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    Summary
    EudraCT Number:2008-008005-21
    Sponsor's Protocol Code Number:DIM18
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2009-08-11
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2008-008005-21
    A.3Full title of the trial
    CONCERT: A Phase 3 Multicenter, Randomized, Placebo-Controlled, Double-Blind Twelve-Month Safety and Efficacy Study Evaluating Dimebon in Patients with Mild-to-Moderate Alzheimer s Disease on Donepezil
    CONCERT: Studio di sicurezza ed efficacia della durata di dodici mesi in doppio cieco, controllato verso placebo, randomizzato, multicentrico di fase III per valutare l effetto del Dimebon in pazienti affetti da morbo di Alzheimer (forme lievi-moderate) in trattamento con Donepezil
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An International Twelve month Trial Evaluating the safety and effectiveness of Dimebon in Patients with Mild to Moderate Alzheimer`s Disease who are taking Donepezil
    Studio Internazionale della durata di 12 mesi per valutare la Sicurezza e l`efficacia del Dimebon in pazienti con Morbo di Alzheimer da lieve a moderato trattati con Donepezil
    A.3.2Name or abbreviated title of the trial where available
    CONCERT
    CONCERT
    A.4.1Sponsor's protocol code numberDIM18
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT00829374
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorMEDIVATION, INC.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportMedivation Inc
    B.4.2CountryUnited States
    B.4.1Name of organisation providing supportPfizer Pharmaceuticals Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMedivation Inc
    B.5.2Functional name of contact pointMedical Officer
    B.5.3 Address:
    B.5.3.1Street Address201 Spear Street
    B.5.3.2Town/ citySan Francisco CA
    B.5.3.3Post code94105
    B.5.3.4CountryUnited States
    B.5.4Telephone number1 415 543 3470
    B.5.5Fax number1 415 543 3411
    B.5.6E-mailinfo@medivation.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDIMEBON
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDIMEBON DIHYDROCHLORIDE
    D.3.9.1CAS number 97657-92-6
    D.3.9.2Current sponsor codeDIMEBON
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDIMEBON
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDIMEBON DIHYDROCHLORIDE
    D.3.9.1CAS number 97657-92-6
    D.3.9.2Current sponsor codeDIMEBON
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Alzheimer's Disease
    Morbo di Alzheimer(forme lievi-moderate)
    E.1.1.1Medical condition in easily understood language
    Alzheimer`s Disease
    Morbo di Alzheimer forme lievi-moderate
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.0
    E.1.2Level LLT
    E.1.2Classification code 10001896
    E.1.2Term Alzheimer's disease
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    . To evaluate the efficacy of Dimebon as compared to placebo on the primary measure of cognition and memory, using Alzheimer Alzheimer s Disease Assessment Scale cognitive subscale, (ADAS-cog). . To evaluate the efficacy of Dimebon as compared to placebo on the primary measure of self-care and daily function, using Alzheimer s Disease Cooperative Study Activities of Daily Living, (ADCS ADL).
    Valutare l efficacia del Dimebon versus placebo sui parametri primari di cognizione e memoria, mediante la Alzheimer s Disease Assessment Scale cognitive subscale, (ADAS-cog). Valutare l efficacia del Dimebon versus di placebo sulle funzioni quotidiane e di cura della persona mediante l Alzheimer s Disease Cooperative Study Activities of Daily Living, (ADCS ADL).
    E.2.2Secondary objectives of the trial
    . To evaluate the efficacy of Dimebon as compared to placebo on the primary measure of global function, Clinician s Interview-Based Impression of Change plus caregiver impression (CIBIC-plus) . To evaluate the efficacy of Dimebon as compared to placebo on the primary measure of behavior using Neuropsychiatric Inventory (NPI). . To evaluate the pharmacoeconomic benefi of Dimebon as compared to placebo using Resource Utilization in Dementia Lite (RUD Lite©). . To evaluate quality of life using the EuroQoL 5 Domain Health Quality Assessment (EQ-5D). . To evaluate the safety and tolerability of Dimebon at two doses, 20mg orally three times per day (TID) and 5 mg orally TID over 52 weeks. . To obtain selected pharmacokinetic data for both the 5 mg TID and 20 mg TID doses of Dimebon.
