A Phase 2 interventional study of LY3154207 and Placebo in Lewy Body Dementia, sponsored by Eli Lilly and Company. Completed at 77 sites in 3 countries. Open to participants aged 40 Years to 85 Years. Per ClinicalTrials.gov, last updated 2021-07-23.
Sponsored by Eli Lilly and Company · Phase 2, Interventional, and Treatment
A randomized placebo-controlled trial to evaluate the safety and efficacy of three doses of study drug LY3154207 treated for 12 weeks in participants with mild-to-moderate dementia associated with LBD (PDD or DLB).
Have a blood pressure (BP) or pulse rate at screening and randomization, as determined by three sequential BP/pulse rate measurements in a seated position:
Participants \<60 years old:
Participants ≥60 years old:
Exclusion Criteria:
Have a serious or unstable medical illness, other than idiopathic LBD (PDD or DLB), including cardiovascular, hepatic, respiratory, hematologic, endocrinologic, neurologic, or renal disease, or clinically significant laboratory or electrocardiogram (ECG) abnormality as determined by the investigator.
Participants received placebo administered orally once a day (QD).
Drug: Placebo
Participants received 10 mg LY3154207 administered orally QD.
Drug: LY3154207
Participants received 30 mg LY3154207 administered orally QD.
Drug: LY3154207
Participants received 75 mg LY3154207 administered orally QD.
Drug: LY3154207
Administered orally.
Administered orally.
Change From Baseline in the Continuity of Attention (CoA) Composite Score of the Cognitive Drug Research Computerized Cognition Battery (CDR-CCB)
The CDR-CCB tests is designed to evaluate the effects of novel compounds on the quality of cognitive functioning which includes tests of attention (simple and choice reaction time, digit vigilance), working memory (spatial and numeric) and episodic memory (word recognition, picture recognition). Continuity of attention measures speed and accuracy and is calculated from 3 attentional tasks on the CDR computerized battery tests. For continuity of attention, the score range is -999 to 35. A high score reflects someone able to keep his/her mind on a single task for a prolonged period. A negative change from baseline reflects impairment compared to baseline. Data presented are model-based bayesian posterior mean response rates with 95% credible interval.
Time frame: Baseline, Week 12
Change From Baseline on the Alzheimer's Disease Cooperative Study-Clinician Global Impression of Change (ADCS-CGIC) Score
The ADCS-CGIC is a validated categorical measure of change in a participant's clinical condition between baseline and follow-up visits; it is used to assess global clinical status. The ADCS CGIC score is based on direct examination of the participant and an interview of the caregiver. The rater should refer to the baseline ADCS-CGIC worksheets in making a rating. A skilled and experienced clinician who is blinded to treatment assignment rates the participant on a 7-point Likert scale, ranging from 1 (marked improvement) to 7 (marked worsening). 1= Very much better 2= Much better 3= A little better 4= Same 5= A little worse 6= Much worse 7= Very much worse. Least squares (LS) means were calculated using mixed model repeated measures adjusting for treatment + visit + treatment\*visit + age\*acheifl + age + concomitant use of acetylcholinesterase inhibitor (AChEI).
Time frame: Baseline, Week 12
Change From Baseline on the CDR-CCB Power of Attention (PoA) Composite Score
The PoA is a composite score derived from the CDR-CCB that measures the intensity of concentration (ability to focus attention): the faster the responses, the more processes are being brought to bear upon the task. Power of attention is calculated from the sum of three cognitive function speed tests: simple reaction time, choice reaction time and the speed of detections in digit vigilance task. Score ranges from 450 milliseconds - 61500 milliseconds. A low score reflects a fast reaction time and a high intensity of concentration. A positive change from baseline reflects impairment compared to the baseline assessment Values are calculated by a computer and higher scores mean better outcome. LS means were calculated using mixed model repeated measures adjusting for baseline total Score + treatment + visit + treatment\*Visit + visit\*baseline total Score + age + concomitant use of AChEI.
