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Continued Safety Monitoring of Solanezumab (LY2062430) in Alzheimer's Disease

Continued Efficacy and Safety Monitoring of Solanezumab, an Anti-Amyloid β Antibody in Patients With Alzheimer's Disease

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01127633
Acronym
EXPEDITION EXT
Enrollment
1457
Registered
2010-05-21
Start date
2010-12-31
Completion date
2017-02-28
Last updated
2019-10-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Alzheimer's Disease

Brief summary

This study is an open-label extension study in Alzheimer's patients who have completed participation in either solanezumab Clinical Trial H8A-MC-LZAM (NCT00905372) or H8A-MC-LZAN (NCT00904683).

Interventions

400 mg of solanezumab administered once every 4 weeks by intravenous infusion (IV) for up to 8 years.

DRUGPlacebo

Participants were from feeder studies (LZAM or LZAN). Placebo administered intravenously every 4 weeks through Week 80.

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Meets National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA) criteria for probable Alzheimer's Disease * Has completed participation in solanezumab Study LZAM or Study LZAN through 80 weeks * Must continue to have a reliable caregiver who is in frequent contact with the patient for the entire study * Must have good vein access to administer infusions * Agrees not to participate in studies of any other investigational compounds for the duration of their participation in Study LZAO

Exclusion criteria

* Are currently enrolled in, or discontinued within the last 30 days from, a clinical trial involving an investigational drug or device or off-label use of a drug or device (other than the study drug/device used in this study), or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study * Meets LZAM or LZAN discontinuation criteria at the end of treatment in LZAM or LZAN study

Design outcomes

Primary

MeasureTime frameDescription
Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs)Baseline through Week 104The number of participants with 1 or more AEs assessed as related to the study drug and is summarized cumulatively. In addition, the number of participants with 1 or more serious AEs is summarized cumulatively. A serious AE is defined as an event that results in death, initial or prolonged hospitalization, is life-threatening, leads to persistent or significant disability/incapacity, is associated with congenital anomaly/birth defect, or is considered significant by the investigator for any other reason. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.

