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    Summary
    EudraCT Number:2014-002601-38
    Sponsor's Protocol Code Number:D5010C00009
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-01-20
    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 number2014-002601-38
    A.3Full title of the trial
    A 24-Month, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Efficacy, Safety, Tolerability, Biomarker and Pharmacokinetics Study of AZD3293 in Early Alzheimer's Disease (The
    AMARANTH Study)
    Studio multicentrico, randomizzato, in doppio cieco, controllato verso placebo, a gruppi paralleli, della durata di 24 mesi, su efficacia, sicurezza, tollerabilità, analisi dei biomarcatori e profilo farmacocinetico di AZD3293 nella malattia di Alzheimer in fase precoce (studio AMARANTH)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study to assess the effect of AZD3293 in early Alzheimer's Disease
    Studio per valutare l'effetto di AZD3293 nella malattia di Alzheimer in fase precoce (studio AMARANTH)
    A.3.2Name or abbreviated title of the trial where available
    The AMARANTH Study
    Studio AMARANTH
    A.4.1Sponsor's protocol code numberD5010C00009
    A.5.4Other Identifiers
    Name:-Number:-
    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 SponsorELI LILLY & COMPANY, LILLY CORPORATE CENTER
    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 supportEli Lilly and Company
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationEli Lilly
    B.5.2Functional name of contact pointClinical Trial Registry Office
    B.5.3 Address:
    B.5.3.1Street AddressLilly Corporate Center, DC 1526
    B.5.3.2Town/ cityIndianapolis
    B.5.3.3Post code46285
    B.5.3.4CountryUnited States
    B.5.4Telephone number0000
    B.5.5Fax number0000
    B.5.6E-mailEU_Lilly_Clinical_Trials@lilly.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 nameAZD3293 20mg
    D.3.2Product code AZD3293
    D.3.4Pharmaceutical form 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.3.9.1CAS number 1522418-41-2
    D.3.9.2Current sponsor codeAZD3293
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 nameAZD3293 50mg
    D.3.2Product code AZD3293
    D.3.4Pharmaceutical form 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.3.9.1CAS number 1522418-41-2
    D.3.9.2Current sponsor codeAZD3293
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 placeboTablet
    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
    Early Alzheimer's Disease (mild cognitive impairment due to AD (ie,prodromal AD) and mild dementia of the Alzheimer's type)
    Malattia di Alzheimer's precoce. Decadimento cognitivo lieve causato da Malattia di Alzheimer ( Alzheimer prodromico) e demenza lieve tipo Alzheimer.
    E.1.1.1Medical condition in easily understood language
    Early Alzheimer's Disease
    Malattia di Alzheimer's precoce
    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 20.0
    E.1.2Level PT
    E.1.2Classification code 10012271
    E.1.2Term Dementia Alzheimer's type
    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 AZD3293 on cognitive and functional outcomes in patients with early Alzheimer's disease (AD) as measured by the Clinical Dementia Rating – Sum of Boxes score.
    To evaluate the safety and tolerability of AZD3293 in patients with early AD.
    Valutare l’efficacia di AZD3293 sugli esiti cognitivi e funzionali di pazienti con malattia di Alzheimer (MA) in stadio precoce, in base al punteggio CDR-SB (Clinical Dementia Rating - Sum of Boxes). Valutare la sicurezza e la tollerabilità di AZD3293 in pazienti con MA in stadio precoce.
    E.2.2Secondary objectives of the trial
    objectives:
    English •To evaluate the efficacy of AZD3293 on:
    - cognitive outcomes as measured by the ADAS-Cog-13 score
    - functional outcome as measured by the FAQ score and the ADCS-ADL
    instrumental items score
    - neuropsychiatric symptoms as assessed by NPI score
    •To evaluate the efficacy of AZD3293 to prolong time in the current
    disease state as measured by the CDR global score
    •To evaluate the effect of AZD3293 on underlying pathology as
    measured by brain volumes using MRI
    •To assess the population pharmacokinetics (PK) of AZD3293 and
    metabolite AZ13569724
    Valutare l'efficacia di AZD3293:
    - Esiti cognitivi come misurati dal punteggio ADAS-Cog-13
    - Esito funzionale come misurato dal punteggio FAQ e dal punteggio agli Items strumentali ADCS-ADL
    - Sintomi neuropsichiatrici come valutati dal punteggio NPI
    • valutare l'efficacia di AZD3293 nel prolungare la durata dello stato attuale della malattia misurata dal punteggio globale CDR
    • Valutare l’effetto di AZD3293 sulla patologia sottostante in base ai volumi cerebrali misurati mediante risonanza magnetica (RMI)
    • valutare la farmacocinetica (PK)di popolazione di AZD3293 e del metabolita AZ13569724
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Other types of substudies
    Specify title, date and version of each substudy with relative objectives: positron emission tomography (PET) in the longitudinal PET sub-study (included in the main protocol).
