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    Summary
    EudraCT Number:2019-001476-11
    Sponsor's Protocol Code Number:AL002-2
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2020-11-06
    Trial 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 number2019-001476-11
    A.3Full title of the trial
    A PHASE 2 RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, MULTICENTER STUDY TO EVALUATE THE EFFICACY AND SAFETY OF AL002 IN PARTICIPANTS WITH EARLY ALZHEIMER’S DISEASE
    Studio di fase 2, randomizzato, in doppio cieco, controllato verso placebo, multicentrico volto a valutare l’efficacia e la sicurezza di AL002 nei partecipanti con malattia di Alzheimer precoce
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Clinical Trial to evaluate AL002 in Participants with early Alzheimer's Disease
    Studio clinico per valutare AL002 nei partecipanti con malattia di Alzheimer precoce
    A.3.2Name or abbreviated title of the trial where available
    NA
    NA
    A.4.1Sponsor's protocol code numberAL002-2
    A.5.4Other Identifiers
    Name:INDNumber:136758
    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 SponsorAlector 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 supportAlector Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAlector Inc.
    B.5.2Functional name of contact pointMedical Doctor
    B.5.3 Address:
    B.5.3.1Street Address131 Oyster Point Blvd, Suite 600
    B.5.3.2Town/ citySouth San Francisco
    B.5.3.3Post codeCA 94080
    B.5.3.4CountryUnited States
    B.5.6E-mailclinicaltrials@alector.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 nameAL002
    D.3.2Product code [AL002]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeAL002
    D.3.9.4EV Substance CodeSUB198089
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    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 Yes
    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 placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous 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
    malattia di Alzheimer precoce
    E.1.1.1Medical condition in easily understood language
    Alzheimer’s Disease
    malattia di Alzheimer
    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 SOC
    E.1.2Classification code 10029205
    E.1.2Term Nervous system disorders
    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 AL002 in participants with Early AD in delaying disease progression compared to standard of care
    Valutare l’efficacia di AL002 in partecipanti con AD precoce nel ritardare la progressione della malattia rispetto allo standard di cura
    E.2.2Secondary objectives of the trial
    To evaluate the efficacy of AL002 in participants with Early AD on efficacy as measured by the rate of change in COAs

    Pharmacokinetics:
    To estimate the concentration of AL002 in participants with Early AD in serum and CSF (when available)

    Safety:
    To evaluate the safety and tolerability of AL002 in participants with Early AD

    Exploratory:
    To evaluate the effects of AL002 in participants with Early AD on exploratory PD biomarkers
    Valutare l’efficacia di AL002 in partecipanti con AD precoce sull’efficacia misurata tramite il tasso di variazione nelle COA

    Farmacocinetica:
    Stimare la concentrazione di AL002 in partecipanti con AD precoce nel siero e nell’LCS (quando disponibili)

    Sicurezza
    Valutare la sicurezza e la tollerabilità di AL002 in partecipanti con AD precoce

    Esplorativo:
    Valutare gli effetti di AL002 in partecipanti con AD precoce su biomarcatori PD esplorativi
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.PT (PT) has any evidence of a condition other than AD that may affect cognition 2.PT has history or presence of vascular disease that has the potential to affect cognitive function, or stroke within past 2 years, or ischemic attack within last 6 months 3.PT has history of severe, clinically significant CNS trauma, or history or presence of intracranial tumor, or presence of infections that affect brain function or history of infections with neurologic sequelae 4.PT has history or presence of systemic autoimmune disorders that potentially cause progressive neurologic disease with associated cognitive deficits, or uveitis with medical intervention, chronic inflammatory or degenerative condition of the eye, current eye infection, any ongoing eye disorder requiring injectable medical therapy or planned invasive eye procedure during the study period 5.PT has history of schizophrenia, schizoaffective disorder, major depression, or bipolar disorder, or is at risk of suicide in the PI´s opinion 6.PT has history of alcohol and/or substance use disorder