pulmonary disease or evidence of clinically significant moderate or severe pulmonary symptoms
  • History of cancer within the last 5 years
  • Evidence or history of diabetes mellitus Type 1
  • Any significant sensory (eg, moderate to severely impaired hearing or severely impaired vision) or hand movement difficulties that would prevent participants from completing the behavioral assessments of the study
  • Treatment with cholinesterase inhibitors other than donepezil or other cholinomimetics within 12 weeks of the baseline visit
  • Treatment with memantine not in combination with donepezil within 12 weeks of the baseline Visit
  • Participants who have been on anticholinergic and/or antimuscarinic treatment including overactive bladder treatments, antihistamines, antipsychotics, and tricyclic antidepressants, within 12 weeks prior to the baseline visit
  • Participants who have been on drugs that are strong inhibitors of CYP2D6 or CYP2C9 (eg, quinidine, paroxetine, fluoxetine, terbinafine, bupropion), or that are moderate or strong inhibitors of CYP3A4 (eg, erythromycin, ketoconazole, rifampicin, fluconazole, carbamazepine) within 21 days prior to the baseline visit
  • Participants who are taking any moderate or strong inducers of CYP3A4 (eg, carbamazepine, phenytoin, rifampin, modafinil, and herbal preparations containing St. John's wort) or strong inducers of CYP2C9 within 21 days prior to the baseline visit
  • Participants who have been on other drugs that could affect cognition (eg, benzodiazepines or gamma-aminobutyric acid A (GABAA) receptor agonists used as anxiolytics, sedative-hypnotics) or over-the-counter (OTC) sleeping aids within 12 weeks prior to the baseline visit
  • Participants who have been on hormone replacement therapy, thyroid supplement, vitamin E, or vitamin B12 unless at a stable dose for 4 weeks before the baseline visit
  • Use of an active Alzheimer's disease vaccine within 2 years prior to screening or monoclonal antibody for treatment of AD within 1 year prior to screening
  • Positive test results for anti-human immunodeficiency virus (anti-HIV) type 1 and 2, hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (anti-HCV) at screening
  • Positive test results for urine drug screen for methadone, cocaine, tetrahydrocannabinol, benzodiazepines, tricyclic antidepressants, barbiturates, phencyclidine, amphetamines, methamphetamine, and opiates at screening or baseline visit
  • Participants with a body weight of less than 40 kg
  • Consumption of food or drinks containing grapefruit juice, cranberry, pomegranate, star fruit, grapefruit, pomelos, exotic citrus fruits or Seville orange or of alcohol within 72 hours before administration of study treatment.

Sites / Locations

  • ATP Clinical Research
  • Irvine Center for Clinical Research
  • Synergy Research Centers
  • Collaborative Neuroscience
  • Alliance Research
  • Syrentis Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Arm Label

Placebo

AGN-242071 5 mg

AGN-242071 15 mg

AGN-242071 25 mg

Arm Description

Two placebo capsules once daily for 28 Days. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.

One AGN-242071 5 mg capsule plus one placebo capsule once daily for 28 days. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.

AGN-242071 starting at a dose of one 5 mg capsule plus one placebo capsule once daily for 5 days followed by AGN-242071 15 mg total dose (one 5 mg and one 10 mg capsules) once daily on Days 6 to 28. Dose can be adjusted based on safety and tolerability. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.

AGN-242071 starting at a dose of one 5 mg capsule plus one placebo capsule once daily for 5 days followed by AGN-24071 15 mg total dose (one 5 mg and one 10 mg capsules) once daily on Days 6 to 10 followed by AGN-242071 25 mg total dose (one 5 mg and one 20 mg capsules) on Days 11 to 28. Dose can be adjusted based on safety and tolerability. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.

Outcomes

Primary Outcome Measures

Change from Baseline in Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) Metabolic Measure of Standard Uptake Value Ratio (SUVR) for Whole Brain, Hippocampal and Dorsolateral Prefrontal Cortices
The effects of AGN-242071 on brain metabolic activity or glucose metabolism will be determined using the FDG-PET scan by reporting results as SUVR.
Percentage of Participants with Treatment-Emergent Adverse Events (TEAE)
An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE that occurs during the treatment period will be considered a TEAE if it was not present before the first dose or if it was present but increased in severity during the treatment period.
Percentage of Participants with Changes from Baseline in Clinically Significant Clinical Laboratory Values
Clinical laboratory safety tests include Chemistry, Hematology and Urinalysis.
Percentage of Participants with Changes from Baseline in Clinically Significant Vital Signs
Vital signs include systolic and diastolic blood pressure, pulse rate, weight, respiration rate, and temperature.
Percentage of Participants with Changes from Baseline in Clinically Significant Electrocardiogram (ECG) Findings
A standard 12-lead ECG will be performed.
Percentage of Participants who have Suicidal Ideation or Behaviours as determined by Columbia-Suicide Severity Rating Scale (C-SSRS)
The C-SSRS is a clinician-rated instrument that reports the severity of both suicidal ideation and suicidal behavior since the last visit.
Clearance of AGN-242071
Clearance will be determined utilizing a population pharmacokinetic (PK) approach implemented in non-linear mixed effects modeling (NONMEM®) software.
Volume of Distribution of AGN-242071
Volume of Distribution will be determined utilizing a population PK approach implemented in NONMEM® software.
Cmax: Maximum Plasma concentration for AGN-242071
AUC: Area Under the Curve for AGN-242071

