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    Summary
    EudraCT Number:2016-004128-42
    Sponsor's Protocol Code Number:E2609-G000-302
    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:2018-02-08
    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 number2016-004128-42
    A.3Full title of the trial
    A Placebo-Controlled, Double-Blind, Parallel-Group, 24 Month Study to Evaluate the Efficacy and Safety of E2609 in Subjects with Early Alzheimer’s Disease
    Studio di 24 mesi controllato verso placebo, in doppio cieco, a gruppi paralleli per valutare l’efficacia e la sicurezza di E2609 in soggetti affetti da malattia di Alzheimer precoce
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    na
    na
    A.3.2Name or abbreviated title of the trial where available
    A Placebo-Controlled, Double-Blind, Parallel-Group, 24 Month Study to Evaluate the Efficacy and Safe
    Studio di 24 mesi controllato verso placebo, in doppio cieco, a gruppi paralleli per valutare l’effi
    A.4.1Sponsor's protocol code numberE2609-G000-302
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT03036280
    A.5.4Other Identifiers
    Name:IND Number:IND00000109308
    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 SponsorEISAI LIMITED
    B.1.3.4CountryUnited Kingdom
    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 supportEISAI Ltd
    B.4.2CountryUnited Kingdom
    B.4.1Name of organisation providing supportEISAI Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationEisai Ltd.
    B.5.2Functional name of contact pointMedical Information
    B.5.3 Address:
    B.5.3.1Street AddressMosquito Way, Hatfield
    B.5.3.2Town/ cityHertfordshire
    B.5.3.3Post codeAL10 9SN
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number00448456761400
    B.5.5Fax number00448456761486
    B.5.6E-mailLMedInfo@eisai.net
    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.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMP
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNElenbecestat
    D.3.9.2Current sponsor codeE2609
    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.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 Yes
    D.2.1.1.1Trade name NEURACEQ - 300 MBQ/ML - SOLUZIONE INIETTABILE - USO ENDOVENOSO - FLACONCINO (VETRO) - 1 FLACONCINO MONODOSE
    D.2.1.1.2Name of the Marketing Authorisation holderPIRAMAL IMAGING GMBH
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameNeuraceq
    D.3.2Product code INN-florbetaben
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMP
    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 Yes
    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: 3
    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 Yes
    D.2.1.1.1Trade name VIZAMYL - 400 MBQ/ML - SOLUZIONE INIETTABILE - USO ENDOVENOSO - FLACONCINO (VETRO) - 1-15 ML - 1 FLACONCINO
    D.2.1.1.2Name of the Marketing Authorisation holderGE HEALTHCARE LIMITED
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameVIZAMYL
    D.3.2Product code NA
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMP
    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 Yes
    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: 4
    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 Yes
    D.2.1.1.1Trade name AMYVID - 800 MBQ/ML SOLUZIONE INIETTABILE - USO ENDOVENOSO - FLACONCINO (VETRO) (1-15 ML CONCENTRAZIONE) 1 FLACONCINO
    D.2.1.1.2Name of the Marketing Authorisation holderELI LILLY NEDERLAND BV
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameAmyvid
    D.3.2Product code NA
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMP
    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 Yes
    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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Early Alzheimer Disease including mild cognitive impairment (MCI) due
    to AD/Prodromal AD and the early stages of mild AD
    Malattie di Alzheimer precoce incluso il deterioramento cognitivo lieve (MCI) a causa di malattia di Alzheimer (AD) / malattia di Alzheimer (AD) prodromica e le prime fasi di malattia di Alzheimer (AD) lieve
    E.1.1.1Medical condition in easily understood language
    Clinical Dementia
    Demenza
    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.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    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.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10074616
    E.1.2Term Prodromal 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 determine whether elenbecestat (E2609) is superior to placebo on the change from baseline in the Clinical Dementia Rating - Sum Of Boxes
    (CDR-SB) at 24 months in subjects with Early Alzheimer's Disease (EAD)
    Determinare se elenbecestat (E2609) è superiore al placebo in termini di variazione del punteggio rispetto al basale della scala per la valutazione clinica della demenza (Clinical Dementia Rating – Sum Of Boxes, CDR-SB) a 24 mesi nei soggetti affetti da malattia di Alzheimer precoce (Early Alzheimer’s Disease, EAD).
