Dominantly Inherited Alzheimer Network Trial: An Opportunity to Prevent Dementia: A Study of Potential Disease Modifying Treatments in Individuals at Risk for or With a Type of Early Onset Alzheimer's Disease Caused by a Genetic Mutation

Registration Number
NCT06424236
Lead Sponsor
Washington University School of Medicine
Brief Summary

The purpose of this study is to assess the safety, tolerability, biomarker, cognitive and clinical efficacy of investigational products in participants with an Alzheimer's disease-causing mutation by determining if treatment with the study drug slows the rate of progression of cognitive/clinical impairment or improves disease-related biomarkers.

Detailed Description

Alzheimer's disease (AD) is defined by the presence of abnormal accumulations of amyloid protein (plaques) and tau protein (tangles) in the brain. The double-blind arm of DIAN-TU-001 Master protocol (NCT01760005) tested whether gantenerumab provided a clinical benefit by slowing the onset or the worsening of the disease. A clinical benefit was not observed i...

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
73
Inclusion Criteria
  • Between 18-80 years of age
  • Individuals who know they have an Alzheimer's disease-causing mutation
  • Individuals who have participated in the double-blind period
  • In the opinion of the investigator and sponsor, treatment is not contraindicated for safety
  • Capable of receiving drug and appropriate clinical safety assessment
  • Able to undergo Magnetic Resonance Imaging (MRI), Lumbar Puncture (LP), Positron Emission Tomography (PET), and complete all study related testing and evaluations.
  • For women of childbearing potential, if partner is not sterilized, subject must agree to use effective contraceptive measures (hormonal contraception, intra-uterine device, sexual abstinence, barrier method with spermicide).
  • Adequate visual and auditory abilities to perform all aspects of the cognitive and functional assessments.
  • Has a Study Partner who in the investigator's judgment is able to provide accurate information as to the subject's cognitive and functional abilities, who agrees to provide information at the study visits which require informant input for scale completion.
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Exclusion Criteria
  • History or presence of brain MRI scans indicative of any other significant abnormality
  • Alcohol or drug dependence currently or within the past 1 year
  • Presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, or foreign metal objects in the eyes, skin or body which would preclude MRI scan.
  • History or presence of clinically significant cardiovascular disease, hepatic/renal disorders, infectious disease or immune disorder, or metabolic/endocrine disorders
  • Anticoagulants except low dose (≤ 325 mg) aspirin.
  • Have been exposed to a monoclonal antibody targeting beta amyloid peptide within the past six months.
  • History of cancer within the last 5 years, except basal cell carcinoma, non-squamous skin carcinoma, prostate cancer or carcinoma in situ with no significant progression over the past 2 years.
  • Positive urine or serum pregnancy test or plans or desires to become pregnant during the course of the trial.
  • Subjects unable to complete all study related testing, including implanted metal that cannot be removed for MRI scanning, required anticoagulation and pregnancy.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Gantenerumab Open Label ExtensionGantenerumabGantenerumab: Subcutaneously every 4 weeks, at escalating doses
Primary Outcome Measures
NameTimeMethod
Change in amyloid load as measured by [11C]PiB-PET composite standardized uptake value ration (C-SUVR)Week 0 and Weeks 48, 104, and 156

The composite PiB partial volume corrected standardized uptake value ratio is used as the biomarker endpoint for amyloid deposition. Corresponding analyses based on conversion of SUVR to centiloid will be performed by Washington University.

Secondary Outcome Measures
NameTimeMethod
Annual Rate of change in Clinical Dementia Rating (CDR) Sum of BoxesWeek 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the CDR Sum of Boxes. Minimum score 0; maximum score 18. Higher score indicates worse performance.

Annual Rate of change in Tau PET Binding Partial Volume Corrected Standardized Uptake Value Ratio (Tau PET SUVR)Week 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the Tau PET Binding Partial Volume Corrected Standardized Uptake Value Ratio (Tau PET SUVR)

Annual Rate of change in Cerebrospinal Fluid (CSF) phosphorylated Tau (pTau)-181Week 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the Cerebrospinal Fluid (CSF) phosphorylated Tau (pTau)-181

Annual Rate of change in DIAN-TU Open Label Extension Cognitive CompositeWeek 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the DIAN-TU OLE Cognitive Composite. The Cognitive Composite is calculated using the WMS-R Digit Span Backward Recall (Minimum score 0; Maximum score 7. Lower indicates worse performance.), the Category Fluency (Animals) value (Minimum score 0; Maximum score Unlimited. Lower...

Annual Rate of change in Clinical Dementia Rating (CDR) GlobalWeek 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the CDR Global. Minimum score 0; maximum score 3. Higher score indicates worse performance.

Annual Rate of change in Mini-Mental State Examination (MMSE)Week 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the Mini-Mental State Examination (MMSE). Minimum score 0; maximum score 30. Lower score indicates worse performance.

Annual Rate of change in Neurofilament Light chain (NfL) in CSF (CSF NfL)Week 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the Neurofilament Light chain (NfL) in CSF (CSF NfL)

Annual Rate of change in Functional Assessment Scale (FAS)Week 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in the Functional Assessment Scale (FAS). Higher score indicates worse performance.

Annual Rate of change in Cerebrospinal Fluid (CSF) Amyloid Beta1-42/40Week 0 and Weeks 48, 104, and 156

Evaluate the efficacy of gantenerumab in reducing disease progression as assessed in CSF Amyloid Beta1-42/40

Trial Locations

Locations (22)

Hopital Roger Salengro - CHU Lille

🇫🇷

Lille, Nord, France

Neuroscience Research Australia

🇦🇺

Randwick, New South Wales, Australia

Yale University School of Medicine

🇺🇸

New Haven, Connecticut, United States

Mental Health Research Institute

🇦🇺

Melbourne, Victoria, Australia

Groupe Hospitalier Pitie-Salpetriere

🇫🇷

Paris cedex 13, Paris, France

CHU de Rouen - Hôpital Charles Nicolle

🇫🇷

Rouen, Seine Maritime, France

St Vincent's University Hospital

🇮🇪

Dublin, Ireland

Emory University

🇺🇸

Atlanta, Georgia, United States

Indiana University School of Medicine

🇺🇸

Indianapolis, Indiana, United States

University of Washington

🇺🇸

Seattle, Washington, United States

CHU de Toulouse - Hôpital Purpan

🇫🇷

Toulouse, Haute Garonne, France

University of Puerto Rico, School of Medicine

🇵🇷

San Juan, Puerto Rico

University of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Hospital Clínic I Provincial de Barcelona

🇪🇸

Barcelona, Spain

Hopital Neurologique Pierre Wertheimer

🇫🇷

Bron cedex, Rhone, France

The National Hospital for Neurology and Neurosurgery

🇬🇧

London, Greater London, United Kingdom

UBC Hospital

🇨🇦

Vancouver, British Columbia, Canada

University of California San Diego Medical Center

🇺🇸

La Jolla, California, United States

Washington University in St. Louis

🇺🇸

Saint Louis, Missouri, United States

Butler Hospital

🇺🇸

Providence, Rhode Island, United States

The McCuster Foundation of Alzheimer's Disease Research

🇦🇺

Nedlands, Western Australia, Australia

University of Alabama in Birmingham

🇺🇸

Birmingham, Alabama, United States

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