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Study of AGB101 in Mild Cognitive Impairment Due to Alzheimer's Disease

Primary Purpose

Mild Cognitive Impairment, Prodromal Alzheimer's Disease

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
AGB101
Placebo
Sponsored by
AgeneBio
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mild Cognitive Impairment

Eligibility Criteria

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

Inclusion Criteria: Subjects between 55 and 85 years old (inclusive) in good general health: Willing and able to consent and participate for the duration of the study. Have eighth-grade education or good work history sufficient to exclude mental retardation. Have visual and auditory acuity adequate for neuropsychological testing. Have proficient fluency of the native local language to participate in all the neuropsychological test assessments. Have a study partner who has sufficient contact with the subject to be able to provide assessment of memory changes, who can accompany the subject to the screening and all major clinic visits for the duration of those visits, and who is able to provide an independent evaluation of the subject's functioning. Have MCI due to AD as defined by all of the following criteria and consistent with the National Institute on Aging-Alzheimer's Association criteria: MMSE scores between 24 and 30 (inclusive; exceptions may be made for subjects with < 8 years of education at the discretion of the sponsor). A memory complaint reported by the subject or his/her study partner. Evidence of lower memory performance based on the delayed recall portion of the ISLT. A Clinical Dementia Rating (CDR) score of 0.5 with a memory box score of ≥ 0.5. Essentially preserved activities of daily living. Cognitive decline not primarily caused by vascular, traumatic, or medical problems (alternative causes of cognitive decline are ruled out). A screening blood-based biomarker consistent with amyloid positivity Have an apolipoprotein E genotype that does not include one or more E4 alleles Permitted medications: With potential pro-cognitive effects, such cholinesterase inhibitors and memantine, must be at a stable dose for ≥ 3 months prior to screening and expected to remain stable throughout the study; estrogen replacement therapy, Ginkgo biloba, and vitamin E must be at a stable dose for ≥ 4 weeks prior to screening and expected to remain stable throughout the study. Other psychotropics, such as antidepressants and antipsychotics, must be at a stable dose for ≥ 3 months prior to screening and expected to remain stable throughout the study. Willing and able to undergo an MRI scan (3 Tesla) with no contraindications to the MRI or documented evidence of an MRI scan. Willing to allow collection of blood for blood-based biomarkers and genome-wide association study (GWAS), apolipoprotein E (ApoE) genotyping, and DNA banking. Exclusion Criteria: Carrying one or more copies of the apolipoprotein E4 (ApoE4) allele. Use of anticonvulsant medications or excluded psychotropic medications within 3 months prior to the baseline visit. Participation in a therapeutic clinical study for any medical or psychiatric indications within 3 months (6 months for biologics) of the screening visit, or at any time during the study. Subjects must understand that they may only enroll in this clinical study once; they may not enroll in any other clinical study while participating in the current study, and they may not participate in a clinical study of a drug, biologic, therapeutic device, or medical food, in which the last dose/administration was received within 3 months (6 months for biologics) prior to screening. History of hypersensitivity or lack of tolerability to AGB101 (levetiracetam). Severe renal impairment (creatinine clearance of < 30 mL/minute) or undergoing hemodialysis. Any significant neurological disease other than suspected incipient AD, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder (lifetime history; infant febrile seizures are not exclusionary), subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic deficits, or known structural brain abnormalities. If no documented MRI scan, presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments, or foreign objects in the eyes, skin, or body that constitute a contraindication to having an MRI scan. Diagnosis of bipolar disorder, or major depression within the past 3 years, as described in the Diagnostic and Statistical Manual of Mental Disorders, 5th Ed (DSM-5). Psychotic features, agitation, or behavioral problems within the last 3 months that could lead to difficulty complying with the protocol. Subjects must not have a major depressive disorder or other types of depression that could confound diagnosis of MCI due to AD, or clinical assessments, in the opinion of the investigator. The Geriatric Depression Scale (long form score > 9 suggests depression) results should be reviewed by the investigator to assist in this determination. Modified Hachinski Ischemic Scale (HIS) score > 4. History of schizophrenia (DSM-5 criteria). History of alcohol or substance abuse or dependence within the past 3 years (DSM-5 criteria). Any significant systemic illness or unstable medical condition that could lead to difficulty in complying with the protocol requirements. Patients with a history of cancer with a high risk of recurrence and preventing completion of the trial. Any unstable medical condition that is likely to require new medical or surgical treatment during the course of the study and where such treatments might affect the collection of efficacy data. Clinically significant abnormalities in B12 or thyroid function test that might interfere with the study. A low B12 (below normative range for elderly) is exclusionary, unless follow-up labs (homocysteine and methylmalonic acid) indicate that it is not physiologically significant. If the B12 deficiency is treated, subjects may become eligible to participate in the study. Residence in a skilled nursing facility. Individuals in independent living communities, assisted living facilities, residential care facilities, or continuing care communities are eligible provided they engage in a sufficient spectrum of activity to permit assessment of all 6 domains contributing to the Clinical Dementia Rating-Sum of Boxes (CDR-SB). Individuals in these facilities must also have a study partner who has the ability to observe the subject during the study and can participate in clinical evaluations. Any use of excluded medications (eg, antiepileptics, certain antidepressants or antipsychotics, antihistamines with anticholinergic properties, opiates). Participation in clinical studies using the ISLT, BPS-O task, or the trail making test (A, B) within 1 month of screening.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Placebo Comparator

