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A Study to Assess the Efficacy and Safety of TC-5214 as an Adjunct Therapy in Patients With Major Depressive Disorder.

A Multicenter, Randomized, Double-Blind Parallel Group Placebo-Controlled Phase III, Efficacy and Safety Study of 3 Fixed Dose Groups of TC-5214 (S-mecamylamine) as an Adjunct to an Antidepressants in Patients With Major Depressive Disorder Who Exhibit an Inadequate Response to Antidepressant Therapy

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01197508
Enrollment
696
Registered
2010-09-09
Start date
2010-09-30
Completion date
2012-01-31
Last updated
2014-04-11

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

Conditions

Major Depressive Disorder

Keywords

Major Depressive Disorder, MDD, Depression

Brief summary

The purpose of this study is to determine if TC-5214 or placebo (a tablet that looks like a medicine tablet or capsule, but contains no active medicine) is safe and effective when taken together with another antidepressant.

Detailed description

A Multicenter, Randomized, Double-Blind Parallel Group Placebo-Controlled Phase III, Efficacy and Safety Study of 3 Fixed Dose Groups of TC-5214 (S-mecamylamine) as an Adjunct to an Antidepressants in Patients with Major Depressive Disorder Who Exhibit an Inadequate Response to Antidepressant Therapy

Interventions

Twice daily for 8 weeks.

DRUGPlacebo

Twice daily for 8 weeks.

Sponsors

Targacept Inc.
CollaboratorINDUSTRY
AstraZeneca
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

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

Inclusion criteria

* Provision of signed and dated informed consent before initiation of any study-related procedures. * The patient must have a clinical diagnosis of major depressive disorder (MDD) with inadequate response to no more than one antidepressant. * Outpatient status at enrollment and randomization.

Exclusion criteria

* Patients with a lifetime history of bipolar disorder, psychotic disorder or post-traumatic stress disorder. * Patients with a history of suicide attempts in the past year and/or seen by the investigator as having a significant history of risk of suicide or homicide. * History of renal insufficiency or impairment or conditions that could affect absorption or metabolism of investigational product.

Design outcomes

Primary

MeasureTime frameDescription
Change in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.Randomization (Week 8) to end of treatment (Week 16)A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Secondary

