Depressive Disorder, Major
Conditions
Brief summary
To assess the effect of a single dose of BI 1358894 compared to placebo on BOLD responses in modulating brain processing of emotional and cognitive stimuli on the amygdala and related brain structure using fMRI in in unmedicated patients with depression.
Interventions
Film-coated tablet
Film-coated tablet
Film-coated tablet
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients having a diagnosis of a MDD according to Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) (single episode or recurrent) with a MADRS total score between ≥ 7 and \< 26 at screening. * Male or female aged 18 to 45 years, inclusive at screening. * Male or female patients. Women of childbearing potential (WOCBP) and men able to father a child must be ready and able to use highly effective methods of birth control. * Patients must be, in the opinion of the Investigator, capable of and eligible for completing the fMRI and tasks. * Patients must be right-handed. * Patients must have acceptable weight as defined by BMI (weight \[kg\]/height \[m\]²) range of 18 to 30 kg/m², inclusive at Visit 1. * Patients must be a non-smoker or light smoker (≤ 5 cigarettes per day). * Patients must have signed the informed consent form prior to the first study-related procedure indicating they understand the purpose of and procedures required for the study and are willing to participate in the study. * Further inclusion criteria apply
Exclusion criteria
* Meeting any diagnostic criteria for a major psychiatric disorder (other than MDD), as determined by DSM-V at screening. * Has received a prescribed medication (including antidepressants) within 28 days prior to Visit 1 (apart from the contraceptive pill) or having received over the counter medication (including pain killers) within 10 days prior to screening. Participants who have taken prescription medication may still be entered into the study, if, in the opinion of the Investigator, the medication received will not interfere with the study procedures or compromise safety. * Patients where it is foreseen (per investigator judgement) that a delay of initiation of standard of care therapy for the depressive disorder to 14 days after day 1 of Visit 2 is medically not justifiable. * A history of alcohol or substance dependence or abuse within the last 12 months from Visit 1. * Has a current or recent history of clinically significant suicidal ideation within the past 6 months, corresponding to a score of 4 or 5 for ideation on the C-SSRS, or a history of suicidal behavior within the past year, as validated by the C-SSRS at screening or treatment visit. * Has a history of, or presents (in the opinion of the Investigator) with, significant neurological or psychiatric conditions (such as stroke, traumatic brain injury, seizures, space occupying lesions, multiple sclerosis, Parkinson's disease, vascular dementia, transient ischemic attack, schizophrenia, blackouts requiring hospitalisation). * A planned medical treatment within the study period that might interfere with the study procedures. * Further
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | A 50 min scan, 6 hours following drug intake. | The primary endpoint was the mean BOLD signal % change in an emotional paradigm, based on the emotional faces from the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) in the corticolimbic system comprising the following eight brain regions of interest: * Amygdala left * Amygdala right * Dorsolateral prefrontal cortex left * Dorsolateral prefrontal cortex right * Insula left * Insula right * Anterior cingulate cortex left * Anterior cingulate cortex right |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | A 50 min scan, 6 hours following drug intake. | The secondary endpoint was the mean BOLD signal % change in an emotional paradigm (affective picture set - OASIS task) in the corticolimbic system, consisting of eight brain regions: * Amygdala left * Amygdala right * Dorsolateral prefrontal cortex left * Dorsolateral prefrontal cortex right * Insula left * Insula right * Anterior cingulate cortex left * Anterior cingulate cortex right |
Countries
Germany
Participant flow
Recruitment details
A single dose, randomized, placebo controlled Phase I study on the effects of BI 1358894 on functional magnetic resonance Imaging measurements in an emotional processing paradigm in patients with Major Depressive Disorder
Pre-assignment details
All subjects were screened for eligibility to participate in trial. Subjects visited specialist site to ensure that they met all implemented inclusion/exclusion criteria, Subjects were not to be randomised to trial drug if any of the specific entry criteria was violated
Participants by arm
| Arm | Count |
|---|---|
| Placebo Matching to BI 1358894 Oral administration of single dose of BI 1358894 matching placebo (4 film-coated tablets) with 240 milliliter (mL) of water after an high-fat, high-calorie breakfast.
