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Major Depressive DisorderPhase 3NCT01838681

Brexpiprazole as Adjunctive Treatment in Patients With Major Depressive Disorder With an Inadequate Response to Antidepressant Treatment

A Phase 3 study testing Brexpiprazole and ADT in people with Major Depressive Disorder, run by H. Lundbeck A/S at 107 sites in 16 countries.

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

To evaluate the long-term efficacy and safety of brexpiprazole as an adjunctive treatment to an antidepressant treatment (ADT) for adult patients with Major Depressive Disorder (MDD). Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Major Depressive Disorder
What is being tested?
Brexpiprazole and ADT
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1,986 participants
Where
107 sitesin 16 countries
Study dates
Jun 2013to Jun 2016
Phase
Phase 3
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 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The patient is an outpatient consulting a psychiatrist.
  • The patient has an MDD diagnosed according to DSM-IV-TR™. The current Major Depressive Episode (MDE) should be confirmed using the Mini International Neuropsychiatric Interview (MINI).
  • The patient has a moderate to severe depression and an insufficient response to at least one and no more than three adequate antidepressant treatments.
  • The patient agrees to protocol-defined use of effective contraception.

Who cannot join

  • The patient has any current psychiatric disorder or Axis I disorder (DSM-IV-TR™ criteria), established as the primary diagnosis, other than MDD.
  • The patient has a current Axis II (DSM-IV-TR™) diagnosis of borderline, antisocial, paranoid, schizoid, schizotypical or histrionic personality disorder.
  • The patient has experienced/experiences hallucinations, delusions or any psychotic symptomatology in the current MDE.
  • The patient suffers from mental retardation, organic mental disorders, or mental disorders due to a general medical condition (DSM-IV-TR™ criteria).
  • The patient, in the opinion of the investigator or according to Columbia-Suicide Severity Rating Scale (C-SSRS), is at significant risk of suicide.
  • The patient has had neuroleptic malignant syndrome.
Show all 11Show fewer
  • The patient has any relevant medical history or current presence of systemic disease.
  • The patient has, at the Screening Visit an abnormal ECG that is, in the investigator's opinion, clinically significant.
  • The patient has a history of cancer, other than basal cell or Stage 1 squamous cell carcinoma of the skin, that has not been in remission for >5 years prior to the first dose of IMP.
  • The patient is, in the investigator's opinion, unlikely to comply with the protocol or is unsuitable for any reason.
  • Other inclusion and exclusion criteria may apply.

Trial locations and contacts

107 sites in 16 countries.

