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A Trial to Evaluate the Efficacy and Safety of PQ912 in Patients With Early AD (VIVA-MIND)

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ClinicalTrials.gov Identifier: NCT03919162
Recruitment Status : Recruiting
First Posted : April 18, 2019
Last Update Posted : October 4, 2021
Sponsor:
Collaborators:
Alzheimer's Disease Cooperative Study (ADCS)
National Institute on Aging (NIA)
Information provided by (Responsible Party):
Vivoryon Therapeutics N.V.

Brief Summary:

This is a phase 2A multi-center, randomized, double blind, placebo-controlled, parallel group study of varoglutamstat, with a stage gate to phase 2B.

In phase 2A there will be adaptive dosing evaluation of three dose levels with exposure to varoglutamstat or placebo for a minimum of 24 weeks, with preliminary evaluation of both cognitive function and pharmacodynamic changes on EEG spectral analysis in approximately 180 participants.

In the event that the stage gate for phase 2B is reached, then phase 2B will assesses efficacy and longer-term safety in a larger study group, i.e., 414.


Condition or disease Intervention/treatment Phase
Early Alzheimer's Disease Drug: PQ912 Other: Placebo Phase 2

Detailed Description:

The goal of this study is to advance a first-in-class, new small molecule treatment for early Alzheimer's disease (AD). Varoglutamstat (PQ912) is an oral, twice daily medication that addresses a novel and significantly differentiated amyloid target: N-terminal post-translationally modified Ab (pGlu-Ab), a particularly toxic subspecies of amyloid beta (Ab). This study will further evaluate whether varoglutamstat's mechanism of action can result in a measurable therapeutic effect on cognition, function and relevant pharmacodynamic and biological markers in early AD.

The study is a phase 2A multi-center, randomized, double-blind, parallel group trial, with a stage gate to phase 2B. Phase 2A will determine the highest dose that is both safe and well tolerated. During this phase, there is an adaptive dosing evaluation, using a well-defined safety stopping boundary, of three dose levels with exposure to varoglutamstat or placebo for a minimum of 24 weeks to help determine which dose will be carried forward in phase 2B. A sequential dose design will be employed in phase 2A where each of three dose cohorts are randomized equally to placebo or varoglutamstat and treated for at least 8 weeks at the originally assigned full dose. Participants will be randomized 1:1 to varoglutamstat or placebo, and stratified between mild AD and MCI, as well as by site.

Phase 2A also includes preliminary evaluation of both cognitive function and pharmacodynamics changes on electroencephalogram (EEG) spectral analysis.

In the event that the stage gate for phase 2B is reached from data in this phase 2A study, then phase 2B will assess the longer-term efficacy and safety of varoglutamstat in a larger study group, using the highest dose selected in phase 2A. In phase 2B, a composite cognitive and functional measure as well as PD biomarkers will be used to evaluate efficacy during the extended treatment period.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 414 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 2A Randomized Double-Blind Placebo-Controlled Trial to Evaluate the Efficacy and Safety of Varoglutamstat (PQ912) in Patients With Early Alzheimer's Disease With a Stage-Gate to Phase 2B (VIVA-MIND)
Actual Study Start Date : September 17, 2021
Estimated Primary Completion Date : December 2022
Estimated Study Completion Date : January 2023

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: 600 mg
First 4 weeks 150 mg BID, week 5-8 300 mg BID, week 9-24 600 mg BID
Drug: PQ912
PQ912 150 mg tablets
Other Name: Varoglutamstat

Experimental: 300 mg
First 4 weeks 150 mg BID, week 5-24 300 mg BID
Drug: PQ912
PQ912 150 mg tablets
Other Name: Varoglutamstat

Experimental: 150 mg
24 weeks on 150 mg BID
Drug: PQ912
PQ912 150 mg tablets
Other Name: Varoglutamstat

Placebo Comparator: Placebo Other: Placebo
Placebo tablets to mimic PQ912 150 mg tablets




Primary Outcome Measures :
  1. 2A Primary safety: proportion of participants who experience any adverse event of interest (AE-I). [ Time Frame: 24 weeks ]
    The primary endpoint in phase 2A is the proportion of participants, for each dose, who experience any adverse event of interest (AE-I) during the safety reporting period, from first dose to completion of 8 weeks at the full originally assigned dose.

  2. 2A Primary PK: derived mean values of varoglutamstat levels and corresponding calculated target occupancy (TO) [ Time Frame: 24 weeks ]
    The pharmacokinetics (PK) endpoints in Phase 2A are the derived mean values of varoglutamstat levels in plasma and the correspondingcalculated TO in CSF, for each dose.

