A Study to Evaluate Safety and Tolerability of Different Doses and Efficacy of PQ912 in Subjects With MCI and Mild AD

Early Alzheimers Disease Clinical Trial

— VIVIAD  

Official title:

A Phase 2b Multicentre, Randomized, Double-blind, Placebo-controlled, Parallel Group Dose Finding, Safety, Tolerability and Efficacy Study of PQ912 in Subjects With MCI and Mild Dementia Due to Alzheimer's Disease.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04498650
• Other study ID #: PBD-01180
• Secondary ID: 2019-003532-23
• Status: Completed
• Phase: Phase 2
• Start date: July 6, 2020
• Est. completion date: January 12, 2024

Study information

• Verified date: March 2024
• Source: Vivoryon Therapeutics N.V.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a phase 2B multicenter, randomized, double-blind, placebo-controlled, parallel group dose finding study to evaluate the safety, tolerability and efficacy of PQ912, an inhibitor of the glutaminyl cyclase enzyme, in 250 subjects with mild cognitive impairment and mild dementia due to Alzheimer 's Disease.

Description:

In the parallel group dose finding part of the study the first 90 subjects will be randomized 1:1:1 between PQ912 300 mg BID, 600 mg BID, and placebo. When the 90th patient has completed the week 24 treatment visit, the DSMB will decide on the dose of PQ912 to be continued. The decision is based on safety findings only, no efficacy data will be considered. After the DSMB has reached a decision on the dose to be continued, all subjects randomized to receive PQ912 will be reallocated to this dose (1:1). The duration of Subjects participation in the study is either 48, 60, 72, 84 or 96 weeks of treatment (depending on time of randomization). Subjects recruited early into the study will be kept on treatment for 96 weeks or until the regular, scheduled study visit which is closest to the scheduled week 48 visit of the last subject recruited in the study, whichever comes first.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 259
• Est. completion date: January 12, 2024
• Est. primary completion date: December 18, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years to 80 Years

Eligibility

Main Inclusion Criteria:

• Positive CSF AD biomarker signature according to the AA-NIA criteria

• Clinical syndrome of MCI or mild dementia according to the AA-NIA Research Framework

• A cognitive impairment in the WAIS IV Coding Test of at least 0.5 standard deviation below the normative data

• Adequate visual and auditory abilities to perform the cognitive and functional assessments in the opinion of the investigator

• Meeting the completion and performance criteria for the CogState NTB

• Outpatient with study partner capable of accompanying the subject on all applicable clinic visits

Main Exclusion Criteria:

• Significant neurological or psychiatric disorders, other than AD, that may affect cognition.

• Atypical clinical presentations of MCI due to AD or mild dementia due to AD, such as the visual variant of AD (including posterior cortical atrophy), frontal variant or the language variant (including logopenic aphasia).

• Moderate and severe dementia with a Mini-Mental State Examination score (MMSE) below 20.

• Current presence of a clinically important major psychiatric disorder (e.g. major depressive disorder) as defined by DSM-5 criteria, or symptom(s) (e.g. hallucinations) that could affect the subject's ability to complete the study.

• History of clinically evident stroke.

• History of seizures within the last two years prior to the screening visit.

• Myocardial infarction within the last six months prior to screening.

• History of uncontrolled hypertension (in the opinion of the investigator) within six months prior to screening.