within the past 2 years 7.PT has MRI evidence of a. >2 lacunar infarcts. b. Any territorial infarct >1 cm3. c. Any white matter lesion as per protocol 8.PT has presence on MRI of microbleeds and areas of leptomeningeal hemosiderosis as per protocol 9.PT has presence of significant cerebral vascular pathology, or any cortical stroke regardless of age as assessed by the MRI central reader 10.PT is unable to tolerate MRI procedures or has a contraindication 11.PT has uncontrolled hypertension or has a history or presence of an abnormal ECG 12.PT has history of ventricular dysrhythmias or risk factors for ventricular dysrhythmias 13.PT has significant kidney disease as per protocol 14.PT has impaired hepatic function as per protocol 15.PT is positive for hepatitis B surface Ag, total hepatitis B core antibody, HIV-1 or -2 antibodies or antigen, or history of spirochetal infection of the CNS. PTs with a positive hepatitis C virus antibody will be allowed if hepatitis C RNA is negative 16.PTs with active or latent TB disease should not be enrolled in the trial 17. Any chronic active immune disorder requiring systemic immunosuppressive therapy within 1 year prior to study enrollment 18.PT has abnormal screening thyroid function tests 19.PT has screening folic acid or low vitamin B12 levels that may be contributing to cognitive impairment 20.PT has screening hemoglobin A1c >8% or poorly controlled insulin dependent diabetes 21.PT has deformity of the lumbosacral region of the spine that in the PI´s opinion would contraindicate LP in those who can only be CSF eligible due to regional lack of availability of PET ligands, or in those who are in Part 1 22.PT has clinically significantly abnormal screening blood or urine results that remain abnormal, or has impaired coagulation 23.PT has history of cancer except:a. Is clinically cured.b. Is not being actively treated and is not likely to require treatment in next 3 years.c. Low probability of recurrence d. Prostate cancer, without progression in the past 2 years 24.PT has known history of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric, human, or humanized antibodies or fusion proteins 25.PT with other severe or unstable medical condition that could put PT at special risk 26.PT resides in a skilled nursing facility, convalescent home, or long-term care facility 27.Takes any medications known to impair consciousness or cognition 28.Is under investigational active immunotherapy to prevent or postpone cognitive decline, or is under any passive immunotherapy or other long acting biologic agent that is under evaluation to prevent or postpone cognitive decline within 1 year of screening 29.Takes investigational treatment within 5 half-lives or 3 months of screening, whichever is longer REFER TO THE PROTOCOL INSUFFICIENT SPACE
    1. Il partecipante (PT) deve soddisfare i criteri clinici NIA-AA per probabile demenza da AD deterioramento cognitivo lieve con o senza una diagnosi formale di demenza.
    2 Il PT ha una sintomatologia lieve, come definito da un punteggio della valutazione del deterioramento cognitivo (MMSE) allo screening =22 punti e un punteggio totale nella scala di valutazione clinica della demenza di 0,5-1,0.
    3 Il PT presenta evidenza di compromissione episodica della memoria, come definito dal punteggio della Batteria ripetibile per la valutazione dello stato neuropsicologico (RBANS) sull’indice di memoria ritardata =85.
    4 Il PT deve essere positivo all’esame del sangue APTUS™-A¿ prima di procedere con gli studi su PET dell’amiloide o LCS per confermare la patologia di beta amiloide (A¿). La dimostrazione dell’amiloidosi tramite PET dell’amiloide o rapporto tau fosforilata (pTau)/beta amiloide (1-42) (A¿42) nell’LCS è richiesta per tutti i partecipanti. I partecipanti con scansione PET dell’amiloide anamnestica positiva che è stata effettuata =24 mesi prima dell’inizio dello screening e che soddisfa i criteri accettabili per una scansione PET dell’amiloide anamnestica, come indicato nei Criteri di inclusione 5, non saranno sottoposti a esame del sangue APTUS™-A¿. I partecipanti con una scansione PET dell’amiloide anamnestica positiva e convalidata sono considerati positivi alla patologia A¿ cerebrale senza ulteriori test. 5 Il PT mostra evidenza di un processo patologico dell’AD; come dimostrato da una scansione PET dell’amiloide positiva tramite lettura visiva condotta dal laboratorio principale della PET o tramite un rapporto pTau/Aß42 nell’LCS superiore a 0,024 come misurato mediante il test Elecsys di Roche. La PET dell’amiloide anamnestica può essere consentita per soddisfare questo criterio; le misurazioni anamnestiche dell’LCS non saranno consentite per soddisfare questo criterio.
