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A Study of Fluoxetine in Major Depressive Disorder (MDD) Short-Term Dosing

A Phase 3, Randomized, Placebo-Controlled, Double-Blind, Parallel-Design Study to Evaluate the Short-Term, Fixed Dose Efficacy and Safety of LY110140 Once Daily Dosing in Japanese Patients With Major Depressive Disorder

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01808612
Enrollment
513
Registered
2013-03-11
Start date
2013-03-31
Completion date
2014-07-31
Last updated
2015-05-12

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

Conditions

Major Depressive Disorder

Brief summary

The purpose of this study is to evaluate the short-term efficacy and safety of Fluoxetine in Japanese adult participants with Major Depressive Disorder (MDD).

Interventions

DRUGFluoxetine
DRUGPlacebo

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

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

Eligibility

Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Outpatient Japanese participants diagnosed with MDD * Diagnosis of moderate or greater severity of MDD * Agree to abstain from sexual activity or to use a reliable method of birth control * Judged to be reliable (agree to keep appointments for clinic visits and to undergo all tests and examinations required by the protocol)

Exclusion criteria

* Have previously been exposed to fluoxetine (LY110140) for any indication in the past * Significant suicidal risk * Have a current or previous diagnosis of bipolar disorder, psychotic depression, schizophrenia or other psychotic disorder, anorexia, bulimia, obsessive compulsive disorder, or post-traumatic stress disorder * Have a history of substance abuse or dependence within the past 6 months, excluding caffeine and nicotine * Have initiated, stopped, or changed the type or intensity of psychotherapy within 6 weeks * Have a history of electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), or vagus nerve stimulation (VNS) within 1 year * Have had treatment with a Monoamine oxidase inhibitor (MAOI) within 14 days * Need to use thioridazine or pimozide during the study * Have previously enrolled, completed, or withdrawn from this study * Have a positive urine drug screen for drugs with abuse potential * Female participants who are either pregnant, nursing, or have recently given birth, or male participants who are planning for their partners to be or become pregnant * Have a history of seizure disorder * Have frequent or severe allergic reactions to multiple medications * Have a serious or unstable medical illness or condition, or psychological condition * Participants deemed ineligible by the investigator or sub-investigator for other reasons

Design outcomes

Primary

MeasureTime frameDescription
Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total ScoreBaseline, 6 weeksHAMD21 is a 21-item assessment used to measure depression severity. Items were rated on a scale from 0 (symptoms not present) to a maximum of 2 to 4 (symptom extremely severe) for a total score ranging from 0 (not at all depressed) to 64 (severely depressed). Least squares (LS) means were calculated using mixed-model repeated measures (MMRM) adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline HAMD21 total score.

Secondary

MeasureTime frameDescription
Percentage of Participants Achieving a Response at 6-Week Endpointup to 6 weeksThe percentage of participants achieving a response (defined as a ≥50% improvement from baseline on the HAMD21 total score) was calculated by dividing the number of participants achieving a response at last observation by the total number of participants at risk, multiplied by 100.
Percentage of Participants Achieving a Remission at 6-Week Endpointup to 6 weeksThe percentage of participants achieving a remission (defined as a HAMD21 total score ≤7) was calculated by dividing the number of participants achieving a remission at last observation by the total number of participants at risk, multiplied by 100.
Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresBaseline, 6 weeksHAMD17 total scores and subscale scores from the HAMD21 are presented. HAMD17 is a 17-item assessment of depression severity (total scores range from 0-52). The Maier subscale (Items 1, 2, 7-10) represents the core symptoms of depression (0-24). Anxiety/Somatization subscale (Items 10-13, 15, 17) evaluates severity of psychic and somatic manifestations of anxiety as well as agitation (0-18). Retardation/Somatization subscale (Items 1, 7, 8, 14) evaluates dysfunction in mood, work, and sexual activity, as well as overall motor retardation (0-14). Sleep subscale (Items 4-6) assesses insomnia (0-6). Individual item scores may range from 0-4 or 0-2. Higher scores indicate more severe symptoms. LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline score.
Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresBaseline, up to 6 weeksSDS was completed by the participant and was used to assess the effect of the participant's symptoms on their work/school (Item 1), social life/leisure activities (Item 2), and family life/home responsibilities (Item 3). Each item was measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption. Total score was the sum of the 3 items and ranged from 0 to 30 with higher values indicating greater disruption in the participant's work/social/family life. LS means were calculated using analysis of covariance (ANCOVA) adjusting for treatment, pooled investigative site, and baseline SDS score.
Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Baseline through 6 weeksC-SSRS captures occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal behavior is defined as a yes answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide. Suicidal ideation is defined as a yes answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation.
Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) ScaleBaseline, 6 weeksCGI-S measures severity of illness at the time of assessment with scores ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill participants). LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline CGI-S score.

