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Major Depressive DisorderPhase 1NCT01670279

Phase 1 Study to Assess the Safety/Tolerability of Brexpiprazole as Adjunctive Therapy in Elderly Subjects With Major Depressive Disorder

A Phase 1 study testing Brexpiprazole in people with Major Depressive Disorder, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 4 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess the safety and tolerability of ascending multiple oral doses of brexpiprazole as adjunctive therapy in the treatment of elderly subjects with MDD. Read more about this study

Who is it for?
Ages 70 to 85 years
Conditions the study is for
Major Depressive Disorder
What is being tested?
Brexpiprazole
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
18 participants
Where
4 sitesUnited States
Study dates
Jul 2012to May 2013
Phase
Phase 1
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 70 to 85 years
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Subjects who are able to provide written informed consent
  • Ability to understand the nature of the trial and follow protocol requirements
  • Male and female patients 70 to 85 years of age
  • Subjects with normal or clinically stable findings on physical examination, medical history, clinical laboratory determinations, ECGs in relation to age
  • BMI of 18 to 35 kg/m2.
  • Stable subjects with a principal psychiatric diagnosis of MDD
  • Subjects willing to discontinue all prohibited psychotropic and other prohibited medication

Who cannot join

  • Sexually active males who are not practicing 2 different methods of birth control during the trial and for 30 days after the last dose of trial medication or who will not remain abstinent during the trial and for 30 days after the last dose
  • Subjects who have had a vagus nerve stimulation device implanted or who have received ECT within 6 months of Screening
  • Subjects with a current Axis I (DSM-IV-TR) diagnosis of:
  • Delirium, dementia, amnestic, or other cognitive disorder
  • Eating disorder (including anorexia nervosa or bulimia)
  • Obsessive-compulsive disorder
Show all 37Show fewer
  • Panic disorder
  • Posttraumatic stress disorder or current or prior Axis I (DSM-IV-TR) diagnosis of Schizophrenia, schizoaffective disorder, or other psychotic disorder, Bipolar I or II disorder or bipolar disorder not otherwise specified
  • Subjects with a clinically significant current Axis II (DSM-IV-TR) diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal, or histrionic personality disorder
  • Subjects experiencing hallucinations, delusions, or any psychotic symptomatology
  • Subjects who have Active Suicidal Ideation with Some Intent to Act and whose most recent episode occurred within the last 6 months
  • Subjects who have met DSM-IV-TR criteria for substance abuse or dependence within the past 180 days
  • Subjects with hypothyroidism or hyperthyroidism and/or an abnormal result for free T4 at Screening
  • Subjects who currently have clinically significant neurological, hepatic, renal, metabolic, hematological, immunological, cardiovascular, pulmonary, or gastrointestinal disorders
  • Subjects with IDDM
  • Subjects with uncontrolled hypertension (DBP > 95 mmHg) or symptomatic hypotension
  • Subjects with epilepsy, a history of epilepsy, or a history of seizure
  • Subjects with a positive drug screen for cocaine or other drugs of abuse
  • The following laboratory test and ECG results are exclusionary:
  • Platelets ≤ 75,000/mm3
  • Hemoglobin ≤ 9 g/dL
  • Neutrophils, absolute ≤ 1000/mm3
  • AST > 3 × upper limit of normal
  • ALT > 3 × upper limit of normal
  • Creatinine ≥ 2 mg/dL
  • HbA1c ≥ 7%
  • QTcF ≥ 450 msec
  • Treatment with a MAOI within the 2 weeks prior to the first dose of trial medication
  • Use of benzodiazepines and/or hypnotics within 1 week prior the first dose of trial medication
  • Use of oral neuroleptics within 30 days prior to or long-acting approved neuroleptics ≤ 1 full cycle plus 14 days prior to the first dose of trial medication on Day 1
  • Prohibited concomitant medications used prior to randomization or anticipated need for such medications during the trial
  • Subjects who would be likely to require prohibited concomitant therapy during the trial
  • Subjects who received brexpiprazole in any prior clinical trial
  • Subjects with a history of neuroleptic malignant syndrome
  • Subjects with a history of true allergic response to more than 1 class of medications
  • Prisoners or subjects who are compulsorily detained for treatment of either a psychiatric or physical illness
  • Subjects who participated in a clinical trial within the last 180 days or who participated in more than 2 clinical trials within the past year.