    6 Se il PT sta ricevendo farmaci per l’AD sintomatica, il regime di dosaggio deve essere rimasto stabile per 3 mesi prima dello screening.
    7 Il PT è disposto ed è in grado di fornire il consenso informato. Se il PT allo studio non è competente, un rappresentante legalmente autorizzato deve fornire il consenso informato in sua vece e il PT deve esprimere il proprio assenso, in conformità alle normative locali, alle linee guida e al comitato etico.
    8Il PT può essere di sesso femminile o maschile e di età pari e compresa tra 50 e 85 anni.
    9 Il PT pesa tra 45 e 120 kg, inclusi.
    10 Allo screening, le partecipanti non devono essere in gravidanza e non devono allattare e deve applicarsi 1 delle seguenti condizioni:
    a. La PT non è una donna in età fertile (woman of childbearing potential, [WOCBP]) (sterilizzata chirurgicamente o fisiologicamente non in grado di rimanere incinta o in post-menopausa da 1 anno [durata di amenorrea di 12 mesi consecutivi senza causa identificata diversa dalla menopausa]).
    b. La PT è una WOCBP e accetta di utilizzare un metodo contraccettivo accettabile a partire dallo screening e fino a 8 settimane dopo l’ultima dose di tentrattamo dello studio. Una contraccezione accettabile è definita come l’uso di contraccettivi ormonali o di un dispositivo intrauterino combinato con almeno 1 delle seguenti forme di co_untraccezin diaframma o cappuccio cervicale o un preservativo. Inoltre, l’astinenza totale, in conformità con lo stile di vita del PT, è accettabile.
    Le WOCBP saranno sottoposte a un test di gravidanza sul siero allo screening.
    11 Durante il periodo di trattamento e per almeno 8 settimane dopo l’ultima dose del trattamento dello studio, i partecipanti di sesso maschile devono acconsentire a:
    c. Utilizzare un preservativo con partner sessuali di sesso femminile in età fertile o con una partner in gravidanza (per la durata della gravidanza)
    d. Evitare di donare sperma
    Spazio insufficiente. Si faccia riferimento al protocollo per lista intera
    E.4Principal exclusion criteria
    1.Participant (PT) has any evidence of a condition other than AD that may affect cognition 2.PT has history or presence of vascular disease that has the potential to affect cognitive function, or stroke within past 2 years, or ischemic attack within last 6 months 3.PT has history of severe, clinically significant CNS trauma, or history or presence of intracranial tumor, or presence of infections that affect brain function or history of infections with neurologic sequelae 4.PT has history or presence of systemic autoimmune disorders that potentially cause progressive neurologic disease with associated cognitive deficits, or uveitis with medical intervention, chronic inflammatory or degenerative condition of the eye, current eye infection, any ongoing eye disorder requiring injectable medical therapy or planned invasive eye procedure during the study period 5.PT has history of schizophrenia, schizoaffective disorder, major depression, or bipolar disorder, or is at risk of suicide in the PI´s opinion 6.PT has history of alcohol and/or substance use disorder within the past 2 years 7.PT has MRI evidence of a. >2 lacunar infarcts. b. Any territorial infarct >1 cm3. c. Any white matter lesion as per protocol 8.PT has presence on MRI of microbleeds and areas of leptomeningeal hemosiderosis as per protocol 9.PT has presence of significant cerebral vascular pathology, or any cortical stroke regardless of age as assessed by the MRI central reader 10.PT is unable to tolerate MRI procedures or has a contraindication 11.PT has uncontrolled hypertension or has a history or presence of an abnormal ECG 12.PT has history of ventricular dysrhythmias or risk factors for ventricular dysrhythmias 13.PT has significant kidney disease as per protocol 14.PT has impaired hepatic function as per protocol 15.PT is positive for hepatitis B surface Ag, total hepatitis B core antibody, HIV-1 or -2 antibodies or antigen, or history of spirochetal infection of the CNS. PTs with a positive hepatitis C virus antibody will be allowed if hepatitis C RNA is negative 16.PTs with active or latent TB disease should not be enrolled in the trial 17. Any chronic active immune disorder requiring systemic immunosuppressive