Alzheimer's Disease
Conditions
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.
Participants were from feeder studies (LZAM or LZAN). Placebo administered intravenously every 4 weeks through Week 80.
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs) | Baseline through Week 104 | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL) | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB) | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI) | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in EuroQol 5-Dimensional Health-Related Quality of Life Scale Proxy Version (EQ-5D Proxy) | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14) | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE) | Baseline, Week 104 | 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. |
| Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Baseline, Week 52 | 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. |
| Change From Baseline to 104-week Endpoint in Volumetric Magnetic Resonance Imaging (vMRI) | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11) | Baseline, Week 104 | 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. |
| Mean Change From Baseline to Endpoint in Amyloid Imaging Parameters in Subjects With Mild Alzheimer's Disease | Baseline, Week 104 | 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. |
| Change From Baseline to 104-week Endpoint in Quality of Life in Alzheimer's Disease (QoL-AD) | Baseline, Week 104 | 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. |
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
| Arm | Count |
|---|---|
| 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 |
| Total | 1,457 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Abnormal Lab/ECG Result | 0 | 1 |
| Overall Study | Adverse Event | 74 | 73 |
| Overall Study | Death | 40 | 43 |
| Overall Study | Lost to Follow-up | 4 | 0 |
| Overall Study | Not treated | 1 | 0 |
| Overall Study | Parent/Caregiver Decision | 246 | 228 |
| Overall Study | Physician Decision | 60 | 45 |
| Overall Study | Protocol Violation | 8 | 16 |
| Overall Study | Sponsor Decision | 163 | 195 |
| Overall Study | Withdrawal by Subject | 57 | 72 |
Baseline characteristics
| Characteristic | Placebo | Total | Solanezumab |
|---|---|---|---|
| Age, Continuous | 73.10 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 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 137 Participants | 286 Participants | 149 Participants |
| Race (NIH/OMB) Black or African American | 13 Participants | 29 Participants | 16 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 5 Participants | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 571 Participants | 1137 Participants | 566 Participants |
| Region of Enrollment Argentina | 41 Participants | 81 Participants | 40 Participants |
| Region of Enrollment Australia | 30 Participants | 60 Participants | 30 Participants |
| Region of Enrollment Brazil | 38 Participants | 72 Participants | 34 Participants |
| Region of Enrollment Canada | 38 Participants | 78 Participants | 40 Participants |
| Region of Enrollment France | 22 Participants | 45 Participants | 23 Participants |
| Region of Enrollment Germany | 37 Participants | 79 Participants | 42 Participants |
| Region of Enrollment Italy | 41 Participants | 86 Participants | 45 Participants |
| Region of Enrollment Japan | 69 Participants | 156 Participants | 87 Participants |
| Region of Enrollment Poland | 18 Participants | 43 Participants | 25 Participants |
| Region of Enrollment Russia | 13 Participants | 28 Participants | 15 Participants |
| Region of Enrollment South Korea | 33 Participants | 65 Participants | 32 Participants |
| Region of Enrollment Spain | 15 Participants | 37 Participants | 22 Participants |
| Region of Enrollment Sweden | 21 Participants | 36 Participants | 15 Participants |
| Region of Enrollment Taiwan | 26 Participants | 49 Participants | 23 Participants |
| Region of Enrollment United Kingdom | 17 Participants | 35 Participants | 18 Participants |
| Region of Enrollment United States | 264 Participants | 507 Participants | 243 Participants |
| Sex: Female, Male Female | 406 Participants | 821 Participants | 415 Participants |
| Sex: Female, Male Male | 317 Participants | 636 Participants | 319 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 485 / 723 | 514 / 734 |
| serious Total, serious adverse events | 308 / 723 | 299 / 734 |
Outcome results
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs) | SAE | 308 participants |
| Placebo | Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs) | Other AE | 485 participants |
| Solanezumab | Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs) | SAE | 299 participants |
| Solanezumab | Assess the Number of Participants With One or More Drug-Related Adverse Events (AEs) or Any Serious AEs (SAEs) | Other AE | 514 participants |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14) | 17.58 Units on a scale | Standard Error 0.532 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive 14-Item Scale (ADAS-Cog14) | 17.56 Units on a scale | Standard Error 0.517 |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11) | 17.78 units on a scale | Standard Error 0.595 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Alzheimer's Disease Assessment Scale - Cognitive Subscore 11-Item Scale (ADAS-Cog11) | 17.38 units on a scale | Standard Error 0.58 |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL) | -26.77 Units on a scale | Standard Error 0.888 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL) | -24.77 Units on a scale | Standard Error 0.871 |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB) | 5.59 Units on a scale | Standard Error 0.174 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Clinical Dementia Rating - Sum of Boxes (CDR-SB) | 5.27 Units on a scale | Standard Error 0.169 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Change 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 scale | Standard Error 0.01 |
| Placebo | Change 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 scale | Standard Error 0.02 |