    To evaluate the effect of AZD3293 on brain metabolic rates using fluorodeoxyglucose (FDG) PET (Protocol Addendum D5010C00009(1) (FDG PET) 12 March 2015).
    CSF longitudinal sub-study (included in main protocol):
    To evaluate the effect of AZD3293 on central markers of pharmacodynamics by assessing Aß 1-42 and Aß 1-40 concentrations.

    Altre tipologie di sottostudi
    specificare il titolo, la data e la versione di ogni sottostudio con i relativi obiettivi: Valutare l’effetto di AZD3293 sul carico cerebrale di amiloide mediante tomografia a emissione di positroni (PET) nell’ambito del sottostudio PET longitudinale ( incluso nel protocollo principale)
    Valutare l’effetto di AZD3293 sui tassi metabolici cerebrali mediante PET con fuorodeossiglucosio (FDG) ( Addendum al protocollo D5010C00009(1) ( FDG PET) 12 Marzo 2015)
    Valutare l’effetto di AZD3293 sui marcatori centrali della farmacodinamica determinando le concentrazioni Aß 1-42 e Aß 1-40.
    E.3Principal inclusion criteria
    •Gradual and progressive change in the patient's memory function over more than 6 months
    •Male or female, aged 55 to 85 years inclusive
    •MMSE score of 20 to 30 inclusive
    •Score of = 85 on the Delayed Memory Index of the Repeatable Battery for the assessment of Neuropsychological Status (RBANS)
    •For a diagnosis of mild AD, patient (1) meets the National Institute on Aging (NIA) and the Alzheimer's Association (AA) (NIA-AA) criteria for
    probable AD and (2) has a CDR global score of 0.5 or 1, with the memory box score =0.5
    •For a diagnosis of MCI due to AD, patient (1) meets NIA-AA criteria for MCI due to AD and (2) had CDR global score of 0.5, with the memory box score =0.5
    •Laboratory tests show no evidence of other etiologies for MCI or dementia
    •PET visual reading or CSF Ab1-42 concentration positive for presence of amyloid
    •Contraception: Women must be postmenopausal or surgically sterile.
    Men must abstain or use barrier contraception from the first day of dosing until 3 months after the last dose and for 24 hours after amyloid scans
    •Concomitant medication: The dose of any concomitant medication must be stable for at least 30 days before screening, and between screening
    and randomization. For cholinesterase inhibitors (a) the dose regimen must be stable for at least 90 days prior to baseline, (b) the patient must be free from any clinically important side effects attributable to the drug, and (c) patient and study partner agree that, barring unforeseen circumstances, the dosage regimen will remain stable for the study
    duration. Treatment with memantine must be discontinued at least 3 weeks before randomization.
    •Agreement to undergo ApoE genotyping
    •The patient must have a reliable study partner with whom he/she cohabits or has regular contact.