therapy within 1 year prior to study enrollment 18.PT has abnormal screening thyroid function tests 19.PT has screening folic acid or low vitamin B12 levels that may be contributing to cognitive impairment 20.PT has screening hemoglobin A1c >8% or poorly controlled insulin dependent diabetes 21.PT has deformity of the lumbosacral region of the spine that in the PI´s opinion would contraindicate LP in those who can only be CSF eligible due to regional lack of availability of PET ligands, or in those who are in Part 1 22.PT has clinically significantly abnormal screening blood or urine results that remain abnormal, or has impaired coagulation 23.PT has history of cancer except:a. Is clinically cured.b. Is not being actively treated and is not likely to require treatment in next 3 years.c. Low probability of recurrence d. Prostate cancer, without progression in the past 2 years 24.PT has known history of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric, human, or humanized antibodies or fusion proteins 25.PT with other severe or unstable medical condition that could put PT at special risk 26.PT resides in a skilled nursing facility, convalescent home, or long-term care facility 27.Takes any medications known to impair consciousness or cognition 28.Is under investigational active immunotherapy to prevent or postpone cognitive decline, or is under any passive immunotherapy or other long acting biologic agent that is under evaluation to prevent or postpone cognitive decline within 1 year of screening 29.Takes investigational treatment within 5 half-lives or 3 months of screening, whichever is longer
    REFER TO THE PROTOCOL INSUFFICIENT SPACE
    1. Il PT ha un’evidenza di una condizione diversa dall’AD, che potrebbe influire sulla cognizione
    2. Il PT ha un’anamnesi di o presenta ictus clinico negli ultimi 2 anni, oppure ha un’anamnesi documentata negli ultimi 6 mesi di un evento acuto coerente con un attacco ischemico transitorio.
    3. Il PT ha un’anamnesi di trauma del SNC grave, clinicamente significativo. Il PT ha un’anamnesi di o presenta tumore intracranico Il PT presenta infezioni che interessano la funzione cerebrale o ha un’anamnesi di infezioni che hanno portato a sequele neurologiche
    4. Il PT ha un’anamnesi di o presenta malattie autoimmuni sistemiche che potenzialmente causano una malattia neurologica progressiva con deficit cognitivi associati Il PT ha un’anamnesi di o presenta uveite con necessità di intervento medico, condizione infiammatoria cronica o degenerativa degli occhi, infezione oculare attuale, qualsiasi patologia dell’occhio in corso che necessita di una terapia medica iniettabile o di una procedura oculare invasiva pianificata durante il periodo dello studio.
    5. Il PT ha un’anamnesi di schizofrenia, disturbo schizo affettivo, depressione importante o disturbo bipolare. Il PT è a rischio di suicidio a giudizio dello Sperimentatore.
    6. Il PT ha un’anamnesi di disturbo da uso di alcol e/o stupefacenti negli ultimi 2 anni.
    7. Il PT ha evidenza nella RM di
    a. >2 infarti lacunari.
    b. Qualsiasi infarto territoriale >1 cm3.
    c. Qualsiasi lesione della sostanza bianca come da protocollo
    8. Il PT presenta sulla RM microemorragie e aree di emosiderosi leptomeningea come da protocollo
    9. Il PT presenta una patologia vascolare cerebrale significativa secondo la valutazione del lettore centrale della RM o Il PT presenta sulla RM qualsiasi ictus corticale a prescindere dall’età.
    10. Il PT non è in grado di tollerare le procedure di RM o ha una controindicazione alla RM
    11. Il PT soffre di ipertensione non controllata . Il PT ha un’anamnesi di o presenta un’anomalia all’ECG
    12. Il PT ha un’anamnesi di aritmie ventricolari o fattori di rischio di aritmie ventricolari
    13. Il PT presenta una malattia renale significativa, come da protocollo
    14. Il PT presenta una funzionalità epatica compromessa come da protocollo
    15. Il PT è positivo all’antigene di superficie dell’epatite B, all’anticorpo core totale dell’epatite B, agli anticorpi o all’antigene dell’HIV-1 o 2 o ha un’anamnesi di infezione da spirochete del SNC Ai partecipanti con un test positivo all’anticorpo del virus dell’epatite C sarà consentito partecipare se l’RNA dell’epatite C è negativo.
