Major Depressive Disorder
Conditions
Keywords
Mental Health, Adolescents, Major Depressive Disorder, Depression, Adolescent Depression, Pediatric Depression
Brief summary
The primary purpose of your participation in this study is to help answer the following research question: Whether 12-week administration of EMSAM (selegiline transdermal system) is safe and effective for the treatment of adolescents (aged 12 through 17 years) with Major Depressive Disorder (MDD).
Detailed description
• Assess the safety and efficacy of EMSAM (selegiline transdermal system) versus placebo in adolescents (aged 12 through 17 years) who meet criteria for Major Depressive Disorder (MDD) without psychotic features, single or recurrent
Interventions
Matching Placebo for EMSAM 6mg, 9mg, or 12mg Flexible Dose- 1 patch/24 hours- 12 Week Study
EMSAM 6mg, 9mg, or 12mg Flexible Dose- 1 patch/24 hours- 12 Week Study
Sponsors
Study design
Eligibility
Inclusion criteria
* Male / Female outpatients 12 to 17 years of age diagnosed with Major Depressive Disorder (MDD). (Must have a Children's Depression Rating Scale-Revised \[CDRS-R\] with a total score of at least 45 at screening.) * Female patients must test negative on a pregnancy at visit 1. * Weight and height must be greater than the 10th percentile according to age and height, * Assent and consent must be given.
Exclusion criteria
* Have a serious or unstable medical illness, psychological condition, clinically significant laboratory or ECG result, hypersensitivity to selegiline, or any other condition that in the opinion of the investigator would compromise participation in the study or be likely to lead to hospitalization during the course of the study. * Have a current or previous diagnosis of bipolar disorder, psychotic depression, schizophrenia or other psychotic disorder, anorexia, bulimia, obsessive compulsive disorder, pervasive development disorder or borderline personality disorder, as determined by the investigator. * Have a risk of suicide * Female patients who are either pregnant, nursing or have recently given birth. * Use of any protocol prohibited medications or substances.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | baseline and 12 Weeks | A summary of the primary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score, as reported by the Child, at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with the last observation carried forward (LOCF) in time. CDRS-R total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| CGI-S - Week 12 (mITT w/LOCF Population) | Baseline and 12 Weeks | A summary of the Clinical Global Impression of Severity (CGI-S) at baseline and Week 12 (EOS), by treatment assigned, is shown for the mITT population with LOCF. The CGI-s is the clinician's assessment of severity of illness (depression). Scores range from 1(minimum) to 7(maximum). A lower score indicates lower illness severity, a higher score indicates higher levels of illness severity. |
| CGI-C - Week 12 (mITT w/LOCF Population) | 12 Weeks | A summary of the Clinicians Global Impression of Change (CGI-C) Score at Week 12 (EOS), by treatment assigned, is shown for the mITT population with LOCF. The CGI-c assesses the overall change in the severity of illness (depression). The clinician rates the subject's change based on a bipolar scale from 1(minimum; Very much improved) to 7(maximum; Very much worse). A lower score indicates lower levels of depression as compared to baseline, a higher score indicates higher levels of depression as compared to baseline. A score of 4 (Unchanged) indicates no change in illness compared to baseline. The scale is not calculated as a statistical change score; the clinician rates their impression of change overall. |
| CGI-C Percent Responders (mITT w/LOCF Population) | 12 Weeks | A summary of the CGI-C percent responders at Week 12 (EOS), by treatment assigned, is shown for the mITT population with LOCF. CGI-C responders were defined as a score of 1 or 2 at the end of the study. A non-responder was defined as a score of ≥3 at end of study. Maximum score is 100%. |
| CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Baseline and 12 Weeks | A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Scored by Parent/Other), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with the last observation carried forward (LOCF) in time. CDRS-R (Parent/Other) total raw scores range from 14 (minimum) 94 (maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. One subscale is summed to calculate a total score: Evaluated Symptom Area. Ratings of Observed Nonverbal Behavior subscale is not included in Parent/Other total calculation. |
| CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | 12 Weeks | A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Best Description), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with the last observation carried forward (LOCF) in time. Best Description ratings are used when ratings based on interviews with different sources (e.g., child, parent, other ratings) differ for a particular symptom. The evaluator must determine which of these ratings most accurately represents the current affective functioning of the child, and circle that rating in the Best Description of Child Column. CDRS-R (Best Description)total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior. |
| CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | 12 Weeks | A summary of the secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Scored by Child), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population with observed cases (w/OC). CDRS-R (Child) total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior. |
| CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | 12 Weeks | A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Scored by Parent/Other), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population with observed cases (w/OC). CDRS-R (Parent/Other) total raw scores range from 14 (minimum) 94 (maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. One subscale is summed to calculate a total score: Evaluated Symptom Area. Ratings of Observed Nonverbal Behavior subscale is not included in Parent/Other total calculation. |
| CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | 12 Weeks | A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Best Description), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with observed cases (w/OC). Best Description ratings are used when ratings based on interviews with different sources (e.g., child, parent, other ratings) differ for a particular symptom area. The evaluator must determine which of these ratings most accurately represents the current affective functioning of the child, and circle that rating in the Best Description of Child Column. CDRS-R (Best Description) total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior. |
| Physical Examination (Screening vs. EOS) | 12 Weeks | Number of physical examination findings that were normal at screening, but abnormal at end of study are presented. Four subjects receiving placebo and four subjects receiving EMSAM had abnormal findings on physical examination at the end of study that were normal at screening. |
| Urinalysis (Change From Baseline) | 12 Weeks | A summary of a secondary safety outcome measure, Urinalysis (Change from Baseline), by treatment assigned, is shown for the safety population. Mean changes from baseline are provided for PH and specific gravity. |
| Vital Signs-Heart Rate (Change From Baseline) | 12 Weeks | Summary mean change in heart rate measured in beats per minute (beats/min or BPM) (supine, standing, and orthostatic change)results for all subjects are presented. |
| Vital Signs-Blood Pressure (Change From Baseline) | 12 Weeks | Summary mean change in blood pressure (systolic/diastolic) measured in millimeters of mercury (mmHg) (supine, standing, and orthostatic change)results for all subjects are presented. |
| Hematology - Red Blood Cell (Change From Baseline) | 12 Weeks | A summary of a secondary safety outcome measure, Hematology - Red Blood Cell (RBC)(Change from Baseline), by treatment assigned, is shown for the safety population. |
| 12 Lead ECG (Change From Baseline) | 12 Weeks | A summary of a secondary safety outcome measure, 12 Lead electrocardiogram (ECG) (Change from Baseline) measured in milliseconds (msec), by treatment assigned, is shown for the safety population. Mean change from Baseline in PR interval, QRS duration, QT interval, and QTc (Bazett and Fridericia corrections) interval are presented. |
| 12 Lead ECG (Change From Baseline)Ventricular Heart Rate | 12 Weeks | A summary of a secondary safety outcome measure, 12 Lead electrocardiogram (ECG) (Change from Baseline)Ventricular Heart Rate measured in beats per minute(beats/min or BPM), by treatment assigned, is shown for the safety population. Mean change from baseline is presented. |
| Hematology - White Blood Cell (WBC) (Change From Baseline) | 12 Weeks | A summary of a secondary safety outcome measure, Hematology (Change from Baseline), by treatment assigned, is shown for the safety population. Mean change from Baseline in ABS BASOPHILS (X10\^9/L), ABS EOSINOPHILS (X10\^9/L), ABS LYMPHOCYTES (X10\^9/L), ABS MONOCYTES (X10\^9/L), and ABS NEUTROPHILS (X10\^9/L) are presented. |
| Hematology - Hematocrit (Change From Baseline) | 12 Weeks | A summary of a secondary safety outcome measure, Hematology - Hematocrit(HCT)(Change from Baseline), by treatment assigned, is shown for the safety population. |
| Hematology - Hemoglobin (Change From Baseline) | 12 Weeks | A summary of a secondary safety outcome measure, Hematology - Hemoglobin(HGB)(Change from Baseline), by treatment assigned, is shown for the safety population. |
Countries
United States
Participant flow
Recruitment details
Male and female adolescent subjects between 12 to 17 years of age diagnosed with moderate to severe major depressive disorder were screened over an approximate two year period at 26 investigative sites in the U.S.