    E.2.2Secondary objectives of the trial
    1. To evaluate the safety and tolerability of elenbecestat (E2609) in subjects with EAD
    2. To determine whether elenbecestat (E2609) is superior to placebo on the time to worsening of Clinical Dementia Rating (CDR) scores in subjects with EAD
    3.To determine whether elenbecestat (E2609) is superior to placebo on the time to conversion to dementia for subjects who were not clinically staged as having dementia at Baseline based on a clinical diagnosis evaluated every 3 months
    4.To determine whether elenbecestat (E2609) is superior to placebo on the rate of change over time (mean slope) based on CDR-SB score over 24 months in subjects with EAD
    5.To determine whether elenbecestat (E2609) is superior to placebo on the Alzheimer's Disease Assessment Scale-Cognition14 (ADAS-cog14),
    Mini Mental State Examination (MMSE), and Functional Assessment Questionnaire (FAQ) at 24 months in subjects with EAD
    Please refers to the Study Protocol for further objectives
    1Valutare la sicurezza e la tollerabilità di E2609 nei soggetti affetti da malattia di Alzheimer precoce. 2. Determinare se E2609 è superiore al placebo in termini di tempo di peggioramento dei punteggi della valutazione clinica della demenza nei soggetti affetti da malattia di Alzheimer precoce. 3.Determinare se E2609 è superiore al placebo in termini di tempo alla conversione in demenza nei soggetti che al basale non sono stati clinicamente classificati come in stadio di demenza, sulla base di una valutazione trimestrale della diagnosi clinica. 4.Determinare se E2609 è superiore al placebo in termini di variazione percentuale nel tempo (pendenza media della curva), sulla base del punteggio CDR-SB nell’arco di 24 mesi, nei soggetti affetti da malattia di Alzheimer precoce. 5. Determinare se a 24 mesi E2609 è superiore al placebo per ADAS-cog14, MMSE, FAQ a 24 mesi. Vedere protocollo per ulteriori obiettivi.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Two longitudinal biomarker substudies will evaluate the effects of study treatment on the underlying pathophysiology of AD using Amyloid PET and/or CSF biomarkers.
    Due sottostudi longitudinali sui biomarcatori valuteranno gli effetti del trattamento dello studio sulla fisiopatologia di base della malattia di Alzheimer utilizzando la PET amiloidea e/o i biomarcatori dell’LCR.
    E.3Principal inclusion criteria
    1. MCI due to Alzheimer's disease or Mild Alzheimer's disease according to the National Institute of Aging – Alzheimer's Association (NIA-AA)
    core clinical criteria and must have all of the following:
    a. MMSE score equal to or greater than 24
    b. CDR global score of 0.5
    c. CDR Memory Box score of 0.5 or greater
    2. A history of subjective memory decline with gradual onset and slow progression over the last 1 year before Screening; this MUST be corroborated by a study partner 3. Cognitive impairment of at least 1 SD from age-adjusted norms in total recall or delayed recall on the ISLT.
    4. Positive biomarker for brain amyloid pathology as indicated by at least 1 of the following:
    a. PET assessment of amyloid imaging agent uptake into brain.
    Note: Amyloid PET screens will be performed according to local regulatory guidelines and thus may be restricted for those subjects who are not
    suitable for lumbar puncture (LP) to obtain CSF for testing of eligibility.
    b. CSF assessment of Aβ(1-42) NOTE: Subjects may undergo both the Amyloid PET and CSF assessments, but need a positive amyloid result in
    only 1 of the 2 procedures to confirm eligibility. Subjects who consent to Amyloid PET or CSF for eligibility purposes are not required to participate in the Amyloid PET or CSF longitudinal substudies. Use of a historical Amyloid PET (conducted within 12 months before the planned date of randomization) is acceptable for determination of eligibility but will not suffice for the baseline assessment if the subject wishes to consent to the Amyloid PET longitudinal substudy. The historical imaging data must be made available to the sponsor. 5. Male or female subjects between 50 and 85 years of age, inclusive at the time of consent
    6. If receiving an AChEI or memantine or both for AD, must be on a stable dose for at least 12 weeks prior to Randomization. Treatment naïve subjects with AD can be entered into the study.