Time frame: Baseline, Week 12
Change From Baseline in the 13-item Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog13)
The ADAS is a rater administered instrument that was designed to assess the severity of the dysfunction in the cognitive and noncognitive behaviors characteristic of persons with AD. The cognitive subscale of the ADAS that was used as the primary efficacy measure consists of 13 items assessing areas of cognitive function most typically impaired in AD: orientation, verbal memory, language, praxis, delayed free recall, digit cancellation. The ADAS--Cog13 scale ranges from 0 to 85. Higher scores indicate greater disease severity. LS means were calculated using mixed model repeated measures adjusting for baseline total Score + treatment + visit + treatment\*Visit + visit\*baseline total Score + age + concomitant use of AChEI.
Time frame: Baseline, Week 12
Change From Screening in the Montreal Cognitive Assessment (MoCA) Score
The Montreal Cognitive Assessment is a screening tool for global cognitive function with a total score ranging from 0 to 30 units on a scale. The MoCA is divided into 7 subscores (maximum possible subscore): visuospatial/executive (5 points), naming (3 points), memory (5 points for delayed recall), attention (6 points), language (3 points), abstraction (2 points) and orientation to time and place (6 points). A score of 26-30 is normal. A score less than 26 is considered as mild cognitive impairment. Higher values represent a better outcome. LS means were calculated using mixed model repeated measures adjusting for baseline total Score + treatment + visit + treatment\*Visit + visit\*baseline total Score + age + concomitant use of AChEI.
Time frame: Screening (Baseline), Week 12
Change From Baseline in the Neuropsychiatric Inventory (NPI) Total Score and Individual Item Scores
The NPI is a condition-specific measure designed to assess neuropsychiatric disturbances in people with Alzheimer Disease (AD),as well as other related dementing disorders.It assesses 12 behavioral disturbances,namely delusions,hallucinations,depression/dysphoria,anxiety,agitation/aggression,elation/euphoria,disinhibition,irritability/lability,apathy, aberrant motor activity, night-time behavior disturbances,and appetite/eating abnormalities.The frequency scored from 0 (never) to 4 (very frequently).The Severity scored from 0 (none) to 3 (marked).The domain score is obtained by multiplying frequency and severity scores.The total NPI score is sum total of all of individual domain scores (0-144).Higher score indiciates more abnormal behaviors.LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
Time frame: Baseline, Week 12
Change From Baseline in the Epworth Sleepiness Scale (ESS) Score
The ESS is a self-administered questionnaire with 8 questions. Each activity is scored on a scale ranging from 0-3, with 0 = would never fall asleep, and 3 = high chance of falling asleep. The total score ranges from 0-24, with a higher number representing an increased propensity for sleepiness. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
Time frame: Baseline, Week 12
Change From Baseline in the Movement Disorder Society's Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Total Score (Sum of Parts I-III)
Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) retains the four-scale structure with a reorganization of the various subscale; (Part I; 13 items) non-motor experiences of daily living, (Part II; 13) motor experiences of daily living, (Part III; 34) motor examination, and (Part IV; 6) motor complications. The scale range for MDS-UPDRS MDS-UPDRS Part I (non-motor experiences of daily living) and Part II (motor experiences of daily living) scores, total score was 0-52, with higher scores reflecting greater severity. For MDS-UPDRS Part III (motor examination) scores, the scale range for Part III Total Score was 0-132, with higher scores reflecting greater severity. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI + levodopa equivalency dose (LED).
Time frame: Baseline, Week 12
Change From Baseline in the Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15) Total Score
The PDAQ-15 is a 15-item measure of instrumental activities of daily living (IADL) that are impacted by cognitive impairment in participants with parkinson's disease dementia (PDD). The PDAQ-15 is derived from the original 50-item scale, which has demonstrated test-retest reliability, construct validity, sensitivity, and specificity to Parkinson's disease (PD) cognitive impairment and the questionnaire is completed by the caregiver. The score range is 0 to 60, with higher scores indicating better function. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
Time frame: Baseline, Week 12
Change From Baseline in Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency Test Score
The DKEFS verbal fluency category switching test measures letter fluency, category fluency, and category switching. The score is the total number of correct words generated during each of the 60-second trials within the three conditions of the test. Scales scores vary from 0 min to N/A max (no concrete maximum). Higher score = higher ability in language processing. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
Time frame: Baseline, Week 12
Change in MDS-UPDRS Parts II (Motor Experiences of Daily Living) and III (Motor Exam) From Baseline to Week 12
Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) retains the four-scale structure with a reorganization of the various subscale; (Part I; 13 items) non-motor experiences of daily living, (Part II; 13) motor experiences of daily living, (Part III; 34) motor examination, and (Part IV; 6) motor complications. The scale range for Part II total score was 0-52, with higher scores reflecting greater severity. For MDS-UPDRS Part III (motor examination) scores, the scale range for Part III Total Score was 0-132, with higher scores reflecting greater severity. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI + LED dose.
