An Extension Study to Evaluate the Long-Term Safety and Tolerability of JNJ-54861911 in Participants in the Early Alzheimer's Disease Spectrum

Study Description

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Brief Summary:

The purpose of this study is to evaluate the long-term safety and tolerability of JNJ-54861911 in participants in the early Alzheimer's disease (AD [progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks]) spectrum that have completed a Phase 1b or Phase 2 clinical trial with JNJ-54861911, who are willing to continue their assigned treatment.

Condition or disease	Intervention/treatment	Phase
Alzheimer Disease	Drug: JNJ-54861911, 10 mg; Drug: JNJ-54861911, 25 mg; Drug: Placebo; Drug: JNJ-54861911, 5 mg	Phase 2

Detailed Description:

Participants in the early Alzheimer's Disease (AD) spectrum, enrolled in ongoing or future clinical trials with JNJ-54861911 (Phase 1b or Phase 2 studies) will be provided the opportunity to participate in this study upon completion of their treatment period under the parent protocol. The study will consist of a Screening phase and 2 sequential treatment phases (a 12-month double-blind [DB] treatment phase [placebo controlled] and an open-label [OL] phase [active]) followed by an End-of-Treatment visit. Treatment in OL phase will continue until registration of JNJ-54861911; unless safety issues emerge as determined by the Data Review Committee (DRC) that would warrant termination of the study. Blood and cerebrospinal fluid (CSF) samples will be collected to evaluate the plasma and CSF pharmacokinetics of JNJ-54861911, as well as amyloid beta fragments. Participants' safety will be monitored throughout the study.

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	90 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Double (Participant, Investigator)
Primary Purpose:	Treatment
Official Title:	A Randomized, Two-Period, Double-Blind Placebo-Controlled and Open-Label, Multicenter Extension Study to Determine the Long-Term Safety and Tolerability of JNJ-54861911 in Subjects in the Early Alzheimer's Disease Spectrum
Actual Study Start Date :	July 2, 2015
Estimated Primary Completion Date :	October 13, 2022
Estimated Study Completion Date :	October 13, 2022

Arms and Interventions

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Arm	Intervention/treatment
Experimental: Double-blind Treatment Phase: JNJ-54861911, 10 mg; Participants will continue with their current treatment regimen (10 milligram [mg] of JNJ-54861911) established in the parent study of JNJ-54861911. Participants will receive 10 milligram (mg) of JNJ-54861911 orally, once daily from Day 1 up Week 52 in the DB treatment phase.	Drug: JNJ-54861911, 10 mg; Participants will self-administer JNJ-54861911 tablet, 10 mg (2*5 mg), orally, once daily.
Experimental: Double-blind Treatment Phase: JNJ-54861911, 25 mg; Participants will continue with their current treatment regimen (25 mg of JNJ-54861911) established in the parent study of JNJ-54861911. Participants will receive 25 mg of JNJ-54861911 orally, once daily from Day 1 up Week 52 in the DB treatment phase.	Drug: JNJ-54861911, 25 mg; Participants will self-administer 1 tablet of JNJ-54861911, containing 25 mg orally, once daily.
Placebo Comparator: Double-blind Treatment Phase: Placebo; Participants will continue with their current treatment regimen established in the parent study of JNJ-54861911. Participants will receive placebo matching to JNJ-54861911 orally, once daily from Day 1 up Week 52 in the DB treatment phase.	Drug: Placebo; Participants will self administer placebo matching to JNJ-54861911 orally once daily.
Active Comparator: Open-label Phase: JNJ-54861911, 5 mg; Participants who were receiving JNJ-54861911, 10 mg and placebo in the DB treatment phase, will receive the 5 mg JNJ-54861911 once daily up to end of treatment visit (until registration of JNJ-54861911 or any safety issue) in Open-label phase.	Drug: JNJ-54861911, 10 mg; Participants will self-administer JNJ-54861911 tablet, 10 mg (2*5 mg), orally, once daily.; Drug: JNJ-54861911, 5 mg; Participants will self-administer JNJ-54861911 tablet, 5 mg, orally, once daily.
Active Comparator: Open-label Phase: JNJ-54861911, 25 mg; Participants who were receiving JNJ-54861911, 25 mg in the DB treatment phase, will continue to receive the same regimen in open-label treatment phase. Participants who were receiving placebo in the DB treatment phase will be randomly assigned to receive 25 mg of JNJ-54861911 once daily up to end of treatment visit (until registration of JNJ-54861911 or any safety issue) in the open-label treatment phase.	Drug: JNJ-54861911, 25 mg; Participants will self-administer 1 tablet of JNJ-54861911, containing 25 mg orally, once daily.

Outcome Measures

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Primary Outcome Measures :

1. Number of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs) [ Time Frame: Day 1 up to 30 days after last dose of study drug administration ]
   An AE is any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Secondary Outcome Measures :

