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Phase 2 Study of BIIB092 in Participants With Early Alzheimer's Disease

Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Assess the Safety, Tolerability, and Efficacy of BIIB092 in Subjects With Mild Cognitive Impairment Due to Alzheimer's Disease or With Mild Alzheimer's Disease

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03352557
Acronym
TANGO
Enrollment
654
Registered
2017-11-24
Start date
2018-05-03
Completion date
2021-08-30
Last updated
2022-11-08

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

Conditions

Alzheimer's Disease

Keywords

Mild cognitive impairment, Alzheimer's disease

Brief summary

The primary objective of the placebo-controlled period is to evaluate the safety and tolerability of BIIB092 in participants with mild cognitive impairment (MCI) due to Alzheimer's disease (AD) or with mild AD. The secondary objectives of the placebo-controlled period are to evaluate the efficacy of multiple doses of BIIB092 in slowing cognitive and functional impairment in participants with MCI due to AD or with mild AD, and to evaluate the immunogenicity of BIIB092 after multiple doses in participants with MCI due to AD or with mild AD. The primary objective of the long-term extension period is to evaluate the long-term safety and tolerability of BIIB092 in participants with MCI due to AD or with mild AD.

Interventions

Administered as specified in treatment arm.

DRUGPlacebo

Administered as specified in treatment arm.

Sponsors

Biogen
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: * Must have a gradual and progressive change in memory function over more than 6 months. * Must meet all of the clinical criteria for mild cognitive impairment (MCI) due to Alzheimer's disease (AD) or mild AD and must have * Objective evidence of cognitive impairment at Screening * Clinical Dementia Rating Scale (CDR) global score of 0.5 for MCI due to AD or 0.5 or 1 for mild AD * Mini-Mental State Examination (MMSE) score of 22 to 30 (inclusive) * CDR Memory Box score of ≥0.5 * Must consent to apolipoprotein E (ApoE) genotyping * Must have 1 informant/study partner * Must have amyloid beta positivity confirmed at Screening Key

Exclusion criteria

* Any medical or neurological/neurodegenerative condition (other than AD) that, in the opinion of the Investigator, might be a contributing cause to the participant's cognitive impairment or could lead to discontinuation, lack of compliance, interference with study assessments, or safety concerns * Clinically significant, unstable psychiatric illness * Have had a stroke or Transient Ischemic Attack (TIA) or unexplained loss of consciousness in the past 1 year * Relevant brain hemorrhage, bleeding disorder and cerebrovascular abnormalities * History of unstable angina, myocardial infarction, chronic heart failure or clinically significant conduction abnormalities within 1 year prior to Screening Visit 1 * Indication of impaired renal or liver function * Alcohol or substance abuse in past 1 year * Clinically significant systemic illness or serious infection within 30 days prior to or during the screening period * Use of allowed medications for chronic conditions at doses that have not been stable for at least 4 weeks prior to Screening Visit 1 and during the screening period up to Study Day 1, or use of AD medications at doses that have not been stable for at least 8 weeks prior to Screening Visit 1 and during the screening period up to Study Day 1. * Use of any medications that, in the opinion of the Investigator, may contribute to cognitive impairment, put the participants at higher risk for adverse events (AEs), or impair the participant's ability to perform cognitive testing or complete study procedures. * Contraindications to study procedures NOTE: Other protocol defined Inclusion/

Design outcomes

Primary

MeasureTime frameDescription
PC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)Day 1 to Week 78 (participants who entered LTE period); Day 1 up to Week 90 (participants who did not LTE period)AE is any untoward medical occurrence in participant or clinical investigation participant administered pharmaceutical product and that does not necessarily have causal relationship with this treatment. AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with use of medicinal (investigational) product, whether or not related to medicinal (investigational) product. SAE is any untoward medical occurrence that at any dose, results in death; in view of investigator places participant at immediate risk of death; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; results in congenital anomaly/birth defect; is medically important event. Participants who completed treatment period in PC period and did not enter LTE period were to be assessed at Week 90 (14 weeks after end of treatment) as safety follow-up.
LTE Period: Percentage of Participants With AEs and SAEsFrom Week 80 to Week 173An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. An SAE is any untoward medical occurrence that at any dose, results in death; in the view of the investigator places the participant at immediate risk of death; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; results in a congenital anomaly/birth defect; is a medically important event.