    - Variazione graduale e progressiva nella funzione mnestica del paziente nell’arco di oltre 6 mesi;
    - Soggetti di entrambi i sessi, di età compresa tra 55 e 85 anni (inclusi);
    -Punteggio MMSE di 20-30 (incluso);
    - Punteggio =85 al test Delayed Memory Index della batteria Repeatable Battery for the Assessment of Neuropsychological Status (RBANS);
    -Per una diagnosi di MA lieve, il paziente deve (1) soddisfare i criteri NIA-AA (National Institute on Aging e Alzheimer’s Association ) per una probabile MA e (2) deve ottenere un punteggio CDR globale di 0,5 o 1, con punteggio alla sottoscala della memoria =0,5;
    - Per una diagnosi di MCI da MA, il paziente deve (1) soddisfare i criteri NIA-AA per la MCI da MA e (2) deve ottenere un punteggio CDR globale di 0,5, con punteggio alla sottoscala della memoria =0,5;
    - Gli esami di laboratorio non mostrano evidenze di altre eziologie per la MCI o la demenza;
    - Lettura visiva della PET o concentrazione di A¿1-42 nel CSF positiva per la presenza di amiloide;
    - Contraccezione; le pazienti devono essere in post-menopausa o chirurgicamente sterili;
    - Gli uomini devono astenersi dai rapporti sessuali o essere disposti a usare un metodo contracettivo di barriera dal primo giorno di trattamento e fino a 3 mesi dopo l’ultima dose di trattamento in studio nonché per 24 ore dopo la PET amiloide;
    - Trattamenti concomitanti: La dose di qualsiasi trattamento concomitante deve essere stabile per almeno 30 giorni prima dello screening e nel periodo che intercorre tra lo screening e la randomizzazione. Qualora il paziente venga trattato con inibitori della colinesterasi, devono essere soddisfatte anche le seguenti condizioni: (a) il paziente deve essere trattato a dosi stabili da almeno 90 giorni prima del basale , (b) il paziente non manifesta effetti indesiderati clinicamente importanti attribuibili al farmaco e (c) il paziente e il partner di studio convengono che, eccezion fatta per circostanze impreviste, il regime posologico resterà stabile per la durata dello studio.Il trattamento con memantina deve essere interrotto almeno 3 settimane prima della randomizzazione.
    - Il paziente acconsente a sottoporsi alla genotipizzazione ApoE.
    -Il paziente deve avere un partner di studio affidabile con il/la quale convive o con cui ha contatti regolari
    E.4Principal exclusion criteria
    •Prior or ongoing participation in any AZD3293 study or other BACE inhibitor study or participation in any other interventional AD study during the proposed study
    •Significant neurological disease affecting the CNS, other than AD, that may affect cognition or ability to complete the study.
    •History of clinically evident stroke or multiple strokes based on history or imaging results
    •History of clinically important carotid or vertebrobasilar stenosis or plaque
    •History of multiple concussions or a concussion with sustained cognitive complaints or objective change in neuropsychological function in the last 5 years
    •Patients with a current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnosis of Major Depressive Disorder (MDD) or any current primary psychiatric diagnosis other than AD if, the psychiatric disorder or symptom is likely to confound interpretation of drug effect, affect cognitive assessment, or affect the patient's ability to complete the study, history of schizophrenia or other chronic psychosis
    •History of alcohol, drug abuse or dependence (except nicotine dependence) within the last 2 years
    •Within 1 year before the screening visit or between screening and baseline: myocardial infarction; moderate or severe congestive heart
    failure, NYHA class III or IV; hospitalization for, or symptoms of, unstable angina; syncope due to orthostatic hypotension or unexplained syncope; known significant structural heart disease; or hospitalization for arrhythmia
    •Congenital QT prolongation
    •Intermittent second- or third-degree atrioventricular (AV) heart block or AV dissociation or history of ventricular tachycardia
    •History of cancer within the last 5 years, with the exception of nonmetastatic basal and/or squamous cell carcinoma of the skin, in situ cervical, or non-progressive prostate cancer
    •Current serious or unstable clinically important systemic illness likely to affect cognitive assessment, deteriorate, or affect the patient's safety