Secondary

MeasureTime frameDescription
Change From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL)Baseline, Week 104ADCS-ADL is a 23-item inventory developed as a Rater-administered questionnaire answered by the participant's caregiver. It measures performance of basic and instrumental activities of daily living by participants. The total score ranges from 0 to 78, with lower scores indicating greater disease severity. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB)Baseline, Week 104CDR-SB is a semi-structured interview of participants and their caregivers. Participant's cognitive status is rated across 6 domains of functioning, including memory, orientation, judgment/problem solving, community affairs, home/hobbies, and personal care. Severity score assigned for each of 6 domains; Total score (SB) ranges from 0 to 18. Higher scores indicate greater disease severity. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI)Baseline, Week 104The NPI is a questionnaire administered to caregivers that quantifies behavioral changes in dementia. Each of the 12 behavioral domains the caregiver reports as present are scored for Frequency, scale: 1 (Occasionally) to 4 (Very Frequently), and Severity, scale: 1 (Mild) to 3 (Severe). If the domain is reported by the caregiver as 'Not Affected,' that domain is scored as 0. The individual domain scores are calculated by multiplying the frequency times the severity for each domain. NPI Total Score is calculated by adding the individual domain scores together for all 12 domains, with a scores range from 0 to 144. Lower scores indicated less severity and higher scores indicated a greater severity of neuropsychiatric disturbance. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursBaseline, Week 104The RUD-Lite is a caregiver-completed assessment designed to assess the amount of formal and informal resources used by participants and the primary caregiver. It is completed by the caregiver and compiles data on the following resources: length of time the caregiver spends giving care, assisting participants with basic activities of daily living (BADL: eating dressing, grooming, bathing); assisting participants with instrumental activities of daily living (IADLs: shopping, cooking, housekeeping, laundry, transportation, taking medication, managing finances), and providing supervision. Scores range from 0 to 24 hours. Higher values indicate greater resource use. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy)Baseline, Week 104EQ-5D (proxy version) is a generic, multidimensional, health-related, quality-of-life instrument assessing caregiver's impression of participants overall health state. Profile allows caregivers to rate participant's health state in 5 health domains: mobility, self-care, usual activities, pain/discomfort, and mood using a 3-level scale: 1 (no problem), 2 (some problems), and 3 (major problems). These attribute combinations are converted into a weighted Health-State Index Score according to the United States (US) population-based algorithm. EQ-5D US Population-Based Index Scores range from -0.11 to 1.0. A score of 1.0 indicated perfect health. The Overall Health State Index Score is caregiver-reported using a visual analogue scale marked 0 (worst imaginable health) to 100 (best imaginable health state). LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14)Baseline, Week 104ADAS-Cog14 is ADAS-Cog11 augmented with delayed free recall, digit cancellation, and maze completion measures. A score of 0 to 10 for delayed free recall and a conversion code of 0 to 5 for digit cancellation and maze completion provide total score ranges for this extended ADAS-Cog14 of 0 to 90. Higher scores indicate greater disease severity. Least Squares (LS) Mean was determined by mixed model repeated measures (MMRM) methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 Mini-Mental State Examination (MMSE) status (mild/moderate), concomitant acetylcholinesterase inhibitors (AChEI)/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE)Baseline, Week 104The MMSE is an instrument used to assess a participant's cognitive function. The instrument is divided into 2 sections. The first section measures orientation, memory, and attention with scores ranging from 0 to 21 (lower scores indicate greater impairment). The second section tests the ability of the participant to name objects, follow verbal and written commands, write a sentence, and copy figures with scores ranging from 0 to 9 (lower scores indicate greater impairment). The range for MMSE Total Score is 0 to 30. Lower scores indicate more impairment. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsBaseline, Week 52Concentration of the peptide Aβ 1-40 and Aβ 1-42 in plasma measured by immunoassay. The immunoassays for plasma Aβ 1-40 and Aβ 1-42 peptides were modified to render them tolerant to the presence of Solanezumab which would otherwise interfere with non-modified assays. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Baseline, Week 104The vMRI assessment of right and left hippocampal volume is reported. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11)Baseline, Week 104The cognitive subscale of the ADAS (ADAS Cog11) was used as a primary efficacy measure and consists of 11 items assessing areas of function most typically impaired in Alzheimer's disease: orientation, verbal memory, language, and praxis. The scale ranges from 0 to 70, with higher scores indicating greater disease severity. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.
Mean Change From Baseline to Endpoint in Amyloid Imaging Parameters in Subjects With Mild Alzheimer's DiseaseBaseline, Week 104Florbetapir PET imaging was used to test for change from baseline. The hypothesis that amyloid burden was reduced in participants between the treatment groups from the feeder studies was tested. The change from baseline to the postbaseline visit of the composite summary standard uptake value ratio of florbetapir F18 was calculated. The composite summary measure is an unweighted average of the 6 smaller regions (anterior cingulate, frontal medial orbital, parietal, posterior cingulate, precuneus, and temporal) normalized to whole cerebellum and to subject-specific white matter.
Change From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)Baseline, Week 104The QoL-AD (Caregiver Total Score) is a disease-specific measure of quality of life for an Alzheimer's Disease (AD) population administered to the participant's primary caregiver, who answers on behalf of the participant. The assessment consists of 13 items covering physical health, energy, mood, living situations, memory, family, marriage, friends, chores, fun, money, self and life as a whole. The assessment is scored on a 4-point Likert scale with scores ranging from 1 (poor) to 4 (excellent). QoL-AD Total Score is defined as the sum of the 13 items with a scores range from 13 to 52. Higher scores denote a better quality of life. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Countries

Argentina, Australia, Brazil, Canada, France, Germany, Italy, Japan, Poland, Russia, South Korea, Spain, Sweden, Taiwan, United Kingdom, United States

Participant flow

Recruitment details

Participants who completed one of the feeder studies (Study LZAM (NCT00905372) or Study LZAN (NCT00904683)) were enrolled in this study.

