Phase 3
N=1,537
Effect of LY450139 on the Long Term Progression of Alzheimer's Disease
Alzheimer's Disease
Bottom Line
View on ClinicalTrials.gov: NCT00594568 ↗Enrolled (actual)
1,537
Serious AEs
14.3%
Results posted
Sep 2014
Primary outcome: Primary: Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 76 Weeks — 6.19; 7.29; 7.68 units on a scale — p=0.134
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- LY450139 (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 55+ yrs
- Sex
- All
- Sponsor
- Eli Lilly and Company
- Primary completion
- May 2011
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 76 Weeks |
6.19; 7.29; 7.68 | 0.134 |
| PRIMARY Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) Score at 16 Weeks After Cessation of Study Drug |
6.59; 7.57; 7.90 | 0.296 |
| PRIMARY Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score at 76 Weeks |
-8.76; -10.13; -12.70 | 0.166 |
| PRIMARY Change From Baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Inventory Score at 16 Weeks After Cessation of Study Drug |
-9.26; -9.15; -11.73 | 0.935 |
| SECONDARY Percent Change From Baseline in Amyloid Beta (Aβ) 1-42 Plasma Concentration at 52 Weeks |
3.86; -5.97; -19.95 | 0.002 sig |
| SECONDARY Change From Baseline in Positron Emission Tomography (PET) Using Fluorine-18 Fluorodeoxyglucose (18F-FDG) at 76 Weeks |
-0.08; -0.12; -0.11 | 0.038 sig |
| SECONDARY Change From Baseline in Hippocampal Volume Using Volumetric Magnetic Resonance Imaging (vMRI) up to 76 Weeks |
-96.54; -75.34; -107.62; -108.69; -93.89; -112.40 | 0.143 |
| SECONDARY Change From Baseline in Amyloid Imaging Positron Emission Tomography (AV-45 PET) up to 76 Weeks |
0.08; 0.06; 0.09 | 0.784 |
| SECONDARY Change From Baseline in Tau Concentration in Spinal Fluid up to 76 Weeks |
75.11; 20.50; 61.00 | 0.634 |
| SECONDARY LY450139 Population Pharmacokinetics: Clearance of LY450139 |
18.8 | — |
| SECONDARY LY450139 Population Pharmacokinetics: Volume of Distribution of LY450139 |
66.8 | — |
| SECONDARY Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog12) Score at 76 Weeks |
6.52; 7.98; 8.33 | 0.062 |
| SECONDARY Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog14) Score at 76 Weeks |
7.42; 8.97; 9.48 | 0.071 |
| SECONDARY Change From Baseline in Mini Mental State Examination (MMSE) Score at 76 Weeks |
-2.95; -3.14; -3.71 | 0.518 |
| SECONDARY Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score at 76 Weeks |
2.31; 2.73; 3.04 | 0.069 |
| SECONDARY Change From Baseline in Neuropsychiatric Inventory (NPI) Score at 76 Weeks |
1.92; 3.31; 4.15 | 0.127 |
| SECONDARY Change From Baseline in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) Visual Analog Scale (VAS) Score at 76 Weeks |
-1.41; -7.49; -5.33 | <0.001 sig |
| SECONDARY Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite) Score (Number of Hospitalizations) up to 76 Weeks |
0.55; 0.66; 0.83 | 0.337 |
| SECONDARY Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog12) Score at 16 Weeks After Cessation of Study Drug |
6.97; 8.27; 8.41 | 0.186 |
| SECONDARY Change From Baseline in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog14) Score at 16 Weeks After Cessation of Study Drug |
7.90; 9.30; 9.89 | 0.202 |
| SECONDARY Change From Baseline in Clinical Dementia Rating-Sum of Boxes (CDR-SB) Score at 4 Weeks After Cessation of Study Drug |
— | — |
| SECONDARY Change From Baseline in Neuropsychiatric Inventory (NPI) Score at 4 Weeks After Cessation of Study Drug |
— | — |
| SECONDARY Change From Baseline in Mini Mental State Examination (MMSE) Score at 4 Weeks After Cessation of Study Drug |
— | — |
| SECONDARY Change From Baseline in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) Visual Analog Scale (VAS) Score at 4 Weeks After Cessation of Study Drug |
— | — |
| SECONDARY Change From Baseline in Resource Utilization in Dementia-Lite (RUD-Lite) Score (Number of Hospitalizations) at 4 Weeks After Cessation of Study Drug |
— | — |
| SECONDARY Change From Baseline in Amyloid Beta (Aβ) 1-42 Concentration in Spinal Fluid up to 76 Weeks |
-86.16; 23.27; -40.51 | — |
| SECONDARY Change From Baseline in Phosphorylated-Tau (P-Tau) Concentration in Spinal Fluid |
9.75; -6.26; -5.13 | — |
Summary
Alzheimer's disease (AD) is a fatal degenerative disease of the brain for which there is no cure. AD causes brain cells to die. AD is thought to be caused by an excess of beta-amyloid (β-amyloid), a sticky protein in the brain that forms amyloid plaques. At autopsy, AD patients are required to have these amyloid plaques in the brain in order to have a definitive diagnosis of AD. Inhibiting the enzyme gamma-secretase (γ-secretase) lowers the production of β-amyloid. Semagacestat (LY450139) is a functional γ-secretase inhibitor and was shown to lower β-amyloid in blood and spinal fluid in humans tested thus far and in blood, spinal fluid, and brain in animals tested thus far. This study used several different tests to measure the effect of semagacestat on both β-amyloid and amyloid plaques for some participants. The build-up of amyloid plaques was measured by a brain scan that takes a picture of amyloid plaques in the brain. Other tests measured the overall function of the brain and brain size in some participants. In this trial, participants who initially received placebo (inactive sugar pill) were, at a certain point in the study, switched over to active drug, semagacestat. In other words, all participants could eventually receive active drug. Participation could last approximately 2 years. Participants taking approved AD medications were permitted to participate in this study and continue taking these medications during the study. All participants who completed this study had the option to continue receiving semagacestat by participating in an open-label study.
Preliminary results from this study (H6L-MC-LFAN [LFAN]) and another similar study (H6L-MC-LFBC [LFBC; NCT00762411]) showed semagacestat did not slow disease progression and was associated with worsening of clinical measures of cognition and the ability to perform activities of daily living. Study drug was stopped in all studies. Studies LFAN, LFBC, and open-label H6L-MC-LFBF (LFBF; NCT01035138) were amended to continue collecting safety data, including cognitive scores, for at least 7 months. The Clinical Trial Registry (CTR) will reflect results of analyses from the original LFAN protocol in addition to those from the amended LFAN protocol.
Eligibility Criteria
Inclusion Criteria
- Meets criteria for mild to moderate Alzheimer's disease (AD) with Mini-Mental State Examination (MMSE) score of 16-26 at Visit 1
- Modified Hachinski Ischemia Scale score of less than or equal to 4
- Geriatric Depression Scale score of less than or equal to 6
- A magnetic resonance imaging (MRI) or computerized tomography (CT) scan in the last 2 years with no findings inconsistent with a diagnosis of AD
- If female, must be without menstruation for at least 12 consecutive months or have had both ovaries removed
Exclusion Criteria
- Is not capable of swallowing whole oral medication
- Has serious or unstable illnesses
- Does not have a reliable caregiver
- Chronic alcohol or drug abuse within the past 5 years
- Has ever had active vaccination for AD
Data sourced from ClinicalTrials.gov (NCT00594568). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.