MeasureTime frameDescription
Remission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)Week 16The percentage of patients with a MADRS total score of ≤8 at end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Early and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16); Week 10, Week 12, Week 14, and Week 16The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score and a MADRS total score of ≤12 at Week 10, Week 12, Week 14, and end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16); Week 12, Week 14, and Week 16The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score and a MADRS total score of ≤12 at Week 12, Week 14, and end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Sustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)Week 12, Week 14, Week 16The percentage of patients with a MADRS total score of ≤8 at Week 12, Week 14, and end of treatment (Week 16)was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Change in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total ScoreRandomization (Week 8) to end of treatment (Week 16)A 17-item, clinician-rated scale that assesses depressive symptoms. The HAMD-17 consists of 17 symptoms, each of which is rated from 0 to 2 or 0 to 4, where 0 is none/absent. The HAMD-17 total score is calculated as the sum of the 17 individual symptom scores; the total score can range from 0 to 52. Higher HAMD-17 scores indicate more severe depression.
Change in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16)A 3-part, clinician-administered scale that rates the improvement or worsening of the patient's illness from randomization (baseline). Each item is scored on a 1 to 7 scale. Higher CGI-S scores indicate greater illness severity.
Response in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of Very Much Improved or Much Improved From Randomization (Week 8) to End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16)A 3-part, clinician-administered scale that rates the improvement or worsening of the patient's illness from randomization (baseline). Each item is scored on a 1 to 7 scale. CGI-I scores \>4 indicate worsening, while scores \<4 indicate improvement.
Change in Hamilton Anxiety Scale (HAM-A) Total Score From Randomization (Week 8) to End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16)A 14-item clinician-administered scale for the evaluation of anxiety symptoms. Each HAM-A item is rated on a 0 to 4 scale. Higher HAM-A scores indicate higher levels of anxiety.
Change in MADRS Total Score From Randomization (Week 8) to Week 9Randomization (Week 8) to Week 9A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Change in MADRS Total Score From Randomization (Week 8) to Week 10Randomization (Week 8) to Week 10A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Response in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16)The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score at end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Change in MADRS Total Score From Randomization (Week 8) to Week 14Randomization (Week 8) to Week 14A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total ScoreRandomization (Week 8) to end of treatment (Week 16)Sheehan Disability Scale (SDS) is 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The SDS total score is calculated as the sum of the score for the 3 inter-correlated domains (school/work, social life, and family life/home responsibilities) and ranges from 0 (unimpaired) to 30 (highly impaired).
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain ScoreRandomization (Week 8) to end of treatment (Week 16)A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the work/school domain score is 0- 10, where 10 is considered to be 'highly impaired'.
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain ScoreRandomization (Week 8) to end of treatment (Week 16)A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the SDS social life domain score is 0- 10, where 10 is considered to be 'highly impaired'.
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain ScoreRandomization (Week 8) to end of treatment (Week 16)A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the SDS family life/home responsibilities domain score is 0- 10, where 10 is considered to be 'highly impaired'.
Change in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total ScoreRandomization (Week 8) to end of treatment (Week 16)The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) total score is derived by summing item scores 1 to 14. Higher scores are indicative of greater enjoyment or satisfaction in each domain. The Q-LES-Q-SF % maximum total score is calculated as 100% × (Q-LES-Q-SF total score - 14) / 56, and can range from 0% to 100%.
Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 15Randomization (Week 8) to end of treatment (Week 16)The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) measures the patient's satisfaction with medication and overall quality of life. The 15th item queries respondents' satisfaction with the medication they are taking. Higher scores are indicative of greater enjoyment or satisfaction in each domain.
Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 16Randomization (Week 8) to end of treatment (Week 16)The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) measures the patient's satisfaction with medication and overall quality of life. The 16th item is a global rating of overall life satisfaction and contentment. Higher scores are indicative of greater enjoyment or satisfaction in each domain.
Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)Randomization (Week 8) to end of treatment (Week 16)A self-assessment questionnaire that provides 2 measures of health status. The EQ-5D index score is a weighted linear combination over 5 dimensions of health status. The score for each of the 5 dimensions can range from 1 to 3, and an equation is used to calculate the EQ-5D index score. The EQ-5D index score can range from possible negative values to a maximum of 1.0. The EQ-VAS is a visual analog scale with a range of 0 to 100. For both variables, a higher score indicates a better health state.
Change in MADRS Total Score From Randomization (Week 8) to Week 12Randomization (Week 8) to Week 12A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Countries

Argentina, Brazil, Bulgaria, Chile, Colombia, Croatia, France, Germany, Hungary, Poland, Romania, Russia, Serbia, Slovakia, South Africa, Spain, Ukraine

Participant flow

Recruitment details

This multicenter study was conducted in Europe, South Africa, and Latin America between 1 September 2010 and 30 January 2012.

Pre-assignment details

The study had an up to 21-day screening/washout period, and an 8-week prospective open-label antidepressant treatment (ADT) period to identify the target patient population of inadequate responders to ADT (\<50% reduction in HAMD-17 total score during the prospective open-label ADT period, a HAMD-17 total score of ≥16 and a CGI-S score ≥4).

Participants by arm

ArmCount
0.1 mg BID TC-5214
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 0.1 mg BID
174
1 mg BID TC-5214
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1 mg BID
174
4 mg BID TC-5214
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 4 mg BID
174
Placebo
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
174
Total696

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdverse Event1013233
Overall StudyCondition under investigation worsened1111
Overall StudyEligiblity criteria not fulfilled0020
Overall StudyLack of Efficacy1221
Overall StudyLost to Follow-up1120
Overall StudyOther2322
Overall StudySevere non-compliance to protocol0313
Overall StudyStudy-specific withdrawal criteria0012
Overall StudyWithdrawal by Subject87154