Participants by arm

ArmCount
Placebo
Participants were from feeder studies (LZAM or LZAN). Placebo administered intravenously every 4 weeks through Week 80.
723
Solanezumab
400 mg of solanezumab administered once every 4 weeks by intravenous infusion (IV) for up to 8 years.
734
Total1,457

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAbnormal Lab/ECG Result01
Overall StudyAdverse Event7473
Overall StudyDeath4043
Overall StudyLost to Follow-up40
Overall StudyNot treated10
Overall StudyParent/Caregiver Decision246228
Overall StudyPhysician Decision6045
Overall StudyProtocol Violation816
Overall StudySponsor Decision163195
Overall StudyWithdrawal by Subject5772

Baseline characteristics

CharacteristicPlaceboTotalSolanezumab
Age, Continuous73.10 Years
STANDARD_DEVIATION 8.004
73.03 Years
STANDARD_DEVIATION 7.883
72.96 Years
STANDARD_DEVIATION 7.766
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
137 Participants286 Participants149 Participants
Race (NIH/OMB)
Black or African American
13 Participants29 Participants16 Participants
Race (NIH/OMB)
More than one race
2 Participants5 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
571 Participants1137 Participants566 Participants
Region of Enrollment
Argentina
41 Participants81 Participants40 Participants
Region of Enrollment
Australia
30 Participants60 Participants30 Participants
Region of Enrollment
Brazil
38 Participants72 Participants34 Participants
Region of Enrollment
Canada
38 Participants78 Participants40 Participants
Region of Enrollment
France
22 Participants45 Participants23 Participants
Region of Enrollment
Germany
37 Participants79 Participants42 Participants
Region of Enrollment
Italy
41 Participants86 Participants45 Participants
Region of Enrollment
Japan
69 Participants156 Participants87 Participants
Region of Enrollment
Poland
18 Participants43 Participants25 Participants
Region of Enrollment
Russia
13 Participants28 Participants15 Participants
Region of Enrollment
South Korea
33 Participants65 Participants32 Participants
Region of Enrollment
Spain
15 Participants37 Participants22 Participants
Region of Enrollment
Sweden
21 Participants36 Participants15 Participants
Region of Enrollment
Taiwan
26 Participants49 Participants23 Participants
Region of Enrollment
United Kingdom
17 Participants35 Participants18 Participants
Region of Enrollment
United States
264 Participants507 Participants243 Participants
Sex: Female, Male
Female
406 Participants821 Participants415 Participants
Sex: Female, Male
Male
317 Participants636 Participants319 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
485 / 723514 / 734
serious
Total, serious adverse events
308 / 723299 / 734

Outcome results

Primary

Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs)

The number of participants with 1 or more AEs assessed as related to the study drug and is summarized cumulatively. In addition, the number of participants with 1 or more serious AEs is summarized cumulatively. A serious AE is defined as an event that results in death, initial or prolonged hospitalization, is life-threatening, leads to persistent or significant disability/incapacity, is associated with congenital anomaly/birth defect, or is considered significant by the investigator for any other reason. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.

Time frame: Baseline through Week 104

Population: All randomized participants who received at least one dose of study drug.

ArmMeasureGroupValue (NUMBER)
PlaceboAssess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs)SAE308 participants
PlaceboAssess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs)Other AE485 participants
SolanezumabAssess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs)SAE299 participants
SolanezumabAssess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs)Other AE514 participants
Secondary

Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14)

ADAS-Cog14 is ADAS-Cog11 augmented with delayed free recall, digit cancellation, and maze completion measures. A score of 0 to 10 for delayed free recall and a conversion code of 0 to 5 for digit cancellation and maze completion provide total score ranges for this extended ADAS-Cog14 of 0 to 90. Higher scores indicate greater disease severity. Least Squares (LS) Mean was determined by mixed model repeated measures (MMRM) methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 Mini-Mental State Examination (MMSE) status (mild/moderate), concomitant acetylcholinesterase inhibitors (AChEI)/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for ADAS-Cog14.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14)17.58 Units on a scaleStandard Error 0.532
SolanezumabChange From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14)17.56 Units on a scaleStandard Error 0.517
p-value: 0.97495% CI: [-1.14, 1.11]Mixed Models Analysis
Secondary

Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11)

