Title

Study Evaluating Intepirdine (RVT-101) in Subjects With Mild to Moderate Alzheimer's Disease on Donepezil: MINDSET Study
A Phase 3, Double-blind, Randomized Study of RVT-101 Versus Placebo When Added to Existing Stable Donepezil Treatment in Subjects With Mild to Moderate Alzheimer's Disease
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    intepirdine ...
  • Study Participants

    1315
This study seeks to confirm a demonstrated treatment effect of intepirdine (RVT-101) as an adjunctive therapy to donepezil for the treatment of subjects with Alzheimer's disease.
This Phase 3 study seeks to confirm a demonstrated treatment effect of intepirdine (RVT-101) on both cognition and activities of daily living when added to stable donepezil treatment in subjects with mild-to-moderate Alzheimer's disease after 24 weeks of double-blind treatment. This study will also provide further information on the safety and tolerability of the 35-mg dose of intepirdine (RVT-101) when used in combination with donepezil compared to donepezil alone. This study is being conducted under the agreement of a Special Protocol Assessment by FDA. Subjects completing this study will be eligible to enroll in a 12 month open-label study of RVT-101 (RVT-101-3002) in which concomitant medications for the treatment of Alzheimer's disease including memantine will be allowed.
Study Started
Oct 31
2015
Primary Completion
Sep 30
2017
Study Completion
Sep 30
2017
Results Posted
Dec 05
2018
Last Update
Dec 05
2018

Drug Placebo

once daily, oral, pill manufactured to match RVT-101 35 mg tablet

Drug RVT-101

once daily, oral, 35 mg tablets

RVT-101 Experimental

RVT-101 adjunct to 5 mg or 10 mg donepezil

Placebo Placebo Comparator

Placebo adjunct to 5 mg or 10 mg donepezil

Criteria

Inclusion Criteria:

Male or female subject with AD
Ongoing donepezil therapy for AD
An MMSE score 12 to 24 inclusive at Screening; MMSE score 10-26 inclusive at Baseline
Hachinski Ischaemia score less than or equal to 4 at Screening.
If female, subject must be: a. of non-childbearing potential or surgically sterile; or, b. willing to use an adequate methods of birth control. Male subjects who are sexually active will also be required to use an adequate form of birth control.
Subject has the ability to comply with procedures for cognitive and other testing in the opinion of the investigator.
Subject has a reliable caregiver who is willing to report on subject's status throughout the study.

Exclusion Criteria:

Other Causes for Dementia

Diagnosis of vascular dementia
Atypical clinical features or clinical course of dementia that would lead the investigator to conclude symptoms are more likely due to an alternate dementia diagnosis including, but not limited to, frontotemporal dementia, Lewy body dementia, or others.

Confounding Medical Conditions

History of significant psychiatric illness such as schizophrenia or bipolar affective disorder or any other significant psychiatric illness that in the opinion of the investigator would interfere with participation in the study;
Any clinically relevant concomitant disease, which, in the opinion of the investigator, makes the subject unsuitable for inclusion in the study.

Summary

RVT-101 Treatment

Placebo Treatment

Screening Period

Run-In Period

RVT-101 Post-Treatment

Placebo Post-Treatment

All Events

Event Type Organ System Event Term RVT-101 Treatment Placebo Treatment Screening Period Run-In Period RVT-101 Post-Treatment Placebo Post-Treatment

Alzheimer's Disease Assessment Scale - Cognitive Subscale 11 Items (ADAS-Cog-11) Score Change From Baseline to Week 24

The 11-item ADAS-Cog assesses a range of cognitive abilities including memory, comprehension, orientation in time and place, and spontaneous speech. The ADAS-Cog-11 total score range is from 0 to 70, with a higher score indicating more severe cognitive impairment.

