MedPath

Progress of Mild Alzheimer's Disease in Participants on Solanezumab Versus Placebo

Phase 3
Terminated
Conditions
Alzheimer's Disease
Interventions
Drug: Placebo
Registration Number
NCT01900665
Lead Sponsor
Eli Lilly and Company
Brief Summary

To test the idea that solanezumab will slow the cognitive decline of Alzheimer's Disease (AD) as compared with placebo in participants with mild AD.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
2129
Inclusion Criteria
  • Meets National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA) criteria for probable AD
  • Has a Modified Hachinski Ischemia Scale score of less than or equal to 4
  • Has a Mini-Mental State Examination (MMSE) score of 20 through 26 at Screening visit
  • Has a Geriatric Depression Scale score of less than or equal to 6 (on the staff-administered short form)
  • Has had a magnetic resonance imaging (MRI) or computerized tomography (CT) scan performed within the past 2 years that has confirmed no findings inconsistent with a diagnosis of AD
  • Has a florbetapir positron emission tomography (PET) scan or cerebrospinal fluid (CSF) result consistent with the presence of amyloid pathology at screening
Exclusion Criteria
  • Does not have a reliable caregiver who is in frequent contact with the participant (defined as at least 10 hours per week), will accompany the participant to the office and/or be available by telephone at designated times, and will monitor administration of prescribed medications
  • Meets National Institute of Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS/AIREN) criteria for vascular dementia
  • Has current serious or unstable illnesses including cardiovascular, hepatic, renal, gastroenterologic, respiratory, endocrinologic, neurologic (other than AD), psychiatric, immunologic, or hematologic disease and other conditions that, in the investigator's opinion, could interfere with the analyses of safety and efficacy in this study; or has a life expectancy of <2 years
  • Has had a history within the last 5 years of a serious infectious disease affecting the brain or head trauma resulting in protracted loss of consciousness
  • Has a history within the last 5 years of a primary or recurrent malignant disease with the exception of resected cutaneous squamous cell carcinoma in situ, basal cell carcinoma, cervical carcinoma in situ, or in situ prostate cancer with a normal prostate-specific antigen posttreatment
  • Has a known history of human immunodeficiency virus (HIV), clinically significant multiple or severe drug allergies, or severe posttreatment hypersensitivity reactions
  • Has received acetylcholinesterase inhibitor (AChEIs), memantine and/or other AD therapy for less than 4 months or has less than 2 months of stable therapy on these treatments
  • Has received medications that affect the central nervous system (CNS), except treatments for AD, for less than 4 weeks
  • Has a history of chronic alcohol or drug abuse/dependence within the past 5 years
  • Has a Visit 1 MRI with results showing >4 Amyloid-related Imaging Abnormality (ARIA), -hemorrhage /hemosiderin deposition (ARIA-H) or presence of ARIA-E (edema/effusions)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo every 4 weeks for 76 weeks with an additional 4 weeks of assessments. Participants who complete the full 80 weeks of treatment/assessment and decide to continue will switch to solanezumab 400 mg every 4 weeks for up to an additional 208 weeks.
SolanezumabSolanezumabSolanezumab 400 milligrams (mg) every 4 weeks for 76 weeks with an additional 4 weeks of assessments. Participants who complete the full 80 weeks of treatment/assessment and decide to continue will take this regimen for up to an additional 208 weeks.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive 14 Item Subscore (ADAS-Cog14)Baseline, Week 80

The ADAS is a rater administered instrument that was designed to assess the severity of the dysfunction in the cognitive and noncognitive behaviors characteristic of persons with AD. The cognitive subscale of the ADAS that was used as the primary efficacy measure consists of 14 items assessing areas of cognitive function most typically impaired in AD: orientation, verbal memory, language, praxis, delayed free recall, digit cancellation, and maze completion measures. The ADAS-Cog14 scale ranges from 0 to 90. Higher scores indicate greater disease severity. Least Squares (LS) Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Alzheimer's Disease Cooperative Study- Instrumental Activities of Daily Living (ADCS-iADL)Baseline, Week 80