    Valutare l efficacia del Dimebon versus placebo sul parametro funzione globale, mediante la Clinician s Interview-Based Impression of Change, inclusiva della valutazione dei caregiver (CIBIC-plus). Valutare l efficacia del Dimebon versus placebo sui parametri del comportamento, il Neuropsychiatric Inventory (NPI). Valutare il beneficio farmacoeconomico del Dimebon rispetto al placebo utilizzando lo strumento Resource Utilization in Dementia Lite (RUD Lite©). Valutare la qualita` della vita usando lo strumento EuroQoL 5 Domain Health Quality Assessment (EQ-5D). Valutare la sicurezza e la tollerabilita` del Dimebon in due dosi, 20 mg per via orale tre volte al giorno (TID) e 5 mg per via orale TID per 52 settimane. Raccogliere dati farmacocinetici (FC) selezionati per le dosi da 5 mg TID e 20 mg TID di Dimebon.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Are men and women ≥ 50 years of age with a diagnosis of probable AD according to the following criteria: a. Diagnostic and Statistical Manual of Mental Disorders-IV Text Revision (DSM-IV-TR) as listed in Appendix A; b. National Institute of Neurological and Communicative Disorders and Stroke Alzheimer s Disease and Related Disorder Association s Criteria (NINCDS-ADRDA) for probable AD as listed in Appendix B; c. Screening MMSE score between 12 and 24, inclusive; d. Modified Hachinski Ischemic Score ≤ 4 (Appendix C in the protocol); 2. Are willing and able to give informed consent. If the patient is not competent, a mentally-competent legally-acceptable representative must provide informed consent on his/her behalf, and the patient must provide verbal assent; 3. Have had brain imaging such as computed tomography (CT) and/or magnetic resonance imaging (MRI) within approximately 12 months of Day 1, consistent with a diagnosis of probable AD without any other clinically significant co-morbid pathologies found. If there has been a significant change in clinical status suggestive of stroke or other possible neurological disease with onset between the time of the last CT or MRI and the Screening evaluation, the scan should be repeated if considered appropriate by the investigator; 4. Have been taking the cholinesterase inhibitor, donepezil, with stable dosing at 10 mg/day for at least four monthsprior to Day 1 (and with no intent to change for the duration of the study) prior to Day 1; 5. Have at least five years of prior education and should have previously (in pre-AD condition) been capable of reading, writing, and communicating effectively with others; 6. Have a caregiver who assists (or directly supervises) the patient at least five days per week for at least three hours per day and has intimate knowledge of the patient s cognitive, functional, and emotional states, and of the patient s personal care. The caregiver must be willing to accompany the patient to all study visits, and must be willing to supervise study drug administration. The caregiver must be willing and able to give informed consent, be able to read and write, and be capable of providing responses to the ADCS-ADL, CIBIC-plus, NPI, the RUD Lite©, and EQ-5D assessment tools; 7. May be living in an assisted care facility if living independently; 8. If female, are either a) of reproductive potential and compliant in using adequate birth control or b) not of reproductive potential. Adequate birth control is defined as consistent practice of an effective and accepted method of contraception (hormone-based, intrauterine device, or double barrier contraception, i.e., condom and diaphragm, diaphragm and spermicidal gel or foam) throughout the duration of the study. Abstinence is an acceptable method of contraception. Female patients not of reproductive potential may have undergone menopause, hysterectomy, bilateral oophorectomy, or tubal ligation. Menopause is defined as one year without menses. If the patient s menopausal status is in question, a follicle-stimulating hormone (FSH) level of > 40 milli-international units per milliliter (mIU/mL) must be documented. Hysterectomy, bilateral oophorectomy, or tubal ligation must be documented; 9. If male, are either a) of reproductive potential and compliant in using adequate birth control or are b) not of reproductive potential. Surgical sterilization must be documented. Adequate birth control for males is defined as a condom and spermicidal gel or foam, or abstinence throughout the duration of the study.