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • Accurate Clinical Trials

    Kissimmee, Florida

  • Miami Jewish Health System

    Miami, Florida

  • CRI Lifetree- Philadelphia Research Center

    Philadelphia, Pennsylvania

  • St. Louis Clinical Trials

    St Louis, Missouri

Other trials in United States

About this study

Official title: A Phase 1, Multicenter, Randomized, Double-blind, Sequential Cohort, Placebo-controlled Trial to Assess the Safety and Tolerability of Ascending Multiple Oral Doses of Brexpiprazole as Adjunctive Therapy in the Treatment of Elderly Subjects With Major Depressive Disorder

The purpose of this study is to assess the safety and tolerability of ascending multiple oral doses of brexpiprazole as adjunctive therapy in the treatment of elderly subjects with MDD.

Read the detailed description

This is a phase 1, multicenter, randomized, double-blind, placebo-controlled, multiple ascending dose trial in 3 sequential cohorts of elderly subjects (age 70 to 85 years old) with MDD. Brexpiprazole will be administered as an adjunct treatment to the current antidepressant therapy that the subject is receiving. Total individual subject duration is expected to be no more than 119 days (a 30-day screening period, a 14-day washout period, up to 45-day in-clinic treatment period, and a 30-day follow-up after the last dose of trial medication).

Being tested
Brexpiprazole, Placebo
Keywords
Major Depressive Disorder (MDD)
Medical subject headings
Depressive Disorder, Major

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BrexpiprazoleDrug

    up to 3mg oral dose once daily

  • PlaceboDrug

Study groups in NCT01670279
Study groupRoleWhat they receive
Cohort 1Experimental14 day titration phase and two fixed dose phases. The first fixed dose phase is 14 days with a daily dose of 2mg brexpiprazole/placebo. The second fixed dose phase is 14 days with a daily dose of 3 mg brexpiprazole/placebo.
Receives: Drug: Brexpiprazole
Cohort 2Experimental14 day titration phase and a 14 day fixed dose phase a daily dose of 3mg brexpiprazole/placebo.
Receives: Drug: Brexpiprazole
Cohort 3Experimental21 day titration phase and a 14 day fixed dose phase a daily dose of 3mg brexpiprazole/placebo.
Receives: Drug: Brexpiprazole
PlaceboPlacebo comparatorPlacebo
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Who Tolerated Brexpiprazole

    Safety and tolerability of brexpiprazole was noted to be primary outcome measure. Brexpiprazole was judged to be tolerated if at least 6 out of 8 (75%) of the participants in a test cohort tolerated the dose after 14 days of QD dosing at the end of the fixed dose phase based on the blinded data. Dose toleration was defined as follows: during the course of the trial, the participants did not experience any moderate or severe adverse events (AEs) or potentially clinically relevant changes from Baseline in laboratory values, vital signs, electrocardiogram (ECG) tracings, Columbia-Suicide Severity Rating Scale (C-SSRS), or extrapyramidal symptom (EPS) ratings, which were assessed as possibly related to the study drug, and would have warranted a dose decrease or discontinuation of the study drug. The safety and tolerability of brexpiprazole was defined by parameters: AEs, laboratory values, vital signs, ECG, C-SSRS, or EPS ratings, the results of each of the parameters reported separately.

    Measured: 45 Days

  2. Number of AEs Reported.

    The AEs were one of the primary parameters to measure the safety and tolerability of individual participants. The AEs were captured for all participants from the time the ICF was signed until the end of the trial. AEs were measured throughout the 14-day titration and 28-day fixed dose phase until follow-up (30 [±2] days after last dose of study medication).

    Measured: Throughout the study, up to 119 days

  3. Incidence of Laboratory Values of Potential Clinical Significance

    The laboratory values were one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance include abnormal values in serum chemistry, hematology, urinalyses and prolactin tests that were identified based on pre-defined criteria.