    Experimental

    Arm Label

    Placebo Oral Tablet

    AGB101 220 mg tablet

    Arm Description

    Matching placebo to AGB101 tablet once daily, taken orally, for 78 weeks

    Single 220 mg AGB101 tablet once daily, taken orally, for 78 weeks.

    Outcomes

    Primary Outcome Measures

    CDR-SB
    Change in CDR-SB score from baseline

    Secondary Outcome Measures

    ADAS-cog14
    Change in ADAS-cog14 score from baseline
    FAQ
    Change in FAQ score from baseline
    MMSE
    Change in MMSE score from baseline

    Full Information

    First Posted
    August 3, 2023
    Last Updated
    August 3, 2023
    Sponsor
    AgeneBio
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05986721
    Brief Title
    Study of AGB101 in Mild Cognitive Impairment Due to Alzheimer's Disease
    Official Title
    A Multicenter, Randomized, Double-blind, Placebo-controlled Study Evaluating the Efficacy and Safety of AGB101 (Low-dose Levetiracetam, 220 mg, Extended Release Tablet) on Slowing Progression of Mild Cognitive Impairment Due to Alzheimer's Disease.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 2024 (Anticipated)
    Primary Completion Date
    July 2028 (Anticipated)
    Study Completion Date
    December 2028 (Anticipated)

    3. Sponsor/Collaborators

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

    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
    The primary objective of the study is to evaluate the efficacy of AGB101 on slowing cognitive and functional impairment as measured by changes in the Clinical Dementia Rating-Sum of Boxes (CDR-SB) score as compared with placebo in participants with mild cognitive impairment due to Alzheimer's Disease (MCI due to AD) also known as prodromal AD. Participants will be randomized to receive placebo or AGB101 (220 mg), once daily for 78 weeks. Secondary objectives are to assess the effect of AGB101 compared with placebo on clinical progression as measured by the Alzheimer's Disease Assessment Scale-Cognitive Subscale 14 (ADAS-cog14), Mini-Mental State Examination (MMSE) and Functional Activities Questionnaire (FAQ).

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    1040 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Placebo Oral Tablet
    Arm Type
    Placebo Comparator
    Arm Description
    Matching placebo to AGB101 tablet once daily, taken orally, for 78 weeks
    Arm Title
    AGB101 220 mg tablet
    Arm Type
    Experimental
    Arm Description
    Single 220 mg AGB101 tablet once daily, taken orally, for 78 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    AGB101
    Intervention Description
    low-dose levetiracetam, 220 mg, extended release tablet
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo oral tablet
    Primary Outcome Measure Information:
    Title
    CDR-SB
    Description
    Change in CDR-SB score from baseline
    Time Frame
    78 weeks
    Secondary Outcome Measure Information:
    Title
    ADAS-cog14
    Description
    Change in ADAS-cog14 score from baseline
    Time Frame
    78 weeks
    Title
    FAQ
    Description
    Change in FAQ score from baseline
    Time Frame
    78 weeks
    Title
    MMSE
    Description
    Change in MMSE score from baseline
    Time Frame
    78 weeks

