Title

Safety, Tolerability, and Pharmacokinetic Study of EVP-6124 in Patients With Alzheimer's Disease
A Randomized, Double-Blind, Placebo-Controlled, Ascending-Dose Phase 1b Safety Study of Three Different Doses of an Alpha-7 Nicotinic Acetylcholine Receptor Agonist (EVP-6124) or Placebo in Patients With Mild to Moderate Probable Alzheimer's Disease
  • Phase

    Phase 1
  • Study Type

    Interventional
  • Intervention/Treatment

    encenicline donepezil rivastigmine ...
  • Study Participants

    49
This study is being conducted to determine the safety, tolerability, and pharmacokinetics (PK) of three different doses of an investigational medication, EVP-6124, in individuals with mild to moderate Alzheimer's disease who are also taking an Alzheimer's medication (AChEI [acetylcholinesterase inhibitor]: either donepezil or rivastigmine). In addition, PK of AChEI medications will be assessed. Cognitive function will be evaluated on an exploratory basis.
This is a randomized, double-blind, placebo-controlled, Phase 1b safety study of three dose levels of EVP-6124 in subjects with mild or moderate Alzheimer's disease and who are taking an AChEI medication (donepezil or rivastigmine).

Study drug will be supplied as capsules and will be orally administered once daily for a total of 28 days. Eligible subjects will be admitted to an inpatient study unit on Day -2 (two days before the first dose of study drug is administered) and will remain confined to the inpatient study unit for a total of five days. Starting on Day 4, subjects will continue the study in the outpatient setting, with study visits on Days 7, 14, 21, and 28. Safety assessments, PK sampling, and cognitive testing will be performed inpatient and at each study visit.
Study Started
Oct 31
2008
Primary Completion
Mar 31
2009
Study Completion
Mar 31
2009
Results Posted
Jul 14
2011
Estimate
Last Update
Apr 20
2012
Estimate

Drug EVP-6124 (0.1 mg/day)

EVP-6124 was administered as one 0.1 mg capsule per day for 28 days.

Drug EVP-6124 (0.3 mg/day)

EVP-6124 was administered as one 0.3 mg capsule every day for 28 days.

Drug EVP-6124 (1.0 mg/day)

EVP-6124 was administered as one 1.0 mg capsule every day for 28 days.

Drug Comparator: Placebo

Matching placebo was administered as one capsule per day for 28 days.

Drug Donepezil

Concomitant therapy with donepezil at a stable dose, taken daily at the same time or immediately after the assigned EVP-6124 dose. Patients must have been taking concomitant therapy for at least 3 months prior to enrollment to be eligible for the study.

Drug Rivastigmine

Concomitant therapy with rivastigmine at a stable dose, taken daily at the same time or immediately after the assigned EVP-6124 dose. Patients must have been taking concomitant therapy for at least 3 months prior to enrollment to be eligible for the study.

EVP-6124 (0.1 mg/day) Experimental

EVP-6124 (0.3 mg/day) Experimental

EVP-6124 (1.0 mg/day) Experimental

Placebo Placebo Comparator

Criteria

Inclusion Criteria:

male and post-menopausal or surgically sterile female pts
50-90 yrs old, who meet clinical criteria for probable Alzheimer's disease (Mini-Mental State Examination of 18-26; Hachinski Ischemic Score ≤4)
must be taking donepezil or rivastigmine for at least 3 mos.

Exclusion Criteria:

Unstable medical condition that is clinically significant in the judgment of the investigator; major organ system dysfunction
Untreated hypothyroidism
Insufficiently controlled diabetes mellitus
Diagnosis of major depression requiring antidepressant medications within the last 5 years
Stroke within 6 months before screening, or concomitant with onset of dementia
Certain concomitant medications

Summary

EVP-6124 (0.1 mg/Day)

EVP-6124 (0.3 mg/Day)

EVP-6124 (1.0 mg/Day)

Placebo

All Events

Event Type Organ System Event Term EVP-6124 (0.1 mg/Day) EVP-6124 (0.3 mg/Day) EVP-6124 (1.0 mg/Day) Placebo

Safety and Tolerability of Multiple Doses of EVP-6124 or Placebo in Subjects With Alzheimer's Disease

All adverse experiences spontaneously reported by subject and/or observed by investigator and repeated clinical evaluation of physical examinations, vital signs, 12-lead ECG (electrocardiogram), ambulatory ECG, and laboratory tests (hematology/blood chemistry/urinalysis)

EVP-6124 (0.1 mg/Day)

No Adverse Events Reported

10.0
Participants

Non-Serious Adverse Events

2.0
Participants

Serious Adverse Events

EVP-6124 (0.3 mg/Day)

No Adverse Events Reported

10.0
Participants

Non-Serious Adverse Events

3.0
Participants

Serious Adverse Events

EVP-6124 (1.0 mg/Day)

No Adverse Events Reported

7.0
Participants

Non-Serious Adverse Events

4.0
Participants

Serious Adverse Events

Placebo

No Adverse Events Reported

9.0
Participants

Non-Serious Adverse Events

4.0
Participants

Serious Adverse Events

EVP-6124 PK Data Following the First Dose of EVP-6124 - Maximum Concentration (Cmax)

EVP-6124 PK data; Maximum Concentration (Cmax); i.e, highest concentration of drug in plasma

EVP-6124 (0.1 mg/Day)

0.0715
ng/mL (Mean)
Standard Deviation: 0.0121

EVP-6124 (0.3 mg/Day)

