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A Phase 3 Study to Evaluate Efficacy and Safety of AL001 in Frontotemporal Dementia (INFRONT-3)

Phase 3
Active, not recruiting
Conditions
Frontotemporal Dementia
Interventions
Drug: Placebo
Drug: Open label - AL001
Registration Number
NCT04374136
Lead Sponsor
Alector Inc.
Brief Summary

A phase 3 double blind, placebo controlled study evaluating the efficacy and safety of AL001 in participants at risk for or with frontotemporal dementia due to heterozygous mutations in the progranulin gene.

Detailed Description

This is a phase 3 double blind, placebo controlled study evaluating the efficacy and safety of AL001 administered intravenously in participants at risk for or with frontotemporal dementia due to heterozygous mutations in the progranulin gene. Study completion marks the end of the open label extension period following the 96-week blinded portion of the study.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
110
Inclusion Criteria
  • Persons with a progranulin gene mutation and at risk of developing FTD symptoms as evidenced by a biomarker, or persons with a progranulin gene mutation and diagnosed with FTD.
  • If symptomatic, one or more of the criteria for the diagnosis of possible behavioral variant FTD, or a diagnosis of Primary Progressive Aphasia.
  • Study partner who consents to study participation and who cares for/visits the participant daily for at least 5 hours per week.
  • Written informed consent must be obtained and documented (from the participant or, where jurisdictions allow it, from their legal decision maker).
Exclusion Criteria
  • Dementia due to a condition other than FTD including, but not limited to, Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, Huntington disease, or vascular dementia.
  • Known history of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric, human, or humanized antibodies or fusion proteins.
  • Current uncontrolled hypertension, diabetes mellitus or thyroid disease. Clinically significant heart disease, liver disease or kidney disease. History or evidence of clinically significant brain disease other than FTD.
  • Females who are pregnant or breastfeeding, or planning to conceive within the study period.
  • Any experimental vaccine or gene therapy.
  • History of cancer within the last 5 years.
  • Current use of anticoagulant medications (e.g., coumadin, heparinoids, apixaban).
  • Residence in a skilled nursing facility, convalescent home, or long term care facility at screening; or requires continuous nursing care.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AL001AL001AL001 every 4 weeks
PlaceboPlaceboPlacebo every 4 weeks
Open label - AL001Open label - AL001AL001 every 4 weeks
Primary Outcome Measures
NameTimeMethod
Evaluation of efficacy of AL001 as measured by the CDR® plus NACC FTLD-SBThrough study completion, on average up to 96 weeks

The Clinical Dementia Rating Dementia Staging Instrument PLUS National Alzheimer's Disease Coordinating Center frontotemporal lobar degeneration Behavior \& Language Domains Sum of Boxes (CDR® plus NACC FTLD-SB) is administered by a healthcare professional and based on individual ratings of the eight domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, personal care, language and behavior. Impairment is scored on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2 and severe = 3. The 8 individual domain ratings, or "box scores", were added together to give the CDR® plus NACC FTLD-SB which ranges from 0-24. Higher score indicates severe impairment.

Secondary Outcome Measures
NameTimeMethod
Evaluation of safety and tolerability of AL001: Incidence of adverse eventsBaseline to 96 weeks

Incidence of adverse events

Change in Clinical Global Impression-Severity (CGI-S) ScoreBaseline to 96 weeks

The CGI-S is used by a clinician to rate the severity of a participant's disease relative to the clinician's past experience with patients who have the same disease using an ordinal scale ranging from 1=normal, not at all ill; 2=borderline ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; and 7=among the most extremely ill patients. Higher scores indicate worsening.

Change in Clinical Global Impression-Improvement (CGI-I) ScoreBaseline to 96 weeks

The CGI-I is used by a clinician to rate how much a participant's disease has improved or worsened relative to baseline using an ordinal scale ranging from 1=very much improved; 2=much improved; 3=minimally improved; 4=no change from baseline; 5=minimally worse; 6= much worse; and 7=very much worse. Higher scores indicate worsening.

Change in Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) ScoreBaseline to 96 weeks

RBANS is 20 to 25 minute battery developed for cognitive assessment, detection, and characterization of dementia. RBANS includes 12 subtests that measure following 5 indices: (1)Attention Index, composed of Digit Span and Coding; (2)Language Index, consisting of Picture Naming and Semantic Fluency subtests; (3)Visuospatial/Construction Index, made up of Figure Copy and Line Orientation subtests; (4)Immediate Memory Index, composed of List Learning and Story Memory subtests, and (5)Delayed Memory Index, consisting of List Recall, List Recognition, Story Recall, and Figure Recall subtests. Completion of RBANS yields 5 index scores based on participant performance on various subtests, as well as a composite Total Index score for battery. Total index scores range from 40 to 160, and are normalized to a mean of 100 and standard deviation (SD) of 15. Higher scores indicate less impairment.

Pharmacodynamic BiomarkersBaseline to 96 weeks

Change in magnetic resonance imaging and blood-based biomarkers and optional CSF biomarkers (neurofilament light chain and progranulin)

Trial Locations

Locations (44)

Dignity Health

🇺🇸

Phoenix, Arizona, United States

University of California San Diego

🇺🇸

La Jolla, California, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Indiana University Health Neuroscience Center

🇺🇸

Indianapolis, Indiana, United States

University of Kansas Alzheimer's Disease Center

🇺🇸

Fairway, Kansas, United States

Johns Hopkins University School of Medicine

🇺🇸

Baltimore, Maryland, United States

Mayo Comprehensive Cancer Center - PPDS

🇺🇸

Rochester, Minnesota, United States

Irving Institute for Clinical and Translational Research

🇺🇸

New York, New York, United States

University Of Cincinnati Gardner Neuroscience institute

🇺🇸

Cincinnati, Ohio, United States

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Dignity Health
🇺🇸Phoenix, Arizona, United States

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