    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: Subjects between 55 and 85 years old (inclusive) in good general health: Willing and able to consent and participate for the duration of the study. Have eighth-grade education or good work history sufficient to exclude mental retardation. Have visual and auditory acuity adequate for neuropsychological testing. Have proficient fluency of the native local language to participate in all the neuropsychological test assessments. Have a study partner who has sufficient contact with the subject to be able to provide assessment of memory changes, who can accompany the subject to the screening and all major clinic visits for the duration of those visits, and who is able to provide an independent evaluation of the subject's functioning. Have MCI due to AD as defined by all of the following criteria and consistent with the National Institute on Aging-Alzheimer's Association criteria: MMSE scores between 24 and 30 (inclusive; exceptions may be made for subjects with < 8 years of education at the discretion of the sponsor). A memory complaint reported by the subject or his/her study partner. Evidence of lower memory performance based on the delayed recall portion of the ISLT. A Clinical Dementia Rating (CDR) score of 0.5 with a memory box score of ≥ 0.5. Essentially preserved activities of daily living. Cognitive decline not primarily caused by vascular, traumatic, or medical problems (alternative causes of cognitive decline are ruled out). A screening blood-based biomarker consistent with amyloid positivity Have an apolipoprotein E genotype that does not include one or more E4 alleles Permitted medications: With potential pro-cognitive effects, such cholinesterase inhibitors and memantine, must be at a stable dose for ≥ 3 months prior to screening and expected to remain stable throughout the study; estrogen replacement therapy, Ginkgo biloba, and vitamin E must be at a stable dose for ≥ 4 weeks prior to screening and expected to remain stable throughout the study. Other psychotropics, such as antidepressants and antipsychotics, must be at a stable dose for ≥ 3 months prior to screening and expected to remain stable throughout the study. Willing and able to undergo an MRI scan (3 Tesla) with no contraindications to the MRI or documented evidence of an MRI scan. Willing to allow collection of blood for blood-based biomarkers and genome-wide association study (GWAS), apolipoprotein E (ApoE) genotyping, and DNA banking. Exclusion Criteria: Carrying one or more copies of the apolipoprotein E4 (ApoE4) allele. Use of anticonvulsant medications or excluded psychotropic medications within 3 months prior to the baseline visit. Participation in a therapeutic clinical study for any medical or psychiatric indications within 3 months (6 months for biologics) of the screening visit, or at any time during the study. Subjects must understand that they may only enroll in this clinical study once; they may not enroll in any other clinical study while participating in the current study, and they may not participate in a clinical study of a drug, biologic, therapeutic device, or medical food, in which the last dose/administration was received within 3 months (6 months for biologics) prior to screening. History of hypersensitivity or lack of tolerability to AGB101 (levetiracetam). Severe renal impairment (creatinine clearance of < 30 mL/minute) or undergoing hemodialysis. Any significant neurological disease other than suspected incipient AD, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder (lifetime history; infant febrile seizures are not exclusionary), subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic deficits, or known structural brain abnormalities. If no documented MRI scan, presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments, or foreign objects in the eyes, skin, or body that constitute a contraindication to having an MRI scan. Diagnosis of bipolar disorder, or major depression within the past 3 years, as described in the Diagnostic and Statistical Manual of Mental Disorders, 5th Ed (DSM-5). Psychotic features, agitation, or behavioral problems within the last 3 months that could lead to difficulty complying with the protocol. Subjects must not have a major depressive disorder or other types of depression that could confound diagnosis of MCI due to AD, or clinical assessments, in the opinion of the investigator. The Geriatric Depression Scale (long form score > 9 suggests depression) results should be reviewed by the investigator to assist in this determination. Modified Hachinski Ischemic Scale (HIS) score > 4. History of schizophrenia (DSM-5 criteria). History of alcohol or substance abuse or dependence within the past 3 years (DSM-5 criteria). Any significant systemic illness or unstable medical condition that could lead to difficulty in complying with the protocol requirements. Patients with a history of cancer with a high risk of recurrence and preventing completion of the trial. Any unstable medical condition that is likely to require new medical or surgical treatment during the course of the study and where such treatments might affect the collection of efficacy data. Clinically significant abnormalities in B12 or thyroid function test that might interfere with the study. A low B12 (below normative range for elderly) is exclusionary, unless follow-up labs (homocysteine and methylmalonic acid) indicate that it is not physiologically significant. If the B12 deficiency is treated, subjects may become eligible to participate in the study. Residence in a skilled nursing facility. Individuals in independent living communities, assisted living facilities, residential care facilities, or continuing care communities are eligible provided they engage in a sufficient spectrum of activity to permit assessment of all 6 domains contributing to the Clinical Dementia Rating-Sum of Boxes (CDR-SB). Individuals in these facilities must also have a study partner who has the ability to observe the subject during the study and can participate in clinical evaluations. Any use of excluded medications (eg, antiepileptics, certain antidepressants or antipsychotics, antihistamines with anticholinergic properties, opiates). Participation in clinical studies using the ISLT, BPS-O task, or the trail making test (A, B) within 1 month of screening.

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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