Secondary Outcome Measures

Full Information

First Posted
October 18, 2017
Last Updated
October 31, 2018
Sponsor
Allergan
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1. Study Identification

Unique Protocol Identification Number
NCT03316898
Brief Title
A FDG-PET Study of AGN-242071 Added to Standard-of-Care (Donepezil ± Memantine) for the Treatment of Participants With Mild to Moderate Alzheimer's Disease
Official Title
A Phase 1b, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multicenter Study to Determine the Safety, Tolerability, Pharmacokinetics, and Brain Metabolic Response, Using FDG-PET, Following Administration of AGN-242071 Added to Standard-of-Care (Donepezil ± Memantine) in Participants With Mild to Moderate Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Business decision to stop the study.
Study Start Date
September 30, 2018 (Anticipated)
Primary Completion Date
November 4, 2018 (Anticipated)
Study Completion Date
November 4, 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Allergan

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a study to evaluate the brain metabolic response using Fluorodeoxyglucose Positron Emission Tomography (FDG-PET), safety, tolerability and pharmacokinetics of AGN-242071 in patients with mild to moderate Alzheimer's Disease on a stable dose of 10 mg donepezil with or without memantine standard of care.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Two placebo capsules once daily for 28 Days. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.
Arm Title
AGN-242071 5 mg
Arm Type
Experimental
Arm Description
One AGN-242071 5 mg capsule plus one placebo capsule once daily for 28 days. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.
Arm Title
AGN-242071 15 mg
Arm Type
Experimental
Arm Description
AGN-242071 starting at a dose of one 5 mg capsule plus one placebo capsule once daily for 5 days followed by AGN-242071 15 mg total dose (one 5 mg and one 10 mg capsules) once daily on Days 6 to 28. Dose can be adjusted based on safety and tolerability. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.
Arm Title
AGN-242071 25 mg
Arm Type
Experimental
Arm Description
AGN-242071 starting at a dose of one 5 mg capsule plus one placebo capsule once daily for 5 days followed by AGN-24071 15 mg total dose (one 5 mg and one 10 mg capsules) once daily on Days 6 to 10 followed by AGN-242071 25 mg total dose (one 5 mg and one 20 mg capsules) on Days 11 to 28. Dose can be adjusted based on safety and tolerability. All participants are on a stable dose of 10 mg donepezil and, if receiving memantine, also on a stable dose of memantine as prescribed by the physician as per standard of care.
Intervention Type
Drug
Intervention Name(s)
AGN-242071
Intervention Description
AGN-242071 capsules administered once daily to patients receiving donepezil 10 mg with or without memantine as prescribed per standard of care.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo capsules once daily to patients receiving donepezil 10 mg with or without memantine as prescribed per standard of care.
Intervention Type
Drug
Intervention Name(s)
Donepezil
Intervention Description
Donepezil 10 mg as prescribed by the physician as per standard of care.
Intervention Type
Drug
Intervention Name(s)
Memantine
Intervention Description
Memantine as prescribed by the physician as per standard of care.
Primary Outcome Measure Information:
Title
Change from Baseline in Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) Metabolic Measure of Standard Uptake Value Ratio (SUVR) for Whole Brain, Hippocampal and Dorsolateral Prefrontal Cortices
Description
The effects of AGN-242071 on brain metabolic activity or glucose metabolism will be determined using the FDG-PET scan by reporting results as SUVR.
Time Frame
Baseline (Day -3 to Day -1) to Day 28
Title
Percentage of Participants with Treatment-Emergent Adverse Events (TEAE)
Description
An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE that occurs during the treatment period will be considered a TEAE if it was not present before the first dose or if it was present but increased in severity during the treatment period.
Time Frame
Day 1 to Day 35
Title
Percentage of Participants with Changes from Baseline in Clinically Significant Clinical Laboratory Values
Description
Clinical laboratory safety tests include Chemistry, Hematology and Urinalysis.
Time Frame
Baseline (Day -3 to Day -1) to Day 35
Title
Percentage of Participants with Changes from Baseline in Clinically Significant Vital Signs
Description
Vital signs include systolic and diastolic blood pressure, pulse rate, weight, respiration rate, and temperature.
Time Frame
Baseline (Day -3 to Day -1) to Day 35
Title
Percentage of Participants with Changes from Baseline in Clinically Significant Electrocardiogram (ECG) Findings
Description
A standard 12-lead ECG will be performed.
Time Frame
Baseline (Day -3 to Day -1) to Day 35
Title
Percentage of Participants who have Suicidal Ideation or Behaviours as determined by Columbia-Suicide Severity Rating Scale (C-SSRS)
Description
The C-SSRS is a clinician-rated instrument that reports the severity of both suicidal ideation and suicidal behavior since the last visit.
Time Frame
Baseline (Day 1) to Day 35
Title
Clearance of AGN-242071
Description
