Study of the Safety and Effectiveness of Two Doses of Investigational Study Drug EVP-6124 in Subjects With Alzheimer's Disease



Status:Terminated
Conditions:Alzheimer Disease, Neurology
Therapuetic Areas:Neurology
Healthy:No
Age Range:55 - 85
Updated:5/4/2016
Start Date:October 2013
End Date:January 2017

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A Randomized, Double-blind, Placebo-controlled, Parallel-Group, 26-Week, Phase 3 Study of 2 Doses of EVP-6124 or Placebo in Subjects With Mild to Moderate Alzheimer's Disease Currently or Previously Receiving an Acetylcholinesterase Inhibitor Medication

The purpose of this study is to evaluate the safety and efficacy of 2 fixed doses of
EVP-6124 compared to placebo for 26 weeks in subjects with mild to moderate Alzheimer's
disease currently receiving stable treatment or previously treated with an
acetylcholinesterase inhibitor.


Inclusion Criteria:

- Ages ≥55 and ≤85 years

- Informed consent form (ICF) signed by the subject or legally acceptable
representative before any study-specific procedures for the subject are performed and
an ICF signed by the support person/caregiver before any study-specific procedures
for the support person/caregiver are performed

- Clinical diagnosis of dementia due to probable AD consistent with criteria
established by a workgroup of the National Institute on Aging and the Alzheimer's
Disease Association

- Clinical decline within 12 months before screening and onset of symptoms at least 12
months or longer before screening, which may include any documented cognition,
functional, or other objective assessment or the clinical judgment of the
investigator or the subject's referring physician that the subject has experienced a
clinical decline within the last 12 months

- Magnetic resonance imaging (MRI) or computed tomography (CT) scan performed within 12
months before screening, with findings consistent with the diagnosis of dementia due
to AD without any other clinically significant comorbid pathologies. If an MRI or CT
scan is unavailable or occurred greater than 12 months before screening, this
assessment should be completed and the findings confirmed before the subject enters
the run-in period (Day -14) (copy of the report will be available at the study site)

- Mini-Mental State Examination (MMSE) score ≥14 and ≤24 at screening and confirmed on
Day 1 prior to randomization (fluctuations of ±2 points are acceptable on Day
1/baseline)

- Clinical Dementia Rating Global score (CDR-GS) ≥1 (at least mild dementia) at
screening and confirmed on Day 1 prior to randomization

- Modified Hachinski Ischemic Scale (mHIS) score ≤4 at screening

- Fertile, sexually active subjects (men and women) must use an effective method of
contraception during the study. Female subjects and the female partner of male
subjects must be surgically sterile (hysterectomy or bilateral tubal ligation),
postmenopausal for at least 1-year, or willing to practice adequate methods of
contraception if of childbearing potential (defined as consistent use of combined
effective methods of contraception [including at least 1 barrier method])

- Reliable and capable support person/caregiver, who if not living in the same
household, interacts with the subject approximately 4 times per week and will be
available to attend clinic visits in person when possible

- Subject living at home, senior residential setting, or an institutional setting
without the need for continuous (ie, 24-hour) nursing care

- General health status acceptable for participation in a 26-week study

- Fluency (oral and written) in the language in which the standardized tests will be
administered

- Receiving a stable dose of an acetylcholinesterase inhibitor (AChEI) (donepezil,
rivastigmine or galantamine) for at least 3 months (90 days) before screening and
with continuous dosing for at least 6 months OR not presently receiving an AChEI (at
least 30 days before screening), but with a history of previous AChEI treatment
(subjects receiving donepezil 23 mg currently or within 3 months before screening are
ineligible)

Exclusion Criteria:

- Exposure to an experimental drug, experimental biologic or experimental medical
device within 2 months (60 days) before screening

- Prior participation in an amyloid vaccination clinical study at any time in the past
or completion of a passive amyloid vaccination study within 6 months before screening

- Inability to swallow a tablet

- In the judgment of the investigator, inability of the subject or the support
person/caregiver to complete a 26-week study

- Inability to be ≥75% compliant with single-blind study drug

- Inability to adequately cooperate or complete the cognitive testing procedures or any
study assessment

- Residence in a skilled nursing facility

- Untreated vitamin B12 or folate deficiency (if treated, must be stably treated for at
least 6 months before screening)

- Clinically significant (in the judgment of the investigator) abnormal serum
electrolytes (sodium, potassium, magnesium) after repeat testing

- Clinically significant untreated hypothyroidism (if treated, thyroid-stimulating
hormone level and thyroid supplementation dose must be stable for at least 6 months
before screening)

- Insufficiently controlled diabetes mellitus (in the judgment of the investigator) or
requiring insulin

- Renal insufficiency (serum creatinine >2.0 mg/dL)

- Malignant tumor within 3 years before screening (except squamous and basal cell
carcinoma or cervical carcinoma in situ or localized prostate cancer)

- Female subjects who are pregnant, nursing, or planning to become pregnant during the
study

- Unstable medical condition that is clinically significant in the judgment of the
investigator

- Alanine transaminase (ALT) or aspartate transaminase (AST) >2.5 times the upper limit
of normal

- History of myocardial infarction or unstable angina within 6 months before screening

- History of more than 1 myocardial infarction within 5 years before screening

- Clinically significant (in the judgment of the investigator) cardiac arrhythmia
(including atrial fibrillation), cardiomyopathy, or cardiac conduction defect
(subjects with a pacemaker are acceptable)

- Symptomatic hypotension or hypertension (supine diastolic blood pressure >95 mmHg)
(in the judgment of the investigator)

- Clinically significant abnormality on screening or baseline electrocardiogram (ECG),
including but not necessarily limited to a confirmed corrected QT interval (QTc)
value ≥450 msec for males or ≥470 msec for females. In subjects with a QRS value
>120msec, those with a QTc value <500 msec may be eligible following discussion with
the Medical Monitor.

- Stroke within 18 months before screening, or history of a stroke concomitant with
onset of dementia

- History of brain tumor, subdural hematoma, or other clinically significant (in the
judgment of the investigator) space-occupying lesion on CT or MRI

- Head trauma with clinically significant (in the judgment of the investigator) loss of
consciousness within 12 months before screening or concurrent with the onset of
dementia

- Onset of dementia secondary (in the judgment of the investigator) to cardiac arrest,
surgery with general anesthesia, or resuscitation

- Specific degenerative central nervous system (CNS) disease diagnosis other than AD
(eg, Huntington's disease, Creutzfeld-Jacob disease, Down's syndrome, Fronto-Temporal
Dementia, Parkinson's disease)

- Subjects with no history of prior treatment with an AChEI (donepezil, rivastigmine,
or galantamine)

- Memantine currently or within 30 days before screening

- Antipsychotics; low doses (in the judgment of the investigator, except clozapine) are
allowed only if given for sleep disturbances, agitation and/or aggression, and only
if the subject has received a stable dose for at least 3 months before screening (but
not within 8 hours before any cognitive test)

- Tricyclic antidepressants and monoamine oxidase inhibitors; all other antidepressants
are allowed only if the subject has received a stable dose for at least 3 months
before screening

- Antiepileptic medications if taken for control of seizures

- Chronic intake of opioid-containing analgesics

- Sedating H1 antihistamines

- Nicotine therapy (including the patch), varenicline (Chantix), or similar therapeutic
agent within 30 days before screening

- Clinically significant urine drug screen or serum alcohol test result in the judgment
of the investigator

- History of ischemic colitis or ischemic enterocolitis
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