Baseline characteristics

Characteristic1 mg BID TC-5214TotalPlacebo4 mg BID TC-52140.1 mg BID TC-5214
Age, Continuous45.0 years
STANDARD_DEVIATION 11.72
45.6 years
STANDARD_DEVIATION 11.21
45.8 years
STANDARD_DEVIATION 11.75
45.6 years
STANDARD_DEVIATION 10.72
46.0 years
STANDARD_DEVIATION 10.66
Hamilton Rating Scale for Depression-17 items (HAMD-17) total score at randomization20.98 Scores on a scale
STANDARD_DEVIATION 3.182
21.30 Scores on a scale
STANDARD_DEVIATION 3.517
21.26 Scores on a scale
STANDARD_DEVIATION 3.614
21.50 Scores on a scale
STANDARD_DEVIATION 3.674
21.49 Scores on a scale
STANDARD_DEVIATION 3.587
Montgomery-Asberg Depression Rating Scale (MADRS) total score at randomization24.67 Scores on a scale
STANDARD_DEVIATION 5.389
24.62 Scores on a scale
STANDARD_DEVIATION 5.152
24.11 Scores on a scale
STANDARD_DEVIATION 4.992
25.03 Scores on a scale
STANDARD_DEVIATION 5.137
24.69 Scores on a scale
STANDARD_DEVIATION 5.086
Race/Ethnicity, Customized
American Indian or Alaska Native
1 participants1 participants0 participants0 participants0 participants
Race/Ethnicity, Customized
Asian
1 participants2 participants1 participants0 participants0 participants
Race/Ethnicity, Customized
Black or African American
3 participants8 participants2 participants1 participants2 participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
0 participants0 participants0 participants0 participants0 participants
Race/Ethnicity, Customized
Other
13 participants53 participants13 participants16 participants11 participants
Race/Ethnicity, Customized
White
156 participants632 participants158 participants157 participants161 participants
Sex: Female, Male
Female
125 Participants498 Participants129 Participants117 Participants127 Participants
Sex: Female, Male
Male
49 Participants198 Participants45 Participants57 Participants47 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
— / —— / —— / —— / —
other
Total, other adverse events
64 / 17468 / 17472 / 17494 / 171
serious
Total, serious adverse events
2 / 1742 / 1744 / 1742 / 171

Outcome results

Primary

Change in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.-11.6 units on a scaleStandard Error 0.65
1 mg BID TC-5214Change in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.-12.2 units on a scaleStandard Error 0.66
4 mg BID TC-5214Change in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.-12.2 units on a scaleStandard Error 0.69
PlaceboChange in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.-12.7 units on a scaleStandard Error 0.65
Comparison: Mixed model repeated measures (MMRM) includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 195% CI: [-0.53, 2.79]MMRM
Comparison: Mixed model repeated measures (MMRM) includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 195% CI: [-1.22, 2.13]MMRM
Comparison: Mixed model repeated measures (MMRM) includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 195% CI: [-1.21, 2.22]MMRM
Secondary

Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 15

The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) measures the patient's satisfaction with medication and overall quality of life. The 15th item queries respondents' satisfaction with the medication they are taking. Higher scores are indicative of greater enjoyment or satisfaction in each domain.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 150.6 units on a scaleStandard Error 0.08
1 mg BID TC-5214Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 150.7 units on a scaleStandard Error 0.08
4 mg BID TC-5214Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 150.5 units on a scaleStandard Error 0.08
PlaceboChange From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 150.7 units on a scaleStandard Error 0.08
Comparison: An analysis of covariance (ANCOVA) with randomization Q-LES-Q-SF item 15 score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.31295% CI: [-0.29, 0.09]ANCOVA
Comparison: An analysis of covariance (ANCOVA) with randomization Q-LES-Q-SF item 15 score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.88595% CI: [-0.18, 0.21]ANCOVA
Comparison: An analysis of covariance (ANCOVA) with randomization Q-LES-Q-SF item 15 score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.06795% CI: [-0.37, 0.01]ANCOVA
Secondary

Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 16

The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) measures the patient's satisfaction with medication and overall quality of life. The 16th item is a global rating of overall life satisfaction and contentment. Higher scores are indicative of greater enjoyment or satisfaction in each domain.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 160.7 units on a scaleStandard Error 0.08
1 mg BID TC-5214Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 160.7 units on a scaleStandard Error 0.08
4 mg BID TC-5214Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 160.6 units on a scaleStandard Error 0.08
PlaceboChange From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 160.8 units on a scaleStandard Error 0.08
Comparison: An analysis of covariance (ANCOVA) with randomization Q-LES-Q-SF item 16 as a fixed effect and pooled center as a random effect.p-value: 0.15295% CI: [-0.33, 0.05]ANCOVA
Comparison: An analysis of covariance (ANCOVA) with randomization Q-LES-Q-SF item 16 as a fixed effect and pooled center as a random effect.p-value: 0.07895% CI: [-0.37, 0.02]ANCOVA
Comparison: An analysis of covariance (ANCOVA) with randomization Q-LES-Q-SF item 16 as a fixed effect and pooled center as a random effect.p-value: 0.03395% CI: [-0.41, -0.02]ANCOVA
Secondary

