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A Study to Verify the Clinical Benefit of Aducanumab in Participants With Early Alzheimer's Disease (ENVISION)

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ClinicalTrials.gov Identifier: NCT05310071
Recruitment Status : Active, not recruiting
First Posted : April 4, 2022
Last Update Posted : February 12, 2024
Sponsor:
Information provided by (Responsible Party):
Biogen

Study Description
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Brief Summary:
The primary objective of this study is to verify the clinical benefit of monthly doses of aducanumab in slowing cognitive and functional impairment as measured by changes in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score as compared with placebo in participants with early Alzheimer's disease.

Condition or disease Intervention/treatment Phase
Alzheimer's Disease Drug: Aducanumab Drug: Placebo Phase 3

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 1512 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 3b/4 Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Verify the Clinical Benefit of Aducanumab (BIIB037) in Participants With Alzheimer's Disease
Actual Study Start Date : June 2, 2022
Estimated Primary Completion Date : December 27, 2025
Estimated Study Completion Date : October 31, 2026

Resource links provided by the National Library of Medicine

Drug Information available for: Aducanumab

Arms and Interventions
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Arm Intervention/treatment
Experimental: Aducanumab
Participants will receive aducanumab, up to 10 milligrams per kilograms (mg/kg), monthly (once every four weeks), administered as intravenous (IV) infusion.
 Drug: Aducanumab
Administered as specified in the treatment arm.
Other Names:
  • BIIB037
  • Aducanumab-avwa
  • Aduhelm
Placebo Comparator: Placebo
Participants will receive placebo, monthly (once every four weeks), administered as IV infusion.
 Drug: Placebo
Administered as specified in the treatment arm.


Outcome Measures
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Primary Outcome Measures :
  1. Change From Baseline in CDR-SB Score at Week 78 [ Time Frame: Baseline, Week 78 ]
    The CDR integrates assessments from 3 domains of cognition (memory, orientation, judgment/problem-solving) and 3 domains of function (community affairs, home/hobbies, personal care). Following caregiver interview and systematic participant examination, the rater assigns a score describing the participant's current performance level in each of these domains of life functioning. The "Sum of boxes" scoring methodology (CDR-SB) sums the score for each of the 6 domains and provides a value ranging from 0 to 18 with higher scores indicating greater impairment. Positive change from baseline indicates greater impairment.


Secondary Outcome Measures :
  1. Change From Baseline in Integrated Alzheimer's Disease Rating Scale (iADRS) Score at Weeks 78 and 106 [ Time Frame: Baseline, Weeks 78 and 106 ]
    The iADRS composite captures decline in both cognition and daily function. The iADRS is a simple linear combination of Alzheimer's disease assessment scale, cognitive subscale (ADAS-Cog13) and the Alzheimer's disease cooperative study scale for activities of daily living in mild cognitive impairment (ADCS-ADL-MCI). The iADRS scale ranges from 0-138, higher scores indicating better performance.

  2. Change From Baseline in ADCS-ADL-MCI Score at Weeks 78 and 106 [ Time Frame: Baseline, Weeks 78 and 106 ]
    The ADCS-ADL-MCI is a functional evaluation scale for MCI participants, based on information provided by an informant who rates 18 areas of daily living, with total score ranging from 0-53. Higher scores indicate greater independent, healthy functioning. Positive change from baseline indicates healthy functioning.

  3. Change From Baseline in ADAS-Cog13 Score at Weeks 78 and 106 [ Time Frame: Baseline, Weeks 78 and 106 ]
    The ADCS-ADAS-Cog13 is a brief objective cognitive assessment of the severity of cognitive symptoms of Alzheimer's disease. The ADAS-Cog13 score ranges from 0 to 85, with higher scores indicating worse performance.

  4. Change From Baseline in Mini-Mental State Examination (MMSE) Score at Weeks 78 and 106 [ Time Frame: Baseline, Weeks 78 and 106 ]
    The MMSE is a brief cognitive screening tool that provides clinicians the ability to rapidly assess cognitive ability in less than 10 minutes. The MMSE score ranges from 0-30, with higher scores indicating better performance.

  5. Change From Baseline in Neuropsychiatric Inventory-10 (NPI-10) Score at Weeks 78 and 106 [ Time Frame: Baseline, Weeks 78 and 106 ]
    The NPI-10 is a questionnaire administered to the informant, designed to obtain information on the presence of neuropsychiatric symptoms and behaviors in a participant with Alzheimer's disease. Ten areas are assessed: delusions, hallucinations, agitation/aggression, depression, anxiety, elation/euphoria, apathy/indifference, disinhibition, irritability and aberrant motor behavior. The NPI total score ranges from 0 to 120. Higher scores indicates greater impairment.

