A Study of Potential Disease Modifying Treatments in Individuals at Risk for or With a Type of Early Onset AD Caused by a Genetic Mutation
A Phase II/III Multicenter Randomized, Double-Blind, Placebo-Controlled, Two-Stage Adaptive Design, Platform Trial of Investigational Treatments for Primary Prevention of Disease Progression in Dominantly Inherited Alzheimer's Disease
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
- Procedures mentioned: MRI scans
Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.
Show the study's own words
- "As part of the DIAN-TU-002 protocol, participants undergo longitudinal assessments that include clinical assessment, cognitive testing, magnetic resonance imaging (MRI) and amyloid imaging, and analysis of cerebrospinal fluid (CSF)."
- "At the start of Stage 2, participants who were randomized to placebo in Stage 1 will follow the same dose titration schedule and MRI safety schedule used in Stage 1."
- "Participants who were randomized to active drug in Stage 1 will follow a mock dose titration and will have the same MRI safety schedule used during the initial drug titration as Stage 1 but will remain on the dose that they were on at the end of Stage 1."
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This study tests whether study drugs can safely prevent or slow the buildup of amyloid, a protein linked to Alzheimer's disease, and later disease changes. It is for adults with normal memory and thinking who have, or may have inherited, a gene change that causes early Alzheimer's disease.
The purpose is to evaluate the biomarker effect, safety, and tolerability of investigational study drugs in participants who are known to have an Alzheimer's disease (AD)-causing mutation. Stage 1 will determine if treatment with the study drug prevents or slows the rate of amyloid beta (Aβ) pathological disease accumulation demonstrated by Aβ positron emission tomography (PET) imaging. Stage 2 will evaluate the effect of early Aβ plaque reduction/prevention on disease progression by assessing downstream non-Aβ biomarkers of AD (e.g., CSF total tau, p-tau, NfL) compared to an external control group from the DIAN-OBS natural history study and the DIAN-TU-001 placebo-treated participants.
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Be at least 18 years old and give written consent to join.
- Have an Alzheimer's-causing change in the APP, PSEN1, or PSEN2 gene, or have an unknown gene status and a direct risk of inheriting a known family gene change.
- Be 11 to 25 years younger than the age when symptoms are expected to start, with normal memory and thinking test results.
- Speak a study-approved language fluently, meet the study's past learning ability requirements, and see and hear well enough for testing.
- Have a study partner who can report on your memory, thinking, and daily activities and give consent as needed.
- Have stable doses of medicines for allowed health conditions for at least 30 days before the starting visit. Some short-term medicines are exceptions.
- If you can become pregnant, have a negative blood pregnancy test. Avoid pregnancy and breastfeeding through 20 weeks after the last dose, and follow the study's birth control rules.
- Be willing and likely to finish all study tests and visits. Do not donate blood for transfusion during the study or for the required time after the last dose.
Who can't join
- A serious brain, nerve, or mental health condition that could affect thinking or study participation. Well-controlled or past conditions may be allowed.
- High suicide risk, current major depression, or serious suicidal thoughts or an attempt in the past 12 months. Stable mild depression or antidepressant use alone does not rule you out.
- A past stroke or major risk for stroke or brain bleeding that could affect thinking or study completion.
- An alcohol or drug use disorder now or within the past year.
- Important brain scan findings, such as small brain bleeds or a bulging blood vessel, or metal or implanted devices that prevent an MRI scan. Minor scan findings may be allowed.
- Heart, liver, or kidney problems that could affect participation or study results.
- Certain infections, including HIV, hepatitis B within the past year, hepatitis C not adequately treated, or past syphilis or Lyme infection of the brain or spinal cord.