The ADCS-ADL is a 23-item inventory developed as a rater-administered questionnaire answered by the participant's caregiver. The ADCS-ADL measures both basic and instrumental activities of daily living by participants. The total score ranges from 0 to 78, with lower scores indicating greater disease severity. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive 11 Item Subscore (ADAS-Cog11)Baseline, Week 80

The cognitive subscale of ADAS (ADAS Cog11) consists of 11 items assessing areas of function most typically impaired in Alzheimer's disease (AD): orientation, verbal memory, language, and praxis. The scale ranges from 0 to 70, with higher scores indicating greater disease severity. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Mini-Mental State Examination (MMSE)Baseline, Week 80

MMSE is a brief screening instrument used to assess cognitive function (orientation, memory, attention, ability to name objects, follow verbal/written commands, write a sentence, and copy figures) in elderly participants. Total score ranges from 0 to 30; lower score indicates greater disease severity. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL)Baseline, Week 80

The ADCS-ADL is a 23-item inventory developed as a rater-administered questionnaire answered by the participant's caregiver. The ADCS-ADL measures both basic and instrumental activities of daily living by participants. The total score ranges from 0 to 78, with lower scores indicating greater disease severity. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Functional Activities Questionnaire (FAQ)Baseline, Week 80

FAQ is a 10-item, caregiver-based questionnaire and was administered to the study partner who was asked to rate the participant's ability to perform a variety of activities ranging from financial management, shopping, playing games, food preparation, traveling, keeping appointments, keeping track of current events, and understanding media. FAQ total score was calculated by adding the scores from each of the 10 items. A negative change indicated an improvement from baseline. FAQ Total Score is the sum of 10 items, ranging from 0 (best possible outcome) to 100 (worst possible outcome). LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB)Baseline, Week 80

CDR-SB is a semi-structured interview of participants and their caregivers. Participant's cognitive status is rated across 6 domains of functioning, including memory, orientation, judgment/problem solving, community affairs, home/hobbies, and personal care. Severity score assigned for each of 6 domains; total score (SB) ranges from 0 to 18. Higher scores indicate greater disease severity. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Neuropsychiatric Inventory (NPI)Baseline, Week 80

NPI assesses psychopathology in participants with dementia and other neurologic disorders. Information is obtained from a caregiver familiar with the participant's behavior. Total score ranges from 12 to 144; Higher scores indicate greater disease severity. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite)Baseline, Week 80

Assesses healthcare resource utilization (formal and informal care). Information gathered on both caregivers (care-giving time, work status) and participants (accommodation and healthcare resource utilization) was gathered from baseline and follow-up interviews. Reported number of hospitalizations per participant up to 76 weeks. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Quality of Life in Alzheimer's Disease (QoL-AD)Baseline, Week 80

Assesses QoL for AD: participant rates mood, relationships, memory, finances, physical condition, and overall QoL assessment. Each of 13 items, rated on a 4-point scale. Sum of items=total score (range: 13 to 52). Higher scores indicate greater QoL. Participant's primary caregiver asked to complete same measure. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in 5-Dimensional EuroQol Quality of Life Scale Proxy Version (EQ-5D Proxy)Baseline, Week 80

EQ-5D (proxy version) measures mobility, self-care, usual activities, pain/discomfort, anxiety/depression. 3 severity levels: no, some, severe problems. Visual analog scale (VAS) assesses caregiver's impression of participant's health state; score ranges: 0 to 100 millimeter (mm). Lower scores=greater disease severity LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Integrated Alzheimer's Disease Rating Scale (iADRS)Baseline, Week 80

Integrated Alzheimer's Disease Rating Scale is used to assess that solanezumab slows down the cognitive and functional decline associated with AD compared with placebo. iADRS is a simple linear combination of ADAS-Cog 13 or 14 and the ADCS-iADL. The scale ranges from 0 to 146, where lower scores indicate worse performance. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Percentage of Participants of Cognitive and Functional RespondersBaseline through Week 80

Assess the proportion of participants who reach certain levels of cognitive and functional decline. Decline in cognition was defined as worsening from baseline by at least 6 or 9 points on the ADAS Cog14. If there is a cognitive decline of a specified cut-off or more at any time then the participant is considered a nonresponder. Functional nonresponders are participants who have not had any of the following at any time point: Clinically evident decline in ability to perform one or more basic ADL present at baseline; A clinically evident decline in ability to perform 20% or more of the instrumental ADL present at baseline; An increase in global CDR score of 1 point or more compared with baseline. A decline from no impairment to mild impairment (bADL, iADL is not considered clinically significant, but other declines of 1 or more points and any participant discontinuation within the first 6 months will be considered a non-responder.