Participants by arm
| Arm | Count |
|---|---|
| Placebo Placebo Selegiline Transdermal System 6, 9 or 12
Placebo : Matching Placebo for EMSAM 6mg, 9mg, or 12mg Flexible Dose- 1 patch/24 hours- 12 Week Study | 156 |
| EMSAM Approved Medication for Major Depressive Disorder: EMSAM (Selegiline Transdermal System) 6mg, 9mg, or 12mg
Selegiline Transdermal System : EMSAM 6mg, 9mg, or 12mg Flexible Dose- 1 patch/24 hours- 12 Week Study | 152 |
| Total | 308 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 5 | 10 |
| Overall Study | Lost to Follow-up | 12 | 9 |
| Overall Study | Non-Compliance | 4 | 7 |
| Overall Study | Other (e.g., Lack of Efficacy) | 5 | 5 |
| Overall Study | Protocol Violation | 2 | 1 |
| Overall Study | Withdrawal by Subject | 14 | 19 |
Baseline characteristics
| Characteristic | Placebo | EMSAM | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 156 Participants | 152 Participants | 308 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 14.7 years STANDARD_DEVIATION 1.6 | 14.8 years STANDARD_DEVIATION 1.62 | 14.8 years STANDARD_DEVIATION 1.61 |
| Race/Ethnicity, Customized Asian | 2 participants | 1 participants | 3 participants |
| Race/Ethnicity, Customized Black | 34 participants | 46 participants | 80 participants |
| Race/Ethnicity, Customized Caucasian | 77 participants | 69 participants | 146 participants |
| Race/Ethnicity, Customized Hispanic | 37 participants | 32 participants | 69 participants |
| Race/Ethnicity, Customized Native American | 1 participants | 1 participants | 2 participants |
| Race/Ethnicity, Customized Other | 5 participants | 3 participants | 8 participants |
| Sex: Female, Male Female | 104 Participants | 93 Participants | 197 Participants |
| Sex: Female, Male Male | 52 Participants | 59 Participants | 111 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 90 / 156 | 95 / 152 |
| serious Total, serious adverse events | 3 / 156 | 7 / 152 |
Outcome results
CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12
A summary of the primary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score, as reported by the Child, at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with the last observation carried forward (LOCF) in time. CDRS-R total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior.