Secondary

MeasureTime frameDescription
PC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreBaseline, Week 78The CDR-SB is a validated clinical assessment of global function in participants with AD. The CDR is comprised of 6 domains: Memory, Orientation, Judgment and Problem Solving, Community Affairs, Home and Hobbies, and Personal Care. CDR-SB is the sum of the scores for these 6 domains. Impairment is scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or box scores, can be added together to give the CDR-SB score which ranges from 0 (none) to 18 (severe impairment).
PC Period: Percentage of Participants With Anti-BIIB092 Antibodies in SerumBaseline up to Week 76

Countries

Australia, France, Germany, Italy, Japan, Poland, Spain, Sweden, United States

Participant flow

Recruitment details

Participants were enrolled at approximately 100 investigational sites from 03 May 2018 to 30 August 2021.

Pre-assignment details

A total of 654 participants with Alzheimer's Disease (AD) were enrolled and randomized to receive placebo or BIIB092 125/375/600/2000 milligrams(mg) in Placebo-Controlled (PC) period. Following PC period, 521 participants entered and 516 were dosed in Long-term Extension (LTE) period, and no participants completed the study due to early termination of the study. WBP/G=Withdrawal by Parent/Guardian

Participants by arm

ArmCount
PC Period: Placebo
Participants received BIIB092-matching placebo, IV infusion, on Day 1 and then once every 4 weeks for 76 weeks during the PC period.
214
PC Period: BIIB092 125 mg/4 Week
Participants received BIIB092, 125 mg, IV infusion, on Day 1 and then once every 4 weeks for 76 weeks during the PC period.
58
PC Period: BIIB092 375 mg/12 Week
Participants received BIIB092, 375 mg, IV infusion, on Day 1 and then once every 12 weeks for 76 weeks during the PC period.
58
PC Period: BIIB092 600 mg/4 Week
Participants received BIIB092, 600 mg, IV infusion, on Day 1 and then once every 4 weeks for 76 weeks during the PC period.
106
PC Period: BIIB092 2000 mg/4 Week
Participants received BIIB092, 2000 mg, IV infusion, on Day 1 and then once every 4 weeks for 76 weeks during the PC period.
218
Total654

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006FG007FG008FG009
LTE Period: Week 80 to Week 173Adverse Event0000030000
LTE Period: Week 80 to Week 173Death0000010111
LTE Period: Week 80 to Week 173Lost to Follow-up0000000031
LTE Period: Week 80 to Week 173Other0000000100
LTE Period: Week 80 to Week 173Physician Decision0000000003
LTE Period: Week 80 to Week 173Progressive Disease0000000120
LTE Period: Week 80 to Week 173Site Terminated by Sponsor0000000020
LTE Period: Week 80 to Week 173Study Terminated by Sponsor00000384975151154
LTE Period: Week 80 to Week 173WBP/G-Concern About Study Procedures/Perceived Risks0000000100
LTE Period: Week 80 to Week 173WBP/G-Other0000010020
LTE Period: Week 80 to Week 173WBP/G-Relocation (Moving or Has Moved)0000000200
LTE Period: Week 80 to Week 173WBP/G-Study Visit Burden/Scheduling Conflicts0000000021
LTE Period: Week 80 to Week 173WBP/G-Unable to Continue to Enable Participation due to Illness/Hospitalization/Death0000000210
LTE Period: Week 80 to Week 173Withdrawal by Participant-Other0000010114
LTE Period: Week 80 to Week 173Withdrawal by Participant-Relocation (Moving or Has Moved)0000010110
LTE Period: Week 80 to Week 173Withdrawal by Participant-Study Visit Burden/Scheduling Conflicts0000010533
PC Period: Day 1 to Week 78Adverse Event10110500000
PC Period: Day 1 to Week 78Death1100100000
PC Period: Day 1 to Week 78Lost to Follow-up1010200000
PC Period: Day 1 to Week 78Noncompliance with Study Drug1000000000
PC Period: Day 1 to Week 78Not Dosed0000400000
PC Period: Day 1 to Week 78Other5103000000
PC Period: Day 1 to Week 78Physician Decision-Unrelated to Safety2000100000
PC Period: Day 1 to Week 78Progressive Disease0000100000
PC Period: Day 1 to Week 78Protocol Deviation1001200000
PC Period: Day 1 to Week 78Randomized by Mistake2001000000
PC Period: Day 1 to Week 78Site Terminated by Sponsor2111200000
PC Period: Day 1 to Week 78WBP/G-Concern About Study Procedures/Perceived Risks1011100000
PC Period: Day 1 to Week 78WBP/G-Desire for Change in Treatment (Unrelated to Safety)1000100000
PC Period: Day 1 to Week 78WBP/G-Other0200300000
PC Period: Day 1 to Week 78WBP/G-Study Visit Burden/Scheduling Conflicts0001300000
PC Period: Day 1 to Week 78WBP/G-Unable to Continue to Enable Participation due to Illness/Hospitalization/Death0000100000
PC Period: Day 1 to Week 78Withdrawal by Participant-Concern About Study Procedures/Perceived Risks1001200000
PC Period: Day 1 to Week 78Withdrawal by Participant-Desire for Change in Treatment (Unrelated to Safety)0010100000
PC Period: Day 1 to Week 78Withdrawal by Participant-Other6225700000
PC Period: Day 1 to Week 78Withdrawal by Participant-Relocation (Moving or Has Moved)1101100000
PC Period: Day 1 to Week 78Withdrawal by Participant-Study Visit Burden/Scheduling Conflicts7110500000