  6. Change From Baseline in Amyloid Positron Emission Tomography (PET) Signal at Weeks 78 and 104 [ Time Frame: Baseline, Weeks 78 and 104 ]
    The cerebral amyloid plaque level was measured by amyloid PET imaging.

  7. Change From Baseline in Tau PET Signal at Weeks 78 and 104 [ Time Frame: Baseline, Weeks 78 and 104 ]
    The cerebral tau level was measured by tau PET imaging.

  8. Change From Baseline in CDR-SB Score at Week 106 [ Time Frame: Baseline, Week 106 ]
    The CDR integrates assessments from 3 domains of cognition (memory, orientation, judgment/problem-solving) and 3 domains of function (community affairs, home/hobbies, personal care). Following caregiver interview and systematic participant examination, the rater assigns a score describing the participant's current performance level in each of these domains of life functioning. The "Sum of boxes" scoring methodology (CDR-SB) sums the score for each of the 6 domains and provides a value ranging from 0 to 18 with higher scores indicating greater impairment. Positive change from baseline indicates greater impairment.

  9. Change From Baseline in Global Statistical Test (GST) Composite Z-Score [ Time Frame: Baseline, Weeks 78 and 106 ]
    The GST is a composite z-score defined as the average of standardized z-scores of the CDR-SB, ADASCog13, and ADCS-ADL-MCI. A positive change from baseline indicates improvement.


Eligibility Criteria
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Ages Eligible for Study:   60 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • The participant must have confirmed amyloid beta pathology by cerebrospinal fluid (CSF) or amyloid PET
  • Must have a history of subjective memory decline with gradual onset and slow progression over the 6 months before Screening, confirmed by study partner
  • The participant must have 1 informant/care partner who, in the Investigator's opinion, has frequent and sufficient contact with the participant (at least 10 hours/week in person or by phone) as to be able to provide accurate information about the participant's cognitive and functional abilities over time

  • Must meet all of the following clinical criteria for MCI due to Alzheimer's disease or mild Alzheimer's disease according to National Institute on Aging and Alzheimer's Association (NIA-AA) criteria

    1. Have an MMSE score between 22 and 30 inclusive
    2. Have a CDR memory score >0.5
    3. Have a Clinical Dementia Rating Scale Global Score (CDR-GS) of 0.5 or 1.0
    4. Have a Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) score of 85 or lower indicative of objective cognitive impairment
  • Apart from a clinical diagnosis of early Alzheimer's disease, the participant must be in good health as determined by the Investigator based on medical history and screening assessments
  • Must consent to apolipoprotein E (ApoE) genotyping. (Note: Participants are not required to be ApoE ε4 carriers)

Key Exclusion Criteria:

  • Any uncontrolled medical or neurological/neurodegenerative condition (other than Alzheimer's disease) that, in the opinion of the Investigator, might be a contributing cause of the participant's cognitive impairment
  • Clinically significant and/or unstable psychiatric illness within 6 months prior to Screening
  • Transient ischemic attack or stroke or any unexplained loss of consciousness within 1 year prior to Screening
  • History of severe allergic or anaphylactic reactions or of hypersensitivity to any of the inactive ingredients in the drug product
  • Participation in any study with purported disease-modifying effect in Alzheimer's disease within 12 months prior to Screening unless documentation of receipt of placebo is available
  • Current use or previous use of medications with a purported disease-modifying effect in Alzheimer's disease, outside of investigational studies
  • Use of any medications that, in the opinion of the Investigator, may contribute to cognitive impairment, put the participant at higher risk for AEs, or impair the participant's ability to perform cognitive testing or complete study procedures
  • Use of any investigational drug
  • Prior exposure to aducanumab either commercially or by participation in a previous study with aducanumab. (Participants are eligible if they did not receive active aducanumab.)
  • A negative PET scan result with any amyloid-targeting ligand within 12 months prior to Screening

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply

Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05310071


Locations
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Sponsors and Collaborators
Biogen
Investigators
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Study Director: Medical Director Biogen
More Information
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Responsible Party: Biogen
ClinicalTrials.gov Identifier: NCT05310071    
Other Study ID Numbers: 221AD305
First Posted: April 4, 2022    Key Record Dates
Last Update Posted: February 12, 2024
Last Verified: February 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: In accordance with Biogen's Clinical Trial Transparency and Data Sharing Policy on https://www.biogentrialtransparency.com/
URL: https://vivli.org/

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Alzheimer Disease
Dementia
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
 Tauopathies
Neurodegenerative Diseases
Neurocognitive Disorders
Mental Disorders