A Randomized, Double-blind, Placebo-controlled Trial to Assess the Efficacy and Safety of AXS-05 for the Treatment of Agitation in Subjects With Dementia of the Alzheimer's Type
| Registry | NCT03226522, acronym ADVANCE |
| Status | Completed |
| Phase | Phase 2 / Phase 3 |
| Study type | Interventional; randomized, parallel, masking: triple, treatment |
| Enrollment | 366 (Actual) |
| Sponsor | Axsome Therapeutics, Inc. (Industry) |
| Conditions | Agitation in Patients With Dementia of the Alzheimer's Type, Alzheimer Disease, Agitation,Psychomotor |
| Interventions | AXS-05, Bupropion, Placebo (Drug) |
| Dates | start 2017-07-13, primary completion 2020-04-17, completion 2020-04-17, first posted 2017-07-21, last updated 2023-09-13 |
| Locations | 78 sites in United States, Australia |
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-Summary
This is a multi-center, randomized, double-blind, placebo-controlled study, to assess the efficacy and safety of AXS-05 in the treatment of agitation in patients with Alzheimer's disease.
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+Arms and interventions
| Arm | Type | Interventions | Description |
|---|
| AXS-05 | Experimental | Drug: AXS-05 | AXS-05 tablets taken by mouth for 5 weeks. |
| Bupropion | Active comparator | Drug: Bupropion | Bupropion tablets taken by mouth for 5 weeks. |
| Placebo | Placebo comparator | Drug: Placebo | Placebo tablets taken by mouth for 5 weeks. |
- AXS-05 (Drug): AXS-05
- Bupropion (Drug): Bupropion
- Placebo (Drug): Placebo
+Outcome measures
Primary outcomes
- Change in CMAI Total Score [5 weeks]: The Cohen-Mansfield Agitation Inventory (CMAI) is a 29-item caregiver-rated questionnaire that assesses the frequency of agitation-related and disruptive behaviors in subjects with dementia. The scale contains 29 behaviors or items organized into four subscales: physically aggressive, physically non-aggressive, verbally aggressive, and verbally non-aggressive. The CMAI is administered by interviewing the caregiver and asking him or her to rate the frequency with which the subject manifests each behavior using a seven-point scale: 1=never (better outcome), 7=several times an hour (worse outcome). The CMAI total score is the sum of the scores for all of the items in the CMAI. CMAI total scores range from a minimum of 29 (better outcome) to a maximum of 203 (worse outcome).
+Eligibility
Sex: All, ages: 65 Years to 90 Years
Key Inclusion Criteria:
* Diagnosis of probable Alzheimer's disease (AD) based on the 2011 National Institute on Aging-Alzheimer Association (NIA-AA) criteria.
* Diagnosis of clinically signification agitation resulting from probable AD according to the International Psychogeriatric Association (IPA) provisional definition of agitation.
Exclusion Criteria:
* Patient has dementia predominantly of non-Alzheimer's type.
* Unable to comply with study procedures.
* Medically inappropriate for study participation in the opinion of the investigator.
+Posted results
Participant flow
| Milestone | AXS-05 | Bupropion | Placebo |
|---|
| Started | 159 | 49 | 158 |
| Safety population | 159 | 49 | 158 |
| Mitt population | 152 | 49 | 156 |
| Completed | 137 | 48 | 136 |
| Not completed | 22 | 1 | 22 |
Outcome results
- Change in CMAI Total Score (Primary), Mean, score on a scale: AXS-05 -15.4 +/- 1.25; Bupropion -10.0 +/- 3.02; Placebo -11.5 +/- 1.10 (p 0.010)
Adverse events
Time frame: Adverse events were collected from the Baseline visit through 30 days after the last study visit (up to 10 weeks).
| Arm | Deaths | Serious adverse events | Other adverse events |
|---|
| AXS-05 | 0/159 (0.0%) | 5/159 (3.1%) | 33/159 (20.8%) |
| Bupropion | 1/49 (2.0%) | 4/49 (8.2%) | 17/49 (34.7%) |
| Placebo | 1/158 (0.6%) | 9/158 (5.7%) | 24/158 (15.2%) |
Serious adverse events by term
| Term | Organ system | AXS-05 | Bupropion | Placebo |
|---|
| Abdominal discomfort | Gastrointestinal disorders | 0/159 | 1/49 | 0/158 |
| Abdominal pain | Gastrointestinal disorders | 0/159 | 1/49 | 0/158 |
| Oedema peripheral | General disorders | 0/159 | 0/49 | 1/158 |
| Staphylococcal infection | Infections and infestations | 1/159 | 0/49 | 0/158 |
| Urinary tract infection | Infections and infestations | 0/159 | 1/49 | 1/158 |
| Fall | Injury, poisoning and procedural complications | 1/159 | 0/49 | 0/158 |
| Road traffic accident | Injury, poisoning and procedural complications | 0/159 | 0/49 | 1/158 |
| Dehydration | Metabolism and nutrition disorders | 0/159 | 0/49 | 1/158 |
| Hyperglycaemia | Metabolism and nutrition disorders | 1/159 | 0/49 | 0/158 |
| Adenocarcinoma gastric | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/159 | 0/49 | 1/158 |
| Transitional cell carcinoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/159 | 0/49 | 0/158 |
| Dementia | Nervous system disorders | 0/159 | 1/49 | 0/158 |
| Dementia Alzheimer's type | Nervous system disorders | 1/159 | 0/49 | 1/158 |
| Syncope | Nervous system disorders | 0/159 | 0/49 | 1/158 |
| Transient ischaemic attack | Nervous system disorders | 0/159 | 0/49 | 1/158 |
| Delirium | Psychiatric disorders | 0/159 | 0/49 | 1/158 |
Other adverse events by term
| Term | Organ system | AXS-05 | Bupropion | Placebo |
|---|
| Diarrhea | Gastrointestinal disorders | 7/159 | 3/49 | 7/158 |
