MedPath

Study of Idalopirdine in Patients With Mild - Moderate Alzheimer's Disease Treated With Donepezil

Phase 3
Completed
Conditions
Alzheimer's Disease
Interventions
Drug: Placebo
Registration Number
NCT01955161
Lead Sponsor
H. Lundbeck A/S
Brief Summary

To establish efficacy of idalopirdine as adjunctive therapy to donepezil for symptomatic treatment of patients with mild-to-moderate Alzheimer's disease (AD).

Detailed Description

The study consisted of a screening period (up to 2-week period from screening to randomization), a 24-week double-blind treatment period with placebo or idalopirdine 30 mg/day or 60 mg/day as adjunctive therapy to donepezil 10 mg/day, and a 4-week safety follow-up period following study completion or withdrawal from treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
933
Inclusion Criteria
  • The patient has a knowledgeable and reliable caregiver.
  • The patient is an outpatient.
  • The patient has probable AD.
  • The patient has mild to moderate AD.
  • Stable treatment with donepezil.
  • The patient, if a woman, must have had her last natural menstruation ≥24 months prior to baseline, OR be surgically sterile.
  • The patient, if a man, agrees to protocol-defined use of effective contraception if his female partner is of childbearing potential, OR must have been surgically sterilised prior to the screening visit.
Exclusion Criteria
  • The patient has evidence of any clinically significant neurodegenerative disease, or other serious neurological disorders other than AD.
  • The patient has a Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) Axis I disorder other than AD.
  • The patient has evidence of clinically significant disease.
  • The patient's donepezil therapy is likely to be interrupted or discontinued during the study.
  • The patient is currently receiving memantine or has taken memantine within 2 months prior to screening.

Other inclusion and exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo adjunct to 10 mg Donepezil
Idalopirdine 30 mgIdalopirdineIdalopirdine adjunct to 10 mg Donepezil
Idalopirdine 60 mgIdalopirdineIdalopirdine adjunct to 10 mg Donepezil
Primary Outcome Measures
NameTimeMethod
Change in CognitionBaseline to Week 24

Change from baseline to Week 24 in Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) total score.

The Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-cog) is a 11-item neuropsychological test that assess the severity of cognitive impairment. The items determine the patient's orientation, memory, language, and praxis. Total score of the 11 items range from 0 to 70 (lower score indicates lower cognitive impairment).

Secondary Outcome Measures
NameTimeMethod
Change in Daily FunctioningBaseline to Week 24

Change from baseline to Week 24 in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL23) total score.

The Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL23) is a 23-item clinician-rated inventory to assess activities of daily living (conducted with a caregiver or informant). Each item comprises a series of hierarchical sub-questions, ranging from the highest level of independent performance to a complete loss for each activity. Total score of the 23 items ranges from 0 to 78 (higher score indicates lower disability).

Change in Global ImpressionBaseline to Week 24

Alzheimer's Disease Cooperative Study - Clinical Global Impression of Change (ADCS-CGIC) score at Week 24.

The Alzheimer's Disease Cooperative Study - Clinical Global Impression of Change is a semi-structured interview to assess clinically relevant changes in patients with AD. The items determine cognition, behavior, social and daily functioning. Severity at baseline is rated on a 7-point scale from 1 (normal, not ill at all) to 7 (among the most extremely ill patients). The clinically relevant change from baseline is rated on a 7-point scale from 1 (marked improvement) to 7 (marked worsening).

Change in Behavioural DisturbanceBaseline to Week 24

Change from baseline to Week 24 in Neuropsychiatric Inventory (NPI) total score.

The Neuropsychiatric Inventory is a 12-item structured interview with a caregiver to assess behavioural disturbances. The NPI comprises 10 behavioural and 2 neurovegetative items. Each item consists of a screening question and several sub-questions that are rated no (not present) or yes (present). Each item is rated for frequency (a 4-point scale from 1 \[occasionally\] to 4 \[very frequent\]) and severity (a 3-point scale from 1 \[mild\] to 3 \[marked\]). The total NPI score is the frequency ratings multiplied by the severity ratings and ranges from 0 to 144 (higher score indicates worse outcome).

Change in Individual Behavioural Disturbance ItemsBaseline to Week 24

Change in single NPI item scores at Week 24.

