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Safety and Efficacy of Cariprazine As Adjunctive Therapy In Major Depressive Disorder

A Double-Blind, Placebo-Controlled Study of Cariprazine (RGH-188) As Adjunctive Therapy In Major Depressive Disorder

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00854100
Enrollment
231
Registered
2009-03-02
Start date
2009-06-30
Completion date
2010-12-06
Last updated
2019-03-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Major Depressive Disorder

Keywords

Adjunctive, Depression, Major Depressive Disorder (MDD)

Brief summary

This is an outpatient study to evaluate the safety, and efficacy of RGH-188 as an add-on therapy to standard antidepressants in patients who did not respond to previous antidepressant therapy.

Interventions

Drug: Antidepressant (citalopram, duloxetine, escitalopram, sertraline, or venlafaxine XR) + Placebo Oral, once daily for 8 weeks following an 8 week Prospective Treatment (Baseline) Period.

DRUGAntidepressant + cariprazine (0.1-0.3 mg/day)

Drug: Antidepressant (citalopram, duloxetine, escitalopram, sertraline, or venlafaxine XR) + cariprazine (0.1-0.3 mg/d) Oral, once daily for 8 weeks following an 8 week Prospective Treatment (Baseline) Period.

DRUGAntidepressant + cariprazine (1-2 mg/d)

Drug: Antidepressant (citalopram, duloxetine, escitalopram, sertraline, or venlafaxine XR) + cariprazine (1-2 mg/d) Oral, once daily for 8 weeks following an 8 week Prospective Treatment (Baseline) Period.

Sponsors

Gedeon Richter Ltd.
CollaboratorINDUSTRY
Forest Laboratories
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* Men and women, 18-65 years old * Currently meet the DSM-IV-TR criteria for moderate to severe MDD without psychotic features. * Previous failure to respond to adequate trials of one or two ADTs with less than 50% reduction in depressive symptoms during the present episode.

Exclusion criteria

* DSM-IV-TR based diagnosis of an axis I disorder, other than MDD, or any axis I disorder other than MDD that was the primary focus of treatment within 6 months before Visit 1

Design outcomes

Primary

MeasureTime frameDescription
Montgomery-Asberg Depression Rating Scale (MADRS)Baseline (Week 8) to Week 16The patient is rated on a scale from 0-6 on 10 items. Apparent sadness, reported sadness, lassitude, pessimistic thoughts, inner tension, suicidal thoughts, reduced sleep and appetite, concentration difficulties, inability to feel. The overall MADRS score ranges from 0-60, with 0 meaning no symptoms and score of 60 meaning maximum severity. The primary efficacy parameter was the change in MADRS score totals from the scores taken at Baseline (Week 8) and during at least one more time point up to and including Week 16.

Secondary

MeasureTime frameDescription
Clinical Global Impression - Improvement (CGI-I)Week 16The Clinical Global Impression-Improvement (CGI-I) scale is a clinician rated scale that, in this study, will be used to rate total improvement or worsening of mental illness starting at Visit 2 (Week 2) and taken at every visit through Visit 11 (Week 16). The patient will be rated on a scale from 1 to 7, 1 indicating that the patient is very much improved and 7 indicating that the patient is very much worse. The secondary efficacy parameter was the CGI-I total score at Week 16.

Countries

United States

Participant flow

Pre-assignment details

The randomized population for RGH-MD-71 totaled 231 participants

Participants by arm

ArmCount
Placebo
Drug: Antidepressant (citalopram, duloxetine, escitalopram, sertraline, or venlafaxine XR) + Placebo
81
Cariprazine 0.1 - 0.3 mg
Drug: Antidepressant (citalopram, duloxetine, escitalopram, sertraline, or venlafaxine XR)+ cariprazine low dose
76
Cariprazine 1.0 - 2.0 mg
Drug: Antidepressant (citalopram, duloxetine, escitalopram, sertraline, or venlafaxine XR) + cariprazine high dose
73
Total230

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event212
Overall StudyInability to complete the study visits001
Overall StudyLost to Follow-up203
Overall StudyProtocol Violation243
Overall StudyWithdrawal by Subject312