1. Percent Change From Baseline in Cerebrospinal Fluid (CSF) Amyloid Beta (ABeta) (1-37, 1-38, 1-40, 1-42) Levels and Soluble Amyloid Precursor Protein (sAPP) Fragments (sAPP-alpha, sAPP-beta), Total sAPP Levels [ Time Frame: Day 1, Week 24 and Week 52 in treatment period 1; Every 96 weeks in treatment period 2 up to end of treatment visit (until registration of JNJ-54861911 or any safety issue) ]
   The CSF and plasma samples will be obtained for measuring levels of different ABeta fragments such as ABeta 1-37, ABeta 1-38, ABeta 1-40, ABeta 1-42. ABeta fragments of different length are produced by cleavage of the APP by beta-secretase (BACE) and the gamma-secretase complex in the brain and excreted into CSF.
2. Percent Change From Baseline in Plasma ABeta Levels 1-37, 1-38, 1-40, and 1-42 [ Time Frame: Day 1, Week 24, and Week 52 in treatment period 1; Every 24 weeks in treatment period 2 up to end of treatment visit (until registration of JNJ-54861911 or any safety issue) ]
   Plasma samples will be obtained for measuring levels of different ABeta fragments such as ABeta 1-37, ABeta 1-38, ABeta 1-40, ABeta 1-42. ABeta fragments of different length are produced by cleavage of the APP by beta-secretase (BACE) and the gamma-secretase complex in the different peripheral tissues, including white blood cells and can be measured in Plasma.
3. Maximum Plasma Concentration (Cmax) of JNJ-54861911 [ Time Frame: Day 1 and Month 12 in treatment period 1; Every 24 weeks and 96 weeks in treatment period 2 up to end of treatment visit (until registration of JNJ-54861911 or any safety issue) ]
   The Cmax is the maximum observed plasma concentration.
4. Area Under the Plasma/CSF Concentration-time Curve From Time 0 to tau Hours Post Dosing (AUCtau) [ Time Frame: Day 1 and Month 12 in treatment period 1; Every 24 weeks and 96 weeks in treatment period 2 up to end of treatment visit (until registration of JNJ-54861911 or any safety issue) ]
   AUCtau is the area under the plasma/CSF concentration-time curve from time 0 to the entire dosing interval. Tau is defined as the dosing interval.
5. Relationship Between Changes in CSF and Plasma ABeta Species and sAPP Fragments With Safety [ Time Frame: Day 1 up to 30 days after last dose of study drug administration ]
   ABeta species and sAPP fragments in plasma and CSF will be measured. Incidence of adverse events and their timing of onset will be examined with regard to these concentrations to assess potential relationships between safety and changes in the ABeta species and sAPP fragments.

Eligibility Criteria

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

Criteria

Inclusion Criteria:

• Participants in the early Alzheimer's disease (AD) spectrum at time of enrollment under the parent protocol and according to its inclusion and exclusion criteria, must have very recently completed their treatment in a Phase 1b or Phase 2 JNJ-54861911 clinical study (example [e.g.], 54861911ALZ2002) under the parent protocol. Enrollment in this study should be completed (Day 1 of double-blind [DB] treatment phase) as soon as possible, but within 6 weeks, following completion of their treatment period under the parent protocol. If not defined under the parent protocol, completion of the treatment period is defined as having completed all study related procedures of the last visit of the treatment period under the parent protocol. A screening phase of up to 12 weeks may be allowed following written approval of the Sponsor
• Participant must be willing and able to adhere to the prohibitions and restrictions specified in this protocol
• Each Participants (or their legally acceptable representative and caregiver depending on disease state and local requirements) must sign an informed consent form (ICF) indicating that he or she understands the purpose of and procedures required for the study and are willing to participate in the study
• Participants must have a reliable informant (relative, partner, or friend). The informant must be willing to participate as a source of information and has at least weekly contact with the participant (contact can be in-person, via telephone or other audio/visual communication). The informant must have sufficient contact such that the Investigator feels he/she can provide meaningful information about the participant's daily function. If possible, an alternate informant meeting these criteria who can replace the primary informant should be identified prior to randomization

Exclusion Criteria:

• Any condition or situation which, in the opinion of the Investigator, may put the participant at significant risk, may confound the study results, or may interfere significantly with participant's participation in the study
• The use of concomitant medications known to prolong the QT/QTc interval
• Participant has a history of moderate or severe hepatic impairment or severe renal insufficiency unless completely resolved for more than a year. Participant has clinically significant ongoing hepatic, renal, cardiac, vascular, pulmonary, gastrointestinal, endocrine, hematologic, rheumatologic, psychiatric or metabolic conditions (e.g., requiring frequent monitoring or medication adjustments or is otherwise unstable)

Contacts and Locations

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Locations

Belgium
Gent, Belgium
Hoboken, Belgium
France
Montpellier Cedex 5, France
Paris, France
Toulouse, France
Germany
Essen, Germany
Homburg, Germany
Luebeck, Germany
Tübingen, Germany
Ulm, Germany
Netherlands
Amsterdam, Netherlands
Spain
Barcelona, Spain
Madrid, Spain
Terrasa Barcelona, Spain
Valencia, Spain
Sweden
Mölndal, Sweden
Stockholm, Sweden

Sponsors and Collaborators

Janssen Research & Development, LLC

Investigators

Study Chair:	Janssen Research & Development, LLC Clinical Trial	Janssen Research & Development, LLC

More Information

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Responsible Party:	Janssen Research & Development, LLC
ClinicalTrials.gov Identifier:	NCT02406027 History of Changes
Other Study ID Numbers:	CR106978; 54861911ALZ2004 ( Other Identifier: Janssen Research & Development, LLC ); 2014-004274-41 ( EudraCT Number )
First Posted:	April 1, 2015
Last Update Posted:	January 30, 2018
Last Verified:	January 2018

Studies a U.S. FDA-regulated Device Product:		No

Keywords provided by Janssen Research & Development, LLC:

Alzheimer's Disease; JNJ-54861911; Placebo

Additional relevant MeSH terms:

Alzheimer Disease; Dementia; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases	Tauopathies; Neurodegenerative Diseases; Neurocognitive Disorders; Mental Disorders