Three hours after the administration of BI 1358894 matching placebo the patient receive 1 film-coated tablet of Placebo. | 24 |
| Citalopram Oral administration of single dose of BI 1358894 matching placebo (4 film-coated tablets) with 240 milliliter (mL) of water after an high-fat, high-calorie breakfast.
Three hours after the first administration of BI 1358894 matching placebo the patient receive a oral administration of single dose of 20 milligram (mg) Citalopram (1 tablet of 20 mg). | 24 |
| BI 1358894 Oral administration of single dose of 100 milligram (mg) BI 1358894 (4 film-coated tablets of 25 mg) with 240 milliliter (mL) of water after an high-fat, high-calorie breakfast.
Three hours after the administration of BI 1358894 the patient receive 1 film-coated tablet of Placebo. | 25 |
| Total | 73 |
Baseline characteristics
| Characteristic | Placebo Matching to BI 1358894 | Citalopram | BI 1358894 | Total |
|---|---|---|---|---|
| Age, Continuous | 30.1 Years STANDARD_DEVIATION 5.6 | 30.8 Years STANDARD_DEVIATION 6.5 | 31.5 Years STANDARD_DEVIATION 6.8 | 30.8 Years STANDARD_DEVIATION 6.3 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 0 Participants | 0 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 22 Participants | 24 Participants | 25 Participants | 71 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 2 Participants | 0 Participants | 3 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 23 Participants | 21 Participants | 25 Participants | 69 Participants |
| Sex: Female, Male Female | 19 Participants | 16 Participants | 13 Participants | 48 Participants |
| Sex: Female, Male Male | 5 Participants | 8 Participants | 12 Participants | 25 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 25 | 0 / 23 | 0 / 23 | 0 / 2 |
| other Total, other adverse events | 13 / 25 | 13 / 23 | 21 / 23 | 2 / 2 |
| serious Total, serious adverse events | 0 / 25 | 0 / 23 | 0 / 23 | 0 / 2 |
Outcome results
Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP)
The primary endpoint was the mean BOLD signal % change in an emotional paradigm, based on the emotional faces from the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) in the corticolimbic system comprising the following eight brain regions of interest: * Amygdala left * Amygdala right * Dorsolateral prefrontal cortex left * Dorsolateral prefrontal cortex right * Insula left * Insula right * Anterior cingulate cortex left * Anterior cingulate cortex right
Time frame: A 50 min scan, 6 hours following drug intake.
Population: Evaluable set (ES): This patient set included all randomised patients who performed the functional Magnetic Resonance Imaging (fMRI) measurements and did not experience severe headaches directly before or during the fMRI measurements. In particular, patients who had to be replaced due to severe headaches were excluded from the ES.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Amygdala left | 0.305 Percent change | Standard Deviation 0.119 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Amygdala right | 0.364 Percent change | Standard Deviation 0.136 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Dorsolateral prefrontal cortex left | 0.065 Percent change | Standard Deviation 0.146 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Dorsolateral prefrontal cortex right | 0.131 Percent change | Standard Deviation 0.202 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Insula left | 0.162 Percent change | Standard Deviation 0.146 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Insula right | 0.157 Percent change | Standard Deviation 0.133 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Anterior cingulate cortex left | 0.003 Percent change | Standard Deviation 0.121 |
| Placebo Matching to BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Anterior cingulate cortex right | -0.008 Percent change | Standard Deviation 0.131 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Dorsolateral prefrontal cortex left | 0.044 Percent change | Standard Deviation 0.111 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Anterior cingulate cortex left | -0.027 Percent change | Standard Deviation 0.074 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Dorsolateral prefrontal cortex right | 0.117 Percent change | Standard Deviation 0.183 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Insula left | 0.110 Percent change | Standard Deviation 0.107 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Insula right | 0.137 Percent change | Standard Deviation 0.107 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Amygdala left | 0.290 Percent change | Standard Deviation 0.134 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Amygdala right | 0.291 Percent change | Standard Deviation 0.146 |
| Citalopram | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Anterior cingulate cortex right | -0.026 Percent change | Standard Deviation 0.087 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Dorsolateral prefrontal cortex left | 0.049 Percent change | Standard Deviation 0.109 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Amygdala right | 0.282 Percent change | Standard Deviation 0.071 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Amygdala left | 0.223 Percent change | Standard Deviation 0.093 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Dorsolateral prefrontal cortex right | 0.125 Percent change | Standard Deviation 0.105 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Anterior cingulate cortex left | -0.024 Percent change | Standard Deviation 0.085 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Insula right | 0.1205 Percent change | Standard Deviation 0.125 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Insula left | 0.075 Percent change | Standard Deviation 0.126 |
| BI 1358894 | Mean Blood Oxygenation Level Depend (BOLD) Signal % Change in an Emotional Paradigm, Based on the Emotional Faces From the Warsaw Set of Emotional Facial Expression Pictures (WSEFEP) | Anterior cingulate cortex right | -0.018 Percent change | Standard Deviation 0.101 |
Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS).
