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Multiple Dose Trial of MK-4334 in Participants With Alzheimer's Clinical Syndrome (MK-4334-005)

Primary Purpose

Alzheimer's Disease, Mild Cognitive Impairment

Status
Unknown status
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
MK-4334
Placebo to MK-4334
Donepepzil
Sponsored by
Merck Sharp & Dohme LLC
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:

Participants with MCI

  • Have a history of subjective memory decline with gradual onset and slow progression for at least one year before screening.
  • Have general cognitive function and activities of daily living sufficiently intact, based on clinical assessment, so as not to meet criteria for mild AD dementia based on National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.
  • Have a Mini Mental State Exam-2 (MMSE-2) score ≥24.
  • Have a Clinical Dementia Rating (CDR) scale score of 0.5, including a memory subscale score ≥ 0.5.

Participants with AD

  • Have a history of cognitive and functional decline with gradual onset and slow progression for at least one year before screening.
  • Meet the criteria for a diagnosis of probable AD based on NINCDS-ADRDA criteria.
  • Have a MMSE-2 score ≥ 12 to ≤ 24 at screening.
  • Have a CDR score of 1 to 2.

All Participants

  • Have a Rosen-Modified Hachinski score ≤ 4.
  • Be on a stable dose of donepezil 10 mg PO daily for symptomatic treatment of Alzheimer's clinical syndrome. The dose must be stable for ≥2 months prior to screening.
  • Be in good health based on medical history, physical examination, vital sign (VS) measurements and electrocardiograms (ECGs) performed prior to randomization.
  • Have a Body Mass Index (BMI) ≤ 35 kg/m^2.
  • If female, is a woman of non-childbearing potential (WONCBP).
  • If male, must agree to either remain abstinent or use contraception during the intervention period and for ≥28 days after the last dose of study intervention.
  • Have acceptable venous access.

Exclusion Criteria:

  • Is at imminent risk of self-harm, based on clinical interview and responses on the Columbia-Suicide Severity Rating Scale (C-SSRS), or of harm to others in the opinion of the investigator.
  • Has a history of uncontrolled endocrine, gastrointestinal, cardiovascular, hematological, hepatic, immunological, renal, respiratory, genitourinary, or major neurological (including stroke and chronic seizures) abnormalities or diseases.
  • Has evidence of a clinically relevant or unstable psychiatric disorder, based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria, including schizophrenia or other psychotic disorder, bipolar disorder, or delirium, at the time of prestudy (screening) visit, or has a history of clinically significant psychiatric disorder of the last 5 years.
  • Has a history of cancer (malignancy), except for: 1.) adequately-treated nonmelanomatous skin carcinoma or carcinoma in situ of the cervix or; 2.) Other malignancies which have been successfully treated with appropriate follow up and therefore unlikely to recur for the duration of the study.
  • Participant has an estimated creatinine clearance (CrCl) ≤55 mL/min based on the Modification of Diet in Renal Disease (MDRD).
  • Has a history of significant multiple and/or severe allergies (e.g., food, drug, latex allergy), or has had an anaphylactic reaction or significant intolerability (i.e., systemic allergic reaction) to prescription or non-prescription drugs or food.
  • Is positive for hepatitis B surface antigen, hepatitis C antibodies or human immunodeficiency virus (HIV).
  • Had major surgery, donated or lost 1 unit of blood (approximately 500 mL) within 4 weeks prior to the prestudy (screening) visit.
  • Is unable to refrain from or anticipates the use of strong or moderate inhibitors or inducers of Cytochrome P450 (CYP) 3A4 (CYP3A4) and CYP2C19 beginning approximately 28 days prior to administration of the initial dose of study drug, throughout the study, and until the post-trial visit.
  • Has participated in another investigational study within 4 weeks (or 5 half-lives, whichever is greater) prior to the prestudy (screening) visit.
  • Has a rate-corrected QT (QTc) interval ≥470 msec (for males) or ≥480 msec (for females).
  • Is a smoker and/or has used nicotine or nicotine-containing products (e.g., nicotine patch and electronic cigarette) within 3 months of screening.
  • Consumes greater than 3 glasses of alcoholic beverages (1 glass is approximately equivalent to: beer [354 mL/12 ounces], wine [118 mL/4 ounces], or distilled spirits [29.5 mL/1 ounce]) per day.
  • Consumes excessive amounts, defined as greater than 6 servings of coffee, tea, cola, energy drinks, or other caffeinated beverages per day.
  • Is a regular user of cannabis, any illicit drugs or has a history of drug (including alcohol) abuse within approximately 2 years. Participants must have a negative urine drug screen prior to randomization.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Donepezil + MK-4334