The Neuropsychiatric Inventory is a 12-item structured interview with a caregiver to assess behavioural disturbances. The NPI comprises 10 behavioural and 2 neurovegetative items. Each item consists of a screening question and several sub-questions that are rated no (not present) or yes (present). Each item is then rated for frequency (a 4-point scale from 1 \[occasionally\] to 4 \[very frequent\]) and severity (a 3-point scale from 1 \[mild\] to 3 \[marked\]). Total score for each single NPI item ranges from 0-12 (frequency multiplied by severity), where higher scores represent worse outcome.

Change in NPI Anxiety Item Score in Patients With an NPI Anxiety Item Score of at Least 2 at BaselineBaseline to Week 24

Change from baseline to Week 24 in NPI anxiety item score in patients with an NPI anxiety item score of at least 2 at baseline

The Neuropsychiatric Inventory is a 12-item structured interview with a caregiver to assess behavioural disturbances. The NPI comprises 10 behavioural and 2 neurovegetative items. Each item consists of a screening question and several sub-questions that are rated no (not present) or yes (present). Each item is then rated for frequency (a 4-point scale from 1 \[occasionally\] to 4 \[very frequent\]) and severity (a 3-point scale from 1 \[mild\] to 3 \[marked\]). The total score for the NPI anxiety item ranges from 0-12 (frequency multiplied by severity), where a higher score represents a worse outcome.

Clinical ImprovementWeek 24

Clinical response at Week 24 (based on pre-specified ADAS-cog, ADCS-ADL23, and ADCS-CGIC changes \[change in ADAS-cog below or equal to -4, change in ADCS-ADL23 at least 0, and ADCS-CGIC below or equal to 4\])

Clinical WorseningWeek 24

Clinical worsening at Week 24 (Based on pre-specified ADAS-cog, ADCS-ADL23, and ADCS-CGIC changes \[change in ADAS-cog above or equal to 4, change in ADCS-ADL23 below 0, and ADCS-CGIC above 4\])

Change in Cognitive Aspects of Mental FunctionBaseline to Week 24

Change from baseline to Week 24 in Mini Mental State Examination (MMSE). The Mini Mental State Examination (MMSE) is an 11-item test to assess the cognitive aspects of mental function. The subtests assess orientation, memory, attention, language, and visual construction. The scores for each item is dichotomous (1 = response is correct, 0 = response is incorrect). Total score of the 11 items ranges from 0 to 30 (higher score indicates lower deficit).

Change in Health-related Quality of Life (EQ-5D) Utility ScoreBaseline to Week 24

Change from baseline to Week 24 in EuroQol 5-dimensional (EQ-5D) utility score

The EQ-5D is a patient-reported assessment that measures the patient's well-being. It consists of an utility score based on 5 descriptive items (mobility, self-care, usual activities, pain/discomfort, and depression/anxiety) and a Visual Analogue Scale (VAS). Each descriptive item is rated on a 3-point index ranging from 1 (no problems) to 3 (extreme problems) that is used for calculating a single summary index (from 0 to 1). A higher EQ-5D score indicates a worse outcome.

Change in Health-related Quality of Life (EQ-5D VAS)Baseline to Week 24

Change from baseline to Week 24 in EQ-5D Visual Analogue Scale (EQ-5D VAS).

The EQ-5D is a patient-reported assessment that measures the patient's well-being. It consists of an utility score based on 5 descriptive items (mobility, self-care, usual activities, pain/discomfort, and depression/anxiety) and a Visual Analogue Scale (VAS). The VAS ranges from 0 (worst imaginable health state) to 100 (best imaginable health state).

Trial Locations

Locations (137)

US043

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Staten Island, New York, United States

US002

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Los Angeles, California, United States

US042

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Boca Raton, Florida, United States

US035

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Kalamazoo, Michigan, United States

US038

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Port Charlotte, Florida, United States

US001

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West Palm Beach, Florida, United States

US046

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Princeton, New Jersey, United States

US018

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Santa Ana, California, United States

US006

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Columbus, Ohio, United States

US024

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Little Rock, Arkansas, United States

US052

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Edmond, Oklahoma, United States

US045

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Long Beach, California, United States

US029

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New York, New York, United States

US056

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New York, New York, United States

IT006

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Brescia, Italy

IT005

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Genoa, Italy

CL004

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Antofagasta, Chile

CL003

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Santiago, Chile

DE010

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Günzburg, Germany

IT004

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Ancona, Italy

FR005

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Paris cedex 10, France

DE009

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Munchen, Germany

CZ006

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Brno, Czechia

DE004

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Unterhaching, Germany

DE002

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Berlin, Germany

FR002

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Toulouse, France

DE006

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Ellwangen, Germany

US041

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Flowood, Mississippi, United States