  3. 2A Primary efficacy: The within-participant change from baseline to week 24 in the composite sum of standardized scores from the ADNI Battery Composite (ABC, 9-item) compared between active arm and placebo. [ Time Frame: 24 weeks ]
    The ABC is a set of ADNI neuropsychological test measures, including: Category Fluency (Animals and Vegetables), Trail Making A and B, Digit Symbol Substitution, Boston Naming Test, Rey's Auditory and Verbal Learning Test (RAVLT, Immediate and Delayed), Digit Span Forward and Backward.

  4. 2A Primary efficacy:The within-participant change from baseline to week 24 in quantitative EEG (global relative theta wave power) [ Time Frame: 24 weeks ]
    The within-participant change frombaseline to week 24 of the global relative theta wave power (4-8 Hz) compared between active arm and placebo.

  5. 2B Primary efficacy: The within-participant change from baseline to week 72 in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score, compared between active arm and placebo. [ Time Frame: 72 weeks ]

    The CDR-SB evaluates cognition and everyday functioning incorporating both informant input and direct assessment of performance. It is scored on a five-point scale a five point scale with following five possible scores: 0 = Normal 0.5 = Very Mild Dementia

    1. = Mild Dementia
    2. = Moderate Dementia
    3. = Severe Dementia


Secondary Outcome Measures :
  1. Key secondary efficacy: CFC2, a cognitive-functional composite [ Time Frame: 72 weeks ]
    The key secondary objective in phase 2B is to evaluate the efficacy of PQ912 as measured by CFC2, a cognitive-functional composite, over a 72-week treatment period.



Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years to 89 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • Age 50-89 (inclusive) at screening
  • Diagnosed as having Mild Cognitive Impairment (MCI) due to Alzheimer's disease (AD) or Mild probable AD according to workgroups of the Diagnostic Guidelines of the National Institute on Aging and Alzheimer's Association (NIA-AA)
  • Mini-Mental State Examination (MMSE) score 20-30 inclusive at screening
  • Montreal Cognitive Assessment score (MoCA) < 26 at screening
  • Clinical Dementia Rating global score 0.5 or 1 with memory score of > 0.5 at screening
  • Positive CSF AD biomarker signature
  • A brain MRI scan within 6 months of screening consistent with a diagnosis of Alzheimer's disease
  • Participants must have a study partner who has frequent interaction with them (approximately >3-4 times per week), will be present for all clinic visits, and can assist in compliance with study procedures.

Key Exclusion Criteria:

  • • Significant neurodegenerative diseases and causes of dementia, other than AD, including Parkinson's disease and Huntington's disease, vascular dementia, CJD (Creutzfeldt-Jakob disease), LBD (Lewy Body dementia), PSP (Progressive Supranuclear Palsy), AIDS (Acquired Immunodeficiency Syndrome), or NPH (normal pressure hydrocephalus)
  • Meeting Diagnostic Criteria for Possible AD according to workgroups of the Diagnostic Guidelines of the NIA-AA
  • Hepatic impairment defined as Child-Pugh class A or more severe liver impairment
  • History of moderate or severe skin reactions to medications or current moderate or severe disease of the skin and subcutaneous tissues
  • History of a major depressive episode within the past 6 months of screening
  • History of diagnosis of schizophrenia
  • History of uncontrolled bipolar disorder within past five years of screening
  • History of seizures within past two years of screening
  • Contraindication to lumbar puncture and MRI
  • Participation in another clinical trial for an investigational agent and having taken at least one dose of study drug, unless confirmed as having been on placebo, within 90 days prior to the baseline visit. The end of a previous investigational trial is defined as the date of the last dose of an investigational agent.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03919162


Contacts
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Contact: Carolyn Revta +1 858-229-4967 viva-mind@health.ucsd.edu
Contact: Kerstin Kuehn-Wache +49 345 5559900 clinics@vivoryon.com

Locations
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United States, California
UCSD Alzheimer's Disease Research Center Recruiting
La Jolla, California, United States, 92037
Sponsors and Collaborators
Vivoryon Therapeutics N.V.
Alzheimer's Disease Cooperative Study (ADCS)
National Institute on Aging (NIA)
Investigators
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Principal Investigator: Howard Feldman Alzheimer's Disease Cooperative Study (ADCS)
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Responsible Party: Vivoryon Therapeutics N.V.
ClinicalTrials.gov Identifier: NCT03919162    
Other Study ID Numbers: PBD-01187
1R01AG061146-01 ( U.S. NIH Grant/Contract )
First Posted: April 18, 2019    Key Record Dates
Last Update Posted: October 4, 2021
Last Verified: October 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Vivoryon Therapeutics N.V.:
Alzheimer's Disease
Mild Cognitove Impairment
Mild Alzheimer's Disease
Additional relevant MeSH terms:
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Alzheimer Disease
Dementia
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Tauopathies
Neurodegenerative Diseases
Neurocognitive Disorders
Mental Disorders