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Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of IONIS-MAPTRx in Patients With Mild Alzheimer's Disease

Phase 1
Completed
Conditions
Mild Alzheimer's Disease
Interventions
Other: Placebo
Registration Number
NCT03186989
Lead Sponsor
Ionis Pharmaceuticals, Inc.
Brief Summary

The purpose of this study was to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of IONIS-MAPTRx in patients with Mild Alzheimer's Disease.

Detailed Description

This was a randomized, double-blind, placebo-controlled study in 46 participants, followed by an Open-Label Extension. This study consisted of two parts:

Part 1: a randomized, double-blind, placebo-controlled multiple ascending dose period in participants with Mild Alzheimer's Disease, followed by Part 2: the open-label, long-term extension period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
46
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part 1: Cohort A: ISIS 814907 10 mgIONIS MAPTRxParticipants received 10 milligrams (mg) ISIS 814907 diluted in 20 milliliters (mL) artificial cerebrospinal fluid (CSF), intrathecally, every four weeks (Q4W) on Days 1, 29, 57, and 85 in Part 1 of the study.
Part 1: Cohort B: ISIS 814907 30 mgIONIS MAPTRxParticipants received 30 mg ISIS 814907 diluted in 20 mL in artificial CSF, intrathecally, Q4W on Days 1, 29, 57, and 85 in Part 1 of the study.
Part 1: Cohort C: ISIS 814907 60 mgIONIS MAPTRxParticipants received 60 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, Q4W on Days 1, 29, 57, and 85 in Part 1 of the study.
Part 2: Late Start Cohort D + ISIS 814907 115 mgIONIS MAPTRxParticipants from MAD Cohort D that were placebo-treated, received 115 mg ISIS 814907 diluted up in 20 mL artificial CSF, intrathecally, Q12W on Days 1, 85, 169, 253, and 337 in Part 2 of the study.
Part 1: Cohort D: ISIS 814907 115 mgIONIS MAPTRxParticipants received 115 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, every 12 weeks (Q12W) on Days 1 and 85 in Part 1 of the study.
Part 2: Early Start Cohort C + ISIS 814907 60 mgIONIS MAPTRxParticipants from MAD Cohort C that were ISIS 814907 60 mg-treated, received 60 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, Q12W on Days 1, 85, 169, 253, and 337 in Part 2 of the study.
Part 1: Pooled PlaceboPlaceboParticipants received 20 mL artificial CSF, intrathecally, as placebo on Days 1, 29, 57, and 85 for the 4-dose regimens, or on Days 1 and 85 for the 2-dose regimens in Part 1 of the study.
Part 2: Late Start Cohort A + Cohort B + Cohort C + ISIS 814907 60 mgIONIS MAPTRxParticipants from MAD Cohorts A, B, C that were placebo-treated, received 60 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, Q12W on Days 1, 85, 169, 253, and 337 in Part 2 of the study.
Part 2: Early Start Cohort A + ISIS 814907 60 mgIONIS MAPTRxParticipants from MAD Cohort A that were ISIS 814907 10 mg -treated, received 60 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, Q12W on Days 1, 85, 169, 253, and 337 in Part 2 of the study.
Part 2: Early Start Cohort B + ISIS 814907 60 mgIONIS MAPTRxParticipants from MAD Cohort B that were ISIS 814907 30 mg-treated, received 60 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, Q12W on Days 1, 85, 169, 253, and 337 in Part 2 of the study.
Part 2: Early Start Cohort D + ISIS 814907 115 mgIONIS MAPTRxParticipants from MAD Cohort D that were ISIS 814907 115 mg-treated, received 115 mg ISIS 814907 diluted in 20 mL artificial CSF, intrathecally, Q12W on Days 1, 85, 169, 253, and 337 in Part 2 of the study.
Primary Outcome Measures
NameTimeMethod
Part 1: Number of Participants With Adverse Events That Are Related to Treatment With ISIS 814907From first dose of study drug up to Week 37 in Part 1

An adverse event (AE) was defined as any unfavourable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of medicinal (investigational) product, whether or not the AE was considered related to the medicinal (investigational) product. A TEAE was defined as any AE that starts or worsens on or after the date of first dose of study treatment. TEAEs were categorised as mild, moderate, and severe to aid in severity assessment.

Part 2: Number of Participants With Adverse Events That Are Related to Treatment With ISIS 814907From first dose of study drug up to Week 64 in Part 2

An AE was defined as any unfavourable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of medicinal (investigational) product, whether or not the AE was considered related to the medicinal (investigational) product. A TEAE was defined as any AE that starts or worsens on or after the date of first dose of study treatment. TEAEs were categorised as mild, moderate, and severe to aid in severity assessment.

Secondary Outcome Measures
NameTimeMethod
CSF Trough Concentration of ISIS 814907Pre dose on Day 85 in Part 1 and Day 337 in Part 2
Maximum Observed Drug Concentration (Cmax) of ISIS 814907 in PlasmaPre-dose, 0.5, 1, 2, 3, 4, and 5 hours post-intrathecal (IT) bolus injection on Day 85 in Part 1 and on Day 337 in Part 2
Time Taken to Reach Maximal Concentration (Tmax) of ISIS 814907 in PlasmaPre-dose, 0.5, 1, 2, 3, 4, and 5 hours post-IT bolus injection on Day 85 in Part 1 and on Day 337 in Part 2
Terminal Elimination Half-life (t1/2λz) of ISIS 814907 in PlasmaPre-dose, 0.5, 1, 2, 3, 4, and 5 hours post-IT bolus injection on Day 85 in Part 1 and on Day 337 in Part 2
Areas Under the Plasma Concentration-time Curve From Zero Time (Predose) to 24 Hours After the IT Administration (AUC0-24h) of ISIS 814907Pre-dose, 0.5, 1, 2, 3, 4, and 5 hours post-IT bolus injection on Day 85 in Part 1 and on Day 337 in Part 2

Trial Locations

Locations (13)

Karolinska University Hospital Huddinge

🇸🇪

Stockholm, Sweden

Clinical Research Services Turku CRST

🇫🇮

Turku, Finland

University College London Hospitals NHS Foundation Trust

🇬🇧

London, United Kingdom

Sheffield Institute for Translational Neuroscience (SITraN)

🇬🇧

Sheffield, United Kingdom

Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)

🇩🇪

Bonn, Germany

Montreal Neurological Hospital

🇨🇦

Montréal, Canada

St Josef Hospital

🇩🇪

Bochum, Germany

MVZ Mittweida Gbr

🇩🇪

Mittweida, Germany

Universittsklinikum Ulm

🇩🇪

Ulm, Germany

VU University Medical Center

🇳🇱

Amsterdam, Netherlands

QPS Netherlands BV

🇳🇱

Groningen, Netherlands

Minnesmottagningen

🇸🇪

Mölndal, Sweden

Royal Liverpool University Hospital

🇬🇧

Liverpool, United Kingdom

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