    7. Subjects must have been on stable doses of all other (ie, non-AD related) permitted concomitant medications for at least 4 weeks prior to Randomization, except for medications which are administered as short courses (eg, up to 3 weeks unless discussed and agreed with Medical Monitor) of treatment (eg, anti-infectives) or which are to be used on aPro re nata (PRN) basis. Subjects who require a short course of treatment, such as an anti-infective, may be randomized once the acute
    illness has completely resolved, even if the concomitant medication continues.
    8. Must have an identified study partner (defined as a person able to support the subject for the duration of the study and who spends at least 8 hours per week with the subject). The study partner must provide written informed consent. In addition, this person must be willing and able to provide follow-up information on the subject throughout the course of the study. This person must, in the opinion of the investigator, spend sufficient time with the subject on a regular basis such that they can reliably fulfill the requirements of being a study partner. A study
    partner need not be living in the same residence with the subject. For such a study partner not residing with the subject, the investigator has to be satisfied that the subject can contact the study partner readily during the times when the study partner is not with the subject. Study partners need to provide input to the following assessments: CDR, FAQ,EQ-5D, QOL-AD, Zarit's Burden Interview, and the clinical assessment of suicidality. Consideration can occur for the investigator to decide whether the study partner can provide information over the telephone or whether the study partner must attend the study visits in person with the subject.
    1. MCI dovuto a malattia di Alzheimer o malattia di Alzheimer lieve, secondo i criteri clinici principali dell’Istituto nazionale sull’invecchiamento - associazione per la malattia di Alzheimer (National Institute of Aging – Alzheimer’s Association, NIA-AA) e devono presentare quanto segue:
    a. Punteggio MMSE pari o superiore a 24
    b. Punteggio CDR globale pari a 0,5
    c. Punteggio CDR nelle caselle relative alla memoria pari o superiore a 0,5
    2. Anamnesi di declino nella memoria soggettiva con esordio graduale e progressione lenta nel corso dell’ultimo anno prima dello screening; tale aspetto DEVE essere confermato da una persona che si prende cura del soggetto .
    3. Deficit cognitivo pari ad almeno 1 DS dagli standard rettificati per età nel richiamo totale o nel richiamo differito al test ISLT.
    4. Positività per biomarcatori di patologia amiloidea cerebrale, indicata da almeno 1 dei seguenti:
    a. Valutazione tramite PET dell’assorbimento cerebrale del tracciante per l’amiloide. Nota: le selezioni mediante PET amiloidea saranno eseguite in conformità alle linee guida regolatorie locali e, pertanto, possono essere limitate ai soggetti non idonei alla rachicentesi (PL) per il prelievo dell’LCR da analizzare ai fini dell’idoneità.
    b. Valutazione dell’Aβ(1-42) nell’LCR
    NOTA: i soggetti possono venire sottoposti a valutazioni sia di PET amiloidea sia dell’LCR, tuttavia, per la conferma dell’idoneità è necessario un risultato positivo per amiloide solo in 1 delle 2 procedure. I soggetti che acconsentono alla PET amiloidea o all’LCR ai fini dell’idoneità non sono tenuti a partecipare ai sottostudi longitudinali della PET amiloidea o dell’LCR. L’uso di una PET amiloidea precedente (eseguita entro 12 mesi dalla data prevista di randomizzazione) è accettabile per la determinazione dell’idoneità ma, qualora il soggetto desideri acconsentire a partecipare al sottostudio longitudinale della PET amiloidea, non sarà sufficiente per la valutazione al basale. I dati storici della diagnostica per immagini devono essere resi disponibili allo sponsor.
    5. Soggetti di ambo i sessi di età compresa tra 50 e 85 anni (compresi) al momento del consenso
    6. Se per l’AD il soggetto sta ricevendo un inibitore dell’acetilcolinesterasi (AChEI) o memantina, oppure entrambi, la dose deve essere rimasta stabile per almeno 12 settimane prima della randomizzazione. I soggetti affetti da AD naïve al trattamento possono essere inclusi nello studio.