Time frame: Baseline, Week 12
Number of Participants Who Met the Potentially Clinically Significant Vital Signs Criteria at 3 Consecutive Time Points at Visit 3
Number of participants who met the potentially clinically significant vital signs criteria at 3 consecutive time points at visit 3 were reported. In the event of an unacceptable rate of participants meeting day 1 stopping rules at other doses, adjustments to doses may be made for subsequently randomized participants at the discretion of the internal assessment committee (IAC).
Time frame: Visit 3 (Day 1 stopping rules)
Change From Baseline in Clinic Blood Pressure (BP) to 8 Hours Post Dose
Systolic and diastolic blood pressure obtained from ambulatory blood pressure monitoring (ABPM) was evaluated. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
Time frame: Baseline, 8 Hours Post Dose
Change From Baseline in Pulse Rate to 8 Hours Post Dose
Pulse rate obtained from ABPM was evaluated. Pulse rate measurements will occur at time 0 and every 60 minutes thereafter up to 8 hours and pulse rate measurements will be done in the seated position only. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
Time frame: Baseline, 8 Hours Post Dose
Change From Baseline In-clinic BP to Week 12
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) obtained from ambulatory blood pressure monitoring (ABPM) was evaluated. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
Time frame: Baseline, Week 12
Change From Baseline in Pulse Rate to Week 12
Pulse rate obtained from ABPM was evaluated. Pulse rate measurements will occur at time 0 and every 60 minutes thereafter up to 8 hours and pulse rate measurements will be done in the seated position only. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
Time frame: Baseline, Week 12
Change in Home Blood Pressure Measurement (HBPM), for SBP, DBP From Baseline to Week 12
Systolic and diastolic blood pressure obtained from ABPM was evaluated. Participants followed a standardized measurement protocol for home blood pressure measurement, involving three consecutive measurements, taken one minute apart after a five-minute seated resting period. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
Time frame: Baseline, Week 12
Change in HBPM for Pulse Rate From Baseline to Week 12
Pulse rate obtained from ABPM was evaluated. Pulse rate measurements will occur at time 0 and every 60 minutes thereafter up to week 12 and pulse rate measurements will be done in the seated position only. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
Time frame: Baseline, Week 12
Change From Baseline in the Physician Withdrawal Checklist (PWC)-20 Total Score From Week 12 to In-Clinic Follow-up Visit
The Penn PWC-20 is a 20-item checklist originally developed to assess the severity of withdrawal symptoms in anxiolytic medication discontinuation. To determine a change in the Intensity of Discontinuation symptoms, the PWC-20 administered by a trained clinician/rater to assess the intensity of discontinuation symptoms. The assessment has 20 items evaluated to detect withdrawal symptoms. Symptoms are rated on a scale of 0-3. 0. Not present 1. Mild 2. Moderate 3. Severe Total scores range from 0 to 60 with higher scores indicating more severe symptoms.Least squares (LS) means were calculated using mixed model analysis of covariance (ANCOVA) adjusting for predose, sequence, period, day, time, treatment, and treatment\*time as fixed effects and participant within sequence and treatment as random effect.
Time frame: Week 12, Follow-up (2 Weeks after Week 12)
Pharmacokinetics (PK): Steady-State Trough Plasma Concentrations of LY3154207
Trough measurements of LY3154207 concentration in plasma at Day 1, Day 7, Day 14, Day 42 and Day 84 was evaluated.