0.1911
ng/mL (Mean)
Standard Deviation: 0.0740

EVP-6124 (1.0 mg/Day)

0.6122
ng/mL (Mean)
Standard Deviation: 0.1235

EVP-6124 PK Data Following the First Dose of EVP-6124 - Time to Maximum Concentration (Tmax)

EVP-6124 PK data; Time to Maximum Concentration (Tmax); i.e, amount of time required to reach highest concentration of drug in plasma

EVP-6124 (0.1 mg/Day)

7.7
hours (Mean)
Standard Deviation: 3.31

EVP-6124 (0.3 mg/Day)

7.94
hours (Mean)
Standard Deviation: 3.61

EVP-6124 (1.0 mg/Day)

10.72
hours (Mean)
Standard Deviation: 6.69

EVP-6124 PK Data Following the First Dose of EVP-6124 - Area Under the Curve (AUC[0-24 h])

EVP-6124 PK data; Area Under the Curve (AUC[0-24 h]); i.e, area under the concentration-time plot

EVP-6124 (0.1 mg/Day)

1.31
h*ng/mL (Mean)
Standard Deviation: 0.23

EVP-6124 (0.3 mg/Day)

3.89
h*ng/mL (Mean)
Standard Deviation: 0.84

EVP-6124 (1.0 mg/Day)

11.44
h*ng/mL (Mean)
Standard Deviation: 2.24

Donepezil PK Data Following the First Dose of EVP-6124 - Maximum Concentration (Cmax)

Donepezil PK data; Maximum Concentration (Cmax); i.e, highest concentration of donepezil (parent compound only) in plasma after dosing with EVP-6124

EVP-6124 (0.1 mg/Day)

29.5
ng/mL (Mean)
Standard Deviation: 15.8

EVP-6124 (0.3 mg/Day)

24.7
ng/mL (Mean)
Standard Deviation: 19.8

EVP-6124 (1.0 mg/Day)

39.2
ng/mL (Mean)
Standard Deviation: 26.7

Placebo

41.9
ng/mL (Mean)
Standard Deviation: 19.7

Donepezil PK Data Following the First Dose of EVP-6124 - Time to Maximum Concentration (Tmax)

Donepezil PK data; Time to Maximum Concentration (Tmax); i.e, amount of time required to reach highest concentration of donepezil (parent compound only) in plasma after dosing with EVP-6124

EVP-6124 (1.0 mg/Day)

3.31
hours (Mean)
Standard Deviation: 3.01

Placebo

3.56
hours (Mean)
Standard Deviation: 4.02

EVP-6124 (0.1 mg/Day)

2.3
hours (Mean)
Standard Deviation: 2.65

EVP-6124 (0.3 mg/Day)

1.85
hours (Mean)
Standard Deviation: 2.15

Donepezil PK Data Following the First Dose of EVP-6124 - Area Under the Curve (AUC[0-24 h])

Donepezil PK data; Area Under the Curve (AUC[0-24 h]); i.e, area under the concentration-time plot for donepezil (parent compound only) after dosing with EVP-6124

EVP-6124 (0.1 mg/Day)

299.0
h*ng/mL (Mean)
Standard Deviation: 179

EVP-6124 (0.3 mg/Day)

240.0
h*ng/mL (Mean)
Standard Deviation: 194

EVP-6124 (1.0 mg/Day)

345.0
h*ng/mL (Mean)
Standard Deviation: 225

Placebo

427.0
h*ng/mL (Mean)
Standard Deviation: 233

Rivastigmine PK Data Following the First Dose of EVP-6124 - Maximum Concentration (Cmax)

Rivastigmine PK data; Maximum Concentration (Cmax); i.e, highest concentration of rivastigmine in plasma after dosing with EVP-6124

EVP-6124 (0.1 mg/Day)

23.35
ng/mL (Mean)
Standard Deviation: 5.16

EVP-6124 (1.0 mg/Day)

3.51
ng/mL (Mean)
Standard Deviation: 0.37

Rivastigmine PK Data Following the First Dose of EVP-6124 - Time to Maximum Concentration (Tmax)

Rivastigmine PK data; Time to Maximum Concentration (Tmax); i.e, amount of time required to reach highest concentration of rivastigmine in plasma after dosing with EVP-6124

EVP-6124 (0.1 mg/Day)

1.0
hours (Mean)
Standard Deviation: 0.02

EVP-6124 (1.0 mg/Day)

12.12
hours (Mean)
Standard Deviation: 15.72

Rivastigmine PK Data Following the First Dose of EVP-6124 - Area Under the Curve (AUC[0-24 h])

Rivastigmine PK data; Area Under the Curve (AUC[0-24 h]); i.e, area under the concentration-time plot for rivastigmine after dosing with EVP-6124

EVP-6124 (0.1 mg/Day)

143.55
h*ng/mL (Mean)
Standard Deviation: 85.52

EVP-6124 (1.0 mg/Day)

54.6
h*ng/mL (Mean)
Standard Deviation: 6.28

Total

49
Participants

Age Continuous

69.8
years (Mean)
Standard Deviation: 10.4

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

EVP-6124 (0.1 mg/Day)

EVP-6124 (0.3 mg/Day)

EVP-6124 (1.0 mg/Day)

Placebo

Drop/Withdrawal Reasons

EVP-6124 (0.1 mg/Day)

EVP-6124 (0.3 mg/Day)