Trial Outcomes & Findings for Effectiveness of Florbetapir (18F) PET Imaging in Changing Patient Management and the Relationship Between Scan Status and Cognitive Decline (NCT NCT01703702)

NCT ID: NCT01703702

Last Updated: 2016-08-17

Results Overview

Comparison of the percentage of patients who have a change in management from baseline to 3 months for patients who receive scan results immediately (intervention arm) and those who receive scan results 12 months later (control arm).

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

641 participants

Primary outcome timeframe

Baseline and 3 months

Results posted on

2016-08-17

Participant Flow

641 patients enrolled in the study. 21 patients withdrew before receiving a florbetapir (F18) PET scan. 620 patients received florbetapir and comprise the Safety Population; 2 patients did not have a valid PET scan. Therefore; 618 patients were randomized to the intervention or control arms and comprise the Efficacy Population.

Participant milestones

Participant milestones
Measure
Intervention
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results. florbetapir (18F): Single i.v. bolus injection of 370MBq (10 mCi) followed by saline flush, 50 minutes prior to imaging, 10 minute image duration
Control
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months florbetapir (18F): Single i.v. bolus injection of 370MBq (10 mCi) followed by saline flush, 50 minutes prior to imaging, 10 minute image duration
Overall Study
STARTED
308
310
Overall Study
COMPLETED
272
288
Overall Study
NOT COMPLETED
36
22

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Effectiveness of Florbetapir (18F) PET Imaging in Changing Patient Management and the Relationship Between Scan Status and Cognitive Decline

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intervention
n=308 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results. florbetapir (18F): Single i.v. bolus injection of 370MBq (10 mCi) followed by saline flush, 50 minutes prior to imaging, 10 minute image duration
Control
n=310 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months florbetapir (18F): Single i.v. bolus injection of 370MBq (10 mCi) followed by saline flush, 50 minutes prior to imaging, 10 minute image duration
Total
n=618 Participants
Total of all reporting groups
Age, Continuous
73.1 years
STANDARD_DEVIATION 8.2 • n=5 Participants
72.7 years
STANDARD_DEVIATION 7.94 • n=7 Participants
72.9 years
STANDARD_DEVIATION 8.07 • n=5 Participants
Sex: Female, Male
Female
142 Participants
n=5 Participants
160 Participants
n=7 Participants
302 Participants
n=5 Participants
Sex: Female, Male
Male
166 Participants
n=5 Participants
150 Participants
n=7 Participants
316 Participants
n=5 Participants
Region of Enrollment
United States
112 participants
n=5 Participants
111 participants
n=7 Participants
223 participants
n=5 Participants
Region of Enrollment
Italy
109 participants
n=5 Participants
112 participants
n=7 Participants
221 participants
n=5 Participants
Region of Enrollment
France
87 participants
n=5 Participants
87 participants
n=7 Participants
174 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and 3 months

Population: Analysis population for this endpoint only includes those patients with both a baseline and follow-up value.

Comparison of the percentage of patients who have a change in management from baseline to 3 months for patients who receive scan results immediately (intervention arm) and those who receive scan results 12 months later (control arm).

Outcome measures

Outcome measures
Measure
Intervention
n=300 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=299 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Clinical and Diagnostic Change in Patient Management
68.0 percentage of patients
55.5 percentage of patients

PRIMARY outcome

Timeframe: Baseline and 12 months

Population: Analysis population for this endpoint only includes those patients with mild cognitive impairment, and who reported both a baseline and follow-up value.

Change from baseline in the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog) 11 Score in patients with mild impairment by positive or negative florbetapir (18F) PET scan result (Aß+/Aß-). ADAS-Cog scores (range 0-70) indicate performance on a series of 11 cognitive tasks where 0 indicates the highest level of cognitive performance and 70 indicates the lowest level of cognitive performance. Change in ADAS-Cog scores were calculated by subtracting the baseline score from the 12 month score. A change in ADAS-Cog greater than 0 indicates a deterioration in cognitive performance whereas a change in ADAS-Cog less than 0 indicates improved cognitive performance.

Outcome measures

Outcome measures
Measure
Intervention
n=178 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=134 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Change in ADAS-Cog 11 Total Score
0.95 units on a scale
Standard Error 0.38
1.29 units on a scale
Standard Error 0.43

SECONDARY outcome

Timeframe: Baseline and 3 months

Population: Analysis population for this endpoint only includes those patients whose scan result was not predicted by their baseline clinical diagnosis and recorded both a baseline and follow-up value.

Comparison of the percentage of patients who have a change in diagnosis from baseline to 3 months for patients in the intervention and control arms for whom the scan result was not predicted by the initial diagnosis.

Outcome measures

Outcome measures
Measure
Intervention
n=111 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=109 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Change in Patient's Clinical Diagnosis
85.6 percentage of patients
11.9 percentage of patients

SECONDARY outcome

Timeframe: Baseline and 3 months

Population: Analysis population for this endpoint only includes those patients whose scan result was predicted by their baseline clinical diagnosis and recorded both a baseline and follow-up value.

Comparison of the percentage point change in the physician's diagnostic confidence from baseline to month 3 in the intervention and control arms for patients whose scan result was predicted by their baseline clinical diagnosis. Diagnostic confidence was recorded by the physician as a whole number percent from 0-100% and the change in confidence was calculated by subtracting the baseline confidence from the confidence recorded at the specified timepoint. Values greater than zero reflect increased diagnostic confidence; values less than zero reflect decreased diagnostic confidence.