Time frame: Day 1: 1-3 hours post-dose; Day 7, Day 14 and Day 42: post-dose; Day 84: pre-dose
| Milestone | Placebo | 10 Milligram (mg) LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Started | 86 | 86 | 85 | 87 |
| Received at least one dose of study drug | 86 | 86 | 85 | 87 |
| Completed | 79 | 78 | 66 | 60 |
| Not completed | 7 | 8 | 19 | 27 |
| Withdrew: Adverse event | 2 | 2 | 6 | 6 |
| Withdrew: Death | 0 | 0 | 1 | 1 |
| Withdrew: Lost to follow-up | 1 | 2 | 0 | 0 |
| Withdrew: Sponsor decision | 1 | 0 | 1 | 8 |
| Withdrew: Physician decision | 0 | 0 | 2 | 4 |
| Withdrew: Progressive disease | 0 | 0 | 1 | 0 |
| Withdrew: Protocol violation | 1 | 0 | 2 | 3 |
| Withdrew: Withdrawal due to assessment committee decision | 0 | 0 | 0 | 2 |
| Withdrew: Withdrawal by subject | 2 | 4 | 5 | 2 |
| Withdrew: Withdrawal due to caregiver circumstances | 0 | 0 | 1 | 1 |
The CDR-CCB tests is designed to evaluate the effects of novel compounds on the quality of cognitive functioning which includes tests of attention (simple and choice reaction time, digit vigilance), working memory (spatial and numeric) and episodic memory (word recognition, picture recognition). Continuity of attention measures speed and accuracy and is calculated from 3 attentional tasks on the CDR computerized battery tests. For continuity of attention, the score range is -999 to 35. A high score reflects someone able to keep his/her mind on a single task for a prolonged period. A negative change from baseline reflects impairment compared to baseline. Data presented are model-based bayesian posterior mean response rates with 95% credible interval.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in the Continuity of Attention (CoA) Composite Score of the Cognitive Drug Research Computerized Cognition Battery (CDR-CCB) | 1.04 (-0.339 to 2.373) | 0.15 (-1.206 to 1.496) | 0.96 (-0.448 to 2.362) | 0.26 (-1.310 to 1.801) |
The ADCS-CGIC is a validated categorical measure of change in a participant's clinical condition between baseline and follow-up visits; it is used to assess global clinical status. The ADCS CGIC score is based on direct examination of the participant and an interview of the caregiver. The rater should refer to the baseline ADCS-CGIC worksheets in making a rating. A skilled and experienced clinician who is blinded to treatment assignment rates the participant on a 7-point Likert scale, ranging from 1 (marked improvement) to 7 (marked worsening). 1= Very much better 2= Much better 3= A little better 4= Same 5= A little worse 6= Much worse 7= Very much worse. Least squares (LS) means were calculated using mixed model repeated measures adjusting for treatment + visit + treatment\*visit + age\*acheifl + age + concomitant use of acetylcholinesterase inhibitor (AChEI).
| Score on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline on the Alzheimer's Disease Cooperative Study-Clinician Global Impression of Change (ADCS-CGIC) Score | 4.0 ± 0.13 | 3.8 ± 0.12 | 3.3 ± 0.13 | 3.1 ± 0.15 |
The PoA is a composite score derived from the CDR-CCB that measures the intensity of concentration (ability to focus attention): the faster the responses, the more processes are being brought to bear upon the task. Power of attention is calculated from the sum of three cognitive function speed tests: simple reaction time, choice reaction time and the speed of detections in digit vigilance task. Score ranges from 450 milliseconds - 61500 milliseconds. A low score reflects a fast reaction time and a high intensity of concentration. A positive change from baseline reflects impairment compared to the baseline assessment Values are calculated by a computer and higher scores mean better outcome. LS means were calculated using mixed model repeated measures adjusting for baseline total Score + treatment + visit + treatment\*Visit + visit\*baseline total Score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline on the CDR-CCB Power of Attention (PoA) Composite Score | 64.14 ± 48.681 | -6.57 ± 48.396 | -42.88 ± 49.804 | -59.58 ± 54.379 |