    1.siano donne e uomini ≥ 50 anni di eta` con una diagnosti di probabile AD in base ai criteri seguenti: a.Diagnostic and Statistical Manual of Mental Disorders-IV Text Revision (DSM-IV-TR) elencato nell Appendice A; b.National Institute of Neurological and Communicative Disorders and Stroke Alzheimer s Disease and Related Disorder Association s Criteria (NINCDS-ADRDA) per AD probabile elencato nell Appendice B; c.Allo Screening punteggio MMSE tra 12 e 24 compresi; d.punteggio Modified Hachinski Ischemic ≤ 4 (Appendice C al protocollo); 2.vogliano e siano in grado di dare il loro consenso informato. Se il paziente non e` in grado, un rappresentante legalmente accettabile e mentalmente abile deve fornire consenso informato per suo conto e il paziente deve fornire accettazione verbale; 3.siano state sottoposte a imaging cerebrale come tomografia computerizzata (CT) e/o risonanza magnetica (MRI) approssimativamente 12 mesi dal Giorno 1, il cui risultato sia compatibile con una diagnosi di probabile AD senza che siano state rilevate altre patologie comorbide clinicamente significative. Se vi e` stato un cambiamento significativo dello stato clinico che suggerisca ictus o altre possibili patologie neurologiche comparso tra il momento dell ultima CT o MRI e la valutazione di screening, l esame deve essere ripetuto ove ritenuto appropriato dal ricercatore; 4.siano stati sottoposti a trattamento con inibitore della colinesterasi, Donepezil, con dosaggio stabile a 10 mg/giorno per almeno quattro mesi prima del Giorno 1(e che non abbiano intenzione di modificarlo per la durata dello studio) prima del Giorno 1; 5.abbiano seguito almeno cinque anni di percorsi di formazione e/o scolastici e, in condizioni pre-AD, fossero in grado di leggere, scrivere e comunicare efficacemente con gli altri; 6.abbiano un caregiver che assista (o supervisioni direttamente) il paziente almeno cinque giorni a settimana per almeno tre ore al giorno che abbia conoscenza approfondita degli stati emozionali, funzionali e cognitivi del paziente e della sua cura personale. Il caregiver deve essere disponibile ad accompagnare il paziente a tutte le visite dello studio e a supervisionare la somministrazione del farmaco dello studio. Il caregiver deve essere disponibile e in grado di fornire consenso informato, essere in grado di leggere e scrivere e di fornire risposte agli strumenti di valutazione ADCS ADL, CIBIC-plus, NPI, the RUD Lite©, ed EQ-5D; 7.vivano in una situazione di cura assistita ove vivano da soli; 8.se donne, siano a) se fertili, disponibili all utilizzo di controlli adeguati sulle nascite oppure b) non fertili. Per controlli adeguati sulle nascite si intende la pratica coerente di un metodo efficace e accettato di contraccezione (a base di ormoni, dispositivo intrauterino o contraccezione con doppia barriera, per es., condom e diaframma, diaframma e gel o schiuma spermicida) per tutta la durata dello studio. L astinenza e` un metodo accettabile di contraccezione.Le pazienti donne non fertili devono essere in menopausa o essere state sottoposte a isterectomia, oforectomia bilaterale o a legatura tubarica. Per menopausa si definisce un anno senza mestruazioni. Se lo stato di menopausa della paziente e` in dubbio, e` necessario documentare un livello di ormone follicolo-stimolante (FSH) &gt; 40 unita` milli-internazionali per millimitro (mIU/mL). L isterectomia, l oforectomia bilateriale o la legatura tubarica devono essere documentate; 9.se uomini, siano a) se fertili disponibili all utilizzo di controlli adeguati sulle nascite oppure b) non fertili. La sterilizzazione chirurgica deve essere documentata. Per gli uomini, il controllo adeguato delle nascite e` l utilizzo di condom o gel o schiuma spermicida, oppure astinenza per tutta la durata dello studio
    E.4Principal exclusion criteria