    Measured: Titration Day 7, Fixed dose Day 14 and 28 and Last Visit

  4. Incidence of Vital Signs of Potential Clinical Significance

    The vital signs were one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance included abnormal values in heart rate, systolic and diastolic blood pressure, respiratory rate and weight that were identified based on pre-defined criteria.

    Measured: Baseline, Titration Day 1, 2, 7, 8, Fixed Days 1, 2, 14, 15, 28, 29, Early Termination and Last Visit.

  5. Incidence of ECG Evaluations of Potential Clinical Significance

    The measurement of ECG was one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance include abnormal changes in heart rate and ECG intervals of PR, QRS, QT, QTcB, and QTcF that were identified based on pre-defined criteria.

    Measured: Titratrion Day 1 and 7, Fixed dose Day 1, 14, 28, Early Termination

  6. Incidence of Physical Examination Evaluation of Potential Clinical Significance

    The physical examination evaluation was one of the primary parameters to measure the safety and tolerability of individual participants. Incidence of TEAEs of potential clinical relevance include abnormal changes in the following body systems: head, ears, eyes, nose, and throat; thorax; abdomen; urogenital; extremities; neurological; and skin and mucosae.

    Measured: Physical examination was performed at Screening, check-in, and discharge

  7. Mean Change From Baseline to Study Completion in Simpson-Angus Scale (SAS) Total Score

    EPS was one of the primary parameters to measure the safety and tolerability of individual participants. The SAS is a rating scale used to measure EPS. The SAS scale consists of a list of 10 symptoms of parkinsonism (gait, arm dropping, shoulder shaking, elbow rigidity, wrist rigidity, head rotation, glabella tap, tremor, salivation, and akathisia), with each item rated from 0 to 4, with 0 being normal and 4 being the worst. The SAS Total score is sum of ratings for all 10 items, with possible Total scores from 0 to 40.

    Measured: End of Titration, Day 15, Day 29, Early Termination and Last visit

  8. Mean Change From Baseline to Study Completion in Barnes Akathisia Global Score

    EPS was one of the primary parameters to measure the safety and tolerability of individual participants. The Barnes Akathisia Rating Scale was an EPS rating scale. The Barnes Akathisia Rating Scale was used to assess the presence and severity of akathisia. This scale consists of 4 items. Only the 4th item, the Global Clinical Assessment of Akathisia, was evaluated in this trial. This item is rated on a 6 point scale, with 0 being best (absent) and 5 being worst (severe akathisia).

    Measured: End of Titration, Day 15, Day 29, Early Termination and Last visit

  9. Mean Change From Baseline to Study Completion in Abnormal Involuntary Movement Scale (AIMS) Rating Score.

    EPS was one of the primary parameters to measure the safety and tolerability of individual participants. The AIMS Scale was an EPS rating scale. The AIMS is a 12 item scale. The first 10 items are rated from 0 to 4 (0=best, 4=worst). Items 11 and 12, related to dental status, have dichotomous responses, 0=no and 1=yes. The AIMS Total Score is the sum of the ratings for the first seven items. The possible total scores are from 0 to 28.

    Measured: End of Titration, Day 15, Day 29, Early Termination and Last visit

  10. Change From Baseline to Study Completion in C-SSRS Score.

    The C-SSRS was one of the primary parameters to measure the safety and tolerability of individual participants. Suicidality was monitored during the trial using the C-SSRS. This scale consists of a baseline evaluation that assesses the lifetime experience of the participant with suicide events and suicidal ideation and a post-baseline evaluation that focuses on suicidality since the last trial visit.

    Measured: Baseline, End of Titration, Fixed dose Day 14 and 28, Day 15 and 29, Early Termination, Last Visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Aug 2012 (estimated)
  2. Study startJul 2012
  3. Primary completionMay 2013
  4. Study completionMay 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01670279
Sponsor's protocol ID
331-12-291
Status last verified
Jan 2016
First submitted
7 Aug 2012
Last updated
4 Feb 2016
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Brexpiprazole in people with Major Depressive Disorder, run by Otsuka Pharmaceutical Development & Commercialization, Inc. at 4 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 37 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Feb 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 4 Feb 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Who Tolerated Brexpiprazole (time frame: 45 Days). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2016.

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