    7. I soggetti devono aver assunto dosi stabili di tutti gli altri (ovvero, non correlati all’AD) farmaci concomitanti consentiti per almeno 4 settimane prima della randomizzazione, ad eccezione dei farmaci somministrati in cicli brevi (ad es. per un massimo di 3 settimane, eccetto se discusso e concordato con il Responsabile del monitoraggio medico) di trattamento (ad es. farmaci antinfettivi, steroidi orali) o che si debbano usare al bisogno (Pro re nata, PRN). I soggetti che necessitano di un ciclo breve di trattamento, come ad es. antinfettivi o steroidi orali, possono essere randomizzati una volta che la malattia acuta si sia completamente risolta, anche se il farmaco concomitante viene continuato.
    8. Il soggetto deve avere a disposizione una persona che si prende cura del soggetto (ovvero, una persona in grado supportare il soggetto per tutta la durata dello studio e che trascorra col medesimo almeno 8 ore a settimana). Questa persona deve fornire il consenso informato scritto e deve inoltre essere disposto e in grado di fornire informazioni di follow-up sul soggetto per tutta la durata dello studio. A giudizio dello sperimentatore, questa persona deve trascorrere regolarmente del tempo sufficiente con il soggetto, in modo da soddisfare in maniera attendibile i requisiti necessari per essere la persona che si prende cura del soggetto . Questa persona non è tenuta a convivere con il soggetto. In caso in cui questa persona non conviva con il soggetto, lo sperimentatore deve essere convinto che il soggetto possa contattarla tempestivamente nei momenti in cui quest’ultimo non si trova insieme al soggetto. Questa persona deve fornire informazioni nelle seguenti valutazioni: CDR, FAQ, EQ 5D, QOL-AD, Intervista di Zarit sull’onere, NPI-10, e valutazione clinica della suicidalità. Lo sperimentatore potrà decidere se consentire a questa persona di fornire le informazioni per via telefonica o se questi debba presenziare alle visite dello studio insieme al soggetto.
    E.4Principal exclusion criteria
    1. Females who are breastfeeding or pregnant at Screening or Baseline(as documented by a positive
    beta-human chorionic gonadotropin test. A separate baseline assessment is required if a negative
    screening pregnancy test was obtained more than 72 hours before the first dose of study drug.
    Females of child-bearing potential who:
    •Within 28 days before study entry, did not use a highly effective
    method of contraception,
    which includes any of the following:
    o total abstinence (if it is their preferred and usual lifestyle)
    o an intrauterine device or intrauterine hormone-releasing system
    o an oral contraceptive (Subject must be on a stable dose of the same
    oral contraceptive product for at least 28 days before dosing and
    throughout the study and for 28 days after study drug discontinuation.)
    o have a vasectomized partner with confirmed azoospermia.
    •Do not agree to use a highly effective method of contraception (as
    described above) throughout the entire study period and for 28 days
    after study drug discontinuation.
    For sites outside of the European Union, it is permissible that if a highly
    effective method of contraception is not appropriate or acceptable to the
    subject, then the subject must agree to use a
    medically acceptable method of contraception, ie, double-barrier
    methods of contraception such
    as condom plus diaphragm or cervical/vault cap with spermicide.