    16. I partecipanti con TB attiva o latente non devono essere arruolati nella sperimentazione.
    17. Qualsiasi disturbo immunitario cronico attivo che richieda una terapia immunosoppressiva sistemica nell’anno precedente l’arruolamento nello studio.
    18. Il PT presenta un test della funzione tiroidea anomalo allo
    19. Il PT presenta livelli di acido folico o di vitamina B12 allo screening sufficientemente bassi
    20. Il PT presenta un’emoglobina allo screening A1c >8% o diabete insulino-dipendente scarsamente controllato
    21. Il PT presenta deformità della regione lombosacrale della colonna vertebrale, che a discrezione dello Sperimentatore, controindicherebbe una PL nelle persone che possono essere idonee in base all’LCS a causa di una mancanza a livello regionale di disponibilità di ligandi PET o in coloro che sono nella Parte 1.
    22. Il PT presenta risultati anomali clinicamente significativi alle analisi di sangue e urine allo screening che rimangono anomali alla ripetizione delle analisi. Il PT presenta una compromissione della coagulazione
    23. Il PT presenta un’anamnesi di tumore. per esclusioni si veda protocollo
    24. Il PT ha un’anamnesi nota di gravi reazioni allergiche, anafilattiche o altre reazioni di ipersensibilità ad anticorpi chimerici, umani o umanizzati o proteine di fusione.
    Spazio insufficiente, fare riferimento al protocollo
    E.5 End points
    E.5.1Primary end point(s)
    Primary Efficacy Endpoint:
    Disease progression as measured by the CDR-SB
    Primary Efficacy Estimand:
    Treatment Policy: All observed values of the primary variable (CDR-SB) will be used regardless of whether or not the participant interrupted study intervention, permanently discontinued study intervention, or took a prohibited medication. The hazard ratio will be used as the summary measure to assess the efficacy of AL002 as compared to standard of care in participants with Early AD in delaying disease progression.
    endopoint primario di efficacia
    Progressione della malattia misurata mediante la CDR-SB
    Estimand primario di efficacia:
    Politica di trattamento: Tutti i valori osservati della variabile primaria (CDR-SB) saranno utilizzati indipendentemente dal fatto che il partecipante abbia interrotto il trattamento dello studio, abbia interrotto definitivamente il trattamento dello studio o abbia assunto un farmaco proibito. Il rapporto di rischio sarà utilizzato come misura di riepilogo per valutare l’efficacia di AL002 rispetto allo standard di cura nei partecipanti con AD precoce nel ritardare la progressione della malattia.
    E.5.1.1Timepoint(s) of evaluation of this end point
    CDR will be done at screening, and on weeks 25, 49, 73, and 97.
    Also at early termination (ET) and FU (every 4 weeks), but if Clinical Outcomes Assessment have been performed within 12 weeks of the Efficacy FU visit, they do not need to be performed at the Efficacy FU visit.
    Saranno eseguiti CDR allo screening e alle settimane 25, 49, 73, e 97, all’interruzione anticipata (Early Termination, [ET]) e nel follow-up (FU) (ogni 4 settimane), ma se la valutazione degli esiti clinici è stata eseguita entro 12 settimane dalla visita di FU di efficacia, non dovranno essere eseguiti alla visita di FU di efficacia.