    or ability to complete the study , including hepatic, renal, gastroenterologic, respiratory, cardiovascular, endocrinologic,
    immunologic, or hematologic disorders
    •History of vitiligo and/or current evidence of post-inflammatory hypopigmentation
    •History of 2 or more clinically important drug allergies, eg, severe druginduced
    rash or anaphylaxis
    •Screening MRI shows evidence of significant abnormality that would suggest another potential etiology for MCI or dementia
    •Uncontrolled hypertension
    •A corrected QT (QTcF) interval measurement >470 msec
    •Known positive serologic findings for HIV antibodies
    •Positive hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV) antibodies
    •Urine drug screen positive for amphetamine, cocaine, phencyclidine, or barbiturate
    •Any clinically important abnormality at screening
    •Calculated creatinine clearance <30 mL/min
    •ALT =2 × the upper limit of normal (ULN) of the performing laboratory, AST =2 × ULN, total bilirubin =1.5 × ULN or ALP =1.5 x ULN
    •Regular use (eg, taken >3 days/week) of narcotic medications within 30 days before baseline
    •Use of strong inhibitors of CYP3A4 within 14 days or 5 half-lives, whichever is longer, or strong inducers of CYP3A4 within 30 days before baseline
    •Use of strong inhibitors of Pgp or BCRP within 14 days or 5 half-lives, whichever is longer, or inducers of Pgp within 30 days before baseline
    •Use of drugs known to significantly prolong QT interval within 14 days
    or 5 half-lives, whichever is longer, prior to baseline
    •Use of medications known to significantly influence coagulation, such as warfarin or heparin
    •Treatment with any investigational drug or device within 60 days or 5 half-lives prior to screening (whichever is longer) or between screening and baseline
    •Prior treatment with an AD vaccine
    •Presence of any of the following MRI contraindications: pacemaker;
    cardiac defibrillator; spinal cord or vagus nerve stimulator; aneurysm clip;
    artificial heart valve; recent coronary or carotid stent; ear implant; CSF shunt; other implanted medical device; metal fragments or foreign objects in the eyes, skin, or body; severe claustrophobia that would
    contraindicate a brain MRI scan
    CSF sub-study:
    •Any spinal malformations or other aspects/clinical findings that may complicate or contraindicate lumbar puncture
    •Current blood-clotting or bleeding disorder, including clinically significant abnormal findings in laboratory assessments of coagulation
    or hematology
    PET sub-study:
    •Present or planned participation in any other research and/or medical
    protocol involving PET ligands or radioactive agents
    •Exposure to ionizing radiation that, in combination with the planned
    administration of study amyloid PET ligand, would result in a cumulative exposure that exceeds local recommended exposure limits
    •Hypersensitivity to the active substance or any of the excipients of AMYVID
    - Precedente o attuale partecipazione in qualsiasi studio con AZD3293 o ad altri studi con inibitori BACE o partecipazione a qualsiasi altro studio interventistico sulla MA per la durata della partecipazione al presente studio;
    - Significativa malattia neurologica a carico del SNC, diversa dalla MA, che può compromettere la funzione cognitiva o la capacità di completare lo studio;
    - Storia di ictus clinicamente evidente o molteplici ictus sulla base dell’anamnesi o dei risultati degli esami di immagin;
    - Storia di stenosi o placche carotidee o vertebrobasilari clinicamente importanti.
    - Storia di molteplici commozioni o commozione con persistenza di disturbi cognitivi o alterazione oggettiva della funzione neuropsicologica negli ultimi 5 anni;
    - Diagnosi corrente di disturbo depressivo maggiore (MDD) secondo i criteri del Manuale diagnostico e statistico dei disturbi mentali, quinta edizione (DSM-V) o qualsiasi altra diagnosi psichiatrica primaria corrente diversa dalla MA (secondo il DSM-V) se, nell’opinione dello sperimentatore, il disturbo o il sintomo psichiatrico può confondere l’interpretazione dell’effetto del farmaco o compromettere la valutazione cognitiva o la capacità del paziente di completare lo studio. Sono esclusi dallo studio i pazienti con storia di schizofrenia o altra psicosi cronica;
