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A Study to Evaluate the Safety, Tolerability and Immunogenicity of Tau Targeted Vaccines in Participants With Early Alzheimer's Disease

Primary Purpose

Alzheimer's Disease, Cognitive Impairment, Tauopathies

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
ACI-35.030
ACI-35.030
ACI-35.030
Placebo
JACI-35.054
JACI-35.054
Sponsored by
AC Immune SA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease focused on measuring Alzheimer's Disease, Cognitive Impairment, Tauopathies, Mild Cognitive Impairment, Dementia, Brain Diseases, Central Nervous System Diseases

Eligibility Criteria

50 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female with age from 50 and up to 75 years old inclusive.
  2. Mild Cognitive Impairment (MCI) due to AD or Mild AD according to NIA-AA criteria and Clinical Dementia Rating scale (CDR) global score of 0.5 or 1 respectively.
  3. Mini Mental State Examination (MMSE) score of 22 or above.
  4. Abnormal level of CSF Abeta amyloid 42 (Aß42) consistent with AD pathology at screening.
  5. Subjects either not taking any marketed treatment for AD or receiving a stable dose of an acetylcholinesterase inhibitor and/or memantine for at least 3 months prior to baseline.
  6. Subjects cared for by a reliable informant or caregiver to assure compliance, assist with clinical assessments and report safety issues.
  7. Women must be post-menopausal for at least one year and/or surgically sterilized.
  8. Subjects who in the opinion of the investigator is able to understand and provide written informed consent.
  9. Both subject and informant or caregiver must be fluent in one of the languages of the study and able to comply with all study procedures, including lumbar punctures.

Exclusion criteria:

  1. Participation in previous clinical trials for AD and/or for neurological disorders using active immunization unless there is documented evidence that the subject was treated with placebo only and the placebo vaccine is not expected to induce any specific immune response.
  2. Participation in previous clinical trials for AD and/or for neurological disorders using any passive immunization within the past 6 months (or 5 half-lives of the investigational antibody, whichever is longer) prior to screening unless there is documented evidence that the subject was treated with placebo only and the placebo is not expected to induce any specific immune response.
  3. Participation in previous clinical trials for AD and/or for neurological disorders using any small molecule drug including BACE-1 inhibitors within the past 3 months prior to screening.
  4. Concomitant participation in any other clinical trial using experimental or approved medications or therapies.
  5. Presence of positive Anti-nuclear Antibody (ANA) titers at a dilution of at least 1:160 in subjects without clinical symptoms of auto-immune disease.
  6. Current or past history of auto-immune disease, or clinical symptoms consistent with the presence of auto-immune disease.
  7. Immune suppression including but not limited to the use of immunosuppressive drugs or systemic steroids unless they have been prescribed transiently more than 3 months prior to screening.
  8. History of severe allergic reaction (e.g., anaphylaxis) including but not limited to severe allergic reaction to previous vaccines and/or medications.
  9. Prior history of clinically significant hypoglycaemic episodes.
  10. Drug or alcohol abuse or dependence currently met or within the past five years according to Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria.
  11. Any clinically significant medical condition likely to interfere with the evaluation of safety and tolerability of the study treatment and/or the adherence to the full study visit schedule.
  12. Any clinically significant medical condition likely to impact the immune system (e.g, any history of acquired or innate immune system disorder).
  13. Use of hydralazine, procainamide, quinidine, isoniazide, TNF-inhibitors, minocycline within the last 12 months prior to screening.
  14. Use of diltiazem unless on a stable dose for at least 3 months prior to screening.
  15. Significant risk of suicide defined, using the Columbia-Suicide Severity Rating Scale, as the subject answering: "yes" to suicidal ideation questions 4 or 5 or answering: "yes" to suicidal behavior within the past 12 months.
  16. Concomitant psychiatric or neurologic disorder other than those considered to be related to AD.
  17. History or presence of uncontrolled seizures.
  18. History of meningoencephalitis within the past 10 years prior to screening.
  19. Subjects with a history of hemorrhagic and/or non-hemorrhagic stroke.
  20. Presence or history of peripheral neuropathy.
  21. History of inflammatory neurological disorders with potential for CNS involvement.
  22. Screening MRI scan showing structural evidence of alternative pathology not consistent with AD which could cause the subject's symptoms.
  23. MRI examination cannot be done for any reason, including but not limited to metal implants contraindicated for MRI studies and/or severe claustrophobia.
  24. Significant hearing or visual impairment or other issues judged relevant by the investigator preventing to comply with the protocol and to perform the outcome measures.
  25. Clinically significant infections or major surgical operation within 3 months prior to screening.
  26. Any vaccine received within the past 2 weeks before screening, including influenza vaccine.
  27. Clinically significant arrhythmias or other clinically significant abnormalities on ECG at screening.
  28. Myocardial infarction within one year prior to baseline, unstable angina pectoris, or significant coronary artery disease.
  29. History of cancer within the past 5 years other than treated squamous cell carcinoma, basal cell carcinoma and melanoma in situ, or in-situ prostate cancer or in-situ breast cancer which have been fully removed and are considered cured.
  30. Clinically significant deviations from normal values for hematologic parameters, liver function tests, and other biochemical measures, that are judged to be clinically significant in the opinion of the investigator.
  31. Pregnancy confirmed by blood test at screening, or subject planning to be pregnant or lactating.
  32. Receipt of any anticoagulant drug or antiplatelet drug, except aspirin at doses of 100 mg daily or lower.
  33. Receipt of any antipsychotic drugs unless on stable low doses for the treatment of insomnia.
  34. Donation of blood or blood products within 30 days prior to screening or plans to donate blood while participating in the study.
  35. Positive Venereal Disease Research Laboratory (VDRL) consistent with active syphilis at screening.
  36. Positive HIV test at screening.
  37. Laboratory or clinical evidence of active hepatitis B and/or C at screening.
  38. Serum creatinine greater than 1.5x upper limit of normal, abnormal thyroid function tests or clinically significant reduction in serum B12 or folate levels.