Outcome measures

Outcome measures
Measure
Intervention
n=189 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=190 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Change in Diagnostic Confidence
23.54 Percentage Point
Standard Error 1.13
2.85 Percentage Point
Standard Error 1.15

SECONDARY outcome

Timeframe: Baseline and 3 months

Population: Analysis population for this endpoint only includes those patients with both a baseline and follow-up value.

Comparison of the percentage of patients in the intervention and control arms who have a change in management relating to advice and counseling from baseline to 3 months.

Outcome measures

Outcome measures
Measure
Intervention
n=300 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=299 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Change in Patient Management: Advice/Counseling
64.7 percentage of patients
58.9 percentage of patients

SECONDARY outcome

Timeframe: Baseline and 3 months

Population: Analysis population for this endpoint only includes those patients with both a baseline and follow-up value.

Comparison of the change in self-efficacy between intervention and control arms. Change in self-efficacy is defined as the difference between total score on the Fortinsky: Family caregivers' self-efficacy for managing dementia scale at Follow-up (3 months) and baseline. Self-efficacy for managing dementia is defined in terms of specific behaviors or tasks that can be learned, and that are highly relevant to daily management of the disease process. The scale consists of 10 questions, each with responses ranging from 1 (not at all certain) to 10 (very certain). The total score is calculated by summing the response for each item. The total score ranges from 10 to 100, with increasing scores representing increasing caregiver self-efficacy.

Outcome measures

Outcome measures
Measure
Intervention
n=301 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=297 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Change in Caregiver Self-efficacy
0.16 units on a scale
Standard Error 1.24
0.00 units on a scale
Standard Error 1.26

SECONDARY outcome

Timeframe: Baseline and 3 months

Population: Analysis population for this endpoint only includes those patients with both a baseline and follow-up value.

Compare the percentage of patients with a change from baseline in the individual patient management categories at 3 months in the interventional and control arms.The individual categories are: Major diagnostic tests, Alzheimer's/cognition medication, neuropsychological tests, physician follow-up for re-evaluation or specialist referral.

Outcome measures

Outcome measures
Measure
Intervention
n=300 Participants
Subjects will receive florbetapir (18F) PET scans and physicians will have immediate access to PET scan results.
Control
n=299 Participants
Subjects will receive florbetapir (18F) PET scans but physicians will be blinded to PET scan results for 12 months
Change in Patient Management: Individual Categories
Major Diagnostic Tests
21 percentage of patients
20.4 percentage of patients
Change in Patient Management: Individual Categories
Alzheimer's/Cognitive Medication
35.7 percentage of patients
22.1 percentage of patients
Change in Patient Management: Individual Categories
Neuropsychological Tests
14.7 percentage of patients
9.7 percentage of patients
Change in Patient Management: Individual Categories
Physician Follow-up for Re-evaluation
15.0 percentage of patients
14.0 percentage of patients
Change in Patient Management: Individual Categories
Specialist Referral
30.7 percentage of patients
23.4 percentage of patients

Adverse Events

Safety Population

Serious events: 2 serious events
Other events: 36 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Safety Population
n=620 participants at risk
620 patients received florbetapir (18F) and comprise the Safety Population.
Injury, poisoning and procedural complications
Subdural haematoma
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Nervous system disorders
Cerebral haemorrhage
0.16%
1/620 • Number of events 1 • 48 hours post-injection

Other adverse events

Other adverse events
Measure
Safety Population
n=620 participants at risk
620 patients received florbetapir (18F) and comprise the Safety Population.
Vascular disorders
Flushing
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Injury, poisoning and procedural complications
Post procedural haematoma
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Cardiac disorders
Palpitations
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Respiratory, thoracic and mediastinal disorders
Epistaxis
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Nervous system disorders
Headache
2.7%
17/620 • Number of events 17 • 48 hours post-injection
Nervous system disorders
Dizziness
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Ear and labyrinth disorders
Vertigo
0.16%
1/620 • Number of events 1 • 48 hours post-injection
General disorders
Asthenia
0.48%
3/620 • Number of events 3 • 48 hours post-injection
General disorders
Fatigue
0.48%
3/620 • Number of events 3 • 48 hours post-injection
General disorders
Feeling abnormal
0.16%
1/620 • Number of events 1 • 48 hours post-injection
General disorders
Malaise
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Psychiatric disorders
Confusional state
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Psychiatric disorders
Hallicination, olfactory
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Psychiatric disorders
Insomnia
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Psychiatric disorders
Irritability
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Psychiatric disorders
Sleep disorder
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Gastrointestinal disorders
Nausea
0.65%
4/620 • Number of events 4 • 48 hours post-injection
Gastrointestinal disorders
Abnormal faeces
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Renal and urinary disorders
Dysuria
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Musculoskeletal and connective tissue disorders
Back pain
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Musculoskeletal and connective tissue disorders
Myalgia
0.16%
1/620 • Number of events 1 • 48 hours post-injection
Infections and infestations
Upper respiratory tract infection
0.16%
1/620 • Number of events 1 • 48 hours post-injection

Additional Information

Chief Medical Officer

Avid Radiopharmaceuticals

Phone: 215-298-0700

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60