    NOTE: All females will be considered to be of child-bearing potential
    unless they are postmenopausal (amenorrheic for at least 12
    consecutive months, in the appropriate age group, and without other
    known or suspected cause) or have been sterilized surgically (ie,
    bilateral tubal ligation, total hysterectomy, or bilateral oophorectomy, all
    with surgery at least 1 month before dosing)
    2. Any condition that may be contributing to cognitive impairment above
    and beyond that caused by
    the subject's AD
    3. Subjects with a history of seizures within 5 years of Screening or
    subjects with disturbance likely
    to be due to seizures within 5 years of Screening
    4. History of transient ischemic attacks (TIA) or stroke within 12 months
    of Screening
    5. Modified Hachinski Ischemia Score greater than 4 at Screening
    6. Any of the following psychiatric symptoms:
    • Psychiatric diagnosis or symptoms, (eg, hallucinations, major
    depression, or delusions) that, in the opinion of the investigator, could
    interfere with study procedures
    • Has a "yes" answer to C-SSRS suicidal ideation items 4 or 5, or any
    suicidal behavior within 6 months before Screening, at Screening, or at
    the Randomization Visit, or has been hospitalized or treated for suicidal
    behavior in the past 5 years before Screening
    7. Have any contraindications to MRI scanning, including cardiac
    pacemaker/defibrillator, ferromagnetic metal implants (eg, in skull and
    cardiac devices other than those approved as safe
    for use in MRI scanners) or
    1.Donne in allattamento o in gravidanza (documentata dalla positività al test della beta-gonadotropina corionica umana) allo screening o al basale. Qualora il test di gravidanza allo screening risultato negativo sia stato eseguito entro più di 72 ore precedenti la prima dose di farmaco dello studio, sarà necessario effettuare una valutazione al basale separata. Soggetti di sesso femminile in età fertile che: Entro i 28 giorni precedenti all’ingresso nello studio non hanno usato un metodo contraccettivo altamente efficace, comprendente uno qualsiasi dei seguenti:
    o astinenza totale (se rientra nel loro stile di vita preferito e consueto)
    o dispositivo intrauterino oppure sistema intrauterino a rilascio di ormoni
    o contraccettivo orale (il soggetto deve assumere una dose stabile dello stesso prodotto contraccettivo orale per almeno 28 giorni prima della somministrazione, per tutta la durata dello studio e per 28 giorni successivi all’interruzione del farmaco dello studio)
    o compagno vasectomizzato con azoospermia confermata.
    • Non acconsentono all’uso di un metodo contraccettivo altamente efficace (tra quelli descritti sopra) per l’intero periodo dello studio e per 28 giorni successivi all’interruzione del farmaco dello studio. Nei centri esterni all’Unione europea, è consentito che, qualora un metodo contraccettivo altamente efficace non sia opportuno o accettato dal soggetto, questi dovrà acconsentire a usare un metodo contraccettivo accettabile dal punto di vista medico, ovvero metodi contraccettivi a doppia barriera, quali preservativo associato a diaframma o cappuccio cervicale con spermicida.
    NOTA: tutte le donne saranno considerate in età fertile, a meno che non siano in fase postmenopausale (amenorroiche da almeno 12 mesi consecutivi, nel gruppo di età appropriato e in assenza di altra causa di amenorrea nota o sospetta) o siano state sterilizzate chirurgicamente (ovvero, sottoposte a legatura tubarica bilaterale, isterectomia totale od ooforectomia bilaterale; in tutti i casi, l’intervento chirurgico deve essere stato eseguito almeno 1 mese prima della somministrazione. 2. Qualsiasi condizione che possa contribuire al deficit cognitivo ben oltre quello causato dall’AD del soggetto. 3. Soggetti con anamnesi di crisi convulsive entro 5 anni dallo screening o con disturbi probabilmente dovuti a crisi convulsive entro 5 anni dallo screening. 4. Anamnesi di attacco ischemico transitorio (AIT) o ictus entro 12 mesi dallo screening. 5. Punteggio della scala ischemica di Hachinski modificata superiore a 4 allo screening.
    6. Uno qualsiasi dei seguenti sintomi psichiatrici:
    •Diagnosi o sintomi psichiatrici (ad es.,allucinazioni, depressione maggiore o delirio) che, a giudizio dello sperimentatore, potrebbero interferire con le procedure dello studio.
    • Risposta positiva ai criteri 4 o 5 sull’ideazione suicidaria del C-SSRS, o qualsiasi comportamento suicida entro 6 mesi dallo screening, allo screening o alla Visita di randomizzazione, oppure ricovero o trattamento per comportamento suicida negli ultimi 5 anni prima dello screening.
    7. Qualsiasi controindicazione alla RM, compresa la presenza di pacemaker/defibrillatore cardiaco, impianti metallici ferromagnetici (ad es., nel cranio e dispositivi cardiaci diversi da quelli approvati come sicuri per l’uso negli scanner a RM) oppure
    • Qualsiasi evidenza di altre lesioni clinicamente significative che potrebbero indicare una diagnosi di demenza diversa dall’AD alla RM cerebrale allo screening.
