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gantenerumab

Phase 3

Alzheimer's Disease | Small molecule | Neurology |Roche Holding AG|Last Updated: Feb 10, 2023

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials3
Total Enrollment1,248

FDA Designations

No designations recorded

Clinical trial landscape

gantenerumab · 8 trials · 3 indications

Phase 3 2Phase 1 6
NCT02051608A Study of Gantenerumab in Participants With Mild Alzheimer DiseaseAlzheimer's Disease
COMPLETED389 Analytics
NCT01224106A Study of Gantenerumab in Participants With Prodromal Alzheimer's DiseaseAlzheimer's Disease
COMPLETED799 Analytics
PHASE3COMPLETED
A Study of Gantenerumab in Participants With Mild Alzheimer Disease
Alzheimer's DiseaseUnlock trial analytics
PHASE3COMPLETED
A Study of Gantenerumab in Participants With Prodromal Alzheimer's Disease
Alzheimer's DiseaseUnlock trial analytics

Study Endpoints

Primary Endpoints

Part 2: Percentage of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs)
First dose up to 4 weeks after the last dose of study drug (up to 249 weeks)

An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. SAE is any adverse event that is fatal or which requires or prolongs inpatient hospitalization or results in persistent or significant disability/incapacity or causes congenital anomaly/birth defect or results in a significant medical event in the investigator's judgment.

Part 2: Percentage of Participants With Treatment Emergent Anti-Drug Antibodies (ADAs)
First dose up to last dose (Baseline up to until maximum 5 years)

Participants were considered positive or negative for ADA based on their baseline and post-baseline sample results. The number and percentage of participants with confirmed positive ADA levels were determined for participants previously (in part 1) on Gantenerumab and Placebo. The prevalence of ADA at baseline was calculated as the percentage of participants with confirmed positive ADA levels at baseline relative to the total number of participants with a sample available at baseline. The incidence of treatment-emergent ADAs was determined as the percentage of participants with confirmed post-baseline positive ADAs relative to the total number of participants that had at least one post-baseline sample available for ADA analysis.

Part 2: Percentage of Participants With Adverse Events Leading to Discontinuation of Treatment
First dose up to 4 weeks after the last dose in OLE (Up to approximately 249 weeks)

Percentage of participants with adverse events leading to discontinuation from treatment were reported.

Mean Change From Baseline in Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) Total Score at Week 104 (Double-Blind Treatment Phase)
Baseline, Week 104

The CDR (Clinical Dementia Rating) is obtained through semi-structured interviews of participants and informants, and cognitive functioning is rated in six domains of functioning: memory, orientation, judgement and problem solving, community affairs, home and hobbies, and personal care. Each domain is rated on a five-point scale of functioning as follows: 0, no impairment; 0.5, questionable impairment; 1, mild impairment; 2, moderate impairment; and 3, severe impairment. The CDR-SOB (Clinical Dementia Rating-Sum of Boxes) is based on summing each of the domain box scores with total scores ranging from 0-18, where lower total scores represent better outcomes and higher total scores represent worse outcomes.

Number of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs) (OLE Phase)
Baseline up until a maximum of 5 years

An Adverse Event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.

Maximum Observed Plasma Concentration (Cmax) of Gantenerumab
Predose (any time before injection), 1, 6, and 12 hours postdose (after injection) on Day 1; on Days 2, 3, 4, 5, 6, 7, 8, 12, 21, 29, 43, 64, and 85
Area Under the Plasma Concentration-Time Curve From Time Zero (Predose) to Extrapolated Infinite Time (AUC 0-inf)
Predose (any time before injection), 1, 6, and 12 hours postdose (after injection) on Day 1; on Days 2, 3, 4, 5, 6, 7, 8, 12, 21, 29, 43, 64, and 85
Local Pain as Assessed Using Visual Analog Scale (VAS)
Immediately after the injection on Day 1
Percentage of participants with adverse events (AEs)
Up to 12 weeks (from Baseline to Day 85 +/- 5 days)
Plasma concentration of gantenerumab
Up to 13 weeks
Relative bioavailability: Area under the concentration-time curve
Pre-dose and up to 85 days post-dose
AEs, laboratory parameters, vital signs.
Throughout study
Pharmacokinetic parameters of R1450 in plasma
Throughout study

