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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT03444870
Other study ID # WN29922
Secondary ID 2017-001364-38
Status Terminated
Phase Phase 3
First received
Last updated
Start date June 6, 2018
Est. completion date February 17, 2023

Study information

Verified date January 2024
Source Hoffmann-La Roche
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This randomized, double-blind, placebo-controlled, parallel-group study will evaluate the efficacy and safety of gantenerumab versus placebo in participants with early (prodromal to mild) AD. All participants must show evidence of beta-amyloid pathology. Eligible participants will be randomized 1:1 to receive either subcutaneous (SC) injection of gantenerumab or placebo. The primary efficacy assessment will be performed at the end of the double blind period at week 116. Participants will then be offered to enter into an open-label extension (OLE). Participants not willing to go to the OLE will participate in a long term follow-up period for up to 50 weeks after the last gantenerumab dose.


Recruitment information / eligibility

Status Terminated
Enrollment 1053
Est. completion date February 17, 2023
Est. primary completion date December 28, 2022
Accepts healthy volunteers No
Gender All
Age group 50 Years to 90 Years
Eligibility Key Inclusion criteria: - Meets National Institute on Aging/Alzheimer's Association (NIAAA) core clinical criteria for probable AD dementia or prodromal AD (consistent with the NIAAA diagnostic criteria and guidelines for mild cognitive impairment) - Evidence of the AD pathological process, as confirmed by CSF tau/A-beta42or amyloid PET scan - Demonstrated abnormal memory function - MMSE score greater than or equal to 22 (= 22) - Clinical dementia rating-global score (CDR-GS) of 0.5 or 1.0 - Availability of a reliable study partner who accepts to participate in study procedures throughout the 2 years duration of study - If receiving symptomatic AD medications, the dosing regimen must have been stable for 3 months prior to screening and until randomization - For enrollment in the China extension, patients must have residence in mainland China, Hong Kong, or Taiwan and be of Chinese ancestry - For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods Key Exclusion criteria: - Any evidence of a condition other than AD that may affect cognition - History of schizophrenia, schizoaffective disorder, major depression, or bipolar disorder - History or presence of clinically evident systemic vascular disease that in the opinion of the investigator has the potential to affect cognitive function - History or presence of clinically evident cerebrovascular disease - History or presence of posterior reversible encephalopathy syndrome - History or presence of any stroke with clinical symptoms within the past 12 months, or documented history within the last 6 months of an acute event that is consistent with a transient ischemic attack - History of severe, clinically significant CNS trauma - History or presence of intracranial mass (e.g., glioma, meningioma) that could potentially impair cognition - Presence of infections that affect brain function or history of infections that resulted in neurologic sequelae - History or presence of systemic autoimmune disorders that potentially cause progressive neurologic disease with associated cognitive deficits - At risk for suicide in the opinion of the investigator - Alcohol and/or substance abuse or dependants in past 2 years - Relevant brain hemorrhage, bleeding disorder and cerebrovascular abnormalities - Any contraindications to brain MRI - Unstable or clinically significant cardiovascular, kidney or liver disease - Uncontrolled hypertension - Unstable or clinically significant cardiovascular disease - Abnormal thyroid function - Patients with evidence of folic acid deficiency Exclusion for Open-Label Extension (OLE): - Discontinued from study treatment during the double-blind treatment period - Received any other investigational medication during the double-blind treatment period or after the end of double-blind treatment - Participation in the OLE deemed inappropriate by the investigator - Presence of ARIA-E findings at the Week 116 MRI scan

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Gantenerumab
Gantenerumab will be administered as per the schedule specified in the respective arm.
Placebo
Placebo will be administered as per the schedule specified in the respective arm.