    • Presenza di altri risultati patologici significativi alla RM cerebrale allo screening, tra cui, a titolo esemplificativo ma non esaustivo: un’area di siderosi superficiale; evidenza di edema vasogenico cerebrale; evidenza di contusione cerebrale, encefalomalacia, aneurismi, malformazioni vascolari o lesioni infettive; evidenza di infarti lacunari multipli o ictus che coinvolga un territorio vascolare maggiore, malattia grave dei vasi minori o della sostanza bianca; lesioni occupanti spazio; o tumori cerebrali (tuttavia, eventuali lesioni diagnosticate come meningiomi o cisti aracnoidee e con dimensioni inferiori a 1 cm al diametro maggiore non devono essere preclusive).
    8. Soggetti con anamnesi di danno epatico da moderato a grave (ad es. classi B o C di Child-Pugh). Uno qualsiasi dei seguenti criteri allo screening escluderà il soggetto: rapporto intern. normalizzato (INR) ≥ 1,7, bilirubina ≥ 1,5 x ULN, albumina < al limite inferiore della norma (LIN), ascite o encefalopatia epatica. Si osservi che una singola anormalità potrebbe soddisfare il criterio di danno moderato (rivisto dall’Emendamento 01).
    9. Risultati delle analisi di laboratorio condotte durante lo screening i cui valori non rientrino nei limiti. Per tutti gli altri criteri di esclusione vedere il protocollo.
    E.5 End points
    E.5.1Primary end point(s)
    Change from baseline in the CDR-SB at 24 months
    Variazione rispetto al basale nel CDR-SB a 24 mesi
    E.5.1.1Timepoint(s) of evaluation of this end point
    24 months
    24 mesi
    E.5.2Secondary end point(s)
    •Time to worsening of CDR scores by 24 months (eg, the worsening of global CDR score is defined as an increase from baseline by at least 0.5
    points on the global CDR scale on 2 consecutive scheduled visits at which global CDR is undertaken)
    •Time to conversion to dementia by 24 months for subjects who were not clinically staged as dementia at Baseline based on clinical diagnosis •The rate of change over time (mean slope) based on CDR-SB score over 24 months
    •Change from baseline in CDR-SB at 27 months (ie, 24 months of treatment plus 3 months posttreatment follow-up) •Change from baseline in ADAS-cog14, MMSE, and FAQ at 24 months •Change from baseline in ADAS-cog14 Word List (immediate recall and delayed recall) at 24 months
    Biomarker Endpoints
    •Change from baseline in amyloid PET SUVR composite at 24 months for brain amyloid levels
    •Change from baseline in CSF biomarkers t-tau and p-tau at 24 months •Change from baseline in CSF amyloid biomarkers Aβ(1-40), Aβ(1-42),and Aβ(1-x) at 24 months •Change from baseline in total hippocampal volume at 24 months using
    vMRI •Change from baseline in the preservation of connectivity on fMRI at 24 months Exploratory Endpoints •Time to change of concomitant AD treatment (ie, dose increase and/or initiation of treatment with AChEI or memantine after randomization) by 24 months
    •The proportion of subjects at 24 months who received dose increases and/or initiation of treatment with AChEI or memantine after
    randomization •The rate of change over time (mean slope) based on NPI-10 item score over 24 months
    •Change from baseline in NPI-10 item at 24 months
    •Change from baseline in EQ-5D (subject self-reported, study partner self-reported, and subject measured by proxy) and QOL-AD (subject and
    study partner) at 24 months
    •Change from baseline in Zarit's Burden Interview at 24 months
    • Tempo al peggioramento dei punteggi CDR entro 24 mesi (ad es. il peggioramento del punteggio CDR complessivo è definito da un incremento rispetto al basale di almeno 0,5 punti sulla scala CDR globale in 2 visite programmate consecutive durante le quali viene somministrata la CDR).