107 sites in 16 countries

Germany14 sites
  • DE007

    Berlin

  • DE014

    Berlin

  • DE015

    Berlin

  • DE006

    Bielefeld

  • DE010

    Bochum

  • DE012

    Gelsenkirchen

  • DE009

    Hanover

  • DE022

    Hattingen

  • DE008

    Heidelberg

  • DE017

    Leipzig

  • DE001

    Nuremberg

  • DE004

    Nuremberg

  • DE002

    Schwerin

  • DE016

    Wiesbaden

Other trials in Germany

Poland13 sites
  • PL010

    Bialystok

  • PL016

    Bialystok

  • PL017

    Bydgoszcz

  • PL007

    Chełmno

  • PL002

    Gdansk

  • PL011

    Gorlice

  • PL018

    Kielce

  • PL013

    Leszno

  • PL001

    Lublin

  • PL006

    Lublin

  • PL014

    Szczecin

  • PL012

    Torun

  • PL019

    Torun

Other trials in Poland

Russia9 sites
  • RU002

    Moscow

  • RU004

    Moscow

  • RU003

    Saint Petersburg

  • RU006

    Saint Petersburg

  • RU007

    Saint Petersburg

  • RU010

    Saint Petersburg

  • RU014

    Saint Petersburg

  • RU012

    Saratov

  • RU005

    Stavropol

Other trials in Russia

United States8 sites
  • US040

    Brooklyn, New York

  • US043

    Cerritos, California

  • US053

    Flowood, Mississippi

  • US046

    Houston, Texas

  • US052

    Houston, Texas

  • US041

    Little Rock, Arkansas

  • US047

    Milwaukee, Wisconsin

  • US042

    Temecula, California

Other trials in United States

Ukraine8 sites
  • UA006

    Kharkiv

  • UA007

    Kherson,Vil. Stepanivka

  • UA003

    Kiev

  • UA014

    Kiev

  • UA002

    Kyiv

  • UA005

    Lviv

  • UA012

    Ternopil

  • UA009

    Vinnytsia

Other trials in Ukraine

Bulgaria7 sites
  • BG007

    Kardzhali

  • BG002

    Pazardzhik

  • BG003

    Rousse

  • BG001

    Sofia

  • BG004

    Sofia

  • BG005

    Varna

  • BG006

    Varna

Other trials in Bulgaria

Estonia6 sites
  • EE002

    Tallinn

  • EE003

    Tallinn

  • EE006

    Tallinn

  • EE001

    Tartu

  • EE005

    Tartu

  • EE004

    Võru

Other trials in Estonia

Finland6 sites
  • FI002

    Helsinki

  • FI003

    Helsinki

  • FI006

    Helsinki

  • FI001

    Kuopio

  • FI007

    Pori

  • FI009

    Tampere

Other trials in Finland

Lithuania6 sites
  • LT003

    Kaunas

  • LT006

    Kaunas Region

  • LT001

    Palanga

  • LT005

    Šilutė

  • LT002

    Vilnius

  • LT004

    Vilnius

Other trials in Lithuania

United Kingdom6 sites
  • GB003

    Blackpool

  • GB005

    Bognor Regis

  • GB002

    Bradford

  • GB004

    Cannock

  • GB001

    Leeds

  • GB006

    Winwick

Other trials in United Kingdom

Canada5 sites
  • CA003

    Burlington

  • CA004

    Edmonton, Alberta

  • CA001

    Kingston

  • CA002

    Montral

  • CA005

    Montreal

Other trials in Canada

Latvia5 sites
  • LV004

    Daugavpils

  • LV005

    Jelgava

  • LV002

    Liepāja

  • LV003

    Riga

  • LV001

    Strenči

Other trials in Latvia

Mexico4 sites
  • MX009

    Guadalajara

  • MX008

    León

  • MX002

    Monterrey

  • MX003

    Monterrey, Nuevo Len

Other trials in Mexico

Romania4 sites
  • RO003

    Bucharest

  • RO006

    Bucharest

  • RO001

    Iași

  • RO004

    Timișoara

Other trials in Romania

Sweden4 sites
  • SE008

    Halmstad

  • SE006

    Malmö

  • SE009

    Skövde

  • SE001

    Stockholm

Other trials in Sweden

South Korea2 sites
  • KR001

    Seoul

  • KR004

    Seoul

Other trials in South Korea

About this study

Official title: Interventional, Randomised, Double-blind, Parallel-group, Placebo-controlled, Flexible-dose Long-term Study to Evaluate the Maintenance of Efficacy and Safety of 1 to 3 mg/Day of Brexpiprazole as Adjunctive Treatment in Patients With Major Depressive Disorder With an Inadequate Response to Antidepressant Treatment

To evaluate the long-term efficacy and safety of brexpiprazole as an adjunctive treatment to an antidepressant treatment (ADT) for adult patients with Major Depressive Disorder (MDD).

Read the detailed description

The total duration of the study was 32 weeks and the study consisted of Periods A, B, and A+. Patients entered the study in Period A and were treated open-label with one of six commercially available antidepressant treatments (ADTs) for 8 weeks. Patients who met the blinded response criteria at the Week 6 Visit, were deemed early responders and were withdrawn from the study. At Week 8, patients with inadequate response to placebo + ADT, as per the randomisation criteria, entered Period B and were randomised to received double-blind brexpiprazole + ADT or placebo + ADT for 24 weeks. Non-randomised patients continued in Period A+ and received placebo + ADT until the end of the study. The primary objective was to compare the efficacy and safety of brexpiprazole with placebo. This comparison occurred Period B; therefore, the focus is Period B.

Being tested
Placebo, Brexpiprazole, ADT
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.