Locations

Country Name City State
Australia St Vincent's Hospital Sydney; Neurology Darlinghurst New South Wales
Australia Central Coast Neurosciences Research Erina New South Wales
Australia Heidelberg Repatriation Hospital; Medical and Cognitive Research Centre Heidelberg West Victoria
Australia Southern Neurology Kogarah New South Wales
Australia Australian Alzheimer's Research Foundation Nedlands Western Australia
Australia Neuro Trials Victoria Noble Park Victoria
Australia The Queen Elizabeth Hospital; Neurology Woodville South Australia
Brazil Hospital Nossa Senhora das Graças; Setor de Pesquisa em Neurologia Curitiba PR
Brazil Instituto de Neurologia de Curitiba Curitiba PR
Brazil Clinica Clinilive ltda Maringa PR
Brazil Hospital das Clinicas - UFRGS Porto Alegre RS
Brazil Clínica Dr. Norton Sayeg LTDA - EPP Sao Paulo SP
Brazil Hospital das Clinicas - FMUSP_X; Neurologia Sao Paulo SP
Canada Center for Diagnosis and Research on Alzheimer's disease Greenfield Park Quebec
Canada Parkwood Hospital; Geriatric Medicine London Ontario
Canada Medical Arts Health Research Group Penticton British Columbia
Canada Alpha Recherche Clinique Quebec
Canada Q & T Research Sherbrooke Sherbrooke Quebec
Canada Baycrest Health Sciences Toronto Ontario
Canada Centre for Memory and Aging Toronto Ontario
Canada St. Michael'S Hospital Toronto Ontario
Canada Sunnybrook Health Sciences Centre Toronto Ontario
Canada The Medical Arts Health Research Group - West Vancouver Vancouver British Columbia
Canada Devonshire Clinical Research Woodstock Ontario
China Beijing Anding Hospital, Capital Medical University Beijing City
China Beijing Tian Tan Hospital,Capital Medical University Beijing City
China China-Japan Friendship Hospital Beijing City
China West China Hospital, Sichuan University Chengdu
China The First Affiliated Hospital, Chongqing Medical University Chongqing
China Fujian Medical University Union Hospital Fuzhou City
China Guangzhou First Municipal People's Hospital Guangzhou
China Sun Yat-sen Memorial Hospital; Neurology Guangzhou
China Guangdong Provincial People's Hospital; Breast Guangzhou City
China The Second Affiliated Hospital, Zhejiang University Hangzhou
China Sir Run Run Shaw Hospital Hangzhou City
China Anhui Provincial Hospital Hefei
China The First Affiliated Hospital of Anhui Medical University Hefei
China The Second Affiliated Hospital to Nanchang University Nanchang
China Zhongda Hospital Affiliated to Southeast University Nanjing
China Jiangsu Province Hospital (the First Affiliated Hospital With Nanjing Medical University) Nanjing City
China Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School Nanjing City
China Shanghai First People's Hospital Shanghai
China Shanghai Mental Health Center Shanghai
China Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai
China Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai
China Huashan Hospital Affiliated to Fudan University Shanghai City
China Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai City
China The University of Hong Kong-Shenzhen Hospital; Local Ethic Committee Shenzhen City
China Tianjin Medical University General Hospital Tianjin
China The First Affiliated Hospital of Wenzhou Medical College Wenzhou
China Northern Jangsu People's Hospital Yangzhou City
China Henan Provincial People's Hospital Zhengzhou
France CHU Amiens Hopital Sud; Neurologie Amiens Cedex1
France Hôpital Avicenne; Centre de Recherche Clinique Bobigny Cedex
France Groupement Hospitalier Est - Hôpital Neurologique; Neurologie A (U502) Bron cedex
France CHU de la Timone - Hopital d Adultes; Service de Neurologie Marseille
France Hôpital Lariboisière Paris
France CHU Poitiers - Hopital La Miletrie Poitiers
France CHU Strasbourg Hôpital Hautepierre Strasbourg
France Gerontopole; Centre de Recherche clinique Toulouse
France Hopital des Charpennes Villeurbanne
Germany Ambulates Gesundheitszentrum der Charité GmbH; MVZ Neurologie Campus Benjamin Franklin Berlin
Germany ECRC Experimental and Clinical Research Center, Charité Campus Berlin Buch, Memory Clinic Berlin
Germany St. Josef-Hospital, Klinik für Neurologie Bochum
Germany Universitätsklinikum Köln; Klinik und Poliklinik für Psychiatrie und Psychotherapie Köln
Germany PANAKEIA - Arzneimittelforschung Leipzig GmbH Leipzig
Germany Universitätsmedizin derJohannes Gutenberg-Universität Mainz;Klinik für Psychiatrie und Psychotherapi Mainz
Germany Klinikum rechts der Isar der TU München; Klinik für Psychiatrie und Psychotherapie München
Germany Universitätsklinikum Münster; Klinik und Poliklinik für Neurologie Münster
Germany Universitätsklinikum Rostock Zentrum für Nervenheilkunde Rostock