    Donepezil + Placebo

    Arm Description

    Oral MK-4334 60/120 mg QD and open-label, oral donepezil 10 mg QD.

    Placebo to MK-4334 QD and open-label, oral donepezil 10 mg QD.

    Outcomes

    Primary Outcome Measures

    Number of Participants Experiencing an Adverse Event (AE)
    An AE is any unfavorable and unintended sign, symptom, or disease (new or exacerbated) in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study treatment. For each arm, the number of participants experiencing an AE will be assessed.
    Number of Participants Discontinuing Study Treatment due to an Adverse Event
    An AE is any unfavorable and unintended sign, symptom, or disease (new or exacerbated) in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. For each arm, the number of participants discontinuing study treatment due to an AE will be assessed.

    Secondary Outcome Measures

    Plasma Steady State Concentration at 24 Hours (C24) of MK-4334
    Plasma steady state concentration at 24 hours (C24) will be reported.
    Plasma Steady State Area Under the Concentration-Time Curve from 0 to 24 hours (AUC0-24) of MK-4334
    Plasma steady state area under the concentration-time curve from 0 to 24 hours (AUC0-24) will be reported.
    Plasma Steady State Maximum Concentration (Cmax) of MK-4334
    Plasma steady state maximum concentration (Cmax) will be reported.
    Plasma Steady State Apparent Half-Life (t1/2) of MK-4334
    Plasma steady state apparent half-life (t1/2) will be reported.
    Plasma Steady State Time to Maximum Concentration (Tmax) of MK-4334
    Plasma steady state time to maximum concentration (Tmax) will be reported.
    Plasma Steady State Apparent Clearance (CL/F) of MK-4334
    Plasma steady state apparent clearance (CL/F) will be reported.
    Plasma Steady State Apparent Volume of Distribution (Vz/F) of MK-4334
    Plasma steady state apparent volume of distribution (Vz/F) will be reported.

    Full Information

    First Posted
    November 12, 2018
    Last Updated
    May 2, 2019
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03740178
    Brief Title
    Multiple Dose Trial of MK-4334 in Participants With Alzheimer's Clinical Syndrome (MK-4334-005)
    Official Title
    A Randomized, Double-Blinded Clinical Trial to Assess the Safety, Tolerability and Pharmacokinetics of MK-4334 in Participants With Alzheimer's Clinical Syndrome on a Stable Dose of Donepezil
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2019
    Overall Recruitment Status
    Unknown status
    Study Start Date
    September 27, 2019 (Anticipated)
    Primary Completion Date
    February 28, 2020 (Anticipated)
    Study Completion Date
    February 28, 2020 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

