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VY7523-102: Randomized, Placebo-Controlled, Double-Blind, Multiple Ascending Dose Study in Participants with Early Alzheimer's Disease

Phase 1
Recruiting
Conditions
Alzheimer's Disease (AD)
Interventions
Drug: Placebo Comparator
Registration Number
NCT06874621
Lead Sponsor
Voyager Therapeutics
Brief Summary

This study is to be conducted in participants with early Alzheimer's Disease to test VY7523, a new drug being researched for treatment of Alzheimer's Disease. This study will look at how safe the drug is and how it works in the brain. It was first tested in normal, healthy participants who volunteered to participate. The study will look at three different dose levels, starting with the lowest dose first and moving to higher doses and more participants after safety has been reviewed by doctors and researchers. Some patients will receive drug while others will receive placebo. This will help to better compare how the drug works between participants receiving drug and placebo. The study will last up to 6 months for the lower dose groups and 18 months for the highest dose group.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
52
Inclusion Criteria
  1. Clinical diagnosis of early AD, defined as:

    1. Meet the NIA-AA core clinical criteria for MCI due to AD or mild AD.
    2. Mini Mental State Examination (MMSE) score between 18 and 30, inclusive, at Screening (Cohort 1 and 2) and score between 22 and 30, inclusive, at Screening (Cohort 3).
    3. Report a history of subjective memory decline with gradual onset and slow progression over at least the last 6 months before Screening; must be corroborated by an informant/caregiver.
    4. CDR Memory Box score ≥0.5 CDR global score of 0.5 for MCI due to AD or 0.5 or 1 for mild AD.
  2. Evidence of pathology consistent with AD diagnosis:

    1. For Cohort 1 and Cohort 2 only, by documented historical amyloid PET showing imaging agent uptake into the brain conducted within 24 months before screening OR elevated plasma pTau217/np-Tau217 ratio within the Screening Period.

    2. For Cohort 3 only, evidence of pathology consistent with AD diagnosis by both:

      • Evidence of Tau PET imaging agent uptake into the brain by central read AND
      • Evidence of positive brain amyloid pathology as indicated by one of the following:
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    1. Documented historical amyloid PET showing imaging agent uptake into the brain conducted within 24 months before screening OR
    2. CSF beta amyloid and tau levels consistent with AD diagnosis within the Screening Period.
  3. Body mass index (BMI) ≥18 and ≤35 kg/m2 at Screening.

  4. Apart from the clinical diagnosis of early AD, participant must be in good health, based on medical history and screening assessments.

  5. If participant is receiving an approved symptomatic AD treatment such as but not limited to acetylcholinesterase inhibitor (AChEIs), memantine, rivastigmine, galantamine and tacrine for AD, participant must be on a stable dose for at least 8 weeks prior to Screening.

    1. Treatment-naive participants for AD can be entered into the study.
    2. Unless otherwise stated, participants must have been on stable doses of all other (non-AD-related) permitted concomitant medications for at least 4 weeks prior to Screening.
    3. Participants currently on β amyloid therapies may not be enrolled.
  6. Must have an identified reliable informant/caregiver (defined as a person able to support the participant for the duration of the study e.g., spouse, sibling, close friend, who spends at least 10 hours per week with the participant) who assented to:

    1. Accompany the participant to clinic visits.
    2. Provide information to study Investigator/staff about functioning, cognitive abilities and AEs.
    3. Support participants returning for per-protocol follow-up visits and procedures.
Exclusion Criteria
  1. Any medical or neurological/neurodegenerative or psychiatric condition (other than AD) that, in the opinion of the Investigator, may be contributing cause to cognitive impairment or could confound interpretation of drug effect, affect study assessments, or affect participant's ability to participate and complete the study or lead to safety concerns.
  2. History of transient ischemic attack or stroke or any unexplained loss of consciousness within 1 year prior to Screening.
  3. History of seizures within 10 years prior to screening or history of epileptic syndrome (except for history of febrile seizures in childhood)
  4. Lifetime history of a major psychiatric disorder including schizophrenia or bipolar disorder. History of major depressive disorder that has resulted in 2 or more hospitalizations in a lifetime.
  5. Presence of a clinically significant uncontrolled medical disorder involving one or more of these major organ systems: cardiovascular (including but not limited to a QTcF of >470 ms for women and >450 ms for men and uncontrolled hypertension), respiratory, renal, gastrointestinal, immunologic, hematologic including bleeding disorder, hepatic, or endocrine.
  6. Contraindications to lumbar puncture, including but not limited to coagulation or bleeding disorders, unsafe suspension of anticoagulant, infections at the injection site, spinal deformities or previous spinal surgeries that may affect safe LP performance, or conditions associated with increased intracranial pressure.
  7. Contraindications to MRI scanning, including but not limited to cardiac pacemaker/defibrillator, ferromagnetic metal implants (devices other than those approved as safe for use in MRI scanners).
  8. History of a malignant disease (cancer) except for resected cutaneous squamous cell carcinoma in situ, basal cell carcinoma, cervical carcinoma in situ, in situ prostate cancer with a normal posttreatment prostate-specific antigen within the last five years or other cancers in remission for at least 5 years
  9. Any immunological disease which is not adequately controlled, or which requires treatment with immunoglobulins, systemic mAbs (or derivatives of mAbs), systemic immunosuppressants, or plasmapheresis during the study.
  10. History of severe allergies, or history of an anaphylactic reaction (nonactive hay fever is acceptable).
  11. Participation in a clinical drug trial or device within 30 days (or 5 half-lives, whichever is longer and 3 months for a biologic) of screening, unless the study blind has been broken and the participant was known to be on placebo.
  12. Last administration of B-secretase and gamma-secretase inhibitors in a study within 3 months or 5 half-lives (whichever is longer) prior to screening, unless it can be documented that the participant only received placebo.
  13. Current use of an approved AD disease modifying or anti-amyloid therapy (including but not limited to any mAb therapies).
  14. Presence of risk for increased or uncontrolled bleeding and/or risk of bleeding that is not managed optimally and could place a participant at an increased risk for intraoperative or postoperative bleeding.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Cohort 1 activeVY7523Low dose VY7523
Cohort 1 placeboPlacebo ComparatorVY7523 matching placebo for Cohort 1 active dose
Cohort 2 activeVY7523mid dose VY7523
Cohort 3 activeVY7523high dose VY7523
Cohort 2 placeboPlacebo ComparatorVY7523 matching placebo for Cohort 2 active dose
Cohort 3 placeboPlacebo ComparatorVY7523 matching placebo for Cohort 3 active dose
Primary Outcome Measures
NameTimeMethod
Characterization of the safety and tolerability of VY7523 in participants with early ADCohorts 1 and 2: up to 6 months Cohort 3: up to 18 months

Incidence of treatment-emergent adverse events (TEAEs) and clinically significant changes from baseline

Secondary Outcome Measures
NameTimeMethod
To characterize the pharmacokinetics (PK) of VY7523 in serumCohort 1 & 2: Month 1 - 6 Cohort 3: Month 1-7, 9, 12, 17 and 18

• Serum VY7523 concentrations

To characterize the pharmacokinetics (PK) of VY7523 in cerebrospinal fluid (CSF) concentrations following multiple IV dosesCohort 1 & 2: Month 6 Cohort 3: Month 12 and 18

VY7523 CSF concentrations

To evaluate the ability of VY7523 to prevent the spread of pathologic tau; Cohort 3 onlyMonth 6, 12 & 18

Changes from baseline in the standardized uptake value ratio (SUVR) using tau-positron emission tomography (PET)

To evaluate the immunogenicity of multiple, escalating intravenous (IV) doses of VY7523Cohort 1 & 2: Month 1, 3, 4, 5 & 6 Cohort 3: Month 1, 2, 6, 9, 12 & 18

Incidence and level of treatment emergent anti-drug antibodies to VY7523

Trial Locations

Locations (25)

VYGR Site 840018

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Los Angeles, California, United States

VYGR Site 840016

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Orange, California, United States

VYGR Site 840022

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San Francisco, California, United States

VYGR Site 840008

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Stamford, Connecticut, United States

VYGR Site 840005

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Delray Beach, Florida, United States

VYGR Site 840021

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Fort Myers, Florida, United States

VYGR Site 840010

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Lady Lake, Florida, United States

VYGR Site 840015

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Miami, Florida, United States

VYGR Site 840014

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Miami, Florida, United States

VYGR Site 840024

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Miami, Florida, United States

VYGR Site 840006

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Orlando, Florida, United States

VYGR Site 840003

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Stuart, Florida, United States

VYGR Site 840004

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The Villages, Florida, United States

VYGR Site 840002

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Wellington, Florida, United States

VYGR Site 840020

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Winter Park, Florida, United States

VYGR Site 840017

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Columbus, Georgia, United States

VYGR Site 840007

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Decatur, Georgia, United States

VYGR Site 840012

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Toms River, New Jersey, United States

VYGR Site 840009

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Matthews, North Carolina, United States

VYGR Site 840023

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Allentown, Pennsylvania, United States

VYGR Site 840011

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Plymouth Meeting, Pennsylvania, United States

VYGR Site 12402

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Ottowa, Ontario, Canada

VYGR Site 124001

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Toronto, Ontario, Canada

VYGR Site 124003

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Montreal, Quebec, Canada

VYGR Site 124004

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Montreal, Quebec, Canada

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