Germany Universitätsklinikum Ulm; Klinik für Neurologie Ulm
Germany Studienzentrum Nordwest Dr med Joachim Springub Herr Wolfgang Schwarz Westerstede
Germany Forschungszentrum Ruhr Witten
Hungary Semmelweis University; Department of Neurology Budapest
Italy IRCCS ?Centro S. Giovanni di Dio? Fatebenefratelli -UO Alzheimer Brescia Lombardia
Italy IRCCS Ospedale San Raffaele; Centro Disturbi della Memoria Milano Lombardia
Italy Nuovo Ospedale Civile S. Agostino-Estense; Clinica Neurologica ? Dipartimento di Neuroscienze Modena Emilia-Romagna
Italy ASST DI MONZA; Neurologia Monza Lombardia
Italy Dipartimento delle Patologie Emergenti; Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone Palermo Sicilia
Italy IRCCS Neuromed; Neurologia I-Centro studio e cura delle demenze e UVA Pozzilli Molise
Italy Fondazione Santa Lucia IRCCS; Neurologia e Riabilitazione Neurologica Roma Lazio
Italy Ospedale San Giovanni Calibita Fatebenefratell;Neurologia Roma Lazio
Italy Umberto I Policlinico di Roma-Università di Roma La Sapienza Roma Lazio
Italy AO Città della Salute e della Scienza Osp.S.Giov.Battista Molinette; SC Geriatria Torino Piemonte
Japan Inage Neurology and Memory Clinic Chiba
Japan Juntendo University Urayasu Hospital Chiba
Japan Medical Corporation Hakuyokai Kashiwado Hospital Chiba
Japan Southern Tohoku Medical Clinic Fukushima
Japan Shonan Kamakura General Hospital Kanagawa
Japan Yuai Clinic Kanagawa
Japan Mishima Hospital Niigata
Japan NHO Shizuoka Institute of Epilepsy and Neurological Disorders Shizuoka
Japan Shizuoka City Shimizu Hospital Shizuoka
Japan Jichiidai Station Brain Clinic Tochigi
Japan National Center of Neurology and Psychiatry Tokyo
Japan Nozomi Memory Clinic Tokyo
Japan P-One Clinic Tokyo
Japan Tokyo Medical and Dental University Hospital Tokyo
Japan Tokyo Medical University Hospital Tokyo
Japan Tokyo Metropolitan Geriatric Hospital Tokyo
Japan Yotsuya Medical Cube Tokyo
Japan Yamagata Tokusyukai Hospital Yamagata
Lithuania Vilnius University Hospital Santariskiu Clinics; Neurology Vilnius
Peru Hospital IV Alberto Sabogal Sologuren; Unidad de Investigacion Bellavista
Peru Clinica Internacional; Unidad De Investigacion Lima
Peru Hospital Nacional Dos de Mayo; Unidad de Investigacion de Neurologia Lima
Peru Hospital Nacional Cayetano Heredia; Servicio de Neurologia San Martin de Porres
Russian Federation State autonomous institution of healthcare Inter-regional clinical and diagnostic center Kazan Tatarstan
Russian Federation Vertebronevrologiya LLC Kazan Tatarstan
Russian Federation FSBHI Siberian Clinical Center of the Federal Medical and Biological Agency Krasnoyarsk Krasnojarsk
Russian Federation City Clin Hosp n.a. S.P.Botkin Moscow Moskovskaja Oblast
Russian Federation University ?linic of headaches Moscow Moskovskaja Oblast
Russian Federation Central Clinical Hospital #2 N.A. Semashko OAO RJHD Moskva Moskovskaja Oblast
Russian Federation City Clinical Hospital # 2 n.a. V.I. Razumovsky Saratov
Russian Federation Russian Medical Military Academy n.a. S.M.Kirov; Neurology Department St Petersburg Sankt Petersburg
Russian Federation Nebbiolo Center for Clinical Trials Tomsk
Spain Hospital General Universitario de Albacete; Servicio de Neurología Albacete
Spain Hospital Clinic i Provincial; Servicio de Neurologia Barcelona
Spain Hospital de la Santa Creu i Sant Pau; Servicio de Neurologia Barcelona
Spain Hospital Vall d'Hebron; Servicio de Neurología Barcelona
Spain Hospital Universitario Reina Sofia; Servicio de Neurologia Cordoba
Spain Hospital Universitari de Bellvitge; Servicio de Neurologia L'Hospitalet de Llobregat Barcelona
Spain Hospital San Pedro; Servicio de Neurología Logroño LA Rioja
Spain Hospital Ramon y Cajal; Servicio de Neurologia Madrid
Spain Hospital Ruber Internacional; Servicio de Neurología Madrid
Spain Hospital Universitario 12 de Octubre; Servicio de Neurologia Madrid
Spain HM Universitario Puerta del Sur CINAC (C.Integ.Neuroc);; Servicio de Psiquiatría Móstoles Madrid
Spain Complejo Asistencial Universitario de Salamanca; Servicio de Psiquiatría Salamanca
Spain Hospital General De Catalunya; Servicio de Neurologia Sant Cugat del Valles Barcelona
Spain Hospital Universitario Marques de Valdecilla; Servicio de Neurología SANtander Cantabria
Spain Hospital Virgen del Rocío; Servicio de Neurología Sevilla
Spain Hospital Universitario Dr. Peset; Servicio de Neurologia Valencia
Spain Servicio de Neurología Hospital Viamed Montecanal. Zaragoza
Taiwan Changhua Christian Hospital; Neurology Changhua County
Taiwan Kaohsiung Medical University Hospital; Neurology Kaohsiung
Taiwan Chang Gung Memorial Foundation - Kaohsiung - Neurology Niaosong Dist.
