Depression
Conditions
Keywords
randomized, placebo controlled, maximum tolerated dose
Brief summary
Trial to determine the maximum tolerated dose (MTD) based on safety and tolerability of MK-8777 (Org 26576, SCH 900777) in participants with major depressive disorder.
Detailed description
This is a randomized, placebo-controlled, safety and tolerability study examining MK-8777 in participants with major depressive disorder. In Part I of the trial, four different cohorts of six participants each will receive multiple rising doses of MK-8777 (ranging from 100 mg twice a day \[BID\] to 300 mg BID) or placebo for up to 16 days. In Part 2, a new cohort of participants will be randomly assigned to receive 100 mg BID of MK-8777, 400 mg BID of MK-8777, or placebo. Following titration (3 days per step), participants will be maintained on the assigned BID dose until Day 27, followed by one day of once a day (QD) dosing, for a total of 28 days. There were 11 treatment arms in total for Part 1 and Part 2 (see Interventions).
Interventions
DRUGMK-8777
Orally administered capsules containing either 50 mg or 100 mg MK-8777.
DRUGPlacebo
Orally administered matching placebo capsules.
Sponsors
Merck Sharp & Dohme LLC
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Female who is non-pregnant, nonlactating, using an acceptable method of birth control, or is not of child-bearing potential; * be diagnosed with current major depressive disorder either mild or severe, as evidenced by a score of at least 9 but not more than 20 on the Quick Inventory of Depression Symptomatology - Clinician Rated (QIDS-C); * be anti-depressant naïve; * be able to refrain from all use of grapefruit containing products from the time of admission until the last assessment is performed at discharge; * smokes less than or equal to 10 cigarettes or equivalent daily.
Exclusion criteria
* has any current and primary Axis I disorder other than major depressive disorder; * has any history of bipolar I or II disorder, dysthymia, psychotic depression, psychotic disorders, posttraumatic stress disorder, borderline personality disorder, obsessive compulsive disorder, or eating disorder; * the duration of the current depressive episode is longer than 2 years at screening; * has any history of a significant suicide attempt, or poses a current risk of attempting suicide; * is known to be human immunodeficiency virus (HIV) positive, or positive for hepatitis B surface antigen or hepatitis A antibodies or hepatitis C total antibodies; * has any clinically significant concurrent endocrine, renal, respiratory, cardiovascular, hematological, immunological, cerebrovascular, neurological, malignancy, or any other concurrent medical condition, or has any history of diabetes mellitus; * donation of blood within 60 days prior to the anticipated first dose of trial medication.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Part 1: Number of Participants With Serious Adverse Events (SAEs) | Up to 30 days following the last dose of study drug (Up to 46 days) | An SAE is defined as any untoward medical occurrence that at any dose: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, or is a congenital anomaly/birth defect. |
| Part 2: Number of Participants With AEs | Up to 7 days following the last dose of study drug (Up to 35 days) | An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. |
| Part 2: Number of Participants With AEs Leading to Discontinuation of Study Drug | Up to the last dose of study drug (Up to 28 days) | An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. Discontinuation refers to discontinuation of study drug (MK-8777 or Placebo). |
| Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | Up to 7 days following the last dose of study drug (Up to 23 days) | An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. A moderate intensity AE is defined as an AE that causes no significant interference with functioning. |
| Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | Up to the last dose of study drug (Up to 16 days) | An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. Discontinuation refers to discontinuation of study drug (MK-8777 or Placebo). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Part 2: Change From Baseline in the MADRS | Baseline and end of treatment (Up to Day 28) | The MADRS is a 10-item scale designed to assess the severity of depression. The questionnaire includes questions on the following symptoms: Apparent sadness, Reported sadness, Inner tension, Reduced sleep, Reduced appetite, Concentration difficulties, Lassitude, Inability to feel, Pessimistic thoughts, and Suicidal thoughts. Each of the 10 symptoms are rated on a scale of 1 to 6, with 1=absent to 6=severe. The MADRS score can range from 0 (symptoms absent) to 60 (severe depression), with a higher score indicating more severe depression. |
| Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | Baseline and end of treatment (Up to Day 16) | The MADRS is a 10-item scale designed to assess the severity of depression. The questionnaire includes questions on the following symptoms: Apparent sadness, Reported sadness, Inner tension, Reduced sleep, Reduced appetite, Concentration difficulties, Lassitude, Inability to feel, Pessimistic thoughts, and Suicidal thoughts. Each of the 10 symptoms are rated on a scale of 1 to 6, with 1=absent to 6=severe. The MADRS score can range from 0 (symptoms absent) to 60 (severe depression), with a higher score indicating more severe depression. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Part 1: Block A MK-8777 Participants receive MK-8777 initiated at 100 mg BID and titrated to a maximum of 600 mg BID. Participants receive MK-8777 for a total of 16 days. | 4 |
| Part 1: Block A Placebo Participants receive placebo BID for a total of 16 days. | 2 |
| Part 1: Block B MK-8777 Participants receive MK-8777 initiated at 200 mg BID and titrated to a maximum of 600 mg BID. Participants receive MK-8777 for a total of 13 days. | 4 |
| Part 1: Block B Placebo Participants receive placebo BID for a total of 13 days. | 2 |
| Part 1: Block C MK-8777 Participants receive MK-8777 initiated at 300 mg BID and titrated to a maximum of 600 mg BID. Participants receive MK-8777 for a total of 10 days. | 4 |
| Part 1: Block C Placebo Participants receive placebo BID for a total of 10 days. | 2 |
| Part 1: Block D MK-8777 Participants receive MK-8777 initiated at 100 mg BID and titrated to a maximum dose determined by the results of Block A. Participants receive MK-8777 for a total of 13 days. | 4 |
| Part 1: Block D Placebo Participants receive placebo BID for a total of 13 days. | 2 |
| Part 2: MK-8777 200 mg Participants receive MK-8777 100 mg BID for 27 days followed by one day of 100 mg QD. Participants receive MK-8777 for a total of 28 days. | 10 |
| Part 2: MK-8777 800 mg Participants receive MK-8777 200 mg BID for 3 days followed by 400 mg BID for 24 days followed by one day of 400 mg QD. Participants receive MK-8777 for a total of 28 days. | 10 |
| Part 2: Placebo Participants receive placebo BID for 27 days followed by one day of placebo QD. Participants receive placebo for 28 days. | 10 |
| Total | 54 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 | FG008 | FG009 | FG010 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| Overall Study | Family Emergency | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
Baseline characteristics
| Characteristic | Part 1: Block A MK-8777 | Part 1: Block A Placebo | Part 1: Block B MK-8777 | Part 1: Block B Placebo | Part 1: Block C MK-8777 | Part 1: Block C Placebo | Part 1: Block D MK-8777 | Part 1: Block D Placebo | Part 2: MK-8777 200 mg | Part 2: MK-8777 800 mg | Part 2: Placebo | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | 28.8 years STANDARD_DEVIATION 5 | 32.5 years STANDARD_DEVIATION 13.4 | 42.0 years STANDARD_DEVIATION 14.8 | 28.5 years STANDARD_DEVIATION 9.2 | 35.5 years STANDARD_DEVIATION 9.7 | 39.0 years STANDARD_DEVIATION 14.1 | 40.5 years STANDARD_DEVIATION 6.8 | 36.5 years STANDARD_DEVIATION 23.3 | 38.3 years STANDARD_DEVIATION 14.4 | 35.6 years STANDARD_DEVIATION 12.8 | 31.1 years STANDARD_DEVIATION 6.5 | 35.4 years STANDARD_DEVIATION 11.3 |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 4 Participants | 1 Participants | 2 Participants | 0 Participants | 0 Participants | 0 Participants | 4 Participants | 4 Participants | 5 Participants | 20 Participants |
| Sex: Female, Male Male | 4 Participants | 2 Participants | 0 Participants | 1 Participants | 2 Participants | 2 Participants | 4 Participants | 2 Participants | 6 Participants | 6 Participants | 5 Participants | 34 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk | EG010 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 4 / 4 | 2 / 2 | 4 / 4 | 2 / 2 | 4 / 4 | 1 / 2 | 4 / 4 | 2 / 2 | 10 / 10 | 9 / 10 | 9 / 10 |
| serious Total, serious adverse events | 0 / 4 | 0 / 2 | 0 / 4 | 0 / 2 | 0 / 4 | 0 / 2 | 0 / 4 | 0 / 2 | 0 / 10 | 0 / 10 | 0 / 10 |
Outcome results
Primary
Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug
An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. Discontinuation refers to discontinuation of study drug (MK-8777 or Placebo).
Time frame: Up to the last dose of study drug (Up to 16 days)
Population: The AST population consisted of all Part 1 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Block A MK-8777 | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 1 participants |
| Part 1: Block A Placebo | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block B MK-8777 | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block B Placebo | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block C MK-8777 | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block C Placebo | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block D MK-8777 | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block D Placebo | Part 1: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
Primary
Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs)
An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. A moderate intensity AE is defined as an AE that causes no significant interference with functioning.