Countries

Japan

Participant flow

Pre-assignment details

This study consisted of 3 periods: a single-blind screening period (1 week of placebo), a double-blind short-term treatment period (1 week of placebo followed by randomization in a 2:1:3 fashion to 20 milligrams \[mg\] fluoxetine, 40 mg fluoxetine, or placebo, respectively, for 6 weeks), and a single-blind discontinuation period (2 weeks of placebo).

Participants by arm

ArmCount
20 mg Fluoxetine
20 mg fluoxetine (capsules) administered orally, once daily, for 6 weeks
168
40 mg Fluoxetine
40 mg fluoxetine (capsules) administered orally, once daily, for 6 weeks
83
Placebo
Placebo (capsules) administered orally, once daily, for 6 weeks
259
Total510

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Discontinuation PeriodAdverse Event100
Discontinuation PeriodLost to Follow-up010
Discontinuation PeriodPhysician Decision100
Treatment PeriodAdverse Event843
Treatment PeriodLack of Efficacy112
Treatment PeriodLost to Follow-up221
Treatment PeriodPhysician Decision104
Treatment PeriodProtocol Violation100
Treatment PeriodSponsor Decision100
Treatment PeriodWithdrawal by Subject104

Baseline characteristics

Characteristic20 mg FluoxetineTotalPlacebo40 mg Fluoxetine
Age, Continuous40.05 years
STANDARD_DEVIATION 11.19
39.20 years
STANDARD_DEVIATION 11.33
38.54 years
STANDARD_DEVIATION 11.65
39.58 years
STANDARD_DEVIATION 10.56
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
168 Participants510 Participants259 Participants83 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
168 Participants510 Participants259 Participants83 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 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
0 Participants0 Participants0 Participants0 Participants
Region of Enrollment
Japan
168 participants510 participants259 participants83 participants
Sex: Female, Male
Female
83 Participants245 Participants129 Participants33 Participants
Sex: Female, Male
Male
85 Participants265 Participants130 Participants50 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —— / —
other
Total, other adverse events
75 / 25949 / 16830 / 835 / 1455 / 872 / 38
serious
Total, serious adverse events
2 / 2590 / 1680 / 831 / 1450 / 870 / 38

Outcome results

Primary

Mean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score

HAMD21 is a 21-item assessment used to measure depression severity. Items were rated on a scale from 0 (symptoms not present) to a maximum of 2 to 4 (symptom extremely severe) for a total score ranging from 0 (not at all depressed) to 64 (severely depressed). Least squares (LS) means were calculated using mixed-model repeated measures (MMRM) adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline HAMD21 total score.

Time frame: Baseline, 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline HAMD21 total score during the Treatment Period.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score-6.18 units on a scaleStandard Error 0.57
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score-6.25 units on a scaleStandard Error 0.77
PlaceboMean Change From Baseline to 6-Week Endpoint on the 21-Item Hamilton Depression Rating Scale (HAMD21) Total Score-6.91 units on a scaleStandard Error 0.49
Comparison: Approximately 522 participants were to be enrolled. Randomization was to be 2:1:3 (20 mg fluoxetine:40 mg fluoxetine:placebo). Assuming 5% of participants would have missing post-baseline data, the study had 85% power to detect an effect size of 0.33 (20 mg fluoxetine compared to placebo on HAMD21 total score) based on simulations with a 0.05 two-sided significance level.p-value: 0.26495% CI: [-0.55, 2]Mixed Models Analysis
Secondary