Taiwan China Medical University Hospital; Neurology North Dist.
Taiwan National Taiwan University Hospital; Neurology Taipei
Taiwan Chang Gung Memorial Foundation - Linkou - Neurology Taoyuan
United States Abington Neurological Associates Abington Pennsylvania
United States JEM Research LLC Atlantis Florida
United States Senior Adults Specialty Research Austin Texas
United States Bradenton Research Center Bradenton Florida
United States University of Virginia Charlottesville Virginia
United States Columbus Memory Center Columbus Georgia
United States Ohio State University; College of Medicine Columbus Ohio
United States Neurology Consultants of Dallas; Research Department Dallas Texas
United States Brain Matters Research, Inc. Delray Beach Florida
United States Precise Research Centers Flowood Mississippi
United States Fort Wayne Neurological Center Fort Wayne Indiana
United States Center for Advanced Research & Education Gainesville Georgia
United States Global Clinical Trials; Irvine, CA Irvine California
United States University of Mississippi Medical Center Jackson Mississippi
United States The Clinical Trial Center, LLC Jenkintown Pennsylvania
United States Neurological Associates of Long Island, PC Lake Success New York
United States UW Wisconsin-Madison Madison Wisconsin
United States Columbia University Medical Center New York New York
United States Sentara Neurology Specialists Norfolk Virginia
United States Research Center for Clinical Studies, Inc. Norwalk Connecticut
United States Drexel University; College of Medicine Philadelphia Pennsylvania
United States Coastal Neurology Port Royal South Carolina
United States National Clinical Research Inc.-Richmond Richmond Virginia
United States Neurological Associates, Inc. Richmond Virginia
United States Sutter Medical Group, Neurology Sacramento California
United States Wasatch Clinical Research, LLC Salt Lake City Utah
United States Syrentis Clinical Research Santa Ana California
United States California Neuroscience Research Medical Group, Inc Sherman Oaks California
United States Southern Illinois University, School of Medicine Springfield Illinois
United States Advanced Memory Research Institute of NJ Toms River New Jersey
United States Center for Neurosciences Tucson Arizona
United States Alzheimer?s Research and Treatment Center Wellington Florida
United States Via Christi Research Wichita Kansas

Sponsors (1)

Lead Sponsor Collaborator
Hoffmann-La Roche

Countries where clinical trial is conducted

United States,  Australia,  Brazil,  Canada,  China,  France,  Germany,  Hungary,  Italy,  Japan,  Lithuania,  Peru,  Russian Federation,  Spain,  Taiwan, 

Outcome

Type Measure Description Time frame Safety issue
Primary DBT Period: Change From Baseline to Week 116 in Global Outcome, as Measured by CDR-SB CDR was derived through semi-structured interview with the participant and an appropriate informant, and it rated impairment across six domains: memory, orientation, judgment, and problem solving, community affairs, home and hobbies, and personal care on a 5-point scale for which 0=no impairment, 0.5=questionable impairment, and 1, 2, and 3=mild, moderate, and severe impairment, respectively. The CDR-SB is based on summing each of the domain box scores with total score ranging from 0-18 with higher scores reflecting greater cognitive and functional impairment. A negative change from baseline indicates improvement. Baseline, Week 116
Primary China Extension: DBT Period: Change From Baseline to Week 116 in Global Outcome, as Measured by CDR-SB CDR was derived through semi-structured interview with the participant and an appropriate informant, and it rated impairment across six domains: memory, orientation, judgment, and problem solving, community affairs, home and hobbies, and personal care on a 5-point scale for which 0=no impairment, 0.5=questionable impairment, and 1, 2, and 3=mild, moderate, and severe impairment, respectively. The CDR-SB is based on summing each of the domain box scores with total score ranging from 0-18 with higher scores reflecting greater cognitive and functional impairment. A negative change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Alzheimer Disease Assessment Scale-Cognition Subscale 13 (ADAS-Cog13) Score The ADAS-Cog13 total score includes all of the items in the ADAS-Cog11 in addition to delayed word recall and the number cancellation. For the ADAS-cog 13 the range is 0-85 (score range for Delayed Word Recall [DWR] score is 0-10 and for Number Cancellation [NC] is 0-5, thus the score is ADAS-cog 11[0-70] plus the scores for DWR and NC). A higher score indicates worse performance. A negative change from baseline indicates improvement in cognitive function. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Alzheimer's Disease Cooperative Study- Activities of Daily Living (ADCS-ADL) Total Score ADCS-ADL is a 23-item rater-administered, observer-reported outcome (ObsRO) that captures a participant's ability to perform basic activities of daily living (e.g., eating and toileting) and more complex ADL or instrumental activities of daily living (iADL, e.g., using the telephone, managing finances, preparing a meal). Total score ranges from 0-78, with higher scores reflecting better functioning. A positive change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Functional Activities Questionnaire (FAQ) Score FAQ is a rater-administered ObsRO (informant-based measure) that measures a participant's functional ability to perform complex higher-order activities. The observer provides performance ratings of the target person on ten complex higher-order activities. Total score that ranges from 0-30, with higher scores reflecting greater functional impairment. A negative change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Mini-Mental State Examination (MMSE) Total Score MMSE is a rater-administered performance-based outcome (PerfO) that includes a set of standardized questions used to evaluate possible cognitive impairment and help stage the severity level of this impairment. The questions target six areas: orientation, registration, attention, short-term recall, language, and constructional praxis/visuospatial abilities. Total score ranges from 0-30, with lower scores indicating greater impairment. A positive change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Alzheimer Disease Assessment Scale-Cognition Subscale 11 (ADAS-Cog11) Score The ADAS-Cog11 was designed to measure cognitive symptom change in participants with Alzheimer's Disease (AD) and consisted of 11 tasks. The standard 11 items (and corresponding score range) were: word recall (0-10), commands (0-5), constructional praxis (0-5), naming objects and fingers (0-5), ideational praxis (0-5), orientation (0-8), word recognition (0-12), spoken language ability (0-5), comprehension of spoken language (0-5), word-finding difficulty (0-5), and remembering test instructions (0-5). The test included 7 performance items and 4 clinician-rated items. The ADAS-Cog11 total score was the sum of all 11 individual items, with a total score ranging from 0 (no impairment) to 70 (severe impairment). Higher scores indicated more severe cognitive impairment. A negative change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Verbal Fluency Task (VFT) Score VFT is a rater administered PerfO that measures speed and flexibility of verbal thought with a total score that ranges from 0-99 (lower scores indicating lower performance). A positive change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in the Coding (Digit Symbol Substitution Test [DSST]) Subtest Coding, also called DSST is a rater administered PerfO that measures speed of processing and associative memory with a total score that ranges from 0-135 (lower scores indicating lower performance). The DSST was adapted from the Wechsler Adult Intelligence Scale. The 120-second version of the test was used in this study. Positive change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Alzheimer's Disease Cooperative Study-Instrumental Activities of Daily Living (ADCS-iADL) Instrumental Score The ADCS-iADL measures activities such as using the telephone, shopping and preparing a meal. The ADCS-iADL consists of 16 questions with a score range of 0 to 56 where a higher score represents better function. Positive change from baseline indicates improvement. Baseline, Week 116
Secondary DBT Period: Number of Participants With at Least One Adverse Event (AE) An AE is any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product, regardless of causal attribution. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 131 weeks)
Secondary DBT Period: Number of Participants With Post-baseline Suicidal Ideation or Suicidal Behavior as Measured Using Columbia-Suicide Severity Rating Scale (C-SSRS) C-SSRS=assessment tool used to assess lifetime suicidality of a participant (at baseline) as well as any new instances of suicidality (C-SSRS since last visit). Structured interview prompts recollection of suicidal ideation, including intensity of ideation, behavior, & attempts with actual/potential lethality. Categories have binary responses (yes/no) & include Wish to be Dead; Non-specific Active Suicidal Thoughts; Active Suicidal Ideation with Any Methods (Not Plan) without Intent to Act; Active Suicidal Ideation with Some Intent to Act, without Specific Plan; Active Suicidal Ideation with Specific Plan and Intent, Preparatory Acts and Behavior; Aborted Attempt; Interrupted Attempt; Actual Attempt (non-fatal); Completed Suicide. Suicidal ideation/behavior is indicated by a "yes" answer to any of the listed categories. Score of 0 is assigned if no suicide risk is present. Score of 1 or higher= suicidal ideation or behavior. Categories with non-zero values are only reported here. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 131 weeks)