Change in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total Score

A 17-item, clinician-rated scale that assesses depressive symptoms. The HAMD-17 consists of 17 symptoms, each of which is rated from 0 to 2 or 0 to 4, where 0 is none/absent. The HAMD-17 total score is calculated as the sum of the 17 individual symptom scores; the total score can range from 0 to 52. Higher HAMD-17 scores indicate more severe depression.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total Score-10.07 units on a scaleStandard Error 0.597
1 mg BID TC-5214Change in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total Score-10.21 units on a scaleStandard Error 0.603
4 mg BID TC-5214Change in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total Score-9.07 units on a scaleStandard Error 0.597
PlaceboChange in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total Score-11.16 units on a scaleStandard Error 0.592
Comparison: Analysis of covariance (ANCOVA) with randomization HAMD-17 total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.1295% CI: [-0.288, 2.481]ANCOVA
Comparison: Analysis of covariance (ANCOVA) with randomization HAMD-17 total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.18495% CI: [-0.452, 2.354]ANCOVA
Comparison: Analysis of covariance (ANCOVA) with randomization HAMD-17 total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.00395% CI: [0.692, 3.484]ANCOVA
Secondary

Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)

A self-assessment questionnaire that provides 2 measures of health status. The EQ-5D index score is a weighted linear combination over 5 dimensions of health status. The score for each of the 5 dimensions can range from 1 to 3, and an equation is used to calculate the EQ-5D index score. The EQ-5D index score can range from possible negative values to a maximum of 1.0. The EQ-VAS is a visual analog scale with a range of 0 to 100. For both variables, a higher score indicates a better health state.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D index score0.128 units on a scaleStandard Error 0.0147
0.1 mg BID TC-5214Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D VAS score16.4 units on a scaleStandard Error 1.52
1 mg BID TC-5214Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D index score0.139 units on a scaleStandard Error 0.0149
1 mg BID TC-5214Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D VAS score17.0 units on a scaleStandard Error 1.54
4 mg BID TC-5214Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D VAS score15.9 units on a scaleStandard Error 1.61
4 mg BID TC-5214Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D index score0.133 units on a scaleStandard Error 0.0155
PlaceboChange in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D index score0.139 units on a scaleStandard Error 0.0146
PlaceboChange in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)EQ-5D VAS score18.7 units on a scaleStandard Error 1.51
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization EQ-5D total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.54395% CI: [-0.0465, 0.0245]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization EQ-5D total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.99895% CI: [-0.036, 0.0361]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization EQ-5D total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.74395% CI: [-0.0432, 0.0308]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization EQ-5D VAS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.24495% CI: [-6.1, 1.56]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization EQ-5D VAS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.38995% CI: [-5.59, 2.18]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization EQ-5D VAS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.16595% CI: [-6.79, 1.16]MMRM
Secondary

Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain Score

A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the SDS family life/home responsibilities domain score is 0- 10, where 10 is considered to be 'highly impaired'.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain Score-2.0 units on a scaleStandard Error 0.2
1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain Score-2.1 units on a scaleStandard Error 0.2
4 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain Score-2.0 units on a scaleStandard Error 0.21
PlaceboChange in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain Score-2.3 units on a scaleStandard Error 0.2
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS family life/home responsibilities domain score. Treatment, visit and treatment by visit interaction are effects in the model; pooled center is a random effect.p-value: 0.17495% CI: [-0.16, 0.87]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS family life/home responsibilities domain score. Treatment, visit and treatment by visit interaction are effects in the model; pooled center is a random effect.p-value: 0.40295% CI: [-0.3, 0.74]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS family life/home responsibilities domain score. Treatment, visit and treatment by visit interaction are effects in the model; pooled center is a random effect.p-value: 0.19795% CI: [-0.18, 0.88]MMRM
Secondary

Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain Score

A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the SDS social life domain score is 0- 10, where 10 is considered to be 'highly impaired'.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain Score-2.1 units on a scaleStandard Error 0.2
1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain Score-2.2 units on a scaleStandard Error 0.2
4 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain Score-2.2 units on a scaleStandard Error 0.21
PlaceboChange in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain Score-2.4 units on a scaleStandard Error 0.2
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS social life domain score. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.24895% CI: [-0.21, 0.82]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS social life domain score. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.49895% CI: [-0.34, 0.7]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS social life domain score. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.44195% CI: [-0.32, 0.74]MMRM
Secondary

Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain Score

A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the work/school domain score is 0- 10, where 10 is considered to be 'highly impaired'.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain Score-2.0 units on a scaleStandard Error 0.21
1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain Score-1.8 units on a scaleStandard Error 0.22
4 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain Score-1.9 units on a scaleStandard Error 0.24
PlaceboChange in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain Score-2.1 units on a scaleStandard Error 0.22
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS work/school domain score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.91495% CI: [-0.54, 0.61]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS work/school domain score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.44695% CI: [-0.36, 0.81]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization SDS work/school domain score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.65695% CI: [-0.47, 0.75]MMRM
Secondary

Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total Score

Sheehan Disability Scale (SDS) is 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The SDS total score is calculated as the sum of the score for the 3 inter-correlated domains (school/work, social life, and family life/home responsibilities) and ranges from 0 (unimpaired) to 30 (highly impaired).

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total Score-6.08 units on a scaleStandard Error 0.561
1 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total Score-6.34 units on a scaleStandard Error 0.569
4 mg BID TC-5214Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total Score-6.21 units on a scaleStandard Error 0.592
PlaceboChange in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total Score-7.06 units on a scaleStandard Error 0.556
Comparison: MMRM model includes treatment, pooled center, visit, and treatment by visit interaction as explanatory variables and the randomization SDS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 195% CI: [-0.464, 2.427]MMRM
Comparison: MMRM model includes treatment, pooled center, visit, and treatment by visit interaction as explanatory variables and the randomization SDS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 195% CI: [-0.74, 2.188]MMRM
Comparison: MMRM model includes treatment, pooled center, visit, and treatment by visit interaction as explanatory variables and the randomization SDS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 195% CI: [-0.649, 2.346]MMRM
Secondary

Change in Hamilton Anxiety Scale (HAM-A) Total Score From Randomization (Week 8) to End of Treatment (Week 16)

A 14-item clinician-administered scale for the evaluation of anxiety symptoms. Each HAM-A item is rated on a 0 to 4 scale. Higher HAM-A scores indicate higher levels of anxiety.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Hamilton Anxiety Scale (HAM-A) Total Score From Randomization (Week 8) to End of Treatment (Week 16)-8.5 units on a scaleStandard Error 0.58
1 mg BID TC-5214Change in Hamilton Anxiety Scale (HAM-A) Total Score From Randomization (Week 8) to End of Treatment (Week 16)-8.6 units on a scaleStandard Error 0.59
4 mg BID TC-5214Change in Hamilton Anxiety Scale (HAM-A) Total Score From Randomization (Week 8) to End of Treatment (Week 16)-8.1 units on a scaleStandard Error 0.58
PlaceboChange in Hamilton Anxiety Scale (HAM-A) Total Score From Randomization (Week 8) to End of Treatment (Week 16)-9.3 units on a scaleStandard Error 0.58
Comparison: An analysis of covariance (ANCOVA) with randomization HAM-A total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.27395% CI: [-0.58, 2.03]ANCOVA
Comparison: An analysis of covariance (ANCOVA) with randomization HAM-A total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.31595% CI: [-0.65, 2]ANCOVA
Comparison: An analysis of covariance (ANCOVA) with randomization HAM-A total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.07895% CI: [-0.13, 2.51]ANCOVA
Secondary

Change in MADRS Total Score From Randomization (Week 8) to Week 10

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to Week 10

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 10-4.8 units on a scaleStandard Error 0.5
1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 10-5.9 units on a scaleStandard Error 0.5
4 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 10-5.0 units on a scaleStandard Error 0.51
PlaceboChange in MADRS Total Score From Randomization (Week 8) to Week 10-6.0 units on a scaleStandard Error 0.5
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.05295% CI: [-0.01, 2.38]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.87495% CI: [-1.11, 1.3]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.09995% CI: [-0.19, 2.24]MMRM
Secondary

Change in MADRS Total Score From Randomization (Week 8) to Week 12

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to Week 12

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 12-8.1 units on a scaleStandard Error 0.55
1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 12-8.5 units on a scaleStandard Error 0.56
4 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 12-7.8 units on a scaleStandard Error 0.57
PlaceboChange in MADRS Total Score From Randomization (Week 8) to Week 12-8.7 units on a scaleStandard Error 0.55
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.39495% CI: [-0.77, 1.95]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.71295% CI: [-1.11, 1.63]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.16795% CI: [-0.41, 2.38]MMRM
Secondary

