E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Agitation Associated with Dementia of the Alzheimer's Type |
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E.1.1.1 | Medical condition in easily understood language |
Agitation behavior associated with Alzheimer's disease |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10001497 |
E.1.2 | Term | Agitation |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Efficacy, Safety, and Tolerability of AVP-786 for the Treatment of Agitation in Patients With Dementia of the Alzheimer's Type |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Diagnosis of probable AD according to the 2011 NIA-AA working groups criteria. 2. The patient has clinically significant, moderate/severe agitation at the time of screening and for at least 2 weeks prior to baseline. 3. The diagnosis of agitation must meet the IPA provisional definition of agitation. 4. CGIS-Agitation score is ≥ 4 (moderately ill) at Screening and Baseline. 5. MMSE score between 6 and 26 (inclusive) at Screening and Baseline. 6. Caregiver must be willing and able to comply with study procedures,including not administering any prohibited medications during the course of the study. |
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E.4 | Principal exclusion criteria |
1. Patient has dementia predominantly of non-Alzheimer's type (e.g., vascular dementia, frontotemporal dementia, Parkinson's disease, substance-induced dementia). 2. Patients with symptoms of agitation that are not secondary to AD (e.g., secondary to pain, other psychiatric disorder, or delirium). 3. Patients with myasthenia gravis (contraindication for quinidine). |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from Baseline to Week 12 in the Cohen-Mansfield Agitation Inventory (CMAI) total score |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The CMAI will be assessed at Screening (Day -28 to Day -1), Baseline (Day 1), Day 8 (Visit 2), Day 15 (Visit 2.1), Day 22 (Visit 3), Day 43 (Visit 4), Day 64 (Visit 5), Day 85 (Visit 6), and Follow up visit (for ET patients). |
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E.5.2 | Secondary end point(s) |
Change from Baseline to Week 12 (Day 85) in the following measures: Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (mADCS-CGIC)-Agitation Neuropsychiatric Inventory (NPI) Clinical Global Impression of Severity of Illness (CGIS)-Agitation Domain Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC) Patient Global Impression of Change (PGIC) Dementia Quality of Life (DEMQOL) Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) Resource Utilization in Dementia (RUD) EuroQol 5-Dimension 5-Level (EQ-5D-5L)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
mADCS-CGIC-Agitation:Day(d) 1,d43(Visit(v) 4),d85(v6 /ET), and Follow-up visit (for ET patients);NPI-Agitation/Aggression domain score and CaregiverDistress score:Screening (d-28 to d-1),d8 (v2), and d15(v2.1); NPI-AberrantMotorBehaviordomain: (d1), d22(v3),d43(v4),d64(v5),and d85(v6/ET); NPI-Irritability/Lability domain:(d1),d22 (v3),d43 (v4),d64(v5),and d85(v6/ET);Total NPI:(d1), d22(v3),d4(v4),d6 (v5),and d85(v6/ET);CGIS-Agitation: Screening (d-28 to d-1),(d1),d43(v4) ,and d85 (v6/ET);ADCS-CGIC-Overall:(d1),d85(v6/ET);PGIC: d43(v4) and d85(v6/ET); DEMQOL:(d1), d43 (v4),and d85(v6/ET) for patients withMMSE ≥10 at the d1;EQ-5D-5L: (d1),d43 (v4),and d85(v6/ET)for patients with MMSE ≥10;ADAS-cog:(d1)and d85(v6/ET) forpatients withanMMSEscoreof≥ 10 at the d1visit;RUD:(d1),d43 (v4),d85(v6/ET) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 13 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 70 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
South Africa |
Czechia |
France |
Germany |
Hungary |
Italy |
Poland |
United Kingdom |
Bulgaria |
Spain |
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E.8.7 | Trial 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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 11 |