Secondary DBT Period: Number of Participants With at Least One Amyloid-Related Imaging Abnormalities-Edema (ARIA-E) Magnetic Resonance Imaging (MRI) Finding ARIA are an identified risk with anti-amyloid antibodies, including gantenerumab. These changes can be identified on brain MRI. In ARIA-E, (E for oedema or effusion), oedema can be seen in different areas of the brain on MRI, representing fluid leakage into the brain parenchyma or sulcal spaces. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 131 weeks)
Secondary DBT Period: Number of Participants With at Least One Amyloid-Related Imaging Abnormalities-Haemosiderin Deposition (ARIA-H) MRI Finding ARIA are an identified risk with anti-amyloid antibodies, including gantenerumab. These changes can be identified on brain MRI. ARIA-H (H for hemosiderosis) are small foci of signal loss observed on MRI sequences sensitive for paramagnetic tissue properties and comprise cerebral microbleeds (small foci of bleeding in the brain parenchyma) and leptomeningeal hemosiderosis (small foci of bleeding on the surface of the brain). These changes also occur sporadically in AD. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 131 weeks)
Secondary DBT Period: Number of Participants With Injection-Site Reactions An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of an investigational product or other protocol-imposed intervention, regardless of attribution. Local injection reactions (or injection site reactions) are defined as AEs related to the injection site that occur during or within 24 hours after study drug administration that are judged to be related to the study drug injection. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 131 weeks)
Secondary DBT Period: Number of Participants With Anti-Drug Antibodies (ADA) to Gantenerumab The number of participants with positive results for ADA against gantenerumab at any of the post-baseline assessment time-points were reported. Participant with an ADA assay result from at least one post-baseline sample was defined as a post-baseline evaluable participant. Treatment Emergent ADA = A participant with a negative or missing baseline ADA result(s) and at least one positive post-baseline ADA result. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 131 weeks)
Secondary DBT Period: Change From Baseline to Week 116 in Brain Amyloid Load as Measured by Amyloid Positron Emission Tomography (PET) Scan in a Subset of Participants Brain amyloid load over time was assessed using [18F] florbetaben or [18F] flutemetamol tracers. These are PET radioligand selective to amyloid. Amyloid PET burden was measured in a composite region of interest (ROI) by using standardized uptake value ratio (SUVR) mapped to the centiloid scale. The weighted composite target region are composed of (both left and right side): frontal lobe, parietal lobe, temporal lobe lateral, cingulum posterior and anterior cingulate gyrus. The reference region used to normalize the composite region was the whole cerebellum. The centiloid scale anchor points are 0 and 100, where 0 represents a high-certainty amyloid negative scan and 100 represents the amount of global amyloid deposition found in a typical AD scan. Baseline, Week 116
Secondary DBT Period: Change From Baseline to Week 116 in Brain Tau Load, as Measured by Tau PET Scan in a Subset of Participants Change in tau load= how much neurofibrillary tau pathology is present in brain assessed by PET Scan. [18F] GTP1 was the tau PET radioligand. Tau load was measured using SUVR in 4 composite target ROIs: Temporal composite target region (left & right)=anterior & posterior superior temporal gyrus, posterior temporal lobe, fusiform gyrus, & middle & inferior temporal gyrus; Medial temporal composite region excluding hippocampus (left & right): amygdala, parahippocampus & anterior medial & lateral temporal lobe; Frontal lobe (left & right) & Parietal lobe (left & right). Inferior cerebellar grey matter=reference region for calculating SUVRs for all 4 regions. Tau-PET-mITT analysis set=all participants in ITT analysis set who participated in Tau PET sub-study & who had at least one Tau PET scan with a valid quantitative measurement & who did not withdraw from Tau PET substudy before randomization. Overall number analyzed=number of participants with data available for analysis. Baseline, Week 116
Secondary DBT Period: Percent Change From Baseline to Week 116 in Cerebrospinal Fluid (CSF) Marker of Disease in a Subset of Participants - Total Tau (tTau) CSF biomarker tTau has been considered as a general marker of neurodegeneration. An elevation in levels of tau, as well as specific pTau species, is thought to be a marker for progressive cellular degeneration in AD. Baseline, Week 116
Secondary DBT Period: Percent Change From Baseline to Week 116 in CSF Marker of Disease in a Subset of Participants - Phosphorylated Tau (pTau-181) CSF phospho-tau is an indicator of neuronal injury and neurodegeneration. CSF biomarker tTau has been considered as a general marker of neurodegeneration. An elevation in levels of pTau species, is thought to be a marker for progressive cellular degeneration in AD. Baseline, Week 116