Sites / Locations

  • Clinical Research Services Helsinki
  • Itä-Suomen Yliopisto - Kuopion Kampus
  • Clinical Research Services Turku
  • Brain Research Center - Den Bosch
  • Brain Research Center - Amsterdam
  • Minnesmottagningen - Sahlgrenska Universitetssjukhuset - Mölndal Sjukhus
  • Kognitiv Mottagning - Karolinska Universitetssjukhuset - Huddinge
  • Edinburgh Clinical Research Facility
  • University College London Hospitals NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Placebo

ACI-35.030 - Low dose

ACI-35.030 - Medium dose

ACI-35.030 - High dose

JACI-35.054 - Low dose

JACI-35.054 - Medium dose

Arm Description

Placebo administered at predefined time points over a 48-week period.

Active vaccine administered at predefined time points over a 48-week period.

Active vaccine administered at predefined time points over a 48-week period.

Active vaccine administered at predefined time points over a 48-week period.

Active vaccine administered at predefined time points over a 48-week period.

Active vaccine administered at predefined time points over a 48-week period.

Outcomes

Primary Outcome Measures

Number of participants with Adverse Events (AEs) assessed by intensity (mild, moderate or severe) and causal relationship (unrelated, unlikely, possibly or probably related)
Change from baseline in anti-phosphorylated Tau IgG titers in blood
Mean change from baseline in systolic and diastolic blood pressure (mmHg)
Mean change from baseline in heart rate (bpm)
Mean change from baseline in body temperature (degree Celsius)
Number of participants reporting suicidal ideation or behavior using Columbia-Suicide Severity Rating Scale (C-SSRS)
Number of participants with abnormal MRI results

Secondary Outcome Measures

Change from baseline in anti-Tau IgG titers in blood
Change from baseline in anti-phosphorylated Tau IgM titers in blood
Change from baseline in anti-Tau IgM titers in blood

Full Information

First Posted
June 22, 2020
Last Updated
October 4, 2023
Sponsor
AC Immune SA
Collaborators
Janssen Research & Development, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04445831
Brief Title
A Study to Evaluate the Safety, Tolerability and Immunogenicity of Tau Targeted Vaccines in Participants With Early Alzheimer's Disease
Official Title
A Phase Ib/IIa Multicenter, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Safety, Tolerability and Immunogenicity of Different Doses, Regimens and Combinations of Tau Targeted Vaccines in Subjects With Early Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
July 31, 2019 (Actual)
Primary Completion Date
September 5, 2023 (Actual)
Study Completion Date
September 5, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AC Immune SA
Collaborators
Janssen Research & Development, LLC