RVT-101

0.39
units on a scale (Least Squares Mean)
Standard Error: 0.211

Placebo

0.75
units on a scale (Least Squares Mean)
Standard Error: 0.213

Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) Score Change From Baseline to Week 24

The ADCS-ADL scale measures functional impairment in terms of activities of daily living. The score ranges from 0 to 78. The lower the score, the greater the impairment; higher scores indicate better (more desirable) function

RVT-101

-1.06
units on a scale (Least Squares Mean)
Standard Error: 0.289

Placebo

-0.97
units on a scale (Least Squares Mean)
Standard Error: 0.293

Clinical Global Impression of Change - Plus Caregiver Interview (CIBIC+) Score at Week 24

The CIBIC+ assessment measures the global functioning of the subject. The CIBIC+ is scored as a seven-point categorical rating, ranging from a score of 1 (indicating "very much improved"), to a score of 4 (indicating "no change"), or to a score of 7 (indicating "very much worse.") Lower CIBIC+ scores indicate better (more desirable) function

RVT-101

4.18
units on a scale (Least Squares Mean)
Standard Error: 0.037

Placebo

4.3
units on a scale (Least Squares Mean)
Standard Error: 0.037

The Dependence Scale (DS) Score Change From Baseline to Week 24

The DS measures the amount of assistance patients with dementia require in performing daily activities. The scale consists of 13 items, representing a range of severity from mild to severe levels of dependency. The score range is from 0 to 15 with higher scores indicating greater dependency.

RVT-101

0.3
units on a scale (Least Squares Mean)
Standard Error: 0.070

Placebo

0.17
units on a scale (Least Squares Mean)
Standard Error: 0.071

Neuropsychiatric Inventory (NPI) Score Change From Baseline to Week 24

The NPI is a behavior rating scale composed of a 12-item structured interview of the caregiver that is scored from 0 to 144 (the higher the score, the greater the psychiatric disturbance). It assesses 12 behavioral disturbances occurring in dementia patients: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor activity, night-time behavior disturbances, and eating disturbances. Both the frequency and the severity of each behavior are determined.

RVT-101

-0.08
units on a scale (Least Squares Mean)
Standard Error: 0.339

Placebo

0.06
units on a scale (Least Squares Mean)
Standard Error: 0.344

ADAS-Cog-13 Score Change From Baseline to Week 24

13-item ADAS-Cog assesses a range of cognitive abilities including memory, comprehension, orientation in time and place, and spontaneous speech. Most items are evaluated by tests, but some are dependent on clinician ratings on a 5-point scale. The ADAS-Cog-13 is the ADAS-Cog-11 with 2 additional items: delayed word recall and total digit cancellation. Scores for the ADAS-Cog-13 range from 0 to 85 with higher scores indicating greater dysfunction.

RVT-101

0.26
units on a scale (Least Squares Mean)
Standard Error: 0.233

Placebo

0.64
units on a scale (Least Squares Mean)
Standard Error: 0.236

Measurement of Concentrations of RVT-101 (Intepirdine) in Plasma

Measurement collected at timepoints Week 6, Week 12, Week 18, and Week 24

RVT-101

Summary Statistics at Week 12

170.95
ng/mL (Geometric Mean)
95% Confidence Interval: 164.4 to 177.76

Summary Statistics at Week 18

198.69
ng/mL (Geometric Mean)
95% Confidence Interval: 189.36 to 208.48

Summary Statistics at Week 24

193.36
ng/mL (Geometric Mean)
95% Confidence Interval: 184.6 to 202.53

Summary Statistics at Week 6

201.11
ng/mL (Geometric Mean)
95% Confidence Interval: 191.88 to 210.78

Total

1276
Participants

Age, Continuous

72.6
years (Mean)
Full Range: 50.0 to 86.0

BMI

26.4
kg/m^2 (Mean)
Full Range: 15.2 to 56.3

Age, Customized

Ethnicity (NIH/OMB)

Race/Ethnicity, Customized

Sex: Female, Male

Overall Study

RVT-101

Placebo

Drop/Withdrawal Reasons

RVT-101

Placebo