    • Tempo alla conversione in demenza entro 24 mesi nei soggetti che al basale non sono stati clinicamente classificati come in stadio di demenza sulla base di della diagnosi clinica
    • Variazione percentuale nel tempo (pendenza media della curva) sulla base del punteggio CDR-SB nell’arco di 24 mesi
    • Variazioni rispetto al basale in CDR-SB a 27 mesi (ossia 24 mesi di trattamento più 3 mesi di follow up post-trattamento)
    • Variazione rispetto al basale nell’ADAS-cog14, nell’MMSE e nel FAQ a 24 mesi
    • Variazione rispetto al basale nella lista di parole ADAS-cog14 (richiamo immdiato e richiamo ritardato) a 24 mesi
    Endpoint dei biormacatori
    • Variazione rispetto al basale nel rapporto tra i valori di captazione standardizzati (SUVR) composti della PET amiloidea a 24 mesi, per i livelli cerebrali di amiloide
    • Variazione rispetto al basale nei biomarcatori t-tau e p-tau nell’LCR a 24 mesi
    • Variazione rispetto al basale nei biomarcatori Aβ(1-40), Aβ(1-42) e Aβ(1-x) nell’LCR a 24 mesiVariazione rispetto al basale nel volume ippocampale totale a 24 mesi, valutata mediante RMv
    • Variazione rispetto al basale nella preservazione della connettività alla RMf a 24 mesi
    Endpoint esplorativi
    • Tempo alla variazione del trattamento concomitante per l’AD (ovvero, aumento della dose e/o inizio di un trattamento con AChEI o memantina dopo la randomizzazione) entro 24 mesi
    • Percentuale di soggetti che a 24 mesi hanno ricevuto incrementi della dose e/o iniziato un trattamento con AChEI o memantina dopo la randomizzazione
    • Variazione percentuale nel tempo (pendenza media della curva), sulla base del punteggio NPI a 10 criteri nell’arco di 24 mesi
    • Variazione rispetto al basale nell’NPI a 10 criteri a 24 mesi
    • Variazione rispetto al basale nell’EQ-5D (dichiarato dal soggetto, dichiarato dalla persona che si prende cura del soggetto e dichiarato dal delegato per il soggetto) e nel QOL-AD (del soggetto e della persona che si prende cura del soggetto ) a 24 mesi
    • Variazione rispetto al basale nell’Intervista di Zarit sull’onere a 24 mesi
    E.5.2.1Timepoint(s) of evaluation of this end point
    Please refer to the relevant endpoint for the specific timepoint
    Fare riferimento alle tempistiche indicate nei singoli endpoint
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Quality of life
    Qualità 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 No
    E.8.2.4Number of treatment arms in the trial2
    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 concerned20
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA130
    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
    Canada
    China
    Czech Republic
    Denmark
    Finland
    France
    Germany
    Hong Kong
    Hungary
    Italy
    Japan
    Korea, Republic of
    Poland
    Portugal
    Singapore
    Slovakia
    South Africa
    Spain
    Taiwan
    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 years3
    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 years3
    E.8.9.2In all countries concerned by the trial months10
    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: 1
    F.1.1.1In Utero Information not present in EudraCT
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) Information not present in EudraCT
    F.1.1.3Newborns (0-27 days) Information not present in EudraCT
    F.1.1.4Infants and toddlers (28 days-23 months) Information not present in EudraCT
    F.1.1.5Children (2-11years) Information not present in EudraCT
    F.1.1.6Adolescents (12-17 years) Information not present in EudraCT
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 200
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 1130
    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 Yes
    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 state80
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 400
    F.4.2.2In the whole clinical trial 1330
    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)
    All subjects, regardless of whether they complete all 24 months of treatment or discontinue study drug prematurely, will complete 2 post-treatment
    Follow-Up Visits (Visit 14 and Visit 15 respectively).
    An open-label Extension Phase will be available for subjects who complete the full 24 months of treatment in the Core study. The Extension Phase will continue until commercial availability of E2609, or until a positive risk-benefit assessment in this indication is not demonstrated.
    Tutti i soggetti, aldilà che completino tutti i 24 mesi di trattamento od abbiano discontinuato il farmaco in studio prematuramente, completeranno 2 visite di follow-up post-trattamento (rispettivamente visite 14 e 15).
    Per i soggetti che completano tutti i 24 mesi di trattamento dello studio principale sarà disponibile una fase di estensione in aperto. La fase di estensione proseguirà fino alla disponibilità commerciale di elenbecestat (E2609), o fino a quando non verrà dimostrata una valutazio
    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 Decision2017-09-14
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-04-20
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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