Mean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale Scores

SDS was completed by the participant and was used to assess the effect of the participant's symptoms on their work/school (Item 1), social life/leisure activities (Item 2), and family life/home responsibilities (Item 3). Each item was measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption. Total score was the sum of the 3 items and ranged from 0 to 30 with higher values indicating greater disruption in the participant's work/social/family life. LS means were calculated using analysis of covariance (ANCOVA) adjusting for treatment, pooled investigative site, and baseline SDS score.

Time frame: Baseline, up to 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline SDS score during the Treatment Period. Missing endpoints were imputed with the last observation carried forward (LOCF) method, using only postbaseline data.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresTotal score (n=167, 81, 259)-1.76 units on a scaleStandard Error 0.59
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresWork/School subscale score (n=143, 64, 226)-0.79 units on a scaleStandard Error 0.27
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresSocial/Leisure subscale score (n=167, 81, 259)-0.66 units on a scaleStandard Error 0.23
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresFamily/Home subscale score (n=167, 81, 259)-0.47 units on a scaleStandard Error 0.21
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresFamily/Home subscale score (n=167, 81, 259)-0.30 units on a scaleStandard Error 0.28
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresTotal score (n=167, 81, 259)-1.55 units on a scaleStandard Error 0.78
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresSocial/Leisure subscale score (n=167, 81, 259)-0.81 units on a scaleStandard Error 0.3
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresWork/School subscale score (n=143, 64, 226)-0.34 units on a scaleStandard Error 0.36
PlaceboMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresFamily/Home subscale score (n=167, 81, 259)-0.41 units on a scaleStandard Error 0.19
PlaceboMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresWork/School subscale score (n=143, 64, 226)-0.88 units on a scaleStandard Error 0.24
PlaceboMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresSocial/Leisure subscale score (n=167, 81, 259)-0.70 units on a scaleStandard Error 0.21
PlaceboMean Change From Baseline to 6-Week Endpoint in Sheehan Disability Scale (SDS) Total Score and Subscale ScoresTotal score (n=167, 81, 259)-1.99 units on a scaleStandard Error 0.53
Secondary

Mean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale

CGI-S measures severity of illness at the time of assessment with scores ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill participants). LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline CGI-S score.

Time frame: Baseline, 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline CGI-S score during the Treatment Period.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale-0.69 units on a scaleStandard Error 0.08
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale-0.67 units on a scaleStandard Error 0.11
PlaceboMean Change From Baseline to 6-Week Endpoint on the Clinical Global Impression of Severity (CGI-S) Scale-0.81 units on a scaleStandard Error 0.07
Secondary

Mean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale Scores

HAMD17 total scores and subscale scores from the HAMD21 are presented. HAMD17 is a 17-item assessment of depression severity (total scores range from 0-52). The Maier subscale (Items 1, 2, 7-10) represents the core symptoms of depression (0-24). Anxiety/Somatization subscale (Items 10-13, 15, 17) evaluates severity of psychic and somatic manifestations of anxiety as well as agitation (0-18). Retardation/Somatization subscale (Items 1, 7, 8, 14) evaluates dysfunction in mood, work, and sexual activity, as well as overall motor retardation (0-14). Sleep subscale (Items 4-6) assesses insomnia (0-6). Individual item scores may range from 0-4 or 0-2. Higher scores indicate more severe symptoms. LS means were calculated using MMRM adjusting for the random effect of participant and fixed categorical effects of treatment, pooled investigative site, visit, and treatment-by-visit interaction, as well as the continuous fixed covariate of baseline score.