    1.major structural brain disease or a single lesion in a critical region;2.any major medical illness or unstable medical condition within 6 months of Screen that may interfere with the pts ability to comply with study procedures and abide by study restrictions, or with the ability to interpret safety data, including: a.Any physical disability b.diagnosis of diabetes mellitus requiring insulin treatment;c.history of cancer within 5 years of enrollment execpt of non-melanoma skin cancers or prostate cancer stable for 6months or AJCC Stage O or 1 cancers that have remote probability of recurrence in opinion of PI and Sponsor counsult; d.Hypotens. sitting <86mmHg or bradycardia <50bpm at Screen o day1 or more than 1 occasion within 3months prior to enroll; Uncontrolled hypertension PAS by a resting > 170 mmHg or PAD > 105 mmHg at Screening or on more than 1 within 3months prior to enroll; A QTcF >470 msec on an ECG at the Screen visit; Active cardiovascular disease unstable angina, decompensated congestive heart failure, clinically relevant arrhythmias.Pts with pacemakers or pts on anticoagulant therapy may be included;e.history of traumatic brain injury with residual neurological deficit or stroke;f.diagnosis of a central nervous system disease other than AD(Parkinson s disease, Huntington s disease, frontotemporal dementia, multi-infarct dementia, dementia with Lewy bodies, normal pressure hydrocephalus);g.A history of epilepsy or seizure disorder requiring ongoing treatment, or any seizure or loss of consciousness within 6 months prior to enrollment;h.Any current psychiatric diagnosis according to DSM-IV-TR that may interfere with the patient s ability to perform the study and all assessments (alcohol or drug-related abuse or alcohol dependence, or alcohol or drug-related dementia, major depression, mental retardation, schizophrenia, bipolar disorder)3.pregnant or breastfeeding females; 4.Reside in a nursing home or assisted care facility with need for 24-hour care and supervision;5.Have a caregiver who is not clinically trained and is paid to care for more than 2 pts;6.HIV seropositivity;7.Have any of the following laboratory abnormalities at the Screen visit: a.Clinically significant Vitamin B12 levels less than the lower limit of normal;b.Clinically significant folate levels less than the lower limit c.TSH levels greater than the upper limit of normal AND a free thyroxine d.RPR confirmed by FTA-ABS; e.Total bilirubin,ALT or AST greater than 2times the upper limit of normal;f.Renal impairment Cr> 133 μmol/L (1.5 mg/dL);g.HT<37% for M and <32% for F, absolute neutrophil cell count <= 1,500/ μL, or platelet cell count <120,000/μL;8.Have taken or plan to take non-donepezil cholinesterase inhibitors 6 months prior to Day 1 through the end of study;9.Have taken or plan to take memantine within 90 days prior to Day 1 through the end of study;10.Use of Axona or prescription nutriceuticals marketed for AD or cognitive impairment within 30 days of Screening and throug;11.History of hypersensitivity to Dimebon or other antihistamines;12.Have used non-selective antihistamines within seven days prior to the start of dosing (Day 1;13.used or plan to use the following medications from 30 days prior to Day1 through the end of study: a.Narcotic analgesics more frequently than 2 times per week as needed for pain;b.Low potency antipsychotics (chlorpromazine, thioridazine;c.Anti-Parkinson s Disease medications(selegiline, levodopa, amantadine)for the treatment of Parkinsonian Symptom Complex;d.Insulin; e.Lithium;f.Clozapine; g.Bupropion; 14.previously participated in a clinical trial evaluating Dimebon;15.participated in an investigational drug or device study within 30 days prior to Day1, or 90 days prior to Day1 if the 16.been treated with immunomodulators to treat AD (vaccines, antibodies, intravenous immunoglobulin, etc.)in last 2 Years