• Contraindication to lumbar puncture and MRI

Related Conditions & MeSH terms

• Alzheimer Disease
• Cognitive Dysfunction
• Early Alzheimers Disease
• Mild Cognitive Impairment Due to AD

Intervention

Drug:
• PQ912
PQ912 50 mg tablets and 150 mg tablets
• Placebo
Placebo tablets to mimic PQ912 50 mg and 150 mg tablets

Locations

Country	Name	City	State
Denmark	Sanos Clinics	Ganderup
Denmark	Sanos Clinics	Herlev
Denmark	Sanos Clinics	Vejle
Germany	Charité - Universitätsmedizin Berlin	Berlin
Germany	Universitätsklinikum Schleswig-Holstein (UKSH), Klinik für Neurologie	Kiel
Germany	Universitätsklinikum Magdeburg / Institut für Kognitive Neurologie und Demenzforschung	Magdeburg
Germany	Institut für Studien zur Psychischen Gesundheit (ISPG)	Mannheim
Germany	Klinikum rechts der Isar der TU München / Klinik für Psychiatrie und Psychotherapie	München
Germany	Universitätsklinikum Münster / Klinik für Allgemeine Neurologie	Münster
Germany	Klinik für Neurologie Universitätsklinikum Ulm	Ulm
Netherlands	Brain Research Center	Amsterdam
Netherlands	Brain Research Center	Den Bosch
Netherlands	Brain Research Center Zwolle	Zwolle
Poland	Podlaskie Centrum	Bialystok
Poland	Klinika Psychiatrii Wieku Podeszlego i Zaburzen Psychotycznych Uniwersytetu Medycznego w Lodzi	Lódz
Poland	SOMED CR	Lódz
Poland	SOMED CR	Warsaw
Spain	Fundació ACE	Barcelona
Spain	Neurology (Memory Unit) - Hospital de la Santa Creu i Sant Pau	Barcelona
Spain	Cae Oroitu	Getxo
Spain	Unidad de Neurociencias. Hospital Victoria Eugenia	Seville

Sponsors (3)

Lead Sponsor	Collaborator
Vivoryon Therapeutics N.V.	Amsterdam UMC, location VUmc, Nordic Bioscience A/S

Countries where clinical trial is conducted

Denmark,  Germany,  Netherlands,  Poland,  Spain, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Exploratory efficacy - The within-participants change from baseline in a set of representative functional network topology EEG measures compared between active arms and placebo.	Evaluation of brain functional network activity and connectivity will be performed using quantitative EEG measurements, as described by (Briels et al. 2020; Poil et al. 2013; Scheltens et al. 2018) Global relative power in the delta (0.5 - 4 Hz), alpha (8 -13 Hz) and beta (13 - 30Hz) frequency bands; Global posterior dominant peak frequency; Amplitude Envelope Correlation (AEC) in the 4- 13 Hz band Functional network topology measures such as centrality, modularity, minimum spanning tree.	48 weeks
Primary	Primary safety: The proportion of participants who experience any Adverse Event (AE), Serious Adverse Event (SAE), Adverse Event of Interest (AE-I)	The safety analysis will include the number of subjects with, and the number of any AE, any SAE (both overall and related), AEs leading to discontinuation of treatment, AEs leading to temporary treatment interruption, treatment compliance, the number of subjects with AEs of interest as defined above, the severity, duration and outcome of AEs	48 weeks
Primary	Primary efficacy: within-participant linear change with time of the combinded z-score for cognition compared between active arm and placebo.	The within-participant change over time in cognition measured by the combined z-score of the Detection test, Identification test and the 'One Back' test (attention and working memory domains) of the Neurological Test Battery	48 weeks and EoT (96 weeks at maximum)
Secondary	Secondary efficacy: The within-participant linear change from baseline to week 48 in quantitative EEG (global relative theta wave power), compared between active and placebo.	Using a quantitative EEG the within-participant change from baseline to week 48 of the global relative theta wave power (4-8 Hz) will serve as a primary efficacy outcome.	48 weeks at minimum or until EoT (96 weeks at maximum)
Secondary	Secondary efficacy: The within-participant linear change with time in overall cognition as measured by the CogState Brief Battery (CBB) Z-score compared between active arm and placebo	he within-participant linear change with time in overall cognition as measured by the CBB (CogState Detection, Identification, One Card Learning and One Back test) -Z-score	48 weeks and EoT (96 weeks at maximum)