Time frame: Baseline, 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline HAMD21 subscale score during the Treatment Period.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresRetardation/Somatization subscale score-2.00 units on a scaleStandard Error 0.2
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresAnxiety/Somatization subscale score-2.04 units on a scaleStandard Error 0.21
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresHAMD17 total score-5.59 units on a scaleStandard Error 0.53
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresMaier subscale score-3.35 units on a scaleStandard Error 0.3
20 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresSleep subscale score-0.83 units on a scaleStandard Error 0.15
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresAnxiety/Somatization subscale score-1.84 units on a scaleStandard Error 0.28
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresHAMD17 total score-5.61 units on a scaleStandard Error 0.71
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresMaier subscale score-3.39 units on a scaleStandard Error 0.4
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresRetardation/Somatization subscale score-2.21 units on a scaleStandard Error 0.27
40 mg FluoxetineMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresSleep subscale score-0.81 units on a scaleStandard Error 0.2
PlaceboMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresSleep subscale score-1.10 units on a scaleStandard Error 0.13
PlaceboMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresRetardation/Somatization subscale score-2.23 units on a scaleStandard Error 0.17
PlaceboMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresHAMD17 total score-6.27 units on a scaleStandard Error 0.45
PlaceboMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresAnxiety/Somatization subscale score-2.06 units on a scaleStandard Error 0.18
PlaceboMean Change From Baseline to 6-Week Endpoint on the HAMD21 Subscale ScoresMaier subscale score-3.30 units on a scaleStandard Error 0.26
Secondary

Number of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)

C-SSRS captures occurrence, severity, and frequency of suicide-related thoughts and behaviors. Suicidal behavior is defined as a yes answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide. Suicidal ideation is defined as a yes answer to any one of 5 suicidal ideation questions: wish to be dead, and 4 different categories of active suicidal ideation.

Time frame: Baseline through 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with at least 1 post-baseline C-SSRS score during the Treatment Period.

ArmMeasureGroupValue (NUMBER)
20 mg FluoxetineNumber of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Suicidal behavior0 participants
20 mg FluoxetineNumber of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Suicidal ideation5 participants
40 mg FluoxetineNumber of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Suicidal behavior0 participants
40 mg FluoxetineNumber of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Suicidal ideation6 participants
PlaceboNumber of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Suicidal behavior1 participants
PlaceboNumber of Participants With Suicidal Behaviors and Ideations Collected by Columbia - Suicide Severity Rating Scale (C-SSRS)Suicidal ideation8 participants
Secondary

Percentage of Participants Achieving a Remission at 6-Week Endpoint

The percentage of participants achieving a remission (defined as a HAMD21 total score ≤7) was calculated by dividing the number of participants achieving a remission at last observation by the total number of participants at risk, multiplied by 100.

Time frame: up to 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with a baseline (which had not achieved remission threshold criteria) and had at least 1 post-baseline HAMD21 total score during the Treatment Period. Missing endpoints were imputed with the last observation carried forward (LOCF) method, using only post-baseline data.

ArmMeasureValue (NUMBER)
20 mg FluoxetinePercentage of Participants Achieving a Remission at 6-Week Endpoint9.5 percentage of participants
40 mg FluoxetinePercentage of Participants Achieving a Remission at 6-Week Endpoint9.6 percentage of participants
PlaceboPercentage of Participants Achieving a Remission at 6-Week Endpoint15.1 percentage of participants
Secondary

Percentage of Participants Achieving a Response at 6-Week Endpoint

The percentage of participants achieving a response (defined as a ≥50% improvement from baseline on the HAMD21 total score) was calculated by dividing the number of participants achieving a response at last observation by the total number of participants at risk, multiplied by 100.

Time frame: up to 6 weeks

Population: Randomized participants who received at least 1 dose of study drug with a baseline and at least 1 post-baseline HAMD21 total score during the Treatment Period. Missing endpoints were imputed with the last observation carried forward (LOCF) method, using only post-baseline data.

ArmMeasureValue (NUMBER)
20 mg FluoxetinePercentage of Participants Achieving a Response at 6-Week Endpoint23.8 percentage of participants
40 mg FluoxetinePercentage of Participants Achieving a Response at 6-Week Endpoint18.1 percentage of participants
PlaceboPercentage of Participants Achieving a Response at 6-Week Endpoint27.8 percentage of participants

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