The cognitive subscale of the ADAS (ADAS Cog11) was used as a primary efficacy measure and consists of 11 items assessing areas of function most typically impaired in Alzheimer's disease: orientation, verbal memory, language, and praxis. The scale ranges from 0 to 70, with higher scores indicating greater disease severity. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for ADAS-Cog11.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11)17.78 units on a scaleStandard Error 0.595
SolanezumabChange From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11)17.38 units on a scaleStandard Error 0.58
Secondary

Change From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL)

ADCS-ADL is a 23-item inventory developed as a Rater-administered questionnaire answered by the participant's caregiver. It measures performance of basic and instrumental activities of daily living by participants. The total score ranges from 0 to 78, with lower scores indicating greater disease severity. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for ADCS-ADL.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL)-26.77 Units on a scaleStandard Error 0.888
SolanezumabChange From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL)-24.77 Units on a scaleStandard Error 0.871
Secondary

Change From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB)

CDR-SB is a semi-structured interview of participants and their caregivers. Participant's cognitive status is rated across 6 domains of functioning, including memory, orientation, judgment/problem solving, community affairs, home/hobbies, and personal care. Severity score assigned for each of 6 domains; Total score (SB) ranges from 0 to 18. Higher scores indicate greater disease severity. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for CDR-SB.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB)5.59 Units on a scaleStandard Error 0.174
SolanezumabChange From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB)5.27 Units on a scaleStandard Error 0.169
Secondary

Change From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy)

EQ-5D (proxy version) is a generic, multidimensional, health-related, quality-of-life instrument assessing caregiver's impression of participants overall health state. Profile allows caregivers to rate participant's health state in 5 health domains: mobility, self-care, usual activities, pain/discomfort, and mood using a 3-level scale: 1 (no problem), 2 (some problems), and 3 (major problems). These attribute combinations are converted into a weighted Health-State Index Score according to the United States (US) population-based algorithm. EQ-5D US Population-Based Index Scores range from -0.11 to 1.0. A score of 1.0 indicated perfect health. The Overall Health State Index Score is caregiver-reported using a visual analogue scale marked 0 (worst imaginable health) to 100 (best imaginable health state). LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for EQ-5D Proxy.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy)Mild Alzheimer's Disease-0.07 Units on a scaleStandard Error 0.01
PlaceboChange From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy)Moderate Alzheimer's Disease-0.16 Units on a scaleStandard Error 0.02
SolanezumabChange From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy)Mild Alzheimer's Disease-0.06 Units on a scaleStandard Error 0.009
SolanezumabChange From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy)Moderate Alzheimer's Disease-0.16 Units on a scaleStandard Error 0.019
Secondary

Change From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE)

The MMSE is an instrument used to assess a participant's cognitive function. The instrument is divided into 2 sections. The first section measures orientation, memory, and attention with scores ranging from 0 to 21 (lower scores indicate greater impairment). The second section tests the ability of the participant to name objects, follow verbal and written commands, write a sentence, and copy figures with scores ranging from 0 to 9 (lower scores indicate greater impairment). The range for MMSE Total Score is 0 to 30. Lower scores indicate more impairment. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for MMSE.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE)-8.08 Units on a scaleStandard Error 0.27
SolanezumabChange From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE)-7.60 Units on a scaleStandard Error 0.263
Secondary

Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI)

The NPI is a questionnaire administered to caregivers that quantifies behavioral changes in dementia. Each of the 12 behavioral domains the caregiver reports as present are scored for Frequency, scale: 1 (Occasionally) to 4 (Very Frequently), and Severity, scale: 1 (Mild) to 3 (Severe). If the domain is reported by the caregiver as 'Not Affected,' that domain is scored as 0. The individual domain scores are calculated by multiplying the frequency times the severity for each domain. NPI Total Score is calculated by adding the individual domain scores together for all 12 domains, with a scores range from 0 to 144. Lower scores indicated less severity and higher scores indicated a greater severity of neuropsychiatric disturbance. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for NPI.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI)Mild Alzheimer's Disease4.49 Units on a scaleStandard Error 0.788
PlaceboChange From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI)Moderate Alzheimer's Disease11.90 Units on a scaleStandard Error 1.517
SolanezumabChange From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI)Mild Alzheimer's Disease5.41 Units on a scaleStandard Error 0.773
SolanezumabChange From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI)Moderate Alzheimer's Disease8.10 Units on a scaleStandard Error 1.427
Secondary