The secondary endpoint was the mean BOLD signal % change in an emotional paradigm (affective picture set - OASIS task) in the corticolimbic system, consisting of eight brain regions: * Amygdala left * Amygdala right * Dorsolateral prefrontal cortex left * Dorsolateral prefrontal cortex right * Insula left * Insula right * Anterior cingulate cortex left * Anterior cingulate cortex right
Time frame: A 50 min scan, 6 hours following drug intake.
Population: Evaluable set (ES): This patient set included all randomised patients who performed the fMRI measurements and did not experience severe headaches directly before or during the fMRI measurements. In particular, patients who had to be replaced due to severe headaches were excluded from the ES.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Amygdala left | 0.231 Percent change | Standard Deviation 0.123 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Amygdala right | 0.200 Percent change | Standard Deviation 0.125 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Dorsolateral prefrontal cortex left | 0.269 Percent change | Standard Deviation 0.132 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Dorsolateral prefrontal cortex right | 0.229 Percent change | Standard Deviation 0.174 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Insula left | 0.279 Percent change | Standard Deviation 0.132 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Insula right | 0.195 Percent change | Standard Deviation 0.142 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Anterior cingulate cortex left | 0.089 Percent change | Standard Deviation 0.1 |
| Placebo Matching to BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Anterior cingulate cortex right | 0.091 Percent change | Standard Deviation 0.129 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Dorsolateral prefrontal cortex left | 0.262 Percent change | Standard Deviation 0.178 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Anterior cingulate cortex left | 0.071 Percent change | Standard Deviation 0.081 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Dorsolateral prefrontal cortex right | 0.220 Percent change | Standard Deviation 0.116 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Insula left | 0.270 Percent change | Standard Deviation 0.125 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Insula right | 0.207 Percent change | Standard Deviation 0.154 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Amygdala left | 0.185 Percent change | Standard Deviation 0.13 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Amygdala right | 0.186 Percent change | Standard Deviation 0.13 |
| Citalopram | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Anterior cingulate cortex right | 0.082 Percent change | Standard Deviation 0.113 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Dorsolateral prefrontal cortex left | 0.147 Percent change | Standard Deviation 0.141 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Amygdala right | 0.132 Percent change | Standard Deviation 0.105 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Amygdala left | 0.148 Percent change | Standard Deviation 0.1 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Dorsolateral prefrontal cortex right | 0.155 Percent change | Standard Deviation 0.141 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Anterior cingulate cortex left | 0.027 Percent change | Standard Deviation 0.11 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Insula right | 0.120 Percent change | Standard Deviation 0.1 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Insula left | 0.164 Percent change | Standard Deviation 0.114 |
| BI 1358894 | Mean BOLD Signal % Change in an Emotional Paradigm in the Corticolimbic System Using the Affective Pictures of the Open Affective Standardised Image Set (OASIS). | Anterior cingulate cortex right | 0.025 Percent change | Standard Deviation 0.104 |