Secondary DBT Period: Percent Change From Baseline to Week 116 in CSF Marker of Disease in a Subset of Participants - Neurofilament Light Chain (NFL) NFL is a neuronal cytoplasmic protein highly expressed in large, myelinated axons. Its levels increase in CSF and blood proportionally to the degree of axonal damage in a variety of neurological disorders, including AD. Baseline, Week 116
Secondary DBT Period: Percent Change From Baseline to Week 116 in CSF Marker of Disease in a Subset of Participants - Neurogranin Baseline, Week 116
Secondary China - DBT Period: Change From Baseline to Week 116 in ADAS-Cog13 Score The ADAS-Cog13 total score includes all of the items in the ADAS-Cog11 in addition to delayed word recall and the number cancellation. For the ADAS-cog 13 the range is 0-85 (score range for Delayed Word Recall [DWR] score is 0-10 and for Number Cancellation [NC] is 0-5, thus the score is ADAS-cog 11[0-70] plus the scores for DWR and NC). A higher score indicates worse performance. A negative change from baseline indicates improvement in cognitive function. Baseline, Week 116
Secondary China - DBT Period: Change From Baseline to Week 116 in ADCS-ADL Total Score ADCS-ADL is a 23-item rater-administered, ObsRO that captures a participant's ability to perform basic activities of daily living (e.g., eating and toileting) and more complex ADL or instrumental activities of daily living (iADL, e.g., using the telephone, managing finances, preparing a meal). Total score ranges from 0-78, with higher scores reflecting better functioning. A positive change from baseline indicates improvement. Baseline, Week 116
Secondary China - DBT Period: Change From Baseline to Week 116 in FAQ Score FAQ is a rater-administered ObsRO (informant-based measure) that measures a participant's functional ability to perform complex higher-order activities. The observer provides performance ratings of the target person on ten complex higher-order activities. Total score that ranges from 0-30, with higher scores reflecting greater functional impairment. A negative change from baseline indicates improvement. Baseline, Week 116
Secondary China - DBT Period: DBT Period: Change From Baseline to Week 116 in MMSE Total Score MMSE is a rater-administered PerfO that includes a set of standardized questions used to evaluate possible cognitive impairment and help stage the severity level of this impairment. The questions target six areas: orientation, registration, attention, short-term recall, language, and constructional praxis/visuospatial abilities. Total score ranges from 0-30, with lower scores indicating greater impairment. A positive change from baseline indicates improvement. Baseline, Week 116
Secondary China - DBT Period: Change From Baseline to Week 116 in ADAS-Cog11 Score The ADAS-Cog11 was designed to measure cognitive symptom change in participants with AD and consisted of 11 tasks. The standard 11 items (and corresponding score range) were: word recall (0-10), commands (0-5), constructional praxis (0-5), naming objects and fingers (0-5), ideational praxis (0-5), orientation (0-8), word recognition (0-12), spoken language ability (0-5), comprehension of spoken language (0-5), word-finding difficulty (0-5), and remembering test instructions (0-5). The test included 7 performance items and 4 clinician-rated items. The ADAS-Cog11 total score was the sum of all 11 individual items, with a total score ranging from 0 (no impairment) to 70 (severe impairment). Higher scores indicated more severe cognitive impairment. A negative change from baseline indicates improvement. Baseline, Week 116
Secondary China - DBT Period: Change From Baseline to Week 116 in VFT Score VFT is a rater administered PerfO that measures speed and flexibility of verbal thought with a total score that ranges from 0-99 (lower scores indicating lower performance). A positive change from baseline indicates improvement. Baseline, Week 116
Secondary China - DBT Period: Change From Baseline to Week 116 in the Coding (DSST) Subtest Coding, also called DSST is a rater administered PerfO that measures speed of processing and associative memory with a total score that ranges from 0-135 (lower scores indicating lower performance). The DSST was adapted from the Wechsler Adult Intelligence Scale. The 120-second version of the test was used in this study. Positive change from baseline indicates improvement. Baseline, Week 116
Secondary China - DBT Period: Number of Participants With at Least One AE An AE is any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product, regardless of causal attribution. Total number of participants with at least one event (AEs) have been reported here. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 124 weeks)