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

    5. Study Description

    Brief Summary
    This study will evaluate the safety, tolerability, and pharmacokinetics of MK-4334 administered once daily (QD) in participants with Alzheimer's clinical syndrome receiving a stable, daily dose of donepezil 10 mg, taken orally (PO). This includes participants with symptoms of mild cognitive impairment (MCI) or mild to moderate Alzheimer's disease (AD). It is hypothesized that the true geometric mean minimum plasma concentration at 24 hours (C24) is at least 60 nM at steady state in the presence of steady-state donepezil 10 mg.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    12 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Donepezil + MK-4334
    Arm Type
    Experimental
    Arm Description
    Oral MK-4334 60/120 mg QD and open-label, oral donepezil 10 mg QD.
    Arm Title
    Donepezil + Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo to MK-4334 QD and open-label, oral donepezil 10 mg QD.
    Intervention Type
    Drug
    Intervention Name(s)
    MK-4334
    Other Intervention Name(s)
    Aricept
    Intervention Description
    Participants with Alzheimer's clinical syndrome (MCI or mild/moderate AD) will receive MK-4334 capsules administered orally, QD on Days 1-14. Participants will receive an initial loading dose of 120 mg (Day 1), followed by a maintenance dose of 60 mg (Days 2-14). Open-label donepezil tablets (dose strength: 10 mg) administered orally, QD on Days 1-14.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo to MK-4334
    Other Intervention Name(s)
    Aricept
    Intervention Description
    Participants with Alzheimer's clinical syndrome (MCI or mild/moderate AD)will receive placebo capsules matching MK-4334 administered orally, QD on Days 1-14. Participants will also receive open-label donepezil tablets (dose strength: 10 mg) administered orally, QD on Days 1-14.
    Intervention Type
    Drug
    Intervention Name(s)
    Donepepzil
    Other Intervention Name(s)
    Aricept
    Intervention Description
    Participants with Alzheimer's clinical syndrome (MCI or mild/moderate AD) will receive open-label, oral donepezil 10 mg QD on Days 1-14.
    Primary Outcome Measure Information:
    Title
    Number of Participants Experiencing an Adverse Event (AE)
    Description
    An AE is any unfavorable and unintended sign, symptom, or disease (new or exacerbated) in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study treatment. For each arm, the number of participants experiencing an AE will be assessed.
    Time Frame
    Up to 42 days
    Title
    Number of Participants Discontinuing Study Treatment due to an Adverse Event
    Description
    An AE is any unfavorable and unintended sign, symptom, or disease (new or exacerbated) in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. For each arm, the number of participants discontinuing study treatment due to an AE will be assessed.
    Time Frame
    Up to 14 days
    Secondary Outcome Measure Information:
    Title
    Plasma Steady State Concentration at 24 Hours (C24) of MK-4334
    Description
    Plasma steady state concentration at 24 hours (C24) will be reported.
    Time Frame
    Day 14: Pre-dose and 24 hours after MK-4334 administration
    Title
    Plasma Steady State Area Under the Concentration-Time Curve from 0 to 24 hours (AUC0-24) of MK-4334
    Description
    Plasma steady state area under the concentration-time curve from 0 to 24 hours (AUC0-24) will be reported.
    Time Frame
    Day 14: Pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, and 24 hours after MK-4334 administration
    Title
    Plasma Steady State Maximum Concentration (Cmax) of MK-4334
    Description
    Plasma steady state maximum concentration (Cmax) will be reported.
    Time Frame
    Day 14: Pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 120, 240, 360, and 480 hours after MK-4334 administration
    Title
    Plasma Steady State Apparent Half-Life (t1/2) of MK-4334
    Description
    Plasma steady state apparent half-life (t1/2) will be reported.
    Time Frame
    Day 14: Pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 120, 240, 360, and 480 hours after MK-4334 administration
    Title
    Plasma Steady State Time to Maximum Concentration (Tmax) of MK-4334
    Description
    Plasma steady state time to maximum concentration (Tmax) will be reported.
    Time Frame
    Day 14: Pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 120, 240, 360, and 480 hours after MK-4334 administration
    Title
    Plasma Steady State Apparent Clearance (CL/F) of MK-4334
    Description
    Plasma steady state apparent clearance (CL/F) will be reported.
    Time Frame
    Day 14: Pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 120, 240, 360, and 480 hours after MK-4334 administration
    Title
    Plasma Steady State Apparent Volume of Distribution (Vz/F) of MK-4334
    Description
    Plasma steady state apparent volume of distribution (Vz/F) will be reported.
    Time Frame
    Day 14: Pre-dose and 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 48, 120, 240, 360, and 480 hours after MK-4334 administration

