A Study of Gantenerumab in Participants With Prodromal Alzheimer's Disease

Study Description

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Brief Summary:

This multi-center, randomized, double-blind, placebo-controlled parallel-group study will evaluate the effect of gantenerumab (RO4909832) on cognition and functioning and the safety and pharmacokinetics in participants with prodromal Alzheimer's Disease. Participants will be randomized to receive subcutaneous (SC) injections of either gantenerumab or placebo. Participants who consent to be part of the sub study will undergo positron emission tomography (PET) scanning to assess brain amyloid. The anticipated time on study treatment is 104 weeks, with an option for an additional 2 years of treatment.

Condition or disease	Intervention/treatment	Phase
Alzheimer's Disease	Drug: Gantenerumab; Drug: Placebo	Phase 3

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	799 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Double (Participant, Investigator)
Primary Purpose:	Treatment
Official Title:	Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Two Year Study to Evaluate the Effect of Subcutaneous RO4909832 on Cognition and Function in Prodromal Alzheimer's Disease and Up to Three Years of an Open-Label Extension With Active Study Treatment
Actual Study Start Date :	November 30, 2010
Estimated Primary Completion Date :	April 13, 2018
Estimated Study Completion Date :	November 20, 2020

Arms and Interventions

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Arm	Intervention/treatment
Experimental: Gantenerumab 105 mg (Parts 1 and 2); Participants with Alzheimer's disease will receive gantenerumab 105 milligrams (mg) by SC injection every 4 weeks (q4w) for 104 weeks or approximately 2 years during Part 1 of the study. Participants who complete the Week 104 visit will be given an option to continue the treatment received during Part 1 for 2 additional years in Part 2.	Drug: Gantenerumab; Participants will receive gantenerumab 105 or 225 mg SC injection q4w.
Experimental: Gantenerumab 225 mg (Parts 1 and 2); Participants with Alzheimer's disease will receive gantenerumab 225 mg by SC injection q4w for 104 weeks or approximately 2 years during Part 1 of the study. Participants who complete the Week 104 visit will be given an option to continue the treatment received during Part 1 for 2 additional years in Part 2.	Drug: Gantenerumab; Participants will receive gantenerumab 105 or 225 mg SC injection q4w.
Placebo Comparator: Placebo (Parts 1 and 2); Participants with Alzheimer's disease will receive placebo SC injection q4w for 104 weeks or approximately 2 years during Part 1 of the study. Participants who complete the Week 104 visit will be given an option to continue the treatment received during Part 1 for 2 additional years in Part 2.	Drug: Placebo; Participants will receive placebo SC injection q4w.

Outcome Measures

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Primary Outcome Measures :

1. Mean Change From Baseline in Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) Total Score at Week 104 [ Time Frame: Baseline, Week 104 ]

Secondary Outcome Measures :

1. Mean Change From Baseline in Alzheimer Disease Assessment Scale-Cognitive Subscale 11 (ADAS-Cog-11) Scores at Week 104 [ Time Frame: Baseline, Week 104 ]
2. Time to Onset of Dementia [ Time Frame: Every 6 months to up to 3 years (1096 days) ]
3. Mean Change From Baseline in Cambridge Neuropsychological Test Automated Battery (CANTAB) Composite Score at Week 104 [ Time Frame: Baseline, Week 104 ]
4. Mean Change from Baseline in Free and Cued Selective Reminding Test (FCSRT) Score at Week 104 [ Time Frame: Baseline, Week 104 ]
5. Mean Change From Baseline in Functional Activities Questionnaire (FAQ) Score at Week 104 [ Time Frame: Baseline, Week 104 ]
6. Mean Change From Baseline in CDR-Global Score at Week 104 [ Time Frame: Baseline, Week 104 ]
7. Mean Change from Baseline in Neuropsychiatric Inventory (NPI) Questionnaire Score at Week 104 [ Time Frame: Baseline, Week 104 ]
8. Percent Change from Baseline in Cerebrospinal Fluid Biomarkers (Phosphorylated-tau [p-tau], Amyloid Beta 1-42 [Abeta 1-42], Total tau [t-tau]) at Week 104 [ Time Frame: Baseline, Week 104 ]
9. Percent Change from Baseline in Hippocampal Volume at Week 104 [ Time Frame: Baseline, Week 104 ]
10. Percent Change From Baseline in Cortical Composite Sustained Uptake Volume Ratio (SUVr) in Different Brain Regions at Week 156 [ Time Frame: Baseline, Week 156 ]
11. Gantenerumab Plasma Concentration at Different Time Points [ Time Frame: Prior to injections at Weeks 1, 8, 20, 44, 53, 68, 100, 101 ]
12. Mean Change From Baseline in Mini Mental State Exam (MMSE) Score at Week 104 [ Time Frame: Baseline, Week 104 ]