- Serious medicine allergies or reactions to study scan agents that could affect participation or results. Medicines that weaken the immune system are also listed, but that rule is cut off in the provided text.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria: 1. Provide written informed consent, signed, and dated by the participant and study partner, or by the participant's legally authorized representative if applicable, according to local regulations for the ICF and, if applicable, country specific ICFs. 2. Participant is at least 18 years old. 3. People of childbearing potential 1. Must have a negative serum pregnancy test at screening (V1) 2. Must agree not to try to become pregnant from the time of signed ICF until twenty (20) weeks after the last dose of any study drug. 3. Must agree not to breastfeed from the time of signed ICF until twenty (20) weeks after the last dose of any study drug. 4. If partner is not sterilized, must agree to use highly effective contraceptive measures, methods that can achieve a failure rate of less than 1% per year when used consistently and correctly from screening (V1) until twenty (20) weeks after last dose of any study drug. i. combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal, transdermal ii. progestogen-only hormonal contraception associated with inhibition of ovulation: oral, injectable, implantable iii. intra-uterine device (IUD) iv. intrauterine hormone-releasing systems (IUS) v. bilateral tubal occlusion vi. vasectomized partner (only when this is the only partner) vii. true sexual abstinence when this is in line with the preferred and usual lifestyle of the participant. (Periodic abstinence \[e.g., calendar, ovulation, symptothermal, post-ovulation methods\], declaration of abstinence for the duration of exposure to IMP, and withdrawal are not acceptable methods of contraception) 4. Mutation Status: 1. Participant is a carrier of a mutation in an APP, PSEN1, or PSEN2 gene that is associated with DIAD or does not know their mutation status and there is a mutation in their family pedigree that puts them at a direct risk of inheriting the known mutation; 2. Participant is -25 to -11 years from predicted age of cognitive symptom onset based on their mutation type or family pedigree Note: If the at-risk parent is deemed a non-carrier through confirmed genetic testing at any time during the study, the participant will be withdrawn. 5. Cognitive status of participant is normal (CDR-SB 0). 6. Fluency in DIAN-TU trial approved language and evidence of adequate premorbid intellectual functioning. Participants must be fluent in languages for which cognitive and clinical measures have been translated and validated for use in the DIAN-TU. Fluency is generally defined as daily or frequent functional use of a language generally from birth or a young age. In cultures where multiple languages are spoken or for participants who are multilingual, determination as to whether a participant's level of fluency in languages for which clinical and cognitive measures are available meets qualification for the study should be made by the site PI. 7. Adequate visual and auditory abilities to perform all aspects of the cognitive and clinical assessments. 8. Receiving stable doses of medication(s) for the treatment of non-excluded medical condition(s) for at least 30 days prior to baseline visit (V2) with the exceptions of medications taken for episodic conditions (e.g., migraine abortive therapy, antibiotics, and other medications for upper respiratory and gastrointestinal ailments). 9. Has a study partner who in the PI's judgment can provide accurate information as to the participant's cognitive and functional abilities, who agrees to provide information at the study visits that require study partner input for scale completion, and who signs the necessary ICF, if applicable. 10. Agrees not to donate blood or blood products for transfusion from the time of Screening (V1) for a study drug arm, for the duration of the study, and for 5 half lives after the final dose of study drug. 11. In the opinion of the PI, the participant will be compliant and have a high probability of completing the study. 12. Willing to complete all study-related testing, evaluations, and procedures. Exclusion Criteria: 1. Significant neurologic disease (other than AD) or psychiatric disease that may currently or during the study affect cognition or the participant's ability to complete the study. This would include disorders such as: recent or severe head trauma causing cognitive change, seizure disorder, neurodegenerative disease other than DIAD, hydrocephalus, cerebral/spinal hematoma, inflammatory disease, CNS infection (e.g., encephalitis or meningitis), neoplasm, toxic exposure, metabolic disorder (including hypoxic or hypoglycemic episodes) or endocrine disorder; psychiatric disorders such as schizophrenia, schizoaffective disorder, bipolar disorder or major depression, or any other psychiatric condition/disorder which could significantly interfere with the participant's cooperative participation (e.g., prominent anxiety, agitation or behavioral problems). Disorders that are controlled medically or remote history of these disorders (e.g., history of febrile seizures in childhood) that are not likely to interfere with cognitive function and compliance with study procedures are not exclusionary. 2. At high risk for suicide, e.g., significant suicidal ideation or attempt within last 12 months, current major depression (as defined in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition \[DSM-V\]), or increased suicide risk based on screening Columbia Suicide Severity Rating Scale (C-SSRS). Current stable mild depression or current use of antidepressant medications are not exclusionary. 