| Fatigue | General disorders | 3/159 | 5/49 | 2/158 |
| Fall | Injury, poisoning and procedural complications | 4/159 | 7/49 | 3/158 |
| Dizziness | Nervous system disorders | 10/159 | 5/49 | 5/158 |
| Headache | Nervous system disorders | 6/159 | 3/49 | 4/158 |
| Somnolence | Nervous system disorders | 13/159 | 2/49 | 5/158 |
| Insomnia | Psychiatric disorders | 1/159 | 3/49 | 3/158 |
+Locations (78)
| Facility | City | Country | Status |
|---|
| Axsome Study Site | Gilbert, Arizona | United States | |
| Axsome Study Site | Phoenix, Arizona | United States | |
| Axsome study site | Scottsdale, Arizona | United States | |
| Axsome study site | Scottsdale, Arizona | United States | |
| Axsome Study Site | Tucson, Arizona | United States | |
| Axsome Study Site | Little Rock, Arkansas | United States | |
| Axsome study site | Canoga Park, California | United States | |
| Axsome study site | Costa Mesa, California | United States | |
| Axsome study site | Fresno, California | United States | |
| Axsome study site | Long Beach, California | United States | |
| Axsome study site | Long Beach, California | United States | |
| Axsome Study Site | Los Alamitos, California | United States | |
| Axsome study site | Riverside, California | United States | |
| Axsome study site | Sacramento, California | United States | |
| Axsome study site | Santa Ana, California | United States | |
| Axsome Study Site | Santa Clarita, California | United States | |
| Axsome study site | Sherman Oaks, California | United States | |
| Axsome study site | Simi Valley, California | United States | |
| Axsome study site | Temecula, California | United States | |
| Axsome study site | Ventura, California | United States | |
| Axsome Study Site | Colorado Springs, Colorado | United States | |
| Axsome study site | Cromwell, Connecticut | United States | |
| Axsome study site | New London, Connecticut | United States | |
| Axsome Study Site | Apopka, Florida | United States | |
| Axsome study site | Boca Raton, Florida | United States | |
| Axsome study site | Boynton Beach, Florida | United States | |
| Axsome Study Site | Coconut Creek, Florida | United States | |
| Axsome Study Site | Greenacres City, Florida | United States | |
| Axsome study site | Hallandale, Florida | United States | |
| Axsome study site | Hialeah, Florida | United States | |
| Axsome Study Site | Lake City, Florida | United States | |
| Axsome study site | Miami, Florida | United States | |
| Axsome study site | Miami, Florida | United States | |
| Axsome Study Site | Orlando, Florida | United States | |
| Axsome study site | Pensacola, Florida | United States | |
| Axsome Study Site | Port Orange, Florida | United States | |
| Axsome study site | Spring Hill, Florida | United States | |
| Axsome study site | Tampa, Florida | United States | |
| Axsome study site | Tampa, Florida | United States | |
| Axsome study site | Atlanta, Georgia | United States | |
| Axsome study site | Decatur, Georgia | United States | |
| Axsome Study Site | Honolulu, Hawaii | United States | |
| Axsome study site | Boise, Idaho | United States | |
| Axsome Study Site | Flossmoor, Illinois | United States | |
| Axsome study site | Avon, Indiana | United States | |
| Axsome Study Site | Overland Park, Kansas | United States | |
| Axsome Study Site | Topeka, Kansas | United States | |
| Axsome study site | Baton Rouge, Louisiana | United States | |
| Axsome Study Site | Lake Charles, Louisiana | United States | |
| Axsome Study Site | Hattiesburg, Mississippi | United States | |
| Axsome study site | Chesterfield, Missouri | United States | |
| Axsome Study Site | St Louis, Missouri | United States | |
| Axsome study site | Las Vegas, Nevada | United States | |
| Axsome Study Site | Las Vegas, Nevada | United States | |
| Axsome Study Site | Princeton, New Jersey | United States | |
| Axsome study site | Toms River, New Jersey | United States | |
| Axsome Study Site | Albany, New York | United States | |
| Axsome study site | Brooklyn, New York | United States | |
| Axsome study site | New York, New York | United States | |
| Axsome study site | New York, New York | United States | |
| Axsome study site | Staten Island, New York | United States | |
| Axsome Study Site | Charlotte, North Carolina | United States | |
| Axsome study site | Charlotte, North Carolina | United States | |
| Axsome Study Site | Winston-Salem, North Carolina | United States | |
| Axsome study site | Cincinnati, Ohio | United States | |
| Axsome Study Site | Dayton, Ohio | United States | |
| Axsome study site | Shaker Heights, Ohio | United States | |
| Axsome Study Site | Oklahoma City, Oklahoma | United States | |
| Axsome study site | DeSoto, Texas | United States | |
| Axsome Study Site | McKinney, Texas | United States | |
| Axsome study site | Wichita Falls, Texas | United States | |
| Axsome study site | Orem, Utah | United States | |
| Axsome Study Site | Charlottesville, Virginia | United States | |
| Axsome Study Site | Richmond, Virginia | United States | |
| Axsome study site | Bellevue, Washington | United States | |
| Axsome Study Site | Everett, Washington | United States | |
| Axsome study site | Spokane, Washington | United States | |
| Axsome study site | Caulfield, Melbourne, Victoria | Australia | |
+Study documents