Time frame: baseline and 12 Weeks
Population: Received at least one dose of placebo or EMSAM study drug, and had at least one post-treatment efficacy assessment with the primary outcome variable (CDRS-R).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | Baseline - Observed | 57.9 units on a scale | Standard Deviation 12.57 |
| Placebo | CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | Week 12 - Observed | 36.4 units on a scale | Standard Deviation 15.91 |
| Placebo | CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | Week 12 - Change From Baseline | -21.5 units on a scale | Standard Deviation 16.47 |
| EMSAM | CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | Baseline - Observed | 56.7 units on a scale | Standard Deviation 12.34 |
| EMSAM | CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | Week 12 - Observed | 35.4 units on a scale | Standard Deviation 15.3 |
| EMSAM | CDRS-R Total Score (Child) (mITT w/LOCF Population) Week 12 | Week 12 - Change From Baseline | -21.4 units on a scale | Standard Deviation 16.61 |
12 Lead ECG (Change From Baseline)
A summary of a secondary safety outcome measure, 12 Lead electrocardiogram (ECG) (Change from Baseline) measured in milliseconds (msec), by treatment assigned, is shown for the safety population. Mean change from Baseline in PR interval, QRS duration, QT interval, and QTc (Bazett and Fridericia corrections) interval are presented.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | 12 Lead ECG (Change From Baseline) | QRS Duration | -0.0 msec | Standard Deviation 5.84 |
| Placebo | 12 Lead ECG (Change From Baseline) | QTc (Bazett Correction) Interval | -4.10 msec | Standard Deviation 19.2 |
| Placebo | 12 Lead ECG (Change From Baseline) | QT Interval | 1.30 msec | Standard Deviation 24.86 |
| Placebo | 12 Lead ECG (Change From Baseline) | QTc (Fridericia Correction) Interval | -2.30 msec | Standard Deviation 16.06 |
| Placebo | 12 Lead ECG (Change From Baseline) | PR Interval | 0.70 msec | Standard Deviation 10.47 |
| EMSAM | 12 Lead ECG (Change From Baseline) | QTc (Fridericia Correction) Interval | -0.60 msec | Standard Deviation 15.27 |
| EMSAM | 12 Lead ECG (Change From Baseline) | PR Interval | -0.90 msec | Standard Deviation 11.04 |
| EMSAM | 12 Lead ECG (Change From Baseline) | QRS Duration | 1.1 msec | Standard Deviation 8.21 |
| EMSAM | 12 Lead ECG (Change From Baseline) | QT Interval | 3.80 msec | Standard Deviation 21.51 |
| EMSAM | 12 Lead ECG (Change From Baseline) | QTc (Bazett Correction) Interval | -2.90 msec | Standard Deviation 20.23 |
12 Lead ECG (Change From Baseline)Ventricular Heart Rate
A summary of a secondary safety outcome measure, 12 Lead electrocardiogram (ECG) (Change from Baseline)Ventricular Heart Rate measured in beats per minute(beats/min or BPM), by treatment assigned, is shown for the safety population. Mean change from baseline is presented.
Time frame: 12 Weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | 12 Lead ECG (Change From Baseline)Ventricular Heart Rate | -1.70 BPM | Standard Deviation 10.4 |
| EMSAM | 12 Lead ECG (Change From Baseline)Ventricular Heart Rate | -2.40 BPM | Standard Deviation 10.43 |
CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population)
A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Best Description), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with the last observation carried forward (LOCF) in time. Best Description ratings are used when ratings based on interviews with different sources (e.g., child, parent, other ratings) differ for a particular symptom. The evaluator must determine which of these ratings most accurately represents the current affective functioning of the child, and circle that rating in the Best Description of Child Column. CDRS-R (Best Description)total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | Baseline - Observed | 60.7 units on a scale | Standard Deviation 12.26 |
| Placebo | CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | Week 12 - Observed | 38 units on a scale | Standard Deviation 16.62 |
| Placebo | CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | Week 12 - Change From Baseline | -22.7 units on a scale | Standard Deviation 16.54 |
| EMSAM | CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | Baseline - Observed | 59.5 units on a scale | Standard Deviation 11.05 |
| EMSAM | CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | Week 12 - Observed | 37 units on a scale | Standard Deviation 15.73 |
| EMSAM | CDRS-R Total Score (Best Description) Week 12 (mITT w/LOCF Population) | Week 12 - Change From Baseline | -22.5 units on a scale | Standard Deviation 16.97 |
CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population)