3. History of clinically evident stroke or history of clinically important carotid or vertebrobasilar stenosis, plaque, or other prominent risk factor for stroke or cerebral hemorrhage (including atrial fibrillation and anticoagulation, documented transient ischemic attack \[TIA\] in the last 12 months) that may be interfering with cognition or is likely to impact with the participant's ability to complete the study. 4. Alcohol or substance use sufficient to meet DSM-V criteria currently or within the past year. 5. History of or Baseline (V2) visit brain MRI scan indicative of any other significant abnormality, definite microhemorrhages, evidence of a cerebral contusion, encephalomalacia, or aneurysms. Minor or clinically insignificant imaging findings are not exclusionary. 6. Presence of certain implanted medical devices, such as some pacemakers, aneurysm clips, artificial heart valves, ear implants, or foreign metal objects in the eyes, skin, or body which would preclude MRI scan. 7. Cardiovascular complications such as uncontrolled hypertension, history of myocardial infarcts, heart failure, atrial fibrillation, long QT interval on ECG likely to interfere with participation in or analysis of the trial in the opinion of the investigator 8. Hepatic or renal abnormalities that in the opinion of the investigator would interfere with participation in or analysis of the trial. 9. History of Human Immunodeficiency Virus (HIV) infection, history of Hepatitis B infection within the past year, history of Hepatitis C infection which has not been adequately treated, history of spirochete infection (e.g., syphilis, Lyme) of the CNS or history of other infection with high risk for interfering with participation or interpretation of the study in the opinion of the investigator. 10. History of clinically significant multiple or severe drug allergies, significant atopy, or severe post-treatment hypersensitivity reactions (including but not limited to erythema multiforme major, linear IgA dermatosis, toxic epidermal necrolysis, and/or exfoliative dermatitis) or sensitivity to study-drug specific PET imaging agents with a high risk for interfering with participation or interpretation of the study in the opinion of the investigator. 11. Treatment with immunosuppressive medications (e.g., systemic corticosteroids) within 90 days prior to Baseline (V2) visit (topical and nasal corticosteroids and inhaled corticosteroids for asthma are permitted) or chemotherapeutic agents for malignancy within the last 3 years. 12. Current clinically significant abnormalities of thyroid function, or clinically significant deficiency in vitamin B12. Vitamin B12 less than the lower limits of normal with normal methylmalonic acid (MMA)/homocysteine is not deemed clinically significant, therefore not exclusionary. 13. Unstable or poorly controlled diabetes which the investigator believes may interfere with participation in or analysis of the study protocol. Participants may be rescreened after 3 months to allow optimization of diabetic control 14. Morbid obesity with significant comorbidities or that would preclude MRI imaging. 15. Current use of anticoagulants (e.g., warfarin, dabigatran, rivaroxaban, or apixaban). Daily use of low dose (\< 325 mg) aspirin is not exclusionary. 16. Have been exposed to a monoclonal antibody targeting Aβ peptide within the past 6 months or 5 half-lives from screening, whichever is longer. 17. Received any other investigational pharmacological treatment within 3 months of Screening or 5 half-lives, whichever is longer. Note: Use of approved treatments for AD and other medications may be permitted in this study. 18. Lack of sufficient venous access. 19. Clinically relevant abnormalities in hematology, coagulation, or clinical chemistry. 20. History of cancer that the investigator believes has high risk of recurrence and impacting study participation or analysis. 21. Any other medical condition that could be expected to progress, recur, or change to such an extent that it could bias the assessment of the clinical or mental status of the participant to a significant degree or put the participant at special risk. 22. Currently, or within the last month prior to screening, participated in a clinical study, including a nonpharmacological study, without prior approval. 23. Participants with the "Dutch" APP E693Q mutation. 24. Unable to complete baseline visit (V2) procedures with appropriate cognitive and clinical scores for eligibility
Study sites (13)
AL
- University of Alabama in Birmingham · Birmingham, AL 35294Erik Roberson · Principal investigatorMore trials in Birmingham
CA
- University of California San Diego Medical Center · La Jolla, CA 92037Doug Galasko · Principal investigatorMore trials in La Jolla
- University of Southern Califonria · Los Angeles, CA 90089John Ringman · Principal investigatorMore trials in Los Angeles
CT
- Yale University School of Medicine · New Haven, CT 06510Christopher Van Dyck · Principal investigatorMore trials in New Haven
GA
- Emory University · Atlanta, GA 30329James Lah · Principal investigatorMore trials in Atlanta
IL
- Advocate Lutheran General Hospital · Park Ridge, IL 60068Darren Gitelman · Principal investigatorMore trials in Park Ridge
IN
- Indiana University School of Medicine · Indianapolis, IN 46202Jared Brosch · Principal investigatorMore trials in Indianapolis
MO
- Washington University in St. Louis · St Louis, MO 63110Barbara Snider · Principal investigatorMore trials in St Louis
NY
- New York University Medical Center · New York, NY 10016Thomas Wisniewski · Principal investigatorMore trials in New York
PA
- University of Pittsburgh · Pittsburgh, PA 15213Sarah Berman · Principal investigatorMore trials in Pittsburgh
RI
- Butler Hospital · Providence, RI 02096Edward Denmead Huey · Principal investigatorMore trials in Providence
TX
- Kerwin Research and Memory Center · Dallas, TX 75231Alka Khera · Principal investigatorMore trials in Dallas
WA
- University of Washington · Seattle, WA 98195Suman Jayadev · Principal investigatorMore trials in Seattle