    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: Participants with MCI Have a history of subjective memory decline with gradual onset and slow progression for at least one year before screening. Have general cognitive function and activities of daily living sufficiently intact, based on clinical assessment, so as not to meet criteria for mild AD dementia based on National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Have a Mini Mental State Exam-2 (MMSE-2) score ≥24. Have a Clinical Dementia Rating (CDR) scale score of 0.5, including a memory subscale score ≥ 0.5. Participants with AD Have a history of cognitive and functional decline with gradual onset and slow progression for at least one year before screening. Meet the criteria for a diagnosis of probable AD based on NINCDS-ADRDA criteria. Have a MMSE-2 score ≥ 12 to ≤ 24 at screening. Have a CDR score of 1 to 2. All Participants Have a Rosen-Modified Hachinski score ≤ 4. Be on a stable dose of donepezil 10 mg PO daily for symptomatic treatment of Alzheimer's clinical syndrome. The dose must be stable for ≥2 months prior to screening. Be in good health based on medical history, physical examination, vital sign (VS) measurements and electrocardiograms (ECGs) performed prior to randomization. Have a Body Mass Index (BMI) ≤ 35 kg/m^2. If female, is a woman of non-childbearing potential (WONCBP). If male, must agree to either remain abstinent or use contraception during the intervention period and for ≥28 days after the last dose of study intervention. Have acceptable venous access. Exclusion Criteria: Is at imminent risk of self-harm, based on clinical interview and responses on the Columbia-Suicide Severity Rating Scale (C-SSRS), or of harm to others in the opinion of the investigator. Has a history of uncontrolled endocrine, gastrointestinal, cardiovascular, hematological, hepatic, immunological, renal, respiratory, genitourinary, or major neurological (including stroke and chronic seizures) abnormalities or diseases. Has evidence of a clinically relevant or unstable psychiatric disorder, based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria, including schizophrenia or other psychotic disorder, bipolar disorder, or delirium, at the time of prestudy (screening) visit, or has a history of clinically significant psychiatric disorder of the last 5 years. Has a history of cancer (malignancy), except for: 1.) adequately-treated nonmelanomatous skin carcinoma or carcinoma in situ of the cervix or; 2.) Other malignancies which have been successfully treated with appropriate follow up and therefore unlikely to recur for the duration of the study. Participant has an estimated creatinine clearance (CrCl) ≤55 mL/min based on the Modification of Diet in Renal Disease (MDRD). Has a history of significant multiple and/or severe allergies (e.g., food, drug, latex allergy), or has had an anaphylactic reaction or significant intolerability (i.e., systemic allergic reaction) to prescription or non-prescription drugs or food. Is positive for hepatitis B surface antigen, hepatitis C antibodies or human immunodeficiency virus (HIV). Had major surgery, donated or lost 1 unit of blood (approximately 500 mL) within 4 weeks prior to the prestudy (screening) visit. Is unable to refrain from or anticipates the use of strong or moderate inhibitors or inducers of Cytochrome P450 (CYP) 3A4 (CYP3A4) and CYP2C19 beginning approximately 28 days prior to administration of the initial dose of study drug, throughout the study, and until the post-trial visit. Has participated in another investigational study within 4 weeks (or 5 half-lives, whichever is greater) prior to the prestudy (screening) visit. Has a rate-corrected QT (QTc) interval ≥470 msec (for males) or ≥480 msec (for females). Is a smoker and/or has used nicotine or nicotine-containing products (e.g., nicotine patch and electronic cigarette) within 3 months of screening. Consumes greater than 3 glasses of alcoholic beverages (1 glass is approximately equivalent to: beer [354 mL/12 ounces], wine [118 mL/4 ounces], or distilled spirits [29.5 mL/1 ounce]) per day. Consumes excessive amounts, defined as greater than 6 servings of coffee, tea, cola, energy drinks, or other caffeinated beverages per day. Is a regular user of cannabis, any illicit drugs or has a history of drug (including alcohol) abuse within approximately 2 years. Participants must have a negative urine drug screen prior to randomization.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php

    Learn more about this trial

    Multiple Dose Trial of MK-4334 in Participants With Alzheimer's Clinical Syndrome (MK-4334-005)

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