AC Immune Announces Late-Breaker Presentation by Genentech at CTAD on Phase 2 Lauriet Study of Semorinemab in Mild-to-Moderate Alzheimer’s Disease
Analysis of the broader mITT population is consistent with the previously reported success in meeting one of the two co-primary endpoints (ADAS-Cog11) with statistically significant reduction in the rate of cognitive decline vs. placebo
Benefit of semorinemab on ADAS-Cog11 in all prespecified subgroups was consistent with the treatment effect in the overall cohort, regardless of disease severity, baseline Tau load, and ApoE carrier status
Benefit on cognition was driven primarily by the memory domain subcomponent of ADAS-Cog11, a core feature of AD
Further analyses evaluating semorinemab’s effects on cerebrospinal fluid (CSF) biomarkers are ongoing as is the open label portion of the study
Previously announced topline results showed that the trial met one of its two co-primary endpoints by demonstrating a statistically significant 43.6% reduction in the rate of cognitive decline with semorinemab compared to placebo (p<0.0025), as measured by the Alzheimer’s Disease Assessment Scale, Cognitive Subscale, 11-item Version (ADAS-Cog11) at week 49 in a prespecified modified intent to treat (mITT) population. The second co-primary endpoint, Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), was not met nor the secondary efficacy endpoints including the Mini-Mental State Examination (MMSE) or the Clinical Dementia Rating-Sum of Boxes (CDR-SB). The prespecified mITT population consisted of 204 patients with mild-to-moderate AD who had missed <1 dose of study drug.
The full topline data presented at CTAD show that semorinemab’s treatment effect on ADAS-Cog11 was confirmed in a larger (n=241) mITT population that included all trial participants who had received >1 dose of study drug and had at least one post-baseline ADAS-Cog11 assessment. Data from this population show a 42.2% reduction in the rate of cognitive decline with semorinemab compared to placebo (p=0.0008), as measured by ADAS-Cog11. This treatment effect was observed consistently in prespecified subgroups based on disease severity, baseline Tau load, and ApoE carrier status. ADAS-Cog11 domain analyses show that semorinemab’s treatment effect was driven predominantly by the memory domain, which is a core feature of AD. As previously announced, no significant treatment effect was observed on the trial’s other co-primary endpoint or the secondary endpoints.
Biomarker analyses reported during the CTAD presentation included Tau positron emission tomography (PET) scans and plasma Tau levels. The biomarker dataset from cerebrospinal fluid (CSF) samples is not available at this time. There was no identifiable treatment effect on global or regional Tau distribution as assessed by PET analysis. Analysis of plasma Tau showed a pronounced increase of plasma Tau levels with semorinemab treatment, which is suggestive of peripheral tau binding and similar to previous studies. Levels of semorinemab in plasma were in the expected range as was the ratio of the level of semorinemab in the CSF to that in plasma (mean 0.29%).
Safety data from the trial confirmed that semorinemab is well tolerated with an acceptable safety profile, consistent with previous data. Adverse events and serious adverse events were well balanced between the two treatment arms, and there were no unanticipated safety signals. The trial’s open label extension remains ongoing.
Prof. Johannes Streffer, CMO of
About the Lauriet study
Lauriet is a double-blind, placebo-controlled, randomized Phase 2 trial assessing semorinemab, an investigational anti-Tau monoclonal antibody, compared to placebo in 272 adult participants with mild-to-moderate AD across 43 study centers globally. The co-primary endpoints of the study evaluated the change from baseline at week 49 in cognition as measured by the Alzheimer’s Disease Assessment Scale, Cognitive Subscale, 11-Item Version (ADAS-Cog11) and the change from baseline in activities of daily living as measured by the Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale. Secondary endpoints evaluated cognitive and functional measures including changes from baseline as measured by the Clinical Dementia Rating-Sum of Boxes (CDR-SB) and the Mini-Mental State Examination (MMSE). The Lauriet open label extension is ongoing. For more information, visit ClinicalTrials.gov (NCT03828747).
Semorinemab is an investigational monoclonal anti-tau antibody that targets the N-terminal portion of the Tau protein, and is designed to bind to Tau and slow its spread between neurons. In tauopathies such as AD, Tau misfolds and forms tangles, which cause cell damage and ultimately neuronal death. It is hypothesized that abnormal Tau protein then spreads between neurons, gradually involving more areas of the brain, and leading to clinical disease progression. Tau-targeting antibody therapies are designed to slow or stop this process of tau spread. Semorinemab is being developed by
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Source: AC Immune SA