    1.gravi patol. cerebrali strutturali o singola lesione in 1 regione critica; 2.gravi patol o condizioni mediche non stabili negli ultimi 6 mesi precedenti lo screening che possano interferire con la capacita` del pz a conformarsi alle procedure dello studio e a rispettare le restrizioni dello studio, o con la capacita` di interpretare dati di sicurezza, compresi: a.disabilita` fisica; b.diagnosi di diabete mellito che necessita di terapia a base di insulina; c.cancro nei 5 anni precedenti lo studio a eccezione di cancro della pelle(non melanoma)o alla prostata stabili per 6 mesi o cancro come definito da AJCC stage 0 o 1 con poca possibilita` di recidive secondo lo Sperim in accordo con Sponsor;d:ipotens.a ripos&lt;86mmHg o bradicard a ripos &lt;50bpm allo screening o day1 o in piu`di 1occasione nei 3 mesi precedenti inserimento in studio; ipertens. non control (PAS riposo &gt;170 mmHg o PAD &gt;105mmHg allo screen o day1 o in piu` di un occasione nei 3 mesi precedenti lo studio; intervallo QTcF &gt;470 msec in un ECG allo screening; patolog. cardiovascolare: angina instabile, insuf. congenita scompensata, aritmie clinicamente rilevanti; e.anamnesi di lesioni cerebrali traumatiche con deficit neurologico residuo o ictus; f.diagnosi di patologia del SNC diversa dall AD (morbo di Parkinson, morbo di Huntington,demenza frontotemporale, demenza multi-infarto, demenza a corpi di Lewy, idrocefalo a pressione normale); g.anamnesi di epilessia o crisi epilettiche che necessita di trattamento continuo, oppure perdita di coscienza nei 6 mesi precedenti lo studio; h.diagnosi psichiatrica attuale in base al DSM-IV-TR che potrebbe interferire con la capacita` del pz a eseguire lo studio e tutte le valutazioni (abuso alcol o droga demenza, depressione, ritardo mentale, schizofrenia, disordine bipolare); 3.donne in gravidanza o allattamento; 4.risiedano in una struttura di assistenza con necessita` di cura e supervisione h24; 5.abbiano un caregiver non clinicamente formato e pagato per occuparsi di piu` di 2 pazienti; 6.HIV siero-positiva nota; 7.presentino una delle anomalie di laboratorio seguenti allo screening: a.Vitamina B12 clinicamente significativi inferiori al limite inferiore del livello normale; b.folato clinicamente significativi inferiori al limite inferiore del livello normale;c.TSH maggiori del limite superiore del valore normale e livelli di tiroxina libera inferiori al limite inferiore del livello normale; d.RPR confermata da FTA-ABS; e.bilirubina totale, ALT o AST maggiori del doppio del limite superiore del livello normale; f.disfunzione renale con Cr&gt;133 µmol/L (1,5 mg/dL); g.HT &lt;37% per M e &lt;32% per F, neutrofili &lt;=1500/µL o piastrine &lt;120.000/µL; 8.assunto o intendano assumere inibitori della colinesterasi diversi dal Donezepil 6 mesi prima del Day 1 fino al termine dello studio; 9.assunto o intendano assumere memantina entro 90 gg prima del Day 1 fino al termine dello studio; 10.uso di Axona o nutriceutical in commercio per AD o disabilita` cognitiva entro 30 gg dallo screening e per tutta al durata dello studio; 11.anamnesi di ipersensibilita` al Dimebon o ad altri antistaminici; 12.uso di antistaminici non selettivi entro 7 gg prima dell inizio del dosaggio (Day 1); 13.assunto o intendano assumere i seguenti farmaci a partire da 30 gg prima del Day1 fino al termine dello studio: a.analgesici narcotici piu` frequentemente di 2 volte a settimana ove necessario per il dolore; b.antipsicotici a bassa potenza (per es., clorpromazina, tioridazina); c.farmaci contro il morbo di Parkinson per il trattamento di Parkinsonian Symptom Complex; d.insulina; e.litio; f.clozapina; g.bupropione; 14.partecipazione a un trial clinico per la valutazione del Dimebon;15. partecipato a studio di farmaci o dispositivi entro 30 gg prima del Day1 o 90 gg prima del Day1 se farmaco terapia per AD; 16.pz trattati con immunomodulatori per cura AD ultimi 2ann
    E.5 End points
    E.5.1Primary end point(s)
    Efficacy: Efficacy outcome measures in this study include the following: 1. Co-primary outcome measures in this study: a. A comparison between the mean change from Baseline to Week 52 in the Dimebon 20 mg TID treatment group and the placebo group on the ADAS-cog; b. A comparison between the mean change from Baseline to Week 52 in the Dimebon 20 mg TID treatment group and the placebo group on the ADCS-ADL; 2. Key secondary outcome measures in this study include: a. A comparison of rates of change in ADCS-ADL across time between the Dimebon 20 mg TID treatment group and the placebo group; b. A comparison between the mean change from Baseline to Week 52 in the Dimebon 