| Solanezumab | Change 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 scale | Standard Error 0.009 |
| Solanezumab | Change 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 scale | Standard Error 0.019 |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE) | -8.08 Units on a scale | Standard Error 0.27 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Mini-Mental State Examination (MMSE) | -7.60 Units on a scale | Standard Error 0.263 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI) | Mild Alzheimer's Disease | 4.49 Units on a scale | Standard Error 0.788 |
| Placebo | Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI) | Moderate Alzheimer's Disease | 11.90 Units on a scale | Standard Error 1.517 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI) | Mild Alzheimer's Disease | 5.41 Units on a scale | Standard Error 0.773 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Neuropsychiatric Inventory (NPI) | Moderate Alzheimer's Disease | 8.10 Units on a scale | Standard Error 1.427 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Change 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 scale | Standard Error 0.331 |
| Placebo | Change 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 scale | Standard Error 0.35 |
| Placebo | Change 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 scale | Standard Error 0.605 |
| Placebo | Change 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 scale | Standard Error 0.573 |
| Solanezumab | Change 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 scale | Standard Error 0.552 |
| Solanezumab | Change 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 scale | Standard Error 0.327 |
| Solanezumab | Change 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 scale | Standard Error 0.585 |
| Solanezumab | Change 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 scale | Standard Error 0.345 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Mild Alzheimer's Disease-Basic ADL | 1.96 hours per day (hr/day) | Standard Error 0.184 |
| Placebo | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Mild Alzheimer's Disease-Instrumental ADL | 1.65 hours per day (hr/day) | Standard Error 0.207 |
| Placebo | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Mild Alzheimer's Disease-Supervision | 2.84 hours per day (hr/day) | Standard Error 0.368 |
| Placebo | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Moderate Alzheimer's Disease-Basic ADL | 3.19 hours per day (hr/day) | Standard Error 0.461 |
| Placebo | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Moderate Alzheimer's Disease-Instrumental ADL | 1.75 hours per day (hr/day) | Standard Error 0.461 |
| Placebo | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Moderate Alzheimer's Disease-Supervision | 5.03 hours per day (hr/day) | Standard Error 0.693 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Moderate Alzheimer's Disease-Instrumental ADL | 1.72 hours per day (hr/day) | Standard Error 0.433 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Mild Alzheimer's Disease-Basic ADL | 1.21 hours per day (hr/day) | Standard Error 0.182 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Moderate Alzheimer's Disease-Basic ADL | 3.54 hours per day (hr/day) | Standard Error 0.436 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Mild Alzheimer's Disease-Instrumental ADL | 1.05 hours per day (hr/day) | Standard Error 0.205 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Moderate Alzheimer's Disease-Supervision | 4.47 hours per day (hr/day) | Standard Error 0.654 |
| Solanezumab | Change From Baseline to 104-week Endpoint in Resource Utilization in Dementia - Lite (RUD-Lite) Caregiver Hours | Mild Alzheimer's Disease-Supervision | 2.59 hours per day (hr/day) | Standard Error 0.361 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Change 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 |
| Placebo | Change 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 |
| Placebo | Change 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 |
| Placebo | Change 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 |
| Solanezumab | Change 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 |
| Solanezumab | Change 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 |
| Solanezumab | Change 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 |
| Solanezumab | Change 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 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-40-Mild Alzheimer's Disease | 176412.04 picograms per milliliter (pg/mL) | Standard Error 3718.292 |
| Placebo | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-42-Mild Alzheimer's Disease | 19854.92 picograms per milliliter (pg/mL) | Standard Error 366.392 |
| Placebo | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-40-Moderate Alzheimer's Disease | 169356 picograms per milliliter (pg/mL) | Standard Error 4627.8 |
| Placebo | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-42-Moderate Alzheimer's Disease | 19237 picograms per milliliter (pg/mL) | Standard Error 556.3 |
| Solanezumab | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-42-Moderate Alzheimer's Disease | 19552 picograms per milliliter (pg/mL) | Standard Error 528.7 |
| Solanezumab | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-40-Mild Alzheimer's Disease | 173064.99 picograms per milliliter (pg/mL) | Standard Error 3717.695 |
| Solanezumab | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-40-Moderate Alzheimer's Disease | 169087 picograms per milliliter (pg/mL) | Standard Error 4511.6 |
| Solanezumab | Change From Baseline to 52-week Endpoint in Plasma Amyloid Beta (Aβ) Levels | Aβ 1-42-Mild Alzheimer's Disease | 19723.48 picograms per milliliter (pg/mL) | Standard Error 368.644 |
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.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Mean Change From Baseline to Endpoint in Amyloid Imaging Parameters in Subjects With Mild Alzheimer's Disease | 0.00 Standard Uptake Value ratio (SUVr) | Standard Deviation 0.131 |
| Solanezumab | Mean 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 |