Baseline characteristics

CharacteristicPC Period: PlaceboPC Period: BIIB092 125 mg/4 WeekPC Period: BIIB092 375 mg/12 WeekPC Period: BIIB092 600 mg/4 WeekPC Period: BIIB092 2000 mg/4 WeekTotal
Age, Continuous69.8 years
STANDARD_DEVIATION 6.63
70.4 years
STANDARD_DEVIATION 6.8
70.3 years
STANDARD_DEVIATION 6.79
69.7 years
STANDARD_DEVIATION 6.66
69.4 years
STANDARD_DEVIATION 7.11
69.7 years
STANDARD_DEVIATION 6.81
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants2 Participants2 Participants1 Participants9 Participants17 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
208 Participants53 Participants55 Participants103 Participants208 Participants627 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants3 Participants1 Participants2 Participants1 Participants10 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants0 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
5 Participants3 Participants2 Participants6 Participants7 Participants23 Participants
Race (NIH/OMB)
Black or African American
4 Participants0 Participants1 Participants1 Participants1 Participants7 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants2 Participants2 Participants1 Participants4 Participants12 Participants
Race (NIH/OMB)
White
201 Participants53 Participants53 Participants98 Participants206 Participants611 Participants
Sex: Female, Male
Female
106 Participants28 Participants26 Participants55 Participants114 Participants329 Participants
Sex: Female, Male
Male
108 Participants30 Participants32 Participants51 Participants104 Participants325 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
EG007
affected / at risk
EG008
affected / at risk
EG009
affected / at risk
deaths
Total, all-cause mortality
1 / 2141 / 580 / 580 / 1061 / 2142 / 450 / 491 / 891 / 1681 / 165
other
Total, other adverse events
121 / 21439 / 5838 / 5868 / 106139 / 21410 / 4511 / 4919 / 8928 / 16829 / 165
serious
Total, serious adverse events
26 / 2146 / 586 / 5813 / 10625 / 2145 / 451 / 499 / 8910 / 16813 / 165

Outcome results

Primary

LTE Period: Percentage of Participants With AEs and SAEs

An AE is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. An SAE is any untoward medical occurrence that at any dose, results in death; in the view of the investigator places the participant at immediate risk of death; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; results in a congenital anomaly/birth defect; is a medically important event.

Time frame: From Week 80 to Week 173

Population: The safety analysis set included all randomized participants who received at least one dose of study treatment (BIIB092 or placebo).

ArmMeasureGroupValue (NUMBER)
PC Period: PlaceboLTE Period: Percentage of Participants With AEs and SAEsAEs68.9 percentage of participants
PC Period: PlaceboLTE Period: Percentage of Participants With AEs and SAEsSAEs11.1 percentage of participants
PC Period: BIIB092 125 mg/4 WeekLTE Period: Percentage of Participants With AEs and SAEsSAEs2.0 percentage of participants
PC Period: BIIB092 125 mg/4 WeekLTE Period: Percentage of Participants With AEs and SAEsAEs55.1 percentage of participants
PC Period: BIIB092 375 mg/12 WeekLTE Period: Percentage of Participants With AEs and SAEsSAEs10.1 percentage of participants
PC Period: BIIB092 375 mg/12 WeekLTE Period: Percentage of Participants With AEs and SAEsAEs58.4 percentage of participants
PC Period: BIIB092 600 mg/4 WeekLTE Period: Percentage of Participants With AEs and SAEsAEs61.3 percentage of participants
PC Period: BIIB092 600 mg/4 WeekLTE Period: Percentage of Participants With AEs and SAEsSAEs6.0 percentage of participants
PC Period: BIIB092 2000 mg/4 WeekLTE Period: Percentage of Participants With AEs and SAEsSAEs7.9 percentage of participants
PC Period: BIIB092 2000 mg/4 WeekLTE Period: Percentage of Participants With AEs and SAEsAEs60.0 percentage of participants
Primary

PC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)

AE is any untoward medical occurrence in participant or clinical investigation participant administered pharmaceutical product and that does not necessarily have causal relationship with this treatment. AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with use of medicinal (investigational) product, whether or not related to medicinal (investigational) product. SAE is any untoward medical occurrence that at any dose, results in death; in view of investigator places participant at immediate risk of death; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; results in congenital anomaly/birth defect; is medically important event. Participants who completed treatment period in PC period and did not enter LTE period were to be assessed at Week 90 (14 weeks after end of treatment) as safety follow-up.