Change From Baseline in Plasma Amyloid-Beta (Aβ) SpeciesBaseline, Week 80

Concentration of amino acid peptide known as Aβ 1-42 in plasma. The change in plasma Aβ analytes after treatment were assessed separately for each plasma Aβ parameter. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Change From Baseline in Volumetric Magnetic Resonance Imaging (vMRI)Baseline, Week 80

The vMRI assessment of right and left hippocampal atrophy, is reported. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Pharmacokinetics (PK): Area Under the Concentration Time Curve (AUC) of Solanezumab (LY2062430)Visit 2 (Post-dose), Visit 5, 9, 15 (Pre-dose, Post-dose) and Visit 22 (Pre-dose): Pre-dose before the infusion, Post-dose 30 minutes End of Infusion

Area Under the Concentration versus Time Curve was evaluated for Solanezumab.

Change From Baseline in Florbetapir Positron Emission Tomography (PET) ScanBaseline, Week 80

Florbetapir PET imaging was used to confirm the presence of amyloid pathology consistent with AD. Change from baseline was done to test the hypothesis that amyloid burden was reduced in participants in the treatment group. The change from baseline to the postbaseline visit of the composite summary standard uptake value ratio of florbetapir F18 was calculated. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit. The composite summary measure is an unweighted average of the 6 smaller regions (anterior cingulate, frontal medial orbital, parietal, posterior cingulate, precuneus, and temporal) normalized to whole cerebellum or subject-specific white matter.

Change From Baseline in Cerebrospinal Fluid (CSF) Aβ LevelsBaseline, Week 80

Concentration of CSF parameters includes amino acid peptide known as Aβ 1-42 and Aβ 1-42. Analyses of these CSF biomarkers was conducted in a subset of participants (as an addendum to the protocol). The dependent variable for each CSF parameter was its change from baseline to endpoint. LS Mean value was controlled for baseline value, baseline age, pooled investigator, treatment and visit.

Trial Locations

Locations (119)

Neurology Center of North Orange County

🇺🇸

Fullerton, California, United States

PharmaSite Research Inc

🇺🇸

Baltimore, Maryland, United States

Senior Clinical Trials, Inc.