Change From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)

The QoL-AD (Caregiver Total Score) is a disease-specific measure of quality of life for an Alzheimer's Disease (AD) population administered to the participant's primary caregiver, who answers on behalf of the participant. The assessment consists of 13 items covering physical health, energy, mood, living situations, memory, family, marriage, friends, chores, fun, money, self and life as a whole. The assessment is scored on a 4-point Likert scale with scores ranging from 1 (poor) to 4 (excellent). QoL-AD Total Score is defined as the sum of the 13 items with a scores range from 13 to 52. Higher scores denote a better quality of life. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for QoL-AD.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Self-Report Total Score-Mild Alzheimer's-1.37 Units on a scaleStandard Error 0.331
PlaceboChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Caregiver Total Score-Mild Alzheimer's-3.28 Units on a scaleStandard Error 0.35
PlaceboChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Self-Report Total Score-Moderate Alzheimer's-2.52 Units on a scaleStandard Error 0.605
PlaceboChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Caregiver Total Score-Moderate Alzheimer's-4.26 Units on a scaleStandard Error 0.573
SolanezumabChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Caregiver Total Score-Moderate Alzheimer's-3.14 Units on a scaleStandard Error 0.552
SolanezumabChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Self-Report Total Score-Mild Alzheimer's-0.98 Units on a scaleStandard Error 0.327
SolanezumabChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Self-Report Total Score-Moderate Alzheimer's-2.34 Units on a scaleStandard Error 0.585
SolanezumabChange From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD)QLAD Caregiver Total Score-Mild Alzheimer's-3.63 Units on a scaleStandard Error 0.345
Secondary

Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours

The RUD-Lite is a caregiver-completed assessment designed to assess the amount of formal and informal resources used by participants and the primary caregiver. It is completed by the caregiver and compiles data on the following resources: length of time the caregiver spends giving care, assisting participants with basic activities of daily living (BADL: eating dressing, grooming, bathing); assisting participants with instrumental activities of daily living (IADLs: shopping, cooking, housekeeping, laundry, transportation, taking medication, managing finances), and providing supervision. Scores range from 0 to 24 hours. Higher values indicate greater resource use. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for RUD-Lite.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursMild Alzheimer's Disease-Basic ADL1.96 hours per day (hr/day)Standard Error 0.184
PlaceboChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursMild Alzheimer's Disease-Instrumental ADL1.65 hours per day (hr/day)Standard Error 0.207
PlaceboChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursMild Alzheimer's Disease-Supervision2.84 hours per day (hr/day)Standard Error 0.368
PlaceboChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursModerate Alzheimer's Disease-Basic ADL3.19 hours per day (hr/day)Standard Error 0.461
PlaceboChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursModerate Alzheimer's Disease-Instrumental ADL1.75 hours per day (hr/day)Standard Error 0.461
PlaceboChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursModerate Alzheimer's Disease-Supervision5.03 hours per day (hr/day)Standard Error 0.693
SolanezumabChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursModerate Alzheimer's Disease-Instrumental ADL1.72 hours per day (hr/day)Standard Error 0.433
SolanezumabChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursMild Alzheimer's Disease-Basic ADL1.21 hours per day (hr/day)Standard Error 0.182
SolanezumabChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursModerate Alzheimer's Disease-Basic ADL3.54 hours per day (hr/day)Standard Error 0.436
SolanezumabChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursMild Alzheimer's Disease-Instrumental ADL1.05 hours per day (hr/day)Standard Error 0.205
SolanezumabChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursModerate Alzheimer's Disease-Supervision4.47 hours per day (hr/day)Standard Error 0.654
SolanezumabChange From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver HoursMild Alzheimer's Disease-Supervision2.59 hours per day (hr/day)Standard Error 0.361
Secondary

Change From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)

