Phase 1/2a Intravenous and Subcutaneous Oligomer-Specific Antibody KHK6640 in Mild to Moderate Alzheimer’s Disease - 21/11/24

Doi : 10.14283/jpad.2024.2 
Marc Cantillon 1, 4, 5, , N. Andreasen 2, N. Prins 3
1 Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA 
2 Department of Neurobiology, Karolinska Institute, Stockholm, Sweden 
3 Brain Research Center, Amsterdam, The Netherlands 
4 Cerecin, Denver, Colorado, USA 
5 125 Paterson St, 08901, New Brunswick, New Jersey, USA 

a marccantillonmd@gmail.com marccantillonmd@gmail.com

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Abstract

Background

KHK6640 is a novel humanized anti-amyloid beta oligomer-specific antibody. Both KHK6640 and the mouse parent antibody E64 have demonstrated high potency and efficacy for cognitive improvement in several rodent Alzheimer’s disease models, including an anti-amyloid beta injection mouse model and in age-matched double transgenic littermates. The favorable safety and pharmacokinetic profiles of KHK6640 reported in preclinical studies warrant clinical trials in Alzheimer’s disease patients.

Objectives

We evaluated the safety, pharmacokinetics, and efficacy of intravenous and subcutaneous oligomer-specific antibody KHK6640 in treating patients with prodromal Alzheimer’s disease or mild to moderate Alzheimer’s disease. DESIGN: Phase I/2a, multicenter, randomized, double-blind, placebo-controlled trial.

Setting

Nine sites in Europe participated in this clinical trial.

Participants

97 patients with prodromal Alzheimer’s disease or mild to moderate Alzheimer’s disease.

Intervention

Single and multiple ascending intravenous and subcutaneous doses of KHK6640 in doses ranging from 0.1 mg/kg to 20 mg/kg or placebo was administered to patients monthly for six months.

Measurements

Primary outcomes were safety including amyloid-related imaging abnormalities for edema and hemorrhage, assessed with magnetic resonance imaging. Plasma and cerebrospinal fluid samples were analyzed to investigate pharmacokinetics and KHK6640 effects on biomarkers. Cognition, brain glucose metabolism and amyloid load were exploratory outcomes.

Results

No amyloid-related imaging abnormalities for edema were observed. Amyloid-related imaging abnormalities for hemorrhage were comparable to that of placebo and population background. KHK6640 exposure was approximately dose-equivalent, with a serum terminal elimination half-life of approximately 19 days. KHK6640 pharmacokinetics in serum and cerebrospinal fluid, including cerebrospinal fluid oligomers trapped by the antibody were dose related. Positive trends seen in the positron emission tomography brain glucose metabolism and amyloid load, cerebrospinal tau but cognition assessments were inconclusive, due to low numbers.

Conclusions

KHK6640 was well-tolerated across all doses, without any amyloid-related imaging abnormalities for edema, and amyloid-related imaging abnormalities for hemorrhage was as population background. The demonstrated dose-response of specific target biomarkers provides dosing guidance on dose and administration method selection for further clinical development.

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Key words : Alzheimer’s disease, Amyloid-β, Oligomer, Immunotherapy, KHK6640


Mappa


 Disclosures: MC received consulting fees from Kyowa, CogRx, AlgRx, Acadia, Novartis, Jocasta and Schering. NDP consulting fees from Aribio, and Amylyx. He was a site PI on this KHK6640 trial sand co-PI of Fuji Film Toyama Chemical trial and received speaker fees from Biogen. NDP served on the DSMB of Abbvie’s M15-566 trial. NA He was a site PI on this KH6640 trial, and received consulting fees from Janssen, Lily, Eisai and Novaris.


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