A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Best Description), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with observed cases (w/OC). Best Description ratings are used when ratings based on interviews with different sources (e.g., child, parent, other ratings) differ for a particular symptom area. The evaluator must determine which of these ratings most accurately represents the current affective functioning of the child, and circle that rating in the Best Description of Child Column. CDRS-R (Best Description) total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | Baseline - Observed | 60.7 units on a scale | Standard Deviation 12.34 |
| Placebo | CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | Week 12 - Observed | 32.1 units on a scale | Standard Deviation 13.18 |
| Placebo | CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | Week 12 - Change From Baseline | -27 units on a scale | Standard Deviation 14.93 |
| EMSAM | CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | Baseline - Observed | 59.4 units on a scale | Standard Deviation 11.1 |
| EMSAM | CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | Week 12 - Observed | 32.4 units on a scale | Standard Deviation 12.75 |
| EMSAM | CDRS-R Total Score (Best Description) Week 12 (mITT w/OC Population) | Week 12 - Change From Baseline | -26.6 units on a scale | Standard Deviation 15.18 |
CDRS-R Total Score (Child) Week 12 (mITT w/OC Population)
A summary of the secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Scored by Child), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population with observed cases (w/OC). CDRS-R (Child) total raw scores range from 17(minimum) 113(maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. Two subscales are summed to calculate a total score: Evaluated Symptom Area and Ratings of Observed Nonverbal Behavior.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | Baseline - Observed | 58.1 units on a scale | Standard Deviation 12.64 |
| Placebo | CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | Week 12 - Observed | 30.8 units on a scale | Standard Deviation 12.41 |
| Placebo | CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | Week 12 - Change From Baseline | -25.5 units on a scale | Standard Deviation 15.07 |
| EMSAM | CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | Baseline - Observed | 56.6 units on a scale | Standard Deviation 12.39 |
| EMSAM | CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | Week 12 - Observed | 31.1 units on a scale | Standard Deviation 12.38 |
| EMSAM | CDRS-R Total Score (Child) Week 12 (mITT w/OC Population) | Week 12 - Change From Baseline | -25.3 units on a scale | Standard Deviation 15.16 |
CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population)
A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Scored by Parent/Other), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population, with the last observation carried forward (LOCF) in time. CDRS-R (Parent/Other) total raw scores range from 14 (minimum) 94 (maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. One subscale is summed to calculate a total score: Evaluated Symptom Area. Ratings of Observed Nonverbal Behavior subscale is not included in Parent/Other total calculation.
Time frame: Baseline and 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Baseline- Observed | 49.4 units on a scale | Standard Deviation 11.27 |
| Placebo | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Week 12- Observed | 30.7 units on a scale | Standard Deviation 13.55 |
| Placebo | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Week 12 - Change From Baseline | -18.7 units on a scale | Standard Deviation 14.09 |
| EMSAM | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Baseline- Observed | 48.8 units on a scale | Standard Deviation 10.1 |
| EMSAM | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Week 12- Observed | 30.5 units on a scale | Standard Deviation 13.36 |
| EMSAM | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/LOCF Population) | Week 12 - Change From Baseline | -18.3 units on a scale | Standard Deviation 14.27 |
CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population)
A summary of a secondary efficacy outcome measure, Children's Depression Rating Scale (CDRS-R) Total Score (Scored by Parent/Other), at Week 12 (EOS), by treatment assigned, is shown for the modified intent-to-treat (mITT) population with observed cases (w/OC). CDRS-R (Parent/Other) total raw scores range from 14 (minimum) 94 (maximum). A lower score indicates a lower likelihood of a depressive disorder, a higher score indicates a higher likelihood of a depressive disorder. One subscale is summed to calculate a total score: Evaluated Symptom Area. Ratings of Observed Nonverbal Behavior subscale is not included in Parent/Other total calculation.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | Baseline - Observed | 49.6 units on a scale | Standard Deviation 11.43 |