4. Oversight

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

5. Study Description

Brief Summary
This study is a multicenter, double blind, randomized, placebo-controlled study to evaluate the safety, tolerability and immunogenicity of different doses, regimens and combinations of Tau targeted vaccines in participants with early Alzheimer's Disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease, Cognitive Impairment, Tauopathies, Mild Cognitive Impairment, Dementia, Brain Diseases, Central Nervous System Diseases
Keywords
Alzheimer's Disease, Cognitive Impairment, Tauopathies, Mild Cognitive Impairment, Dementia, Brain Diseases, Central Nervous System Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
57 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo administered at predefined time points over a 48-week period.
Arm Title
ACI-35.030 - Low dose
Arm Type
Experimental
Arm Description
Active vaccine administered at predefined time points over a 48-week period.
Arm Title
ACI-35.030 - Medium dose
Arm Type
Experimental
Arm Description
Active vaccine administered at predefined time points over a 48-week period.
Arm Title
ACI-35.030 - High dose
Arm Type
Experimental
Arm Description
Active vaccine administered at predefined time points over a 48-week period.
Arm Title
JACI-35.054 - Low dose
Arm Type
Experimental
Arm Description
Active vaccine administered at predefined time points over a 48-week period.
Arm Title
JACI-35.054 - Medium dose
Arm Type
Experimental
Arm Description
Active vaccine administered at predefined time points over a 48-week period.
Intervention Type
Biological
Intervention Name(s)
ACI-35.030
Intervention Description
Administration of a Low dose of ACI-35.030
Intervention Type
Biological
Intervention Name(s)
ACI-35.030
Intervention Description
Administration of a Medium dose of ACI-35.030
Intervention Type
Biological
Intervention Name(s)
ACI-35.030
Intervention Description
Administration of a High dose of ACI-35.030
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Administration of Placebo
Intervention Type
Biological
Intervention Name(s)
JACI-35.054
Intervention Description
Administration of a Low dose of JACI-35.054
Intervention Type
Biological
Intervention Name(s)
JACI-35.054
Intervention Description
Administration of a Medium dose of JACI-35.054
Primary Outcome Measure Information:
Title
Number of participants with Adverse Events (AEs) assessed by intensity (mild, moderate or severe) and causal relationship (unrelated, unlikely, possibly or probably related)
Time Frame
from screening up to week 74
Title
Change from baseline in anti-phosphorylated Tau IgG titers in blood
Time Frame
from baseline up to week 74
Title
Mean change from baseline in systolic and diastolic blood pressure (mmHg)
Time Frame
from baseline up to week 74
Title
Mean change from baseline in heart rate (bpm)
Time Frame
from baseline up to week 74
Title
Mean change from baseline in body temperature (degree Celsius)
Time Frame
from baseline up to week 74
Title
Number of participants reporting suicidal ideation or behavior using Columbia-Suicide Severity Rating Scale (C-SSRS)
Time Frame
from baseline up to week 74
Title
Number of participants with abnormal MRI results
Time Frame
from baseline up to week 74
Secondary Outcome Measure Information:
Title
Change from baseline in anti-Tau IgG titers in blood
Time Frame
from baseline up to week 74
Title
Change from baseline in anti-phosphorylated Tau IgM titers in blood
Time Frame
from baseline up to week 74
Title
Change from baseline in anti-Tau IgM titers in blood
Time Frame
from baseline up to week 74
Other Pre-specified Outcome Measures:
Title
Change from baseline of functional performance using Clinical Dementia Rating scale Sum of Boxes (CDR-SB)
Description
The score ranges from 0 to 18. A higher score indicates a worse outcome.
Time Frame
from baseline up to week 74
Title
Change from baseline of cognitive performance using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
Description
The total scale index score ranges from 40 to 160. A higher score indicates a better outcome.
Time Frame
from baseline up to week 74
Title
Change from baseline of behavior using Neuropsychiatric Inventory Scale (NPI)
Description
The score ranges from 0 to 144. A higher score indicates a worse outcome.
Time Frame
from baseline up to week 74

