MedPath

Study of Idalopirdine in Patients With Mild - Moderate Alzheimer's Disease Treated With an Acetylcholinesterase Inhibitor

Phase 3
Completed
Conditions
Alzheimer's Disease
Interventions
Drug: Placebo
Registration Number
NCT02006654
Lead Sponsor
H. Lundbeck A/S
Brief Summary

To establish efficacy of idalopirdine as adjunctive therapy to acetylcholinesterase inhibitors (AChEIs) for symptomatic treatment of patients with mild-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 60mg/day as adjunctive therapy to an acetylcholinesterase inhibitor (donepezil 10mg/day, rivastigmine at the patient's individual maintenance dose, or galantamine at the patient's individual maintenance dose), and a 4-week safety follow-up period following study completion or withdrawal from treatment. The dose could be decreased once during the study to 30mg/day if 60mg/day was not well tolerated in the opinion of the investigator. The dose could be increased again to 60mg/day, after which the dose was kept fixed for the remainder of the study. Dose changes were permitted until Week 12 (Visit 5).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
734
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 an AChEI.
  • 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 current AChEI 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
Idalopirdine 60 mg (or 30 mg)IdalopirdineIdalopirdine adjunct to base treatment with an AChEI
PlaceboPlaceboPlacebo adjunct to base treatment with an AChEI
Primary Outcome Measures
NameTimeMethod
Change in CognitionBaseline and 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 Global ImpressionBaseline and 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 Daily FunctioningBaseline and 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 Individual Behavioural Disturbance ItemsBaseline and 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 Behavioural DisturbanceBaseline and 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 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 NPI score is the frequency ratings multiplied by the severity ratings and ranges from 0 to 144 (higher score indicates 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 Health-related Quality of Life (EQ-5D) Utility ScoreBaseline and 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 NPI Anxiety Item Score in Patients With an NPI Anxiety Item Score of at Least 2 at BaselineBaseline and 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.

Change in Cognitive Aspects of Mental FunctionBaseline and 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 VAS)Baseline and 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 (107)