| Placebo | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | Week 12 - Observed | 25.5 units on a scale | Standard Deviation 10.7 |
| Placebo | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | Week 12 - Change From Baseline | -22.6 units on a scale | Standard Deviation 12.97 |
| EMSAM | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | Baseline - Observed | 48.9 units on a scale | Standard Deviation 10.21 |
| EMSAM | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | Week 12 - Observed | 25.8 units on a scale | Standard Deviation 9.59 |
| EMSAM | CDRS-R Total Score (Parent/Other) Week 12 (mITT w/OC Population) | Week 12 - Change From Baseline | -22.2 units on a scale | Standard Deviation 12.66 |
CGI-C Percent Responders (mITT w/LOCF Population)
A summary of the CGI-C percent responders at Week 12 (EOS), by treatment assigned, is shown for the mITT population with LOCF. CGI-C responders were defined as a score of 1 or 2 at the end of the study. A non-responder was defined as a score of ≥3 at end of study. Maximum score is 100%.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | CGI-C Percent Responders (mITT w/LOCF Population) | Percent Responder | 59.3 Percent Responder |
| Placebo | CGI-C Percent Responders (mITT w/LOCF Population) | Percent Non-Responder | 40.7 Percent Responder |
| EMSAM | CGI-C Percent Responders (mITT w/LOCF Population) | Percent Non-Responder | 41.4 Percent Responder |
| EMSAM | CGI-C Percent Responders (mITT w/LOCF Population) | Percent Responder | 58.6 Percent Responder |
CGI-C - Week 12 (mITT w/LOCF Population)
A summary of the Clinicians Global Impression of Change (CGI-C) Score at Week 12 (EOS), by treatment assigned, is shown for the mITT population with LOCF. The CGI-c assesses the overall change in the severity of illness (depression). The clinician rates the subject's change based on a bipolar scale from 1(minimum; Very much improved) to 7(maximum; Very much worse). A lower score indicates lower levels of depression as compared to baseline, a higher score indicates higher levels of depression as compared to baseline. A score of 4 (Unchanged) indicates no change in illness compared to baseline. The scale is not calculated as a statistical change score; the clinician rates their impression of change overall.
Time frame: 12 Weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | CGI-C - Week 12 (mITT w/LOCF Population) | 2.387 units on a scale | Standard Deviation 1.208 |
| EMSAM | CGI-C - Week 12 (mITT w/LOCF Population) | 2.386 units on a scale | Standard Deviation 1.138 |
CGI-S - Week 12 (mITT w/LOCF Population)
A summary of the Clinical Global Impression of Severity (CGI-S) at baseline and Week 12 (EOS), by treatment assigned, is shown for the mITT population with LOCF. The CGI-s is the clinician's assessment of severity of illness (depression). Scores range from 1(minimum) to 7(maximum). A lower score indicates lower illness severity, a higher score indicates higher levels of illness severity.
Time frame: Baseline and 12 Weeks
Population: Received at least one dose of placebo or EMSAM study drug, and had at least one post-treatment efficacy assessment with the primary outcome variable (CDRS-R).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | CGI-S - Week 12 (mITT w/LOCF Population) | Baseline CGI-S Scale | 4.494 units on a scale | Standard Deviation 0.659 |
| Placebo | CGI-S - Week 12 (mITT w/LOCF Population) | Week 12 CGI-S Scale | 3.000 units on a scale | Standard Deviation 1.333 |
| EMSAM | CGI-S - Week 12 (mITT w/LOCF Population) | Baseline CGI-S Scale | 4.527 units on a scale | Standard Deviation 0.662 |
| EMSAM | CGI-S - Week 12 (mITT w/LOCF Population) | Week 12 CGI-S Scale | 3.007 units on a scale | Standard Deviation 1.25 |
Hematology - Hematocrit (Change From Baseline)
A summary of a secondary safety outcome measure, Hematology - Hematocrit(HCT)(Change from Baseline), by treatment assigned, is shown for the safety population.
Time frame: 12 Weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hematology - Hematocrit (Change From Baseline) | -0.58 percent | Standard Deviation 2.294 |
| EMSAM | Hematology - Hematocrit (Change From Baseline) | -1.13 percent | Standard Deviation 3.093 |
Hematology - Hemoglobin (Change From Baseline)
A summary of a secondary safety outcome measure, Hematology - Hemoglobin(HGB)(Change from Baseline), by treatment assigned, is shown for the safety population.