Change in MADRS Total Score From Randomization (Week 8) to Week 14

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to Week 14

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 14-9.5 units on a scaleStandard Error 0.59
1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 14-10.6 units on a scaleStandard Error 0.6
4 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 14-9.6 units on a scaleStandard Error 0.62
PlaceboChange in MADRS Total Score From Randomization (Week 8) to Week 14-11.0 units on a scaleStandard Error 0.59
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects the model; pooled center is a random effect.p-value: 0.04695% CI: [0.02, 2.95]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.68195% CI: [-1.17, 1.79]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.08795% CI: [-0.19, 2.84]MMRM
Secondary

Change in MADRS Total Score From Randomization (Week 8) to Week 9

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to Week 9

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 9-3.0 units on a scaleStandard Error 0.42
1 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 9-3.0 units on a scaleStandard Error 0.43
4 mg BID TC-5214Change in MADRS Total Score From Randomization (Week 8) to Week 9-2.6 units on a scaleStandard Error 0.42
PlaceboChange in MADRS Total Score From Randomization (Week 8) to Week 9-3.2 units on a scaleStandard Error 0.42
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.5995% CI: [-0.68, 1.19]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.67995% CI: [-0.74, 1.14]MMRM
Comparison: MMRM model includes treatment, pooled center, visit and treatment by visit interaction as explanatory variables and the randomization MADRS total score as a covariate. Treatment, visit and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.21595% CI: [-0.35, 1.53]MMRM
Secondary

Change in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total Score

The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) total score is derived by summing item scores 1 to 14. Higher scores are indicative of greater enjoyment or satisfaction in each domain. The Q-LES-Q-SF % maximum total score is calculated as 100% × (Q-LES-Q-SF total score - 14) / 56, and can range from 0% to 100%.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total Score13.08 units on a scaleStandard Error 1.388
1 mg BID TC-5214Change in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total Score13.24 units on a scaleStandard Error 1.402
4 mg BID TC-5214Change in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total Score11.84 units on a scaleStandard Error 1.409
PlaceboChange in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total Score14.55 units on a scaleStandard Error 1.391
Comparison: ANCOVA with randomization Q-LES-Q-SF % maximum total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.37195% CI: [-4.697, 1.756]ANCOVA
Comparison: ANCOVA with randomization Q-LES-Q-SF % maximum total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.43295% CI: [-4.597, 1.967]ANCOVA
Comparison: ANCOVA with randomization Q-LES-Q-SF % maximum total score as covariate, treatment as a fixed effect and pooled center as a random effect.p-value: 0.10595% CI: [-5.992, 0.573]ANCOVA
Secondary

Change in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)

A 3-part, clinician-administered scale that rates the improvement or worsening of the patient's illness from randomization (baseline). Each item is scored on a 1 to 7 scale. Higher CGI-S scores indicate greater illness severity.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.1 mg BID TC-5214Change in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)-1.5 units on a scaleStandard Error 0.09
1 mg BID TC-5214Change in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)-1.6 units on a scaleStandard Error 0.09
4 mg BID TC-5214Change in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)-1.7 units on a scaleStandard Error 0.1
PlaceboChange in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)-1.7 units on a scaleStandard Error 0.09
Comparison: MMRM model includes treatment, pooled center, visit, and treatment by visit interaction as explanatory variables and the randomization CGI-S total score as a covariate. Treatment, visit, and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.13195% CI: [-0.05, 0.42]MMRM
Comparison: MMRM model includes treatment, pooled center, visit, and treatment by visit interaction as explanatory variables and the randomization CGI-S total score as a covariate. Treatment, visit, and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.55195% CI: [-0.17, 0.31]MMRM
Comparison: MMRM model includes treatment, pooled center, visit, and treatment by visit interaction as explanatory variables and the randomization CGI-S total score as a covariate. Treatment, visit, and treatment by visit interaction are fixed effects in the model; pooled center is a random effect.p-value: 0.64595% CI: [-0.19, 0.3]MMRM
Secondary

Early and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)

