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
About this trial
This is an interventional treatment trial for Alzheimer's Disease
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.
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
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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