Time frame: 12 Weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hematology - Hemoglobin (Change From Baseline) | -0.18 g/dL | Standard Deviation 0.694 |
| EMSAM | Hematology - Hemoglobin (Change From Baseline) | -0.36 g/dL | Standard Deviation 0.854 |
Hematology - Red Blood Cell (Change From Baseline)
A summary of a secondary safety outcome measure, Hematology - Red Blood Cell (RBC)(Change from Baseline), by treatment assigned, is shown for the safety population.
Time frame: 12 Weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Hematology - Red Blood Cell (Change From Baseline) | -0.04 x10^12/L | Standard Deviation 0.234 |
| EMSAM | Hematology - Red Blood Cell (Change From Baseline) | -0.12 x10^12/L | Standard Deviation 0.313 |
Hematology - White Blood Cell (WBC) (Change From Baseline)
A summary of a secondary safety outcome measure, Hematology (Change from Baseline), by treatment assigned, is shown for the safety population. Mean change from Baseline in ABS BASOPHILS (X10\^9/L), ABS EOSINOPHILS (X10\^9/L), ABS LYMPHOCYTES (X10\^9/L), ABS MONOCYTES (X10\^9/L), and ABS NEUTROPHILS (X10\^9/L) are presented.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS MONOCYTES (X10^9/L) | 0.01 (X10^9/L) | Standard Deviation 0.134 |
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS BASOPHILS (X10^9/L) | -0.00 (X10^9/L) | Standard Deviation 0.04 |
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS NEUTROPHILS (X10^9/L) | 0.01 (X10^9/L) | Standard Deviation 1.542 |
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | PLATELETS (X10^9/L) | -0.01 (X10^9/L) | Standard Deviation 44.126 |
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS LYMPHOCYTES (X10^9/L) | -0.09 (X10^9/L) | Standard Deviation 0.535 |
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | WBC (X10^9/L) | -0.09 (X10^9/L) | Standard Deviation 1.813 |
| Placebo | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS EOSINOPHILS (X10^9/L) | -0.01 (X10^9/L) | Standard Deviation 0.1 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | WBC (X10^9/L) | -0.12 (X10^9/L) | Standard Deviation 1.614 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS BASOPHILS (X10^9/L) | 0.00 (X10^9/L) | Standard Deviation 0.035 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS EOSINOPHILS (X10^9/L) | 0.01 (X10^9/L) | Standard Deviation 0.115 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS LYMPHOCYTES (X10^9/L) | -0.03 (X10^9/L) | Standard Deviation 0.538 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS MONOCYTES (X10^9/L) | -0.00 (X10^9/L) | Standard Deviation 0.148 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | PLATELETS (X10^9/L) | 1.82 (X10^9/L) | Standard Deviation 54.452 |
| EMSAM | Hematology - White Blood Cell (WBC) (Change From Baseline) | ABS NEUTROPHILS (X10^9/L) | -0.10 (X10^9/L) | Standard Deviation 1.346 |
Physical Examination (Screening vs. EOS)
Number of physical examination findings that were normal at screening, but abnormal at end of study are presented. Four subjects receiving placebo and four subjects receiving EMSAM had abnormal findings on physical examination at the end of study that were normal at screening.
