Drug Development

Drug Development Overview

Background

Patients with Alzheimer’s disease (AD) often face challenging neuropsychiatric symptoms, like agitation. This can lead to increased stress for caregivers and more placements in long-term care facilities. AXS-05, a new drug combining dextromethorphan and bupropion, is being studied for treating AD agitation (ADA). It is already FDA-approved for major depressive disorder.

Study Details

Two major studies were conducted: Phase 2 ADVANCE-1 and Phase 3 ACCORD. Both studies focused on patients aged 65-90 with probable AD.

ADVANCE-1 Study

This study looked at how AXS-05 affects ADA over 5 weeks. Patients were divided into three groups: AXS-05, bupropion, or placebo.

  • Primary Endpoint: Change in agitation scores (Cohen-Mansfield Agitation Inventory – CMAI).
  • Results: AXS-05 significantly reduced agitation scores compared to both bupropion and placebo.
  • Common Side Effects: Somnolence (8.2%), dizziness (6.3%), diarrhea (4.4%).

ACCORD Study

This study measured how well AXS-05 prevents ADA relapse over a longer period.

  • Primary Endpoint: Time until relapse.
  • Results: AXS-05 increased time-to-relapse and had lower relapse rates compared to placebo.
  • Common Side Effects: Dizziness (9.6%), diarrhea (4.5%), falls (5.1%).

Conclusion

AXS-05 showed a significant reduction in ADA symptoms after 5 weeks and increased time before relapse. It was well tolerated, making it a promising treatment option for ADA.

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