The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score and a MADRS total score of ≤12 at Week 10, Week 12, Week 14, and end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to end of treatment (Week 16); Week 10, Week 12, Week 14, and Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (NUMBER)
0.1 mg BID TC-5214Early and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)7.5 percentage of participants analyzed
1 mg BID TC-5214Early and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)8.1 percentage of participants analyzed
4 mg BID TC-5214Early and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)9.6 percentage of participants analyzed
PlaceboEarly and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)9.2 percentage of participants analyzed
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.71195% CI: [0.36, 1.99]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.59495% CI: [0.34, 1.85]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.74995% CI: [0.5, 2.65]Regression, Logistic
Secondary

Remission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)

The percentage of patients with a MADRS total score of ≤8 at end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (NUMBER)
0.1 mg BID TC-5214Remission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)37.0 percentage of participants analyzed
1 mg BID TC-5214Remission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)35.1 percentage of participants analyzed
4 mg BID TC-5214Remission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)30.0 percentage of participants analyzed
PlaceboRemission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)39.1 percentage of participants analyzed
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.63695% CI: [0.54, 1.45]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.21595% CI: [0.44, 1.2]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.03495% CI: [0.35, 0.96]Regression, Logistic
Secondary

Response in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)

The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score at end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (NUMBER)
0.1 mg BID TC-5214Response in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)48.6 percentage of participants analyzed
1 mg BID TC-5214Response in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)51.1 percentage of participants analyzed
4 mg BID TC-5214Response in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)41.2 percentage of participants analyzed
PlaceboResponse in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)54.0 percentage of participants analyzed
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.14495% CI: [0.45, 1.12]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.20395% CI: [0.47, 1.17]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.00595% CI: [0.32, 0.82]Regression, Logistic
Secondary

Response in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of Very Much Improved or Much Improved From Randomization (Week 8) to End of Treatment (Week 16)

A 3-part, clinician-administered scale that rates the improvement or worsening of the patient's illness from randomization (baseline). Each item is scored on a 1 to 7 scale. CGI-I scores \>4 indicate worsening, while scores \<4 indicate improvement.

Time frame: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (NUMBER)
0.1 mg BID TC-5214Response in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of Very Much Improved or Much Improved From Randomization (Week 8) to End of Treatment (Week 16)59.5 percentage of participants analyzed
1 mg BID TC-5214Response in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of Very Much Improved or Much Improved From Randomization (Week 8) to End of Treatment (Week 16)62.1 percentage of participants analyzed
4 mg BID TC-5214Response in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of Very Much Improved or Much Improved From Randomization (Week 8) to End of Treatment (Week 16)58.8 percentage of participants analyzed
PlaceboResponse in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of Very Much Improved or Much Improved From Randomization (Week 8) to End of Treatment (Week 16)67.8 percentage of participants analyzed
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization Clinical Global Impression Severity (CGI-S) as a covariate.p-value: 0.04695% CI: [0.38, 0.99]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization Clinical Global Impression Severity (CGI-S) as a covariate.p-value: 0.05195% CI: [0.38, 1]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization Clinical Global Impression Severity (CGI-S) as a covariate.p-value: 0.0495% CI: [0.37, 0.98]Regression, Logistic
Secondary

Sustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)

The percentage of patients with a MADRS total score of ≤8 at Week 12, Week 14, and end of treatment (Week 16)was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Week 12, Week 14, Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (NUMBER)
0.1 mg BID TC-5214Sustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)10.6 percentage of participants analyzed
1 mg BID TC-5214Sustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)10.5 percentage of participants analyzed
4 mg BID TC-5214Sustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)8.0 percentage of participants analyzed
PlaceboSustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)12.1 percentage of participants analyzed
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.91395% CI: [0.48, 2.27]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.84195% CI: [0.42, 2.01]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.23995% CI: [0.26, 1.39]Regression, Logistic
Secondary

Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)

The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score and a MADRS total score of ≤12 at Week 12, Week 14, and end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Time frame: Randomization (Week 8) to end of treatment (Week 16); Week 12, Week 14, and Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

ArmMeasureValue (NUMBER)
0.1 mg BID TC-5214Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)14.7 percentage of patients analyzed
1 mg BID TC-5214Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)19.3 percentage of patients analyzed
4 mg BID TC-5214Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)15.3 percentage of patients analyzed
PlaceboSustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)23.7 percentage of patients analyzed
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.03795% CI: [0.28, 0.96]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.22295% CI: [0.38, 1.25]Regression, Logistic
Comparison: Logistic regression model including treatment and pooled center as fixed effects and the randomization MADRS total score as a covariate.p-value: 0.04295% CI: [0.28, 0.98]Regression, Logistic

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026