Time frame: 12 Weeks
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo | Physical Examination (Screening vs. EOS) | 4 Number of Abnormal Exams |
| EMSAM | Physical Examination (Screening vs. EOS) | 4 Number of Abnormal Exams |
Urinalysis (Change From Baseline)
A summary of a secondary safety outcome measure, Urinalysis (Change from Baseline), by treatment assigned, is shown for the safety population. Mean changes from baseline are provided for PH and specific gravity.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Urinalysis (Change From Baseline) | PH | -0.02 units on a scale | Standard Deviation 0.906 |
| Placebo | Urinalysis (Change From Baseline) | Specific Gravity | 0.00 units on a scale | Standard Deviation 0.008 |
| EMSAM | Urinalysis (Change From Baseline) | PH | -0.11 units on a scale | Standard Deviation 1.052 |
| EMSAM | Urinalysis (Change From Baseline) | Specific Gravity | 0.00 units on a scale | Standard Deviation 0.008 |
Vital Signs-Blood Pressure (Change From Baseline)
Summary mean change in blood pressure (systolic/diastolic) measured in millimeters of mercury (mmHg) (supine, standing, and orthostatic change)results for all subjects are presented.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Vital Signs-Blood Pressure (Change From Baseline) | Supine Systolic Blood Pressure | 0.9 mmHg | Standard Deviation 8.94 |
| Placebo | Vital Signs-Blood Pressure (Change From Baseline) | Supine Diastolic Blood Pressure | 1.1 mmHg | Standard Deviation 8.21 |
| Placebo | Vital Signs-Blood Pressure (Change From Baseline) | Standing Systolic Blood Pressure | -1.2 mmHg | Standard Deviation 10.29 |
| Placebo | Vital Signs-Blood Pressure (Change From Baseline) | Standing Diastolic Blood Pressure | 0.8 mmHg | Standard Deviation 8.5 |
| Placebo | Vital Signs-Blood Pressure (Change From Baseline) | Orthostatic Change in Systolic Blood Pressure | -2.1 mmHg | Standard Deviation 9.32 |
| Placebo | Vital Signs-Blood Pressure (Change From Baseline) | Orthostatic Change in Diastolic Blood Pressure | -0.4 mmHg | Standard Deviation 7.84 |
| EMSAM | Vital Signs-Blood Pressure (Change From Baseline) | Orthostatic Change in Systolic Blood Pressure | -2.3 mmHg | Standard Deviation 11.3 |
| EMSAM | Vital Signs-Blood Pressure (Change From Baseline) | Supine Systolic Blood Pressure | -0.3 mmHg | Standard Deviation 11.8 |
| EMSAM | Vital Signs-Blood Pressure (Change From Baseline) | Standing Diastolic Blood Pressure | -0.1 mmHg | Standard Deviation 9.11 |
| EMSAM | Vital Signs-Blood Pressure (Change From Baseline) | Supine Diastolic Blood Pressure | 1.4 mmHg | Standard Deviation 8.52 |
| EMSAM | Vital Signs-Blood Pressure (Change From Baseline) | Orthostatic Change in Diastolic Blood Pressure | -1.5 mmHg | Standard Deviation 7.85 |
| EMSAM | Vital Signs-Blood Pressure (Change From Baseline) | Standing Systolic Blood Pressure | -2.5 mmHg | Standard Deviation 11.63 |
Vital Signs-Heart Rate (Change From Baseline)
Summary mean change in heart rate measured in beats per minute (beats/min or BPM) (supine, standing, and orthostatic change)results for all subjects are presented.
Time frame: 12 Weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Vital Signs-Heart Rate (Change From Baseline) | Supine Heart Rate | .20 BPM | Standard Deviation 11.9 |
| Placebo | Vital Signs-Heart Rate (Change From Baseline) | Standing Heart Rate | -0.6 BPM | Standard Deviation 14.26 |
| Placebo | Vital Signs-Heart Rate (Change From Baseline) | Orthostatic Change in Heart Rate | -.80 BPM | Standard Deviation 11.7 |
| EMSAM | Vital Signs-Heart Rate (Change From Baseline) | Supine Heart Rate | -.10 BPM | Standard Deviation 9.91 |
| EMSAM | Vital Signs-Heart Rate (Change From Baseline) | Standing Heart Rate | 2.6 BPM | Standard Deviation 15.12 |
| EMSAM | Vital Signs-Heart Rate (Change From Baseline) | Orthostatic Change in Heart Rate | 2.80 BPM | Standard Deviation 13.8 |