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female with age from 50 and up to 75 years old inclusive. Mild Cognitive Impairment (MCI) due to AD or Mild AD according to NIA-AA criteria and Clinical Dementia Rating scale (CDR) global score of 0.5 or 1 respectively. Mini Mental State Examination (MMSE) score of 22 or above. Abnormal level of CSF Abeta amyloid 42 (Aß42) consistent with AD pathology at screening. Subjects either not taking any marketed treatment for AD or receiving a stable dose of an acetylcholinesterase inhibitor and/or memantine for at least 3 months prior to baseline. Subjects cared for by a reliable informant or caregiver to assure compliance, assist with clinical assessments and report safety issues. Women must be post-menopausal for at least one year and/or surgically sterilized. Subjects who in the opinion of the investigator is able to understand and provide written informed consent. Both subject and informant or caregiver must be fluent in one of the languages of the study and able to comply with all study procedures, including lumbar punctures. Exclusion criteria: Participation in previous clinical trials for AD and/or for neurological disorders using active immunization unless there is documented evidence that the subject was treated with placebo only and the placebo vaccine is not expected to induce any specific immune response. Participation in previous clinical trials for AD and/or for neurological disorders using any passive immunization within the past 6 months (or 5 half-lives of the investigational antibody, whichever is longer) prior to screening unless there is documented evidence that the subject was treated with placebo only and the placebo is not expected to induce any specific immune response. Participation in previous clinical trials for AD and/or for neurological disorders using any small molecule drug including BACE-1 inhibitors within the past 3 months prior to screening. Concomitant participation in any other clinical trial using experimental or approved medications or therapies. Presence of positive Anti-nuclear Antibody (ANA) titers at a dilution of at least 1:160 in subjects without clinical symptoms of auto-immune disease. Current or past history of auto-immune disease, or clinical symptoms consistent with the presence of auto-immune disease. Immune suppression including but not limited to the use of immunosuppressive drugs or systemic steroids unless they have been prescribed transiently more than 3 months prior to screening. History of severe allergic reaction (e.g., anaphylaxis) including but not limited to severe allergic reaction to previous vaccines and/or medications. Prior history of clinically significant hypoglycaemic episodes. Drug or alcohol abuse or dependence currently met or within the past five years according to Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) criteria. Any clinically significant medical condition likely to interfere with the evaluation of safety and tolerability of the study treatment and/or the adherence to the full study visit schedule. Any clinically significant medical condition likely to impact the immune system (e.g, any history of acquired or innate immune system disorder). Use of hydralazine, procainamide, quinidine, isoniazide, TNF-inhibitors, minocycline within the last 12 months prior to screening. Use of diltiazem unless on a stable dose for at least 3 months prior to screening. Significant risk of suicide defined, using the Columbia-Suicide Severity Rating Scale, as the subject answering: "yes" to suicidal ideation questions 4 or 5 or answering: "yes" to suicidal behavior within the past 12 months. Concomitant psychiatric or neurologic disorder other than those considered to be related to AD. History or presence of uncontrolled seizures. History of meningoencephalitis within the past 10 years prior to screening. Subjects with a history of hemorrhagic and/or non-hemorrhagic stroke. Presence or history of peripheral neuropathy. History of inflammatory neurological disorders with potential for CNS involvement. Screening MRI scan showing structural evidence of alternative pathology not consistent with AD which could cause the subject's symptoms. MRI examination cannot be done for any reason, including but not limited to metal implants contraindicated for MRI studies and/or severe claustrophobia. Significant hearing or visual impairment or other issues judged relevant by the investigator preventing to comply with the protocol and to perform the outcome measures. Clinically significant infections or major surgical operation within 3 months prior to screening. Any vaccine received within the past 2 weeks before screening, including influenza vaccine. Clinically significant arrhythmias or other clinically significant abnormalities on ECG at screening. Myocardial infarction within one year prior to baseline, unstable angina pectoris, or significant coronary artery disease. History of cancer within the past 5 years other than treated squamous cell carcinoma, basal cell carcinoma and melanoma in situ, or in-situ prostate cancer or in-situ breast cancer which have been fully removed and are considered cured. Clinically significant deviations from normal values for hematologic parameters, liver function tests, and other biochemical measures, that are judged to be clinically significant in the opinion of the investigator. Pregnancy confirmed by blood test at screening, or subject planning to be pregnant or lactating. Receipt of any anticoagulant drug or antiplatelet drug, except aspirin at doses of 100 mg daily or lower. Receipt of any antipsychotic drugs unless on stable low doses for the treatment of insomnia. Donation of blood or blood products within 30 days prior to screening or plans to donate blood while participating in the study. Positive Venereal Disease Research Laboratory (VDRL) consistent with active syphilis at screening. Positive HIV test at screening. Laboratory or clinical evidence of active hepatitis B and/or C at screening. Serum creatinine greater than 1.5x upper limit of normal, abnormal thyroid function tests or clinically significant reduction in serum B12 or folate levels.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philip Scheltens, MD
Organizational Affiliation
Amsterdam UMC Alzheimer Center de Boelelaan Amsterdam The Netherlands
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinical Research Services Helsinki
City
Helsinki
Country
Finland
Facility Name
Itä-Suomen Yliopisto - Kuopion Kampus
City
Kuopio
Country
Finland
Facility Name
Clinical Research Services Turku
City
Turku
Country
Finland
Facility Name
Brain Research Center - Den Bosch
City
's-Hertogenbosch
Country
Netherlands
Facility Name
Brain Research Center - Amsterdam
City
Amsterdam
Country
Netherlands
Facility Name
Minnesmottagningen - Sahlgrenska Universitetssjukhuset - Mölndal Sjukhus
City
Mölndal
Country
Sweden
Facility Name
Kognitiv Mottagning - Karolinska Universitetssjukhuset - Huddinge
City
Stockholm
Country
Sweden
Facility Name
Edinburgh Clinical Research Facility
City
Edinburgh
Country
United Kingdom
Facility Name
University College London Hospitals NHS Foundation Trust
City
London
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

A Study to Evaluate the Safety, Tolerability and Immunogenicity of Tau Targeted Vaccines in Participants With Early Alzheimer's Disease

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