5 mg TID treatment group and the placebo group on the ADAS-cog; c. A comparison between the mean change from Baseline to Week 52 in the Dimebon 5 mg TID treatment group and the placebo group on the ADCS-ADL; 3. Additional secondary endpoints for this study include: a. A comparison between the distributions of the Dimebon 20 mg TID treatment group and the placebo group on the ADCS-CGIC at Week 52; b. A comparison between the mean change from Baseline to Week 52 of the Dimebon 20 mg TID treatment group and the placebo group on the NPI; c. A comparison between the mean change from Baseline to Week 52 of the Dimebon 20 mg TID treatment group and the placebo group on the MMSE; d. Comparisons of the Dimebon 20 mg TID treatment group and the placebo group at Weeks 13, 26, and 39 for all outcomes; e. Comparisons of the Dimebon 5 mg TID treatment group and the placebo group at Weeks 13, 26, and 39 for all outcomes and at Week 52 for outcomes other than the co-primary outcomes; f. RUD Lite© and EQ-5D data summarized descriptively by treatment group. Safety: The safety of Dimebon will be assessed by the frequency of serious adverse events, the frequency of discontinuation of Dimebon treatment due to an adverse event, the frequency and severity of adverse events, as well as the frequency of new laboratory and ECG abnormalities among the three treatment groups. Safety measures thus include adverse events, vital signs, physical examinations, ECGs, and clinical laboratory testing. Pharmacokinetics: Dimebon plasma concentrations will be measured at Baseline and Week 13. The impact of covariates will be evaluated in order to identify underlying factors responsible for the variability of PK parameters and to identify sub-populations.
    Efficacia: 1.misure dei risultati co-primari in questo studio: a.un confronto tra il cambiamento medio dalla Baseline alla Settimana 52 nel gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo sull ADAS-cog; b.un confronto tra il cambiamento medio dalla Baseline alla Settimana 52 nel gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo sull ADCS-ADL; 2.misure dei risultati secondari principali in questo studio: a.un confronto delle frequenze di cambiamento nell ADCS-ADL nel tempo tra il gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo; b.un confronto tra il cambiamento medio dalla Baseline alla Settimana 52 nel gruppo di trattamento con Dimebon 5 mg TID e il gruppo placebo sull ADAS-cog; c.un confronto tra il cambiamento medio dalla Baseline alla Settimana 52 nel gruppo di trattamento con Dimebon 5 mg TID e il gruppo placebo sull ADCS-ADL; 3.punti di arrivo secondari aggiuntivi in questo studio: a.un confronto tra le distribuzioni del gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo sull ADCS-CGIC alla Settimana 52; b.un confronto tra il cambiamento medio dalla Baseline alla Settimana 52 del gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo sull NPI; c.un confronto tra il cambiamento medio dalla Baseline alla Settimana 52 del gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo sul MMSE; d.confronti del gruppo di trattamento con Dimebon 20 mg TID e il gruppo placebo alla Settimana 13, 26 e 39 per tutti i risultati; e.confronti del gruppo di trattamento con Dimebon 5 mg TID e il gruppo placebo alla Settimana 13, 26 e 39 per tutti i risultati e alla Settimana 52 per risultati diversi dai risultati co-primari; f.dati RUD Lite© ed EQ-5D riassunti in maniera descrittiva per gruppo di trattamento Sicurezza La sicurezza del Dimebon sara` valutata dalla frequenza di effetti collaterali gravi, dalla frequenza dell interruzione del trattamento con Dimebon a causa di effetti collaterali, dalla frequenza e dalla gravita` degli effetti collaterali, nonche` dalla frequenza delle nuove anomalie in ECG e laboratorio tra i tre gruppi di trattamento. Le misure di sicurezza comprendono quindi effetti collaterali, segni vitali, esami obiettivi, ECG e test clinici di laboratorio Farmacocinetica Le concentrazioni di Dimebon nel plasma saranno misurate alla Baseline e alla Settimana 13. L impatto di covariate sara` valutato al fine di identificare i fattori sottostanti responsabili della variabilita` dei parametri FC e per identificare sottopopolazioni.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Twelve months