The ADAS is a rater administered instrument that was designed to assess the severity of the dysfunction in the cognitive and noncognitive behaviors characteristic of persons with AD. The cognitive subscale of the ADAS that was used as the primary efficacy measure consists of 13 items assessing areas of cognitive function most typically impaired in AD: orientation, verbal memory, language, praxis, delayed free recall, digit cancellation. The ADAS--Cog13 scale ranges from 0 to 85. Higher scores indicate greater disease severity. LS means were calculated using mixed model repeated measures adjusting for baseline total Score + treatment + visit + treatment\*Visit + visit\*baseline total Score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in the 13-item Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog13) | -0.71 ± 0.707 | -1.11 ± 0.691 | -1.42 ± 0.720 | -1.59 ± 0.799 |
The Montreal Cognitive Assessment is a screening tool for global cognitive function with a total score ranging from 0 to 30 units on a scale. The MoCA is divided into 7 subscores (maximum possible subscore): visuospatial/executive (5 points), naming (3 points), memory (5 points for delayed recall), attention (6 points), language (3 points), abstraction (2 points) and orientation to time and place (6 points). A score of 26-30 is normal. A score less than 26 is considered as mild cognitive impairment. Higher values represent a better outcome. LS means were calculated using mixed model repeated measures adjusting for baseline total Score + treatment + visit + treatment\*Visit + visit\*baseline total Score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Screening in the Montreal Cognitive Assessment (MoCA) Score | 0.90 ± 0.432 | 1.34 ± 0.423 | 1.12 ± 0.448 | 1.84 ± 0.496 |
The NPI is a condition-specific measure designed to assess neuropsychiatric disturbances in people with Alzheimer Disease (AD),as well as other related dementing disorders.It assesses 12 behavioral disturbances,namely delusions,hallucinations,depression/dysphoria,anxiety,agitation/aggression,elation/euphoria,disinhibition,irritability/lability,apathy, aberrant motor activity, night-time behavior disturbances,and appetite/eating abnormalities.The frequency scored from 0 (never) to 4 (very frequently).The Severity scored from 0 (none) to 3 (marked).The domain score is obtained by multiplying frequency and severity scores.The total NPI score is sum total of all of individual domain scores (0-144).Higher score indiciates more abnormal behaviors.LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Total Score | -1.62 ± 0.868 | -2.24 ± 0.852 | -3.32 ± 0.920 | -2.37 ± 1.005 |
| Delusions | 0.13 ± 0.124 | -0.04 ± 0.121 | -0.25 ± 0.130 | 0.02 ± 0.144 |
| Hallucinations | -0.09 ± 0.131 | -0.11 ± 0.128 | -0.44 ± 0.137 | -0.38 ± 0.151 |
| Agitation/Aggression | 0.04 ± 0.130 | -0.06 ± 0.126 | -0.02 ± 0.135 | -0.20 ± 0.148 |
| Depression/Dysphoria | -0.22 ± 0.155 | -0.16 ± 0.151 | -0.33 ± 0.164 | -0.35 ± 0.179 |
| Anxiety | -0.15 ± 0.141 | -0.15 ± 0.138 | 0.07 ± 0.149 | -0.22 ± 0.163 |
| Elation/Euphoria | 0.14 ± 0.069 | 0.03 ± 0.068 | 0.00 ± 0.074 | 0.06 ± 0.080 |
| Apathy/Indifference | -0.36 ± 0.191 | -0.81 ± 0.186 | -0.68 ± 0.202 | -0.55 ± 0.220 |
| Disinhibition | -0.13 ± 0.082 | -0.11 ± 0.080 | 0.21 ± 0.087 | -0.09 ± 0.095 |
| Irritability/Lability | -0.19 ± 0.130 | -0.43 ± 0.127 | -0.25 ± 0.137 | 0.02 ± 0.150 |
| Aberrant Motor Behavior | -0.13 ± 0.106 | 0.03 ± 0.103 | -0.23 ± 0.112 | -0.09 ± 0.122 |
| Sleep/Nighttime Behavior Disorders | -0.19 ± 0.287 | 0.00 ± 0.278 | -0.58 ± 0.302 | -0.30 ± 0.329 |
| Appetite/Eating Disorders | -0.37 ± 0.270 | -0.47 ± 0.263 | -0.80 ± 0.284 | -0.27 ± 0.311 |
The ESS is a self-administered questionnaire with 8 questions. Each activity is scored on a scale ranging from 0-3, with 0 = would never fall asleep, and 3 = high chance of falling asleep. The total score ranges from 0-24, with a higher number representing an increased propensity for sleepiness. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in the Epworth Sleepiness Scale (ESS) Score | -0.33 ± 0.437 | -1.04 ± 0.426 | -1.21 ± 0.452 | -1.92 ± 0.500 |
Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) retains the four-scale structure with a reorganization of the various subscale; (Part I; 13 items) non-motor experiences of daily living, (Part II; 13) motor experiences of daily living, (Part III; 34) motor examination, and (Part IV; 6) motor complications. The scale range for MDS-UPDRS MDS-UPDRS Part I (non-motor experiences of daily living) and Part II (motor experiences of daily living) scores, total score was 0-52, with higher scores reflecting greater severity. For MDS-UPDRS Part III (motor examination) scores, the scale range for Part III Total Score was 0-132, with higher scores reflecting greater severity. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI + levodopa equivalency dose (LED).
