A Study to Evaluate Safety and Tolerability of Different Doses and Efficacy of PQ912 in Subjects With MCI and Mild AD
- Conditions
- Mild Cognitive Impairment Due to ADEarly Alzheimers Disease
- Interventions
- Drug: Placebo
- Registration Number
- NCT04498650
- Lead Sponsor
- Vivoryon Therapeutics N.V.
- Brief Summary
This is a phase 2B multicenter, randomized, double-blind, placebo-controlled, parallel group dose finding study to evaluate the safety, tolerability and efficacy of PQ912, an inhibitor of the glutaminyl cyclase enzyme, in 250 subjects with mild cognitive impairment and mild dementia due to Alzheimer 's Disease.
- Detailed Description
In the parallel group dose finding part of the study the first 90 subjects will be randomized 1:1:1 between PQ912 300 mg BID, 600 mg BID, and placebo. When the 90th patient has completed the week 24 treatment visit, the DSMB will decide on the dose of PQ912 to be continued. The decision is based on safety findings only, no efficacy data will be considered. After the DSMB has reached a decision on the dose to be continued, all subjects randomized to receive PQ912 will be reallocated to this dose (1:1). The duration of Subjects participation in the study is either 48, 60, 72, 84 or 96 weeks of treatment (depending on time of randomization). Subjects recruited early into the study will be kept on treatment for 96 weeks or until the regular, scheduled study visit which is closest to the scheduled week 48 visit of the last subject recruited in the study, whichever comes first.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 259
- Positive CSF AD biomarker signature according to the AA-NIA criteria
- Clinical syndrome of MCI or mild dementia according to the AA-NIA Research Framework
- A cognitive impairment in the WAIS IV Coding Test of at least 0.5 standard deviation below the normative data
- Adequate visual and auditory abilities to perform the cognitive and functional assessments in the opinion of the investigator
- Meeting the completion and performance criteria for the CogState NTB
- Outpatient with study partner capable of accompanying the subject on all applicable clinic visits
Main
- Significant neurological or psychiatric disorders, other than AD, that may affect cognition.
- Atypical clinical presentations of MCI due to AD or mild dementia due to AD, such as the visual variant of AD (including posterior cortical atrophy), frontal variant or the language variant (including logopenic aphasia).
- Moderate and severe dementia with a Mini-Mental State Examination score (MMSE) below 20.
- Current presence of a clinically important major psychiatric disorder (e.g. major depressive disorder) as defined by DSM-5 criteria, or symptom(s) (e.g. hallucinations) that could affect the subject's ability to complete the study.
- History of clinically evident stroke.
- History of seizures within the last two years prior to the screening visit.
- Myocardial infarction within the last six months prior to screening.
- History of uncontrolled hypertension (in the opinion of the investigator) within six months prior to screening.
- Contraindication to lumbar puncture and MRI
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 300 mg PQ912 Dose in weeks 1 and 2: 50 mg once daily (evening) Dose in weeks 3 and 4: 50 mg BID Dose in weeks 5-8: 150 mg BID Dose in weeks 9-24: 300 mg BID Placebo Placebo - 600 mg PQ912 Dose in weeks 1 and 2: 50 mg once daily (evening) Dose in weeks 3 and 4: 50 mg BID Dose in weeks 5-8: 150 mg BID Dose in weeks 9-12: 300 mg BID Dose in weeks 12-24: 600 mg BID
- Primary Outcome Measures
Name Time Method Primary efficacy: within-participant linear change with time of the combinded z-score for cognition compared between active arm and placebo. 48 weeks and EoT (96 weeks at maximum) The within-participant change over time in cognition measured by the combined z-score of the Detection test, Identification test and the 'One Back' test (attention and working memory domains) of the Neurological Test Battery
Primary safety: The proportion of participants who experience any Adverse Event (AE), Serious Adverse Event (SAE), Adverse Event of Interest (AE-I) 48 weeks The safety analysis will include the number of subjects with, and the number of any AE, any SAE (both overall and related), AEs leading to discontinuation of treatment, AEs leading to temporary treatment interruption, treatment compliance, the number of subjects with AEs of interest as defined above, the severity, duration and outcome of AEs
- Secondary Outcome Measures
Name Time Method Secondary efficacy: The within-participant linear change from baseline to week 48 in quantitative EEG (global relative theta wave power), compared between active and placebo. 48 weeks at minimum or until EoT (96 weeks at maximum) Using a quantitative EEG the within-participant change from baseline to week 48 of the global relative theta wave power (4-8 Hz) will serve as a primary efficacy outcome.
Secondary efficacy: The within-participant linear change with time in overall cognition as measured by the CogState Brief Battery (CBB) Z-score compared between active arm and placebo 48 weeks and EoT (96 weeks at maximum) he within-participant linear change with time in overall cognition as measured by the CBB (CogState Detection, Identification, One Card Learning and One Back test) -Z-score
Trial Locations
- Locations (17)
Institut für Studien zur Psychischen Gesundheit (ISPG)
🇩🇪Mannheim, Germany
Unidad de Neurociencias. Hospital Victoria Eugenia
🇪🇸Seville, Spain
Universitätsklinikum Schleswig-Holstein (UKSH), Klinik für Neurologie
🇩🇪Kiel, Germany
Universitätsklinikum Münster / Klinik für Allgemeine Neurologie
🇩🇪Münster, Germany
Sanos Clinics
🇩🇰Vejle, Denmark
Fundació ACE
🇪🇸Barcelona, Spain
Klinikum rechts der Isar der TU München / Klinik für Psychiatrie und Psychotherapie
🇩🇪München, Germany
Neurology (Memory Unit) - Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Klinik für Neurologie Universitätsklinikum Ulm
🇩🇪Ulm, Germany
Cae Oroitu
🇪🇸Getxo, Spain
Universitätsklinikum Magdeburg / Institut für Kognitive Neurologie und Demenzforschung
🇩🇪Magdeburg, Germany
Charité - Universitätsmedizin Berlin
🇩🇪Berlin, Germany
Brain Research Center
🇳🇱Den Bosch, Netherlands
Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych Uniwersytetu Medycznego w Łodzi
🇵🇱Łódź, Poland
SOMED CR
🇵🇱Łódź, Poland
Podlaskie Centrum
🇵🇱Białystok, Poland
Brain Research Center Zwolle
🇳🇱Zwolle, Netherlands