US608

🇺🇸

Deerfield Beach, Florida, United States

DE616

🇩🇪

Unterhaching, Germany

DE601

🇩🇪

Munich, Germany

DE609

🇩🇪

Berlin, Germany

DE605

🇩🇪

Homburg, Germany

BR607

🇧🇷

Rio de Janeiro, Brazil

CZ605

🇨🇿

Havlickuv Brod, Czechia

CZ603

🇨🇿

Plzen, Czechia

CZ607

🇨🇿

Praha 10 - Strasnice, Czechia

AU606

🇦🇺

Newcastle, Australia

US621

🇺🇸

Albany, New York, United States

DE610

🇩🇪

Bad Honnef, Germany

DE608

🇩🇪

Karlstadt, Germany

US604

🇺🇸

Oxnard, California, United States

AU604

🇦🇺

Kanwal, Australia

CZ602

🇨🇿

Chocen, Czechia

US633

🇺🇸

Charlotte, North Carolina, United States

DE602

🇩🇪

Mittweida, Germany

US601

🇺🇸

Farmington Hills, Michigan, United States

AU601

🇦🇺

West Perth, Australia

IL605

🇮🇱

Bat Yam, Israel

CZ601

🇨🇿

Prague, Czechia

US606

🇺🇸

Prairie Village, Kansas, United States

DE612

🇩🇪

Bad Homburg, Germany

DE603

🇩🇪

Ulm, Germany

DE617

🇩🇪

Berlin, Germany

BR609

🇧🇷

Itapira, Brazil

KR603

🇰🇷

Seoul, Korea, Republic of

BR608

🇧🇷

Belo Horizonte, Brazil

TR607

🇹🇷

Samsun, Turkey

US618

🇺🇸

Norristown, Pennsylvania, United States

ES611

🇪🇸

Bilbao, Spain

ES610

🇪🇸

Sant Cugat del Vallès, Spain

AU603

🇦🇺

Caulfield, Australia

AU602

🇦🇺

Heidelberg West, Australia

AU610

🇦🇺

Woodville south, Australia

US626

🇺🇸

Costa Mesa, California, United States

US611

🇺🇸

Elkhart, Indiana, United States

US632

🇺🇸

Staten Island, New York, United States

US630

🇺🇸

Toms River, New Jersey, United States

US607

🇺🇸

Saint Louis, Missouri, United States

DE604

🇩🇪

Erbach, Germany

CZ608

🇨🇿

Chocen, Czechia

DE611

🇩🇪

Freiburg, Germany

CZ604

🇨🇿

Praha 6, Czechia

CZ606

🇨🇿

Kladno, Czechia

DE606

🇩🇪

Rostock, Germany

ES607

🇪🇸

Valencia, Spain

TR605

🇹🇷

Istanbul, Turkey

IL604

🇮🇱

Holon, Israel

IL602

🇮🇱

Ramat Gan, Israel

KR601

🇰🇷

Seongnam-si, Korea, Republic of

ES603

🇪🇸

Barcelona, Spain

GB601

🇬🇧

Brentford, United Kingdom

KR604

🇰🇷

Seoul, Korea, Republic of

ES612

🇪🇸

Burgos, Spain

TR601

🇹🇷

Istanbul, Turkey

TR603

🇹🇷

İstanbul, Turkey

TR606

🇹🇷

Izmir, Turkey

GB603

🇬🇧

Northampton, United Kingdom

ES604

🇪🇸

Barcelona, Spain

ES608

🇪🇸

Barcelona, Spain

ES602

🇪🇸

Lleida, Spain

ES605

🇪🇸

Terrassa, Spain

SK602

🇸🇰

Svidnik, Slovakia

CH605

🇨🇭

Lausanne, Switzerland

ES601

🇪🇸

Barcelona, Spain

ES613

🇪🇸

Madrid, Spain

ES606

🇪🇸

Sevilla, Spain

US625

🇺🇸

Bellflower, California, United States

US627

🇺🇸

Santa Ana, California, United States

US616

🇺🇸

Hialeah, Florida, United States

US631

🇺🇸

Port Charlotte, Florida, United States

US603

🇺🇸

North Palm Beach, Florida, United States

US622

🇺🇸

Elk Grove Village, Illinois, United States

US613

🇺🇸

Lawrenceville, New Jersey, United States

AU609

🇦🇺

Glen Iris, Australia

DE607

🇩🇪

Gelsenkirchen, Germany

KR602

🇰🇷

Seoul, Korea, Republic of

RS603

🇷🇸

Kragujevac, Serbia

RS601

🇷🇸

Novi Sad, Serbia

SG602

🇸🇬

Singapore, Singapore

TR602

🇹🇷

Balova, Turkey

US609

🇺🇸

Danbury, Connecticut, United States

IL601

🇮🇱

Haifa, Israel

MX605

🇲🇽

Monterrey, Mexico

CH603

🇨🇭

Biel, Switzerland

MX603

🇲🇽

Monterrey, Mexico

US612

🇺🇸

Mesa, Arizona, United States

US635

🇺🇸

Manchester, New Jersey, United States

US614

🇺🇸

Norwalk, Connecticut, United States

IL603

🇮🇱

Tel Aviv, Israel

MX604

🇲🇽

Monterrey, Mexico

SK605

🇸🇰

Bratislava, Slovakia

SK604

🇸🇰

Rimavska Sobota, Slovakia

MX602

🇲🇽

Mexico, Mexico

MX601

🇲🇽

Monterrey, Mexico

MX606

🇲🇽

Saltillo, Mexico

RS602

🇷🇸

Belgrade, Serbia

SG601

🇸🇬

Singapore, Singapore

SK601

🇸🇰

Banska Bystrica, Slovakia

SK603

🇸🇰

Bratislava, Slovakia

CH602

🇨🇭

Les Acacias, Switzerland

CH601

🇨🇭

Schlieren, Switzerland

US620

🇺🇸

Miami, Florida, United States

US619

🇺🇸

Houston, Texas, United States

US623

🇺🇸

Oklahoma City, Oklahoma, United States

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