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in the Movement Disorder Society's Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Total Score (Sum of Parts I-III) | -0.18 ± 2.112 | -6.58 ± 1.941 | -7.56 ± 2.084 | -10.77 ± 2.287 |
The PDAQ-15 is a 15-item measure of instrumental activities of daily living (IADL) that are impacted by cognitive impairment in participants with parkinson's disease dementia (PDD). The PDAQ-15 is derived from the original 50-item scale, which has demonstrated test-retest reliability, construct validity, sensitivity, and specificity to Parkinson's disease (PD) cognitive impairment and the questionnaire is completed by the caregiver. The score range is 0 to 60, with higher scores indicating better function. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in the Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15) Total Score | -0.32 ± 0.976 | 0.23 ± 0.961 | 2.09 ± 1.018 | 1.24 ± 1.128 |
The DKEFS verbal fluency category switching test measures letter fluency, category fluency, and category switching. The score is the total number of correct words generated during each of the 60-second trials within the three conditions of the test. Scales scores vary from 0 min to N/A max (no concrete maximum). Higher score = higher ability in language processing. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency Test Score | -0.19 ± 0.280 | 0.44 ± 0.271 | 0.88 ± 0.292 | 0.30 ± 0.325 |
Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) retains the four-scale structure with a reorganization of the various subscale; (Part I; 13 items) non-motor experiences of daily living, (Part II; 13) motor experiences of daily living, (Part III; 34) motor examination, and (Part IV; 6) motor complications. The scale range for Part II total score was 0-52, with higher scores reflecting greater severity. For MDS-UPDRS Part III (motor examination) scores, the scale range for Part III Total Score was 0-132, with higher scores reflecting greater severity. LS means were calculated using mixed model repeated measures adjusting for baseline total score + treatment + visit + treatment\*visit + visit\*baseline total score + age + concomitant use of AChEI + LED dose.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Motor Experiences of Daily Living | 0.28 ± 0.656 | -1.45 ± 0.649 | -2.08 ± 0.700 | -3.22 ± 0.779 |
| Motor Exam | -0.12 ± 1.343 | -3.39 ± 1.240 | -3.40 ± 1.331 | -4.35 ± 1.434 |
Number of participants who met the potentially clinically significant vital signs criteria at 3 consecutive time points at visit 3 were reported. In the event of an unacceptable rate of participants meeting day 1 stopping rules at other doses, adjustments to doses may be made for subsequently randomized participants at the discretion of the internal assessment committee (IAC).