Clearance will be determined utilizing a population pharmacokinetic (PK) approach implemented in non-linear mixed effects modeling (NONMEM®) software.
Time Frame
Day 1 to Day 28
Title
Volume of Distribution of AGN-242071
Description
Volume of Distribution will be determined utilizing a population PK approach implemented in NONMEM® software.
Time Frame
Day 1 to Day 28
Title
Cmax: Maximum Plasma concentration for AGN-242071
Time Frame
Day 28
Title
AUC: Area Under the Curve for AGN-242071
Time Frame
Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnostic evidence of probable Alzheimer's Disease (AD) per the 2011 National Institutes of Aging-Alzheimer's Association (NIA-AA) criteria Participants receiving donepezil at a stable dose of 10 mg daily with or without stable dose memantine for at least 6 weeks prior to the screening visit. Exclusion Criteria: Participants with illness apart from AD that could contribute to cognitive dysfunction History of clinically significant suicidal ideation within the past 6 months Thyroid disease unless the participant is euthyroid and stable on treatment for at least 3 months prior to screening Participants with a personal or family history of congenital long QT syndrome or sudden death Clinically significant cardiovascular disease in the past 6 months prior to screening Participants with signs and symptoms of peripheral vascular disease (PVD) A transient ischemic attack or other acute ischemic event affecting the brain, spinal cord, or peripheral circulation in the past 6 months prior to screening Any history of cerebrovascular accident or stroke Any history of a seizure disorder other than a single febrile seizure Pulmonary disease or evidence of clinically significant moderate or severe pulmonary symptoms History of cancer within the last 5 years Evidence or history of diabetes mellitus Type 1 Any significant sensory (eg, moderate to severely impaired hearing or severely impaired vision) or hand movement difficulties that would prevent participants from completing the behavioral assessments of the study Treatment with cholinesterase inhibitors other than donepezil or other cholinomimetics within 12 weeks of the baseline visit Treatment with memantine not in combination with donepezil within 12 weeks of the baseline Visit Participants who have been on anticholinergic and/or antimuscarinic treatment including overactive bladder treatments, antihistamines, antipsychotics, and tricyclic antidepressants, within 12 weeks prior to the baseline visit Participants who have been on drugs that are strong inhibitors of CYP2D6 or CYP2C9 (eg, quinidine, paroxetine, fluoxetine, terbinafine, bupropion), or that are moderate or strong inhibitors of CYP3A4 (eg, erythromycin, ketoconazole, rifampicin, fluconazole, carbamazepine) within 21 days prior to the baseline visit Participants who are taking any moderate or strong inducers of CYP3A4 (eg, carbamazepine, phenytoin, rifampin, modafinil, and herbal preparations containing St. John's wort) or strong inducers of CYP2C9 within 21 days prior to the baseline visit Participants who have been on other drugs that could affect cognition (eg, benzodiazepines or gamma-aminobutyric acid A (GABAA) receptor agonists used as anxiolytics, sedative-hypnotics) or over-the-counter (OTC) sleeping aids within 12 weeks prior to the baseline visit Participants who have been on hormone replacement therapy, thyroid supplement, vitamin E, or vitamin B12 unless at a stable dose for 4 weeks before the baseline visit Use of an active Alzheimer's disease vaccine within 2 years prior to screening or monoclonal antibody for treatment of AD within 1 year prior to screening Positive test results for anti-human immunodeficiency virus (anti-HIV) type 1 and 2, hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (anti-HCV) at screening Positive test results for urine drug screen for methadone, cocaine, tetrahydrocannabinol, benzodiazepines, tricyclic antidepressants, barbiturates, phencyclidine, amphetamines, methamphetamine, and opiates at screening or baseline visit Participants with a body weight of less than 40 kg Consumption of food or drinks containing grapefruit juice, cranberry, pomegranate, star fruit, grapefruit, pomelos, exotic citrus fruits or Seville orange or of alcohol within 72 hours before administration of study treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mitalee Tamhane, PhD
Organizational Affiliation
Allergan
Official's Role
Study Director
Facility Information:
Facility Name
ATP Clinical Research
City
Costa Mesa
State/Province
California
ZIP/Postal Code
94105
Country
United States
Facility Name
Irvine Center for Clinical Research
City
Irvine
State/Province
California
ZIP/Postal Code
92614
Country
United States
Facility Name
Synergy Research Centers
City
Lemon Grove
State/Province
California
ZIP/Postal Code
91945
Country
United States
Facility Name
Collaborative Neuroscience
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Alliance Research
City
Long Beach
State/Province
California
ZIP/Postal Code
90807
Country
United States
Facility Name
Syrentis Clinical Research
City
Santa Ana
State/Province
California
ZIP/Postal Code
92705
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A FDG-PET Study of AGN-242071 Added to Standard-of-Care (Donepezil ± Memantine) for the Treatment of Participants With Mild to Moderate Alzheimer's Disease

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