🇺🇸

Laguna Hills, California, United States

Texas Neurology, PA

🇺🇸

Dallas, Texas, United States

University of California Los Angeles School of Medicine

🇺🇸

Los Angeles, California, United States

University of Pittsburgh Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

CTT Consultants

🇺🇸

Prairie Village, Kansas, United States

Heartland Research Associates

🇺🇸

Wichita, Kansas, United States

Via Christi Regional Medical Center

🇺🇸

Wichita, Kansas, United States

Xenoscience

🇺🇸

Phoenix, Arizona, United States

Banner Alzheimer's Institute

🇺🇸

Phoenix, Arizona, United States

Artemis Institute for Clinical Research

🇺🇸

San Diego, California, United States

Pacific Research Network Inc

🇺🇸

San Diego, California, United States

San Francisco Clinical Research Center

🇺🇸

San Francisco, California, United States

University of California, San Francisco

🇺🇸

San Francisco, California, United States

Miami Jewish Home and Hospital for the Aged

🇺🇸

Miami, Florida, United States

Las Vegas Radiology

🇺🇸

Las Vegas, Nevada, United States

Cutting Edge Research Group

🇺🇸

Oklahoma City, Oklahoma, United States

Diagnostic Research Group

🇺🇸

San Antonio, Texas, United States

University of Utah School of Medicine

🇺🇸

Salt Lake City, Utah, United States

Veterans Affairs Puget Sound Health Care System

🇺🇸

Seattle, Washington, United States

Indiana University School of Medicine

🇺🇸

Indianapolis, Indiana, United States

Quantum Laboratories

🇺🇸

Deerfield Beach, Florida, United States

Atlanta Center of Medical Research

🇺🇸

Atlanta, Georgia, United States

Renstar Medical Research

🇺🇸

Ocala, Florida, United States

Private Office: J. Gary Booker

🇺🇸

Shreveport, Louisiana, United States

Brigham and Womens Hospital

🇺🇸

Boston, Massachusetts, United States

Drexel University College of Medicine at EPPI

🇺🇸

Philadelphia, Pennsylvania, United States

Neurology Specialists Inc.

🇺🇸

Dayton, Ohio, United States

Maine Research Associates

🇺🇸

Auburn, Maine, United States

ActivMed Practices & Research, Inc

🇺🇸

Methuen, Massachusetts, United States

Northern Michigan Neurology

🇺🇸

Traverse City, Michigan, United States

Boston Center for Memory

🇺🇸

Newton, Massachusetts, United States

SPRI Clinical Trials, LLC.

🇺🇸

Brooklyn, New York, United States

Hattiesburg Clinic

🇺🇸

Hattiesburg, Mississippi, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Insight Clinical Trials

🇺🇸

Shaker Heights, Ohio, United States

The Corvallis Clinic P.C.

🇺🇸

Corvallis, Oregon, United States

Rhode Island Mood & Memory Research Institute

🇺🇸

East Providence, Rhode Island, United States

Ohio State Univ College Of Medicine

🇺🇸

Columbus, Ohio, United States

Red River Medical Center, LLC

🇺🇸

Oklahoma City, Oklahoma, United States

University Psychiatry Associates Avera Health

🇺🇸

Sioux Falls, South Dakota, United States

National Clinical Research - Norfolk Inc

🇺🇸

Norfolk, Virginia, United States

University of Texas Southwestern Medical Center at Dallas

🇺🇸

Dallas, Texas, United States

Richmond Behavorial Associates

🇺🇸

Staten Island, New York, United States

Dent Neurological Institute

🇺🇸

Amherst, New York, United States

Mount Sinai Medical Center

🇺🇸

New York, New York, United States

Arizona Health Sciences Center

🇺🇸

Tucson, Arizona, United States

Neurology Clinical Research, Inc

🇺🇸

Sunrise, Florida, United States

The Memory Clinic

🇺🇸

Bennington, Vermont, United States

Wake Research Associates

🇺🇸

Raleigh, North Carolina, United States

St Josephs Hospital and Medical Center

🇺🇸

Phoenix, Arizona, United States

Banner Sun Health Research Institute

🇺🇸

Sun City, Arizona, United States

ANI Arizona Neurological Institute Research, PC

🇺🇸

Sun City, Arizona, United States

American Neuropsychiatric Research Institute, Inc

🇺🇸

Carson, California, United States

Center for Neurosciences

🇺🇸

Tucson, Arizona, United States

Torrance Clinical Research

🇺🇸

Lomita, California, United States

Institute for Memory Impairment & Neurological Disorders

🇺🇸

Irvine, California, United States

Univ of Southern California Medical Center

🇺🇸

Los Angeles, California, United States

Anderson Clinical Research

🇺🇸

Redlands, California, United States

St. Joseph Health

🇺🇸

Santa Rosa, California, United States

Associated Neurologists of Southern Connecticut

🇺🇸

Fairfield, Connecticut, United States

Research Center for Clinical Studies

🇺🇸

Norwalk, Connecticut, United States

Parkinson's Disease and Movement Disorders

🇺🇸

Boca Raton, Florida, United States

MD Clinical

🇺🇸

Hallandale Beach, Florida, United States

Cohen Medical Associates P.A.