Eligibility Criteria

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Ages Eligible for Study:	50 Years to 85 Years (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Adult participants, 50-85 years of age
• Participants with prodromal Alzheimer's disease who are not receiving memantine or cholinesterase inhibitors
• Has a study partner who in the investigator's judgement has frequent and sufficient contact with the participant as to be able to provide accurate information as to the participant's cognitive and functional abilities, who agrees to provide information at clinic visits which require partner input for scale completion
• Has had sufficient education or work experience to exclude mental retardation
• Study partner has noticed a recent gradual decrease in participant's memory (over the last 12 months), which the participant may or may not be aware of
• Screening Mini Mental State Exam (MMSE) score of 24 or above

Additional inclusion criteria for sub study:

• Able and willing to travel to PET imaging center and complete the planned scanning sessions
• Past and planned exposure to ionizing radiation not exceeding safe and permissible levels

Exclusion Criteria:

• Other prior or current neurologic or medical disorder which may currently or during the course of the study impair cognition or psychiatric functioning
• A history of stroke
• A documented history of transient ischemic attack within the last 12 months
• History of schizophrenia, schizoaffective or bipolar disorder
• Currently meets criteria for major depression
• Within the last 2 years, unstable or clinical significant cardiovascular disease (myocardial infarction, angina pectoris)

Additional exclusion criteria for sub study:

• Inclusion in a research and/or medical protocol involving PET ligands or other radioactive agents within 12 months
• Present or planned participation in a research and/or medical protocol involving PET ligands or radioactive agents other than study WN25203
• Have planned or are planning to have exposure to ionizing radiation that in combination with the planned administration with study amyloid PET ligand would result in a cumulative exposure that exceeds local recommended exposure limits

Contacts and Locations

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  Show 156 Study Locations

Sponsors and Collaborators

Hoffmann-La Roche

Investigators

Study Director:	Clinical Trials	Hoffmann-La Roche

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Ostrowitzki S, Lasser RA, Dorflinger E, Scheltens P, Barkhof F, Nikolcheva T, Ashford E, Retout S, Hofmann C, Delmar P, Klein G, Andjelkovic M, Dubois B, Boada M, Blennow K, Santarelli L, Fontoura P; SCarlet RoAD Investigators. A phase III randomized trial of gantenerumab in prodromal Alzheimer's disease. Alzheimers Res Ther. 2017 Dec 8;9(1):95. doi: 10.1186/s13195-017-0318-y.

Delrieu J, Ousset PJ, Vellas B. Gantenerumab for the treatment of Alzheimer's disease. Expert Opin Biol Ther. 2012 Aug;12(8):1077-86. doi: 10.1517/14712598.2012.688022. Epub 2012 May 15. Review.

Responsible Party:	Hoffmann-La Roche
ClinicalTrials.gov Identifier:	NCT01224106 History of Changes
Other Study ID Numbers:	WN25203; 2010-019895-66 ( EudraCT Number )
First Posted:	October 19, 2010
Last Update Posted:	March 27, 2018
Last Verified:	March 2018

Additional relevant MeSH terms:

Alzheimer Disease; Dementia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Tauopathies	Neurodegenerative Diseases; Neurocognitive Disorders; Mental Disorders; Antibodies, Monoclonal; Immunologic Factors; Physiological Effects of Drugs