| Participants | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Number of Participants Who Met the Potentially Clinically Significant Vital Signs Criteria at 3 Consecutive Time Points at Visit 3 | 0 | 0 | 1 | 1 |
Systolic and diastolic blood pressure obtained from ambulatory blood pressure monitoring (ABPM) was evaluated. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
| millimeter of mercury (mmHg) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Sitting Systolic Blood Pressure | 9.8 ± 1.90 | 10.1 ± 1.89 | 10.4 ± 1.92 | 19.2 ± 1.87 |
| Sitting Diastolic Blood Pressure | 4.6 ± 0.99 | 4.9 ± 0.98 | 5.5 ± 1.00 | 8.1 ± 0.97 |
Pulse rate obtained from ABPM was evaluated. Pulse rate measurements will occur at time 0 and every 60 minutes thereafter up to 8 hours and pulse rate measurements will be done in the seated position only. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
| beats/min | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in Pulse Rate to 8 Hours Post Dose | -2.2 ± 0.94 | 0.2 ± 0.95 | 1.3 ± 0.95 | 6.4 ± 0.93 |
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) obtained from ambulatory blood pressure monitoring (ABPM) was evaluated. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
| millimeters of mercury (mmHg) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Sitting Systolic Blood Pressure | -1.2 ± 1.22 | 0.5 ± 1.19 | 0.1 ± 1.29 | 3.0 ± 1.38 |
| Sitting Diastolic Blood Pressure | -0.9 ± 0.71 | -1.0 ± 0.70 | -0.2 ± 0.75 | 0.3 ± 0.80 |
Pulse rate obtained from ABPM was evaluated. Pulse rate measurements will occur at time 0 and every 60 minutes thereafter up to 8 hours and pulse rate measurements will be done in the seated position only. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
| beats/min | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change From Baseline in Pulse Rate to Week 12 | -0.2 ± 0.67 | 0.3 ± 0.66 | 1.5 ± 0.71 | 2.6 ± 0.75 |
Systolic and diastolic blood pressure obtained from ABPM was evaluated. Participants followed a standardized measurement protocol for home blood pressure measurement, involving three consecutive measurements, taken one minute apart after a five-minute seated resting period. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
| mmHg | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Sitting Systolic Blood Pressure | -1.1 ± 2.52 | -8.2 ± 2.40 | 2.0 ± 2.58 | -2.2 ± 2.62 |
| Sitting Diastolic Blood Pressure | 1.5 ± 1.50 | -2.8 ± 1.45 | 1.0 ± 1.55 | -0.8 ± 1.58 |
Pulse rate obtained from ABPM was evaluated. Pulse rate measurements will occur at time 0 and every 60 minutes thereafter up to week 12 and pulse rate measurements will be done in the seated position only. LS means were calculated using mixed model repeated measures adjusting for baseline + treatment + visit + visit\*baseline + treatment\*visit.
| beats/min | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Change in HBPM for Pulse Rate From Baseline to Week 12 | 1.4 ± 1.52 | 1.4 ± 1.47 | 0.7 ± 1.59 | 0.8 ± 1.62 |
The Penn PWC-20 is a 20-item checklist originally developed to assess the severity of withdrawal symptoms in anxiolytic medication discontinuation. To determine a change in the Intensity of Discontinuation symptoms, the PWC-20 administered by a trained clinician/rater to assess the intensity of discontinuation symptoms. The assessment has 20 items evaluated to detect withdrawal symptoms. Symptoms are rated on a scale of 0-3. 0. Not present 1. Mild 2. Moderate 3. Severe Total scores range from 0 to 60 with higher scores indicating more severe symptoms.Least squares (LS) means were calculated using mixed model analysis of covariance (ANCOVA) adjusting for predose, sequence, period, day, time, treatment, and treatment\*time as fixed effects and participant within sequence and treatment as random effect.
| Units on a scale | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| Week 12 | -1.51 ± 0.670 | -0.53 ± 0.690 | -0.47 ± 0.701 | 0.05 ± 0.811 |
| Follow-up | -1.27 ± 0.844 | 0.12 ± 0.877 | 0.13 ± 0.904 | 3.32 ± 1.040 |
Trough measurements of LY3154207 concentration in plasma at Day 1, Day 7, Day 14, Day 42 and Day 84 was evaluated.
