Major Depressive Disorder
Conditions
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.
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.
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
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Montgomery-Asberg Depression Rating Scale (MADRS) | Baseline (Week 8) to Week 16 | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Global Impression - Improvement (CGI-I) | Week 16 | 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. |
Countries
United States
Participant flow
Pre-assignment details
The randomized population for RGH-MD-71 totaled 231 participants
Participants by arm
| Arm | Count |
|---|---|
| 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 |
| Total | 230 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Adverse Event | 2 | 1 | 2 |
| Overall Study | Inability to complete the study visits | 0 | 0 | 1 |
| Overall Study | Lost to Follow-up | 2 | 0 | 3 |
| Overall Study | Protocol Violation | 2 | 4 | 3 |
| Overall Study | Withdrawal by Subject | 3 | 1 | 2 |
Baseline characteristics
| Characteristic | Placebo | Cariprazine 0.1 - 0.3 mg | Cariprazine 1.0 - 2.0 mg | Total |
|---|---|---|---|---|
| Age, Continuous | 45.2 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 Participants | 9 Participants | 9 Participants | 25 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 74 Participants | 67 Participants | 64 Participants | 205 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants | 0 Participants | 0 Participants | 2 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 2 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) Black or African American | 10 Participants | 15 Participants | 11 Participants | 36 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 2 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 69 Participants | 57 Participants | 60 Participants | 186 Participants |
| Sex: Female, Male Female | 61 Participants | 52 Participants | 51 Participants | 164 Participants |
| Sex: Female, Male Male | 20 Participants | 24 Participants | 22 Participants | 66 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 1 / 502 | 0 / 81 | 0 / 76 | 0 / 73 |
| other Total, other adverse events | 262 / 502 | 32 / 81 | 29 / 76 | 35 / 73 |
| serious Total, serious adverse events | 9 / 502 | 1 / 81 | 0 / 76 | 1 / 73 |
Outcome results
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Montgomery-Asberg Depression Rating Scale (MADRS) | -8.0 Units on a Scale | Standard Error 1 |
| Cariprazine 0.1 - 0.3 mg | Montgomery-Asberg Depression Rating Scale (MADRS) | -7.5 Units on a Scale | Standard Error 1.1 |
| Cariprazine 1.0 - 2.0 mg | Montgomery-Asberg Depression Rating Scale (MADRS) | -9.8 Units on a Scale | Standard Error 1.1 |
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Clinical Global Impression - Improvement (CGI-I) | 2.5 Units on a Scale | Standard Error 0.1 |
| Cariprazine 0.1 - 0.3 mg | Clinical Global Impression - Improvement (CGI-I) | 2.5 Units on a Scale | Standard Error 0.1 |
| Cariprazine 1.0 - 2.0 mg | Clinical Global Impression - Improvement (CGI-I) | 2.3 Units on a Scale | Standard Error 0.1 |