The vMRI assessment of right and left hippocampal volume is reported. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for vMRI.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Right hippocampal volume-Mild Alzheimer's Disease-230.23 Cubic millimeter (mm³)Standard Error 8.232
PlaceboChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Left hippocampal volume-Mild Alzheimer's Disease-257.15 Cubic millimeter (mm³)Standard Error 8.153
PlaceboChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Right hippocampal volume-Moderate Alzheimer's-261.39 Cubic millimeter (mm³)Standard Error 11.796
PlaceboChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Left hippocampal volume-Moderate Alzheimer's-255.16 Cubic millimeter (mm³)Standard Error 11.466
SolanezumabChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Left hippocampal volume-Moderate Alzheimer's-253.29 Cubic millimeter (mm³)Standard Error 10.858
SolanezumabChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Right hippocampal volume-Mild Alzheimer's Disease-230.07 Cubic millimeter (mm³)Standard Error 8.195
SolanezumabChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Right hippocampal volume-Moderate Alzheimer's-256.52 Cubic millimeter (mm³)Standard Error 11.246
SolanezumabChange From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI)Left hippocampal volume-Mild Alzheimer's Disease-244.00 Cubic millimeter (mm³)Standard Error 8.115
Secondary

Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels

Concentration of the peptide Aβ 1-40 and Aβ 1-42 in plasma measured by immunoassay. The immunoassays for plasma Aβ 1-40 and Aβ 1-42 peptides were modified to render them tolerant to the presence of Solanezumab which would otherwise interfere with non-modified assays. LS Mean was determined by MMRM methodology with baseline, pooled investigator, treatment, visit, feeder visit 1 MMSE status (mild/moderate), concomitant AChEI/Memantine use at baseline (yes/no), baseline age and treatment\*visit.

Time frame: Baseline, Week 52

Population: All Feeder Intent-to-Treat Population: All randomized participants from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for plasma Aβ 1-40 and Aβ 1-42.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-40-Mild Alzheimer's Disease176412.04 picograms per milliliter (pg/mL)Standard Error 3718.292
PlaceboChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-42-Mild Alzheimer's Disease19854.92 picograms per milliliter (pg/mL)Standard Error 366.392
PlaceboChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-40-Moderate Alzheimer's Disease169356 picograms per milliliter (pg/mL)Standard Error 4627.8
PlaceboChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-42-Moderate Alzheimer's Disease19237 picograms per milliliter (pg/mL)Standard Error 556.3
SolanezumabChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-42-Moderate Alzheimer's Disease19552 picograms per milliliter (pg/mL)Standard Error 528.7
SolanezumabChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-40-Mild Alzheimer's Disease173064.99 picograms per milliliter (pg/mL)Standard Error 3717.695
SolanezumabChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-40-Moderate Alzheimer's Disease169087 picograms per milliliter (pg/mL)Standard Error 4511.6
SolanezumabChange From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) LevelsAβ 1-42-Mild Alzheimer's Disease19723.48 picograms per milliliter (pg/mL)Standard Error 368.644
Secondary

Mean Change From Baseline to Endpoint in Amyloid Imaging Parameters in Subjects With Mild Alzheimer's Disease

Florbetapir PET imaging was used to test for change from baseline. The hypothesis that amyloid burden was reduced in participants between the treatment groups from the feeder studies was tested. The change from baseline to the postbaseline visit of the composite summary standard uptake value ratio of florbetapir F18 was calculated. The composite summary measure is an unweighted average of the 6 smaller regions (anterior cingulate, frontal medial orbital, parietal, posterior cingulate, precuneus, and temporal) normalized to whole cerebellum and to subject-specific white matter.

Time frame: Baseline, Week 104

Population: Feeder Intent-to-Treat Population: All randomized participants with mild Alzheimer's Disease from feeder studies, who received at least one dose of study drug and had baseline \& at least one post baseline observation for Amyloid Plaque Burden.

ArmMeasureValue (MEAN)Dispersion
PlaceboMean Change From Baseline to Endpoint in Amyloid Imaging Parameters in Subjects With Mild Alzheimer's Disease0.00 Standard Uptake Value ratio (SUVr)Standard Deviation 0.131
SolanezumabMean Change From Baseline to Endpoint in Amyloid Imaging Parameters in Subjects With Mild Alzheimer's Disease-0.01 Standard Uptake Value ratio (SUVr)Standard Deviation 0.222

Source: ClinicalTrials.gov · Data processed: Mar 4, 2026