    - Storia di abuso o dipendenza da alcol o sostanze (ad eccezione della dipendenza da nicotina) (secondo il DSM-V) nei 2 anni precedenti la visita di screening;
    - Uno dei seguenti eventi nell’anno precedente la visita di screening o nel periodo che intercorre tra lo screening e il basale: infarto del miocardio; insufficienza cardiaca congestizia moderata o grave di classe NYHA III o IV; ospedalizzazione per angina instabile o sintomi di angina instabile; sincope da ipotensione ortostatica o sincope di natura inspiegata; cardiopatia strutturale significativa nota (p.es. significativa malattia valvolare, cardiomiopatia ipertrofica); oppure ospedalizzazione per aritmia;
    - Prolungamento congenito del tratto QT;
    - Blocco atrioventricolare (AV) di secondo o terzo grado intermittente o dissociazione AV o storia di tachicardia ventricolare;
    - Storia di cancro negli ultimi 5 anni, ad eccezione del carcinoma cutaneo baso- e/o squamocellulare non metastatico, del carcinoma in situ della cervice o del carcinoma prostatico non progressive;
    - Malattia sistemica corrente, seria o instabile, clinicamente importante che, nell’opinione dello sperimentatore, può influenzare la valutazione cognitiva, alterare o compromettere la sicurezza del paziente o la sua capacità di completare lo studio, inclusi disturbi epatici, renali, gastroenterologici, respiratori, cardiovascolari, endocrinologici, immunologici o ematologici;
    - Storia di vitiligine e/o evidenze correnti di ipopigmentazione post-infiammatoria;
    - Storia di 2 o più allergie a farmaci clinicamente importanti, p. es. rash o anafilassi grave indotti da farmaco;
    - La RMI allo screening mostra evidenze di anomalie significative indicative di un’altra potenziale eziologia per la MCI o la demenza;
    - pertensione non controllata;
    - Intervallo QT corretto (QTcF) >470 msec;
    - Positività nota agli anticorpi del virus dell’immunodeficienza umana (HIV) nel siero;
    - Positività agli anticorpi dell’antigene di superficie dell’epatite B (HBsAg) o del virus dell’epatite C (HCV);
    -positività ad anfetamina, cocaina, fenciclidina o barbiturici agli esami delle urine;
    - Qualsiasi anomalia clinicamente importante emersa allo screening;
    - Clearance della creatinina calcolata <30 mL/min;
    - ALT =2 × il limite superiore della norma (LSN) del laboratorio di analisi, AST =2 × LSN, bilirubina totale =1,5 × LSN o ALP =1,5 × LSN;
    - Uso regolare (p. es. assunti >3 giorni/settimana) di farmaci narcotici nei 30 giorni precedenti il basale;
    - Uso di potenti inibitori del CYP3A4 nei 14 giorni o nelle 5 emivite, a seconda di quale periodo sia più lungo, precedenti il basale o di potenti induttori del CYP3A4 nei 30 giorni precedenti il basale;
    - Uso di potenti inibitori della Pgp o del BCRP nei 14 giorni o nelle 5 emivite, a seconda di quale periodo sia più lungo, precedenti il basale o di induttori della Pgp nei 30 giorni precedenti il basale;
    - Uso di farmaci che prolungano in misura significativa l’intervallo QT nei 14 giorni o nelle 5 emivite, a seconda di quale periodo sia più lungo, precedenti il basale basale;
    - Uso di farmaci noti per influenzare in misura significativa la coagulazione, come warfarin o eparina;
    - Trattamento con qualsiasi farmaco o dispositivo sperimentale nei 60 giorni o nelle 5 emivite precedenti lo screening (a seconda di quale periodo sia più lungo) o nel periodo che intercorre tra lo screening e il basale;
    - Precedente trattamento con un vaccino per la MA;
    - Presenza di una delle seguenti controindicazioni per la RMI: pacemaker; defibrillatore cardiaco; stimolatore del midollo spinale o del nervo vago; clip per aneurisma; valvola cardiaca artificiale;
    E.5 End points
    E.5.1Primary end point(s)
    Clinical Dementia Rating - Sum of Boxes (CDR-SB) score
    Punteggio del CDR SB
    E.5.1.1Timepoint(s) of evaluation of this end point
    Baseline up to 104 Weeks
    Basale sino a 104 settimane
    E.5.2Secondary end point(s)
    Efficacy
    •Change from baseline to Week 104 in the ADAS-Cog-13 score
    •Change from baseline to Week 104 in the FAQ score
    •Change from baseline to Week 104 in the ADCS-ADL instrumental items
    score
    •Time to loss of 1 global stage on the CDR global score through Week
    104
    •Change from baseline to Week 104 in the NPI total score
    •Changes from baseline in the CDR-SB, ADAS-Cog-13, FAQ, ADCS-ADL
    instrumental items, and NPI total scores across time.