Secondary China - DBT Period: Number of Participants With Post-baseline Suicidal Ideation or Suicidal Behavior as Measured Using C-SSRS C-SSRS=assessment tool used to assess lifetime suicidality of a participant (at baseline) as well as any new instances of suicidality (C-SSRS since last visit). Structured interview prompts recollection of suicidal ideation, including intensity of ideation, behavior, & attempts with actual/potential lethality. Categories have binary responses (yes/no) & include Wish to be Dead; Non-specific Active Suicidal Thoughts; Active Suicidal Ideation with Any Methods (Not Plan) without Intent to Act; Active Suicidal Ideation with Some Intent to Act, without Specific Plan; Active Suicidal Ideation with Specific Plan and Intent, Preparatory Acts and Behavior; Aborted Attempt; Interrupted Attempt; Actual Attempt (non-fatal); Completed Suicide. Suicidal ideation/behavior is indicated by a "yes" answer to any of the listed categories. Score of 0 is assigned if no suicide risk is present. Score of 1 or higher= suicidal ideation or behavior. Categories with non-zero values are only reported here. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 124 weeks)
Secondary China - DBT Period: Number of Participants With at Least One ARIA-E MRI Finding ARIA are an identified risk with anti-amyloid antibodies, including gantenerumab. These changes can be identified on brain MRI. In ARIA-E, (E for oedema or effusion), oedema can be seen in different areas of the brain on MRI, representing fluid leakage into the brain parenchyma or sulcal spaces. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 124 weeks)
Secondary China - DBT Period: Number of Participants With at Least One ARIA-H MRI Finding ARIA are an identified risk with anti-amyloid antibodies, including gantenerumab. These changes can be identified on brain MRI. ARIA-H (H for hemosiderosis) are small foci of signal loss observed on MRI sequences sensitive for paramagnetic tissue properties and comprise cerebral microbleeds (small foci of bleeding in the brain parenchyma) and leptomeningeal hemosiderosis (small foci of bleeding on the surface of the brain). These changes also occur sporadically in AD. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 124 weeks)
Secondary China - DBT Period: Number of Participants With Injection-Site Reactions An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of an investigational product or other protocol-imposed intervention, regardless of attribution. Local injection reactions (or injection site reactions) are defined as AEs related to the injection site that occur during or within 24 hours after study drug administration that are judged to be related to the study drug injection. From Day 1 up to 14 weeks after the last dose of blinded study drug (up to 124 weeks)
Secondary OLE Period: Number of Participants With at Least One AEs An AE is any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product, regardless of causal attribution. From day of first dose in OLE period up to 14 weeks after the last OLE dose (up to 68 weeks)
Secondary OLE Period: Number of Participants With Post-baseline Suicidal Ideation or Suicidal Behavior as Measured Using C-SSRS C-SSRS=assessment tool used to assess lifetime suicidality of a participant (at baseline) as well as any new instances of suicidality (C-SSRS since last visit). Structured interview prompts recollection of suicidal ideation, including intensity of ideation, behavior, & attempts with actual/potential lethality. Categories have binary responses (yes/no) & include Wish to be Dead; Non-specific Active Suicidal Thoughts; Active Suicidal Ideation with Any Methods (Not Plan) without Intent to Act; Active Suicidal Ideation with Some Intent to Act, without Specific Plan; Active Suicidal Ideation with Specific Plan and Intent, Preparatory Acts and Behavior; Aborted Attempt; Interrupted Attempt; Actual Attempt (non-fatal); Completed Suicide. Suicidal ideation/behavior is indicated by a "yes" answer to any of the listed categories. Score of 0 is assigned if no suicide risk is present. Score of 1 or higher= suicidal ideation or behavior. Categories with non-zero values are only reported here. From day of first dose in OLE period up to 14 weeks after the last OLE dose (up to 68 weeks)
Secondary OLE Period: Number of Participants With at Least One ARIA-H MRI Finding ARIA are an identified risk with anti-amyloid antibodies, including gantenerumab. These changes can be identified on brain MRI. ARIA-H (H for hemosiderosis) are small foci of signal loss observed on MRI sequences sensitive for paramagnetic tissue properties and comprise cerebral microbleeds (small foci of bleeding in the brain parenchyma) and leptomeningeal hemosiderosis (small foci of bleeding on the surface of the brain). These changes also occur sporadically in AD. From day of first dose in OLE period up to 14 weeks after the last OLE dose (up to 68 weeks)
Secondary OLE Period: Number of Participants With at Least One ARIA-E MRI Finding ARIA are an identified risk with anti-amyloid antibodies, including gantenerumab. These changes can be identified on brain MRI. In ARIA-E, (E for oedema or effusion), oedema can be seen in different areas of the brain on MRI, representing fluid leakage into the brain parenchyma or sulcal spaces. From day of first dose in OLE period up to 14 weeks after the last OLE dose (up to 68 weeks)
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