    E.5.2Secondary end point(s)
    Secondary Efficacy Endpoints:
    • Rate of change in MMSE
    • Rate of change in RBANS
    • Rate of change in ADAS- Cog13
    • Rate of change in ADCS-ADL-MCI
    • Rate of change in ADCOMS
    • Change from baseline to Week 48, 72, & 96 in CDR-SB
    • Change from baseline to Week 48, 72, & 96 in MMSE
    • Change from baseline to Week 48, 72, & 96 in RBANS
    • Change from baseline to Week 48, 72, & 96 in ADAS- Cog13
    • Change from baseline to Week 48, 72, & 96 in ADCS-ADL-MCI
    • Change from baseline to Week 48, 72, & 96 in ADCOMS
    Secondary Efficacy Estimands:
    Treatment policy estimands will be used to assess the secondary efficacy objectives. For each objective, all observed values collected, for each of the below secondary endpoints, will be used regardless of whether or not the participant interrupted study intervention, permanently discontinued study intervention, or took a prohibited medication. The ratio of slopes will be used as the summary measure for the first 5 endpoints listed and the difference in means will be used as the summary measure for the 6th to 11th endpoints.

    Pharmacokinetic Endpoints:
    Serum PK concentrations of AL002 and relevant PK parameters
    CSF PK concentrations of AL002 (when available)

    Safety Endpoints:
    Incidences of AEs, AESIs, and SAEs
    Changes from baseline in vital signs, physical findings, neurological findings, ophthalmological findings, ECG, and clinical laboratory results
    C-SSRS
    MRI abnormalities

    Exploratory PD Biomarker Endpoints:
    Changes from baseline in levels of sTREM2 in CSF and/or plasma
    Changes from baseline in levels of biomarkers related to microglia function in CSF and/or plasma (eg, CSF1R, IL1RN, osteopontin, YKL-40)
    Changes from baseline in levels of biomarkers related to AD pathology in CSF and/or plasma (eg, Aß40, Aß42, pTau, tTau)
    Changes from baseline in levels of neurodegeneration biomarkers in plasma and CSFa (eg, NfL)
    Changes from baseline in brain volume, assessed by volumetric MRI
    Changes from baseline in brain pathological tau burden as assessed by Tau-PET (for participants who agree to participate in the optional assessment only)
    Changes from baseline in sleep and movement measurements via the MC10 device (for participants who agree to participate in the optional assessment only)
    Changes from baseline in speech measurements via the WLSA (for participants who agree to participate in the optional assessment only); Endpoint secondari di efficacia:
    • Tasso di variaz nella MMSE
    • Tasso di variaz nella RBANS
    • Tasso di variaz nell’ADAS-Cog13
    • Tasso di variaz nell’ADCS-ADL-MCI
    • Tasso di variaz nell’ADCOMS
    • Variaz dal basale alla Sett 48, 72 e 96 nella CDR-SB
    • Variaz dal basale alla Sett 48, 72 e 96 nella MMSE
    • Variaz dal basale alla Sett 48, 72 e 96 nella RBANS
    • Variaz dal basale alla Sett 48, 72 e 96 nell’ADAS-Cog13
    • Variaz dal basale alla Sett 48, 72 e 96 nell’ADCS-ADL-MCI
    • Variaz dal basale alla Sett 48, 72 e 96 nell’ADCOMS
    Estimand secondari di efficacia:
    Saranno utilizzati estimand della politica di trattamento per valutare gli obiettivi secondari di efficacia. Per ogni obiettivo, tutti i valori osservati raccolti, per ciascuno dei seguenti endpoint secondari, saranno utilizzati indipendentemente dal fatto che il partecipante abbia interrotto il trattamento dello studio, abbia interrotto definitivamente il trattamento dello studio o abbia assunto un farmaco proibito. Il rapporto delle pendenze sarà utilizzato come misura di riepilogo per i primi 5 endpoint elencati e la differenza nelle medie sarà utilizzata come misura di riepilogo per gli endpoint dal 6° all’11°.