IT002

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Firenze, Italy

CA008

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Newmarket, Canada

CA001

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Toronto, Canada

CZ003

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Praha 10, Czechia

CZ002

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Praha 6, Czechia

FR004

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Saint Etienne Cedex 2, France

FR003

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Nantes Cedex, France

CZ005

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Rychnov nad Kneznou, Czechia

CZ004

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Pardubice, Czechia

CZ007

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Kutna Hora, Czechia

CZ001

🇨🇿

Praha 2, Czechia

FR001

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Paris, France

FR006

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Besancon Cedex, France

ZA004

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George, South Africa

ES006

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Barcelona, Spain

FR008

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Limoges Cedex1, France

ZA002

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Rosebank, South Africa

DE005

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Hannover, Germany

PL004

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Gliwice, Poland

PL003

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Warszawa, Poland

UA008

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Dnipropetrovsk, Ukraine

ES005

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Manresa, Spain

UA006

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Kherson,Vil. Stepanivka, Ukraine

UA007

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Kyiv, Ukraine

UA001

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Lviv, Ukraine

PL007

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Katowice, Poland

ES003

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Santiago de Compostela, Spain

US012

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Phoenix, Arizona, United States

US058

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San Francisco, California, United States

US040

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Indianapolis, Indiana, United States

US027

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Birmingham, Alabama, United States

DK003

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Aarhus N, Denmark

DK001

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Copenhagen, Denmark

DK002

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Odense C, Denmark

US060

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Denver, Colorado, United States

US026

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Portland, Oregon, United States

CL001

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Valdivia, Chile

CL002

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Santiago, Chile

RO001

🇷🇴

Tirgu Mures, Romania

BG005

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Plovdiv, Bulgaria

BG002

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Sofia, Bulgaria

CA002

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Gatineau, Canada

US023

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Imperial, California, United States

US053

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Glendale, California, United States

US015

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La Jolla, California, United States

US021

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Bradenton, Florida, United States

US020

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Atlanta, Georgia, United States

US051

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Joliet, Illinois, United States

US030

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Chicago, Illinois, United States

US048

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Kailua, Hawaii, United States

US036

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Freeport, Maine, United States

US032

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Newton, Massachusetts, United States

US049

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Albany, New York, United States

US044

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Toms River, New Jersey, United States

US054

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Saint Louis, Missouri, United States

US028

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Toms River, New Jersey, United States

US010

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Amherst, New York, United States

US008

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New York, New York, United States

US014

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Manhasset, New York, United States

AR003

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Buenos Aires, Argentina

US037

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Orangeburg, New York, United States

US007

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Centerville, Ohio, United States

US057

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Jenkintown, Pennsylvania, United States

US025

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Madison, Wisconsin, United States

US047

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Arlington, Virginia, United States

AR002

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Buenos Aires, Argentina

AR006

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Buenos Aires, Argentina

AR007

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Buenos Aires, Argentina

AR010

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Rosario, Argentina

BE003

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Brugge, Belgium

AR009

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Cordoba, Argentina

AR004

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Mar del Plata, Argentina

AR005

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Mendoza, Argentina

BE002

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Brussels, Belgium

AR008

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Mendoza, Argentina

BE006

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Thuin, Belgium

BE005

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Leuven, Belgium

BE004

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Bruxelles, Belgium

BE001

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Roeselare, Belgium

BG001

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Sofia, Bulgaria

BG006

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Sofia, Bulgaria

BG003

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Sofia, Bulgaria

BG004

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Sofia, Bulgaria

BG007

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Varna, Bulgaria

CA006

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London, Canada

CA004

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Toronto, Canada

CL005

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Santiago, Chile

ZA003

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Bloemfontein, South Africa

DE007

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Heidelberg, Germany

DE008

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Ulm, Germany

PL006

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Sopot, Poland

IT003

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Lamezia Terme, Italy

PL005

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Poznan, Poland

IT001

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Milano, Italy

PL008

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Wroclaw, Poland

IT007

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Palermo, Italy

RO002

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Bucharest, Romania

PL002

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Szczecin, Poland

ZA006

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Cape Town, South Africa

ES002

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Alicante, Spain

ZA007

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Cape Town, South Africa

ZA001

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Pretoria, South Africa

ES001

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San Sebastian, Spain

ZA005

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Port Elizabeth, South Africa

ES004

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Salamanca, Spain

US050

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Brooksville, Florida, United States

US019

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Orlando, Florida, United States

US004

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Milwaukee, Wisconsin, United States

UA005

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Kyiv, Ukraine

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