| nanogram per milliliter (ng/mL) | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|
| Day 1 | 34.95 ± 28.82 | 89.36 ± 88.03 | 223.30 ± 208.63 |
| Day 7 | 50.53 ± 38.20 | 123.61 ± 100.89 | 297.35 ± 242.47 |
| Day 14 | 45.85 ± 33.61 | 129.24 ± 89.24 | 321.65 ± 253.11 |
| Day 42 | 44.25 ± 33.93 | 149.22 ± 122.01 | 333.40 ± 257.74 |
| Day 84 | 25.01 ± 30.43 | 59.39 ± 58.20 | 126.53 ± 197.67 |
Collected over Up To 4 Months. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo | 0/86 (0%) | 3/86 (3.5%) | 20/86 (23.3%) |
| 10 mg LY3154207 | 0/86 (0%) | 5/86 (5.8%) | 26/86 (30.2%) |
| 30 mg LY3154207 | 1/85 (1.2%) | 3/85 (3.5%) | 30/85 (35.3%) |
| 75 mg LY3154207 | 1/87 (1.1%) | 10/87 (11.5%) | 43/87 (49.4%) |
| Event | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| PancreatitisGastrointestinal disorders | 0/86 | 0/86 | 1/85 | 0/87 |
| Septic shockInfections and infestations | 0/86 | 0/86 | 1/85 | 0/87 |
| FallInjury, poisoning and procedural complications | 0/86 | 0/86 | 1/85 | 0/87 |
| RhabdomyolysisMusculoskeletal and connective tissue disorders | 0/86 | 0/86 | 1/85 | 0/87 |
| Angina pectorisCardiac disorders | 1/86 | 0/86 | 0/85 | 0/87 |
| ConstipationGastrointestinal disorders | 0/86 | 1/86 | 0/85 | 0/87 |
| OesophagitisGastrointestinal disorders | 1/86 | 0/86 | 0/85 | 0/87 |
| Herpes zoster meningoencephalitisInfections and infestations | 0/86 | 1/86 | 0/85 | 0/87 |
| Pseudomonas infectionInfections and infestations | 1/86 | 0/86 | 0/85 | 0/87 |
| HyperammonaemiaMetabolism and nutrition disorders | 0/86 | 1/86 | 0/85 | 0/87 |
| Event | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 |
|---|---|---|---|---|
| FallInjury, poisoning and procedural complications | 4/86 | 12/86 | 6/85 | 12/87 |
| FatigueGeneral disorders | 4/86 | 2/86 | 1/85 | 9/87 |
| DizzinessNervous system disorders | 4/86 | 4/86 | 6/85 | 9/87 |
| HallucinationPsychiatric disorders | 4/86 | 2/86 | 5/85 | 9/87 |
| HeadacheNervous system disorders | 1/86 | 2/86 | 8/85 | 7/87 |
| NauseaGastrointestinal disorders | 3/86 | 2/86 | 7/85 | 8/87 |
| VomitingGastrointestinal disorders | 3/86 | 0/86 | 2/85 | 7/87 |
| DiarrhoeaGastrointestinal disorders | 1/86 | 2/86 | 5/85 | 2/87 |
| Urinary tract infectionInfections and infestations | 2/86 | 5/86 | 1/85 | 0/87 |
| DyskinesiaNervous system disorders | 2/86 | 2/86 | 3/85 | 5/87 |
All randomized participants.
| Age, Continuous(years) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 | Total |
|---|---|---|---|---|---|
| Mean | 73.00 ± 7.02 | 72.50 ± 6.70 | 71.90 ± 7.35 | 73.00 ± 5.21 | 72.60 ± 6.60 |
| Sex: Female, Male(Participants) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 | Total |
|---|---|---|---|---|---|
| Female | 16 | 13 | 15 | 15 | 59 |
| Male | 70 | 73 | 70 | 72 | 285 |
| Ethnicity (NIH/OMB)(Participants) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 | Total |
|---|---|---|---|---|---|
| Hispanic or Latino | 8 | 5 | 9 | 11 | 33 |
| Not Hispanic or Latino | 77 | 81 | 76 | 75 | 309 |
| Unknown or Not Reported | 1 | 0 | 0 | 1 | 2 |
| Race (NIH/OMB)(Participants) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 1 | 1 | 0 | 0 | 2 |
| Asian | 2 | 1 | 1 | 0 | 4 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 | 0 |
| Black or African American | 4 | 3 | 2 | 2 | 11 |
| White | 79 | 81 | 81 | 85 | 326 |
| More than one race | 0 | 0 | 1 | 0 | 1 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 |
| Region of Enrollment(Participants) | Placebo | 10 mg LY3154207 | 30 mg LY3154207 | 75 mg LY3154207 | Total |
|---|---|---|---|---|---|
| Canada | 3 | 2 | 3 | 2 | 10 |
| Puerto Rico | 5 | 2 | 4 | 4 | 15 |
| United States | 78 | 82 | 78 | 81 | 319 |
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.
Supporting information: Study protocol, Sap, Csr
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