    Endpoint secondari di efficacia:
    • Tasso di variaz nella MMSE
    • Tasso di variaz nella RBANS
    • Tasso di variaz nell’ADAS-Cog13
    • Tasso di variaz nell’ADCS-ADL-MCI
    • Tasso di variaz nell’ADCOMS
    • Variaz dal basale alla Sett 48, 72 e 96 nella CDR-SB
    • Variaz dal basale alla Sett 48, 72 e 96 nella MMSE
    • Variaz dal basale alla Sett 48, 72 e 96 nella RBANS
    • Variaz dal basale alla Sett 48, 72 e 96 nell’ADAS-Cog13
    • Variaz dal basale alla Sett 48, 72 e 96 nell’ADCS-ADL-MCI
    • Variaz dal basale alla Sett 48, 72 e 96 nell’ADCOMS
    Estimand secondari di efficacia:
    Saranno utilizzati estimand della politica di trattamento per valutare gli obiettivi secondari di efficacia. Per ogni obiettivo, tutti i valori osservati raccolti, per ciascuno dei seguenti endpoint secondari, saranno utilizzati indipendentemente dal fatto che il partecipante abbia interrotto il trattamento dello studio, abbia interrotto definitivamente il trattamento dello studio o abbia assunto un farmaco proibito. Il rapporto delle pendenze sarà utilizzato come misura di riepilogo per i primi 5 endpoint elencati e la differenza nelle medie sarà utilizzata come misura di riepilogo per gli endpoint dal 6° all’11°.
    Endpoint secondari di efficacia:
    • Tasso di variaz nella MMSE
    • Tasso di variaz nella RBANS
    • Tasso di variaz nell’ADAS-Cog13
    • Tasso di variaz nell’ADCS-ADL-MCI
    • Tasso di variaz nell’ADCOMS
    • Variaz dal basale alla
    E.5.2.1Timepoint(s) of evaluation of this end point
    MMSE, RBANS, ADAS-Cog13, and ADCS-ADL-MCI tests performed prior to study drug administration, and any stressful procedures.ADCOMS is a composite measurement of all.Part1 PK samples on day 1,8,15,29,43. Part 2 PK samples at weeks: 1,3,5,6,9,13,17,25,37,49,61,73,85,97, ET and SFU/ 8 weeks
    Part 1 CSF at screening and day 43. Part 2 Predose Baseline and at week 49, 73, ET and Early FU/4 weeks. Part 1 ADA samples day 1, 15, 29 and 43.Part 2 at weeks1,3,9,17,25,37,49,61,73,85,97,ET, SFU /8weeks AEs start being collected at Predose Baseline Visit and subsequent visits . Vital signs will be collected and AEs documented prior to and at the end of infusion. AEs, AESIs, and SAEs will be assessed after the participant signs the informed consent through to 8 weeks after the last dose of study drug.
    Test MMSE, RBANS, ADAS-Cog13, e ADCS-ADL-MCI eseguiti prima della somministraz. del farmaco e qualsiasi procedura stressante. ADCOMS è una misuraz composita di tutti.
    I PK della Parte 1 ai gg 1, 8, 15, 29 e 43. I campioni di PK della Parte 2 alle sett: 1, 3, 5, 6, 9, 13, 17, 25, 37, 49, 61, 73, 85, 97, ET e SFU/8 sett Parte 1 CSF allo screening e al gg 43. Parte 2 pre-dose al basale e alla sett 49, 73, ET e al FU iniziale/4 sett. I campioni per ADA della Parte 1 ai gg 1, 15, 29 e 43. Parte 2 alle sett 1, 3, 9, 17, 25, 37, 49, 61, 73, 85, 97, ET, SFU /8 sett. Gli EA sono raccolti alla Visita basale pre-dose e alle visite dopo. I segni vitali sono raccolti e gli EA sono documentati prima e alla fine dell’infusione. EA, AESI e SAE sono valutati dopo ICF e fino a 8 sett dopo l’ultima dose.
    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 No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Tolerability
    tollerabilità
    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) No
    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 trial4
    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 concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA55
    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
    Australia
    Canada
    France
    Germany
    Italy
    Netherlands
    Poland
    Spain
    United Kingdom
    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 years2
    E.8.9.1In the Member State concerned months4
    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 months4
    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: 13
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 252
    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 No
    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
    Azlheimer's Disease Patients
    pazienti con malattia di Azlheimer
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state17
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 156
    F.4.2.2In the whole clinical trial 265
    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)
    Not different from normal treatment on this condition. Standard of care considered by the Investigator.
    Non diverso dal normale trattamento per questa patologia. Standard di cura considerato dallo Sperimentatore.
    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 Decision2020-11-30
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-10-13
    P. End of Trial
    P.End of Trial StatusOngoing
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