    Biomarker
    •Changes from screening in volumetric MRI measures
    CSF sub-study:
    •Changes from screening in CSF Aß 1-40 and Aß 1-42
    •Changes from screening in CSF biomarkers total tau and
    phosphorylated tau
    PET sub-study:
    •Change from screening in brain amyloid as measured by amyloid PET
    •Change from baseline in brain metabolism as measured by FDG PET
    Safety
    •Frequencies of clinically significant changes in physical examination
    findings, including results of neurological, skin, and eye examinations
    •Frequencies of non-serious adverse events (AEs) and serious AEs
    (SAEs)
    •Changes in vital signs
    •Changes in ECG findings
    •Changes in clinical laboratory test results
    •Frequency and severity of amyloid-related imaging abnormalities
    (ARIA)
    •Worsening in cognition, as measured by the ADAS-Cog-13
    •Changes in Columbia - Suicide Severity Rating Scale (C-SSRS) scores
    Pharmacokinetic
    •Plasma AZD3293 and metabolite AZ13569724 concentrations
    •Evaluation of covariates that may contribute to AZD3293 and
    AZ13569724 PK variability
    •CSF AZD3293 and AZ13569724 PK at Weeks 52 and 97 (CSF sub-study)
    Efficacia
    •Variazione del punteggio ADAS-Cog-13 dal basale alla Settimana 104
    • Variazione del punteggio agli item strumentali della scala ADCS-ADL dal basale alla Settimana 104
    • Variazione del punteggio FAQ dal basale alla Settimana 104
    • Tempo alla perdita di 1 stadio globale al punteggio CDR globale fino alla Settimana 104
    • Variazione del punteggio NPI totale dal basale alla Settimana 104
    • Variazione nel tempo rispetto al basale dei seguenti punteggi: CDR-SB, ADAS-Cog-13, item strumentali della scala ADCS-ADL, FAQ e NPI totale
    Biomarker
    • Variazione della concentrazione dei biomarcatori Aß1-40 e Aß1-42 nel CSF rispetto allo screening (sottostudio longitudinale sul CSF)
    • Variazione della concentrazione dei biomarcatori tau totale e tau fosforilato nel CSF rispetto allo screening (sottostudio longitudinale sul CSF)
    • Variazione della concentrazione di amiloide cerebrale misurata mediante PET amiloide rispetto allo screening (sottostudio PET longitudinale)
    • Variazione del metabolismo cerebrale misurato mediante FDG PET rispetto al basale
    • Variazione dei parametri volumetrici alla RMI rispetto al basale
    Sicurezza
    • Frequenza delle variazioni clinicamente significative negli esiti degli esami obiettivi, inclusi i risultati degli esami neurologici, cutanei e oftalmologici
    • Frequenza degli eventi avversi non seri (AE) e degli eventi avversi seri (SAE)
    • Variazioni dei segni vitali
    • Variazioni del tracciato elettrocardiografico (ECG)
    • Variazioni dei risultati degli esami clinici di laboratorio.
    • Frequenza e gravità delle anomalie correlate ad amiloide evidenziate alla RMI (ARIA)
    • Peggioramento della funzione cognitiva, come indicato dal punteggio ADAS-Cog-13
    • Variazioni del punteggio C-SSRS (Columbia-Suicide Severity Rating Scale)
    Farmacocinetica
    • Le concentrazioni plasmatiche di AZD3293 e del metabolita AZ13569724 saranno usate per stimare la PK in base a una strategia a campionamento ridotto.
    • La strategia a campionamento ridotto sarà usata anche per valutare le covariate che potrebbero contribuire alla variabilità farmacocinetica di AZD3293 e di AZ13569724.
    • La farmacocinetica di AZD3293 e AZ13569724 nel CSF sarà valutata alle Settimane 52 e 97 (sottostudio longitudinale sul CSF).
    E.5.2.1Timepoint(s) of evaluation of this end point
    All safety endpoints will be evaluated at all time points from screening.
    Time points for the primary and secondary efficacy endpoints that will be
    tested through a step-down approach.
    Tutti gli end point di sicurezza saranno valutati in tutti i tempi di rilevazione a partire dallo screening. Gli endpoint priomari e secondari di efficacia clinica saranno verificati mediante un approccio step-down .
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    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) Yes
    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 No
    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 concerned15
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA91
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    Canada
    Japan
    Korea, Republic of
    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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months7
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months7
    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.1.1.1In 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: 136
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 768
    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 No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    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 No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state150
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 904
    F.4.2.2In the whole clinical trial 2202
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    It is anticipated the first subject ending treatment will be in 2017. At
    present , plans for the treatment or care after participation in the trial
    are under development. It is likely that the completers will be offered participation in a long term extension if they so wish.
    Si anticipa che il primo soggetto terminerà il trattamento nel 2017. Al momento sono in valutazioni piani per il trattamento e l'assistenza previsti al termine della partecipazione allo studio. E' probabile che ai soggetti che completeranno lo studio sarà offerta la partecipazione ad uno studio di estensione a lungo termine se lo desiderano.
    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 Decision2015-10-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-11-05
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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