Time frame: Up to 7 days following the last dose of study drug (Up to 23 days)
Population: The All Subjects Treated (AST) population consisted of all Part 1 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Block A MK-8777 | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 2 participants |
| Part 1: Block A Placebo | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 0 participants |
| Part 1: Block B MK-8777 | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 1 participants |
| Part 1: Block B Placebo | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 2 participants |
| Part 1: Block C MK-8777 | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 4 participants |
| Part 1: Block C Placebo | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 0 participants |
| Part 1: Block D MK-8777 | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 3 participants |
| Part 1: Block D Placebo | Part 1: Number of Participants With Moderate Intensity Adverse Events (AEs) | 2 participants |
Primary
Part 1: Number of Participants With Serious Adverse Events (SAEs)
An SAE is defined as any untoward medical occurrence that at any dose: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, or is a congenital anomaly/birth defect.
Time frame: Up to 30 days following the last dose of study drug (Up to 46 days)
Population: The AST population consisted of all Part 1 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Block A MK-8777 | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block A Placebo | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block B MK-8777 | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block B Placebo | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block C MK-8777 | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block C Placebo | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block D MK-8777 | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
| Part 1: Block D Placebo | Part 1: Number of Participants With Serious Adverse Events (SAEs) | 0 participants |
Primary
Part 2: Number of Participants With AEs
An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product.
Time frame: Up to 7 days following the last dose of study drug (Up to 35 days)
Population: The AST population consisted of all Part 2 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Block A MK-8777 | Part 2: Number of Participants With AEs | 10 participants |
| Part 1: Block A Placebo | Part 2: Number of Participants With AEs | 9 participants |
| Part 1: Block B MK-8777 | Part 2: Number of Participants With AEs | 9 participants |
Primary
Part 2: Number of Participants With AEs Leading to Discontinuation of Study Drug
An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug, whether or not considered related to the use of the product. Discontinuation refers to discontinuation of study drug (MK-8777 or Placebo).
Time frame: Up to the last dose of study drug (Up to 28 days)
Population: The AST population consisted of all Part 2 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Part 1: Block A MK-8777 | Part 2: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block A Placebo | Part 2: Number of Participants With AEs Leading to Discontinuation of Study Drug | 0 participants |
| Part 1: Block B MK-8777 | Part 2: Number of Participants With AEs Leading to Discontinuation of Study Drug | 1 participants |
Secondary
Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS)
The MADRS is a 10-item scale designed to assess the severity of depression. The questionnaire includes questions on the following symptoms: Apparent sadness, Reported sadness, Inner tension, Reduced sleep, Reduced appetite, Concentration difficulties, Lassitude, Inability to feel, Pessimistic thoughts, and Suicidal thoughts. Each of the 10 symptoms are rated on a scale of 1 to 6, with 1=absent to 6=severe. The MADRS score can range from 0 (symptoms absent) to 60 (severe depression), with a higher score indicating more severe depression.
Time frame: Baseline and end of treatment (Up to Day 16)
Population: The AST population consisted of all Part 1 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Part 1: Block A MK-8777 | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -10.00 score on a scale | Standard Deviation 7.53 |
| Part 1: Block A Placebo | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -24.50 score on a scale | Standard Deviation 2.12 |
| Part 1: Block B MK-8777 | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -13.50 score on a scale | Standard Deviation 14.46 |
| Part 1: Block B Placebo | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -7.00 score on a scale | Standard Deviation 8.49 |
| Part 1: Block C MK-8777 | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -10.25 score on a scale | Standard Deviation 9.36 |
| Part 1: Block C Placebo | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -9.50 score on a scale | Standard Deviation 3.54 |
| Part 1: Block D MK-8777 | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -19.00 score on a scale | Standard Deviation 9.76 |
| Part 1: Block D Placebo | Part 1: Change From Baseline in the Montgomery-Ashberg Depression Rating Scale (MADRS) | -2.00 score on a scale | Standard Deviation 5.66 |
Secondary
Part 2: Change From Baseline in the MADRS
The MADRS is a 10-item scale designed to assess the severity of depression. The questionnaire includes questions on the following symptoms: Apparent sadness, Reported sadness, Inner tension, Reduced sleep, Reduced appetite, Concentration difficulties, Lassitude, Inability to feel, Pessimistic thoughts, and Suicidal thoughts. Each of the 10 symptoms are rated on a scale of 1 to 6, with 1=absent to 6=severe. The MADRS score can range from 0 (symptoms absent) to 60 (severe depression), with a higher score indicating more severe depression.
Time frame: Baseline and end of treatment (Up to Day 28)
Population: The AST population consisted of all Part 2 participants who received at least one dose of study drug (MK-8777 or Placebo).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Part 1: Block A MK-8777 | Part 2: Change From Baseline in the MADRS | -15.40 score on a scale | Standard Deviation 6.4 |
| Part 1: Block A Placebo | Part 2: Change From Baseline in the MADRS | -13.70 score on a scale | Standard Deviation 11.57 |
| Part 1: Block B MK-8777 | Part 2: Change From Baseline in the MADRS | -13.30 score on a scale | Standard Deviation 9.04 |