    12 Mesi
    E.5.2Secondary end point(s)
    Comparison between mean change from Baseline to week 52 of Dimebon 20 mg TID treatment group and placebo group on the CIBIN-plus. Comparison between the mean change from Baseline to Week 52 of Dimebon 20 mg TID treatment group and placebo group on NIP RUD Lite© e EQ5D data summarized descriptively by treatment group. Safety Safety of Dimebon will be assessed by frequency of SAE, of discontinuation of Dimebon treatment due to AE, frequency and severity of AE, frequency of new laboratory and ECG abnormalities among the 3 treatment groups. Safety measures thaus include AE, vital signes, physical examinations, ECGs and clinical lab test. Pharmacokinetics: Dimebon plasma concentration will be measured at baseline and week 13. The impact of covariates will be evaluated to indentify underlying factors responsible for the varability of pk parameters and to identify sub-population
    •Valutare l’efficacia del Dimebon versus placebo sul parametro funzione globale, mediante la Clinician’s Interview-Based Impression of Change, inclusiva della valutazione dei caregiver (CIBIC-plus). •Valutare l’efficacia del Dimebon versus placebo sui parametri NPI. •Valutare sinteticamente RUD Lite© e EQ5D nel gruppo in trattamento. Safety end point Sicurezza di Dimebon valutata dalla frequenza di SAE, dall`interruzione del dimebon a causa di AE, dalla frequenza e severita' di AE, frequenza di anomalie nei dati di laboratorio e ECG nei tre gruppi in trattamento. I dati di safety includono AE, segni vitali, ECG e test di laboratorio. Farmacocinetica La concentrazione di Dimebon sul plasma verra' misurata al baseline e alla settimana 13. l`impatto delle covarianti sara' valuato per identifiare fattori responsabili per la varabilita' dei parametri PK e indentificare una sotto popolazione
    E.5.2.1Timepoint(s) of evaluation of this end point
    Twelve months
    12 mesi
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic Yes
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Quality of life
    Qualita' della Vita
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    - Stesso farmaco ad altro dosaggio
    - same IMP used at different dosage
    E.8.2.4Number of treatment arms in the trial3
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA40
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    New Zealand
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LPLV of last patient undergoing the trial
    LPLV dell`ultimo paziente in studio
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1Number of subjects for this age range: 0
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 142
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 861
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception For clinical trials recorded in the database before the 10th March 2011 this question read: "Women of childbearing potential" and did not include the words "not using contraception". An answer of yes could have included women of child bearing potential whether or not they would be using contraception. The answer should therefore be understood in that context. This trial was recorded in the database on 2009-08-11. Yes
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    If the patient is not competent, a mentally-competent legally acceptable representative must porvide informed consent on his/her behalf, and patient ust provide verbal assent
    in caso il consenso verra' firmato da Legale rappresentante, il pz dara' consenso verbale
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state70
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 350
    F.4.2.2In the whole clinical trial 1050
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2009-09-30
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2009-06-11
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2012-01-12
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