Time frame: Day 1 to Week 78 (participants who entered LTE period); Day 1 up to Week 90 (participants who did not LTE period)

Population: The safety analysis set included all randomized participants who received at least one dose of study treatment (BIIB092 or placebo).

ArmMeasureGroupValue (NUMBER)
PC Period: PlaceboPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)AEs84.6 percentage of participants
PC Period: PlaceboPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)SAEs12.1 percentage of participants
PC Period: BIIB092 125 mg/4 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)AEs86.2 percentage of participants
PC Period: BIIB092 125 mg/4 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)SAEs10.3 percentage of participants
PC Period: BIIB092 375 mg/12 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)AEs82.8 percentage of participants
PC Period: BIIB092 375 mg/12 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)SAEs10.3 percentage of participants
PC Period: BIIB092 600 mg/4 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)SAEs12.3 percentage of participants
PC Period: BIIB092 600 mg/4 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)AEs88.7 percentage of participants
PC Period: BIIB092 2000 mg/4 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)AEs88.3 percentage of participants
PC Period: BIIB092 2000 mg/4 WeekPC Period: Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)SAEs11.7 percentage of participants
Secondary

PC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) Score

The CDR-SB is a validated clinical assessment of global function in participants with AD. The CDR is comprised of 6 domains: Memory, Orientation, Judgment and Problem Solving, Community Affairs, Home and Hobbies, and Personal Care. CDR-SB is the sum of the scores for these 6 domains. Impairment is scored in each of 6 cognitive categories on a scale in which none = 0, questionable = 0.5, mild = 1, moderate = 2, and severe = 3. The 6 individual category ratings, or box scores, can be added together to give the CDR-SB score which ranges from 0 (none) to 18 (severe impairment).

Time frame: Baseline, Week 78

Population: FAS included all randomized participants who received study treatment (BIIB092 or placebo). As pre-specified in study protocol, 125 mg and 375 mg groups were pooled as 'Low dose' group for efficacy analyses.

ArmMeasureGroupValue (MEAN)Dispersion
PC Period: PlaceboPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreBaseline3.07 score on a scaleStandard Deviation 1.467
PC Period: PlaceboPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreChange at Week 781.71 score on a scaleStandard Deviation 2.376
PC Period: BIIB092 125 mg/4 WeekPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreChange at Week 782.10 score on a scaleStandard Deviation 2.375
PC Period: BIIB092 125 mg/4 WeekPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreBaseline2.92 score on a scaleStandard Deviation 1.62
PC Period: BIIB092 375 mg/12 WeekPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreBaseline3.24 score on a scaleStandard Deviation 1.557
PC Period: BIIB092 375 mg/12 WeekPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreChange at Week 782.23 score on a scaleStandard Deviation 2.987
PC Period: BIIB092 600 mg/4 WeekPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreBaseline3.04 score on a scaleStandard Deviation 1.378
PC Period: BIIB092 600 mg/4 WeekPC Period: Change From Baseline Over Time at Week 78 on the Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) ScoreChange at Week 781.76 score on a scaleStandard Deviation 2.038
Secondary

PC Period: Percentage of Participants With Anti-BIIB092 Antibodies in Serum

Time frame: Baseline up to Week 76

Population: The ADA evaluable set is defined as participants in the FAS who have an evaluable postbaseline ADA sample.

ArmMeasureValue (NUMBER)
PC Period: PlaceboPC Period: Percentage of Participants With Anti-BIIB092 Antibodies in Serum1.9 percentage of participants
PC Period: BIIB092 125 mg/4 WeekPC Period: Percentage of Participants With Anti-BIIB092 Antibodies in Serum0 percentage of participants
PC Period: BIIB092 375 mg/12 WeekPC Period: Percentage of Participants With Anti-BIIB092 Antibodies in Serum0 percentage of participants
PC Period: BIIB092 600 mg/4 WeekPC Period: Percentage of Participants With Anti-BIIB092 Antibodies in Serum1.0 percentage of participants
PC Period: BIIB092 2000 mg/4 WeekPC Period: Percentage of Participants With Anti-BIIB092 Antibodies in Serum0 percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 23, 2026