Secondary Endpoints

Part 1: Percentage of Participants With AEs, SAEs
First dose up to last dose (Up to approximately 152 weeks)
Part 1: Percentage of Participants With Treatment Emergent ADAs
First dose up to last dose (Up to approximately 152 weeks)
Part 1: Gantenerumab Plasma Concentration at Multiple Timepoints
Pre-dose: Weeks 4, 8, 12, 24, 48, 72 and Post dose: Day 4
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Part 1 (Double Blind treatment): PlaceboPLACEBO_COMPARATORParticipants received matching placebo by subcutaneous (SC) injection every 4 weeks (Q4W) up to 100 weeks during Part 1 of the study.
Part 1 (Double Blind treatment): GantenerumabEXPERIMENTALParticipants received 105 mg Gantenerumab by SC injection Q4W for 24 weeks and if eligible 225 mg SC injection Q4W from weeks 28-100 during Part 1 of the study.
Part 2 (Open-Label Extension [OLE] treatment): Placebo switched to Gantenerumab Up to 1200 mgPLACEBO_COMPARATORParticipants who had received Placebo in Part 1, received Gantenerumab at doses up to 1200 mg by SC injection Q4W for up to 2 years. Additionally, participants were given the option to continue receiving open-label gantenerumab treatment for 3 years.
Part 2 (OLE treatment): Gantenerumab up to 1200 mgEXPERIMENTALParticipants who had received Gantenerumab in Part 1, received treatment at doses up to 1200 mg by SC injection Q4W for up to 2 years. Additionally, participants were given the option to continue receiving open-label gantenerumab treatment for 3 years.
Placebo (Parts 1 and 2)PLACEBO_COMPARATORParticipants with Alzheimer's disease received Placebo by SC injection every 4 weeks (Q4W) for 104 weeks or approximately 2 years during Part 1 of the study. Participants who completed the Week 104 visit were given an option to continue the treatment received during Part 1, for 2 additional years in Part 2.
Gantenerumab 105 mg (Parts 1 and 2)EXPERIMENTALParticipants with Alzheimer's disease received Gantenerumab 105 mg by SC injection every 4 weeks (Q4W) for 104 weeks or approximately 2 years during Part 1 of the study. Participants who completed the Week 104 visit were given an option to continue the treatment received during Part 1, for 2 additional years in Part 2.
Gantenerumab 225 mg (Parts 1 and 2)EXPERIMENTALParticipants with Alzheimer's disease received Gantenerumab 225 mg by SC injection every 4 weeks (Q4W) for 104 weeks or approximately 2 years during Part 1 of the study. Participants who completed the Week 104 visit were given an option to continue the treatment received during Part 1, for 2 additional years in Part 2.
Placebo (Parts 1 and 2) switched to Gantenerumab Up to 1200mg (Part 3 Open-Label Extension [OLE])PLACEBO_COMPARATORParticipants with Alzheimer's disease who had received Placebo by SC injection in Part 1 or Part 2, now received Gantenerumab at doses up to 1200 mg by SC injection every 4 weeks (Q4W) for up to 5 additional years.
Gantenerumab Up to 1200 mg (Part 3 Open-Label Extension [OLE])EXPERIMENTALParticipants with Alzheimer's disease who had received Gantenerumab by SC injection in Part 1 or Part 2, now received Gantenerumab at doses up to 1200 mg by SC injection every 4 weeks (Q4W) for up to 5 additional years.
Gantenerumab G4EXPERIMENTALParticipants will receive single dose of gantenerumab HCLF manufactured by G4 process on Day 1.
Gantenerumab G3EXPERIMENTALParticipants will receive single dose of gantenerumab HCLF manufactured by G3 process on Day 1.
Gantenerumab + PlaceboEXPERIMENTALParticipants will be randomized to receive gantenerumab HCLF and placebo solution via SC injection according to different sequences for the site of administration and different injection speeds.
Part I (Dose Escalation): GantenerumabEXPERIMENTALParticipants will receive a single SC dose of gantenerumab on Day 1.
Part I (Dose Escalation): PlaceboPLACEBO_COMPARATORParticipants will receive a single SC dose of matching placebo on Day 1.
Part II (PK Extension): GantenerumabEXPERIMENTALParticipants will receive a single SC dose of gantenerumab on Day 1. The dose range will be determined by safety and tolerability data collected from Part I.
High Concentration Liquid Formulation (HCLF)EXPERIMENTAL -
Lyophilized formulationACTIVE_COMPARATOR -
HCLFEXPERIMENTAL -
LyoFACTIVE_COMPARATOR -
1EXPERIMENTAL -

Interventions

NameTypeDescription
PlaceboDRUGParticipants received Placebo SC injection Q4W.
GantenerumabDRUGParticipants received Gantenerumab at 105 mg , 225 mg, or at doses up to 1200 mg SC injection Q4W.
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Eligibility Criteria

Age Range50 Years to 90 Years
SexALL
Healthy VolunteersNo
Study Sites131

Inclusion Criteria: * Clinical diagnosis of probable mild Alzheimer disease (AD) based on National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA) criteria or major NCD based whether or not receiving AD approved m...

Countries:United StatesArgentinaAustraliaBelgiumBulgariaCanadaDenmarkFinlandFranceGermanyHungaryItalyJapanNetherlandsPortugalRussiaSouth KoreaSpainSwedenSwitzerlandTurkey (Türkiye)United KingdomBrazilChileCzechiaMexicoPolandIsrael
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Frequently asked questions about gantenerumab

What is Gantenerumab used for?

Gantenerumab is an investigational drug being studied for Alzheimer's disease. It has been evaluated in clinical trials for prodromal Alzheimer's disease, mild Alzheimer disease, and in healthy participants for bioavailability studies. It is not approved and remains in clinical development.

Who makes Gantenerumab?

Gantenerumab is being developed by Roche Holding AG, which trades under the ticker RHHBY. Roche has sponsored multiple clinical trials of the drug across different stages of Alzheimer's disease.

What phase is Gantenerumab in?

Gantenerumab has completed Phase 1 and Phase 3 clinical trials. The Phase 1 trials studied multiple ascending doses and bioavailability, while the Phase 3 trials evaluated the drug in prodromal and mild Alzheimer's disease. It remains investigational and is not FDA approved.

What clinical trials is Gantenerumab in?

Gantenerumab has been studied in four completed trials. NCT00531804 was a Phase 1 multiple ascending dose study in Alzheimer's patients. NCT01224106 and NCT02051608 were Phase 3 trials in prodromal and mild Alzheimer's disease. NCT03236844 was a Phase 1 bioavailability study in healthy participants.

Is Gantenerumab the same as R1450?

Yes, Gantenerumab is also known as R1450. The Phase 1 trial NCT00531804 is titled 'A Multiple Ascending Dose Study of R1450 in Patients With Alzheimer Disease,' confirming that R1450 is an alternative name for Gantenerumab.