Baseline characteristics

CharacteristicPlaceboCariprazine 0.1 - 0.3 mgCariprazine 1.0 - 2.0 mgTotal
Age, Continuous45.2 Years
STANDARD_DEVIATION 10.2
46.6 Years
STANDARD_DEVIATION 11.7
44.2 Years
STANDARD_DEVIATION 12.1
45.3 Years
STANDARD_DEVIATION 11.3
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants9 Participants9 Participants25 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
74 Participants67 Participants64 Participants205 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
Asian
0 Participants2 Participants1 Participants3 Participants
Race (NIH/OMB)
Black or African American
10 Participants15 Participants11 Participants36 Participants
Race (NIH/OMB)
More than one race
0 Participants2 Participants1 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
69 Participants57 Participants60 Participants186 Participants
Sex: Female, Male
Female
61 Participants52 Participants51 Participants164 Participants
Sex: Female, Male
Male
20 Participants24 Participants22 Participants66 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
1 / 5020 / 810 / 760 / 73
other
Total, other adverse events
262 / 50232 / 8129 / 7635 / 73
serious
Total, serious adverse events
9 / 5021 / 810 / 761 / 73

Outcome results

Primary

Montgomery-Asberg Depression Rating Scale (MADRS)

The patient is rated on a scale from 0-6 on 10 items. Apparent sadness, reported sadness, lassitude, pessimistic thoughts, inner tension, suicidal thoughts, reduced sleep and appetite, concentration difficulties, inability to feel. The overall MADRS score ranges from 0-60, with 0 meaning no symptoms and score of 60 meaning maximum severity. The primary efficacy parameter was the change in MADRS score totals from the scores taken at Baseline (Week 8) and during at least one more time point up to and including Week 16.

Time frame: Baseline (Week 8) to Week 16

Population: 231 patients were randomized, and of them, 230 received at least 1 dose of treatment (Double-blind Safety Population), and had at least a baseline and 1 post-baseline MADRS assessment (Double-blind Intent To Treat Population). All patients in the Double-blind Intent To Treat Population were included in the efficacy analyses.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboMontgomery-Asberg Depression Rating Scale (MADRS)-8.0 Units on a ScaleStandard Error 1
Cariprazine 0.1 - 0.3 mgMontgomery-Asberg Depression Rating Scale (MADRS)-7.5 Units on a ScaleStandard Error 1.1
Cariprazine 1.0 - 2.0 mgMontgomery-Asberg Depression Rating Scale (MADRS)-9.8 Units on a ScaleStandard Error 1.1
p-value: 0.74695% CI: [-2.4, 3.4]ANCOVA
p-value: 0.22795% CI: [-4.8, 1.1]ANCOVA
Secondary

Clinical Global Impression - Improvement (CGI-I)

The Clinical Global Impression-Improvement (CGI-I) scale is a clinician rated scale that, in this study, will be used to rate total improvement or worsening of mental illness starting at Visit 2 (Week 2) and taken at every visit through Visit 11 (Week 16). The patient will be rated on a scale from 1 to 7, 1 indicating that the patient is very much improved and 7 indicating that the patient is very much worse. The secondary efficacy parameter was the CGI-I total score at Week 16.

Time frame: Week 16

Population: 231 patients were randomized, and of them, 230 received at least 1 dose of treatment (Double-blind Safety Population), and had at least a baseline and 1 post-baseline MADRS assessment (Double-blind Intent To Treat Population). All patients in the Double-blind Intent To Treat Population were included in the efficacy analyses.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboClinical Global Impression - Improvement (CGI-I)2.5 Units on a ScaleStandard Error 0.1
Cariprazine 0.1 - 0.3 mgClinical Global Impression - Improvement (CGI-I)2.5 Units on a ScaleStandard Error 0.1
Cariprazine 1.0 - 2.0 mgClinical Global Impression - Improvement (CGI-I)2.3 Units on a ScaleStandard Error 0.1
p-value: 0.91895% CI: [-0.3, 0.3]ANCOVA
p-value: 0.16795% CI: [-0.6, 0.1]ANCOVA

Source: ClinicalTrials.gov · Data processed: Feb 23, 2026