🇺🇸

Delray Beach, Florida, United States

Galiz Research

🇺🇸

Hialeah, Florida, United States

Mayo Clinic of Jacksonville

🇺🇸

Jacksonville, Florida, United States

Premiere Research Institute at Palm Beach Neurology

🇺🇸

West Palm Beach, Florida, United States

Alexian Brothers Medical Center

🇺🇸

Elk Grove Village, Illinois, United States

Rush Alzheimer's Disease Center

🇺🇸

Chicago, Illinois, United States

Maine Neurology

🇺🇸

Scarborough, Maine, United States

McLean Hospital

🇺🇸

Belmont, Massachusetts, United States

Boston University Medical Center

🇺🇸

Boston, Massachusetts, United States

New York University Medical Center

🇺🇸

New York, New York, United States

Albany Medical College

🇺🇸

Albany, New York, United States

PMG Research of Charlotte, LLC

🇺🇸

Charlotte, North Carolina, United States

Valley Medical Research

🇺🇸

Centerville, Ohio, United States

Butler Hospital

🇺🇸

Providence, Rhode Island, United States

Quillen College of Medicine, East TN State University

🇺🇸

Johnson City, Tennessee, United States

Vanderbilt Univeristy School of Medicine

🇺🇸

Nashville, Tennessee, United States

For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

🇬🇧

Newcastle, United Kingdom

Collaborative Neuroscience Network - CNS

🇺🇸

Long Beach, California, United States

UCLA Medical Center

🇺🇸

Los Angeles, California, United States

Sharp Mesa Vista Hospital

🇺🇸

San Diego, California, United States

University of California - San Diego

🇺🇸

La Jolla, California, United States

Behavioral Health Center Research

🇺🇸

Charlotte, North Carolina, United States

Apostle Clinical Trials, Inc

🇺🇸

Long Beach, California, United States

Apex Research Institute

🇺🇸

Santa Ana, California, United States

Blue Ridge Research Center

🇺🇸

Roanoke, Virginia, United States

Hoag Memorial Hospital

🇺🇸

Newport Beach, California, United States

Pacific Neuroscience Medical Group

🇺🇸

Oxnard, California, United States

Neuropsychiatric Research Center of Southwest Florida

🇺🇸

Fort Myers, Florida, United States

Christiana Care Research Institute

🇺🇸

Newark, Delaware, United States

Brain Matters Research

🇺🇸

Delray Beach, Florida, United States

Georgetown University Hospital

🇺🇸

Washington, District of Columbia, United States

Infinity Clinical Research . LLC

🇺🇸

Hollywood, Florida, United States

Jacksonville Center for Clinical Research

🇺🇸

Jacksonville, Florida, United States

Cleveland Clinic of Las Vegas

🇺🇸

Las Vegas, Nevada, United States

AdvanceMed Research

🇺🇸

Lawrenceville, New Jersey, United States

Guilford Neurologic Associates

🇺🇸

Greensboro, North Carolina, United States

University of California, Davis - Health Systems

🇺🇸

Sacramento, California, United States

Institute for Neurodegenerative Disorders

🇺🇸

New Haven, Connecticut, United States

Yale University School of Medicine

🇺🇸

New Haven, Connecticut, United States

Compass Research

🇺🇸

Orlando, Florida, United States

Axiom Research

🇺🇸

Tampa, Florida, United States

Stedman Clinical Trials

🇺🇸

Tampa, Florida, United States

University of South Florida

🇺🇸

Tampa, Florida, United States

Univ of Nebraska Med Center

🇺🇸

Omaha, Nebraska, United States

PMG Research of Winston-Salem, LLC

🇺🇸

Winston-Salem, North Carolina, United States

Summit Research Network Inc

🇺🇸

Portland, Oregon, United States

Roper St. Francis Healthcare

🇺🇸

Charleston, South Carolina, United States

National Clinical Research - Richmond

🇺🇸

Richmond, Virginia, United States

Baptist Physician's Lexington

🇺🇸

Lexington, Kentucky, United States

Albuquerque Neurosciences

🇺🇸

Albuquerque, New Mexico, United States

California Neuroscience Research

🇺🇸

Sherman Oaks, California, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

Radiant Research

🇺🇸

Murray, Utah, United States

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