  • PlaceboDrug

    Once daily, tablets, orally

  • BrexpiprazoleDrug

    1, 2, or 3 mg/day, once daily dose, tablets, orally. Uptitration in weekly steps from 1 mg/day

  • ADTDrug

    Duloxetine, escitalopram, fluoxetine, paroxetine IR, sertraline, venlafaxine XR; dosing according to label

Study groups in NCT01838681
Study groupRoleWhat they receive
PlaceboPlacebo comparatorPlacebo adjunct to open-label treatment with a commercially available antidepressant (ADT)
Receives: Drug: Placebo; Drug: ADT
BrexpiprazoleExperimentalBrexpiprazole adjunct to open-label treatment with a commercially available ADT
Receives: Drug: Brexpiprazole; Drug: ADT

What is being measured

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

  1. Full Remission During the Randomised Treatment Period

    Full remission is defined as a Montomery and Åsberg Depression Rating Scale (MADRS) total score ≤10 and a ≥50% decrease from randomisation in MADRS total score for at least 8 consecutive weeks during randomized treatment. The MADRS is a depression rating scale consisting of 10 items, each rated 0 to 6. The 10 items represent the core symptoms of depressive illness. The overall score ranges from 0 (symptoms absent) to 60 (severe depression). The MADRS total score is the sum of the 10 items.

    Measured: From randomisation to end of Period B (24 weeks)

Secondary outcomes (17)
  1. Full Functional Remission During the Randomised Treatment Period

    Full functional remission is defined as a Sheehan Disability Scale (SDS) total score <=6 and all SDS domain scores <=2 observed for at least 8 consecutive weeks during the randomised treatment period. The SDS assesses functional impairment in 3 domains: work/school, social life or leisure activities, and home life or family responsibilities. The participant rates the extent to which each aspect is impaired on a 10-point visual analog scale, from 0 (not at all) to 10 (extremely). The 3 scores are added together to calculate the total score, which ranges from 0 to 30, with higher scores indicating more impairment.

    Measured: From randomisation to end of Period B (24 weeks)

  2. Full Global Score Remission During the Randomised Treatment Period

    Full global score remission is defined as a Clinical Global Impression - Severity of Illness (CGI-S) score <=2 observed for at least 8 consecutive weeks during the randomised treatment period. The CGI-S is a 7-point scale where the clinician rates the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis, on the following scale: 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

    Measured: From randomisation to end of Period B (24 weeks)

  3. Total Time in Remission During the Randomised Treatment Period

    The total time the patient spends in remission during randomised treatment. Remission is defined as a MADRS total score <=10 and a >=50% decrease from randomisation in MADRS total score. Time in remission is defined as the sum of days over all periods between Period B visits where remission was obtained. The period between two visits is counted as in remission if the patient was in remission when the period started.

    Measured: From randomisation to end of Period B (24 weeks)

  4. Time to Full Remission During the Randomised Treatment Period

    The time from randomisation until full remission has been obtained. Full remission is defined as a MADRS total score ≤10 and a ≥50% decrease from randomisation in MADRS total score for at least 8 consecutive weeks during randomised treatment. The time to full remission was calculated using Kaplan-Meier Methods.

    Measured: From randomisation to end of Period B (24 weeks)

  5. Full Remission Sustained During the Randomised Treatment Period

    Full remission sustained is defined as having obtained full remission and remain in remission until completion of the study. Full remission is defined as a MADRS total score ≤10 and a ≥50% decrease from randomisation in MADRS total score for at least 8 consecutive weeks during randomised treatment.

    Measured: From randomisation to end of Period B (24 weeks)

  6. Change From Randomisation to Week 6 in MADRS Total Score During the Randomised Treatment Period

    The MADRS is a depression rating scale consisting of 10 items, each rated 0 to 6. The 10 items represent the core symptoms of depressive illness. The overall score ranges from 0 (symptoms absent) to 60 (severe depression). The MADRS total score is the sum of the 10 items.

    Measured: From randomisation to week 6

  7. Change From Randomisation to Week 24 in MADRS Total Score During the Randomised Treatment Period

    The MADRS is a depression rating scale consisting of 10 items, each rated 0 to 6. The 10 items represent the core symptoms of depressive illness. The overall score ranges from 0 (symptoms absent) to 60 (severe depression). The MADRS total score is the sum of the 10 items.

    Measured: From randomisation to end of Period B (24 weeks)

  8. Response at Week 6 During the Randomised Treatment Period

    Response is defined as a >=50% decrease from randomisation in MADRS total score.

    Measured: From randomisation to week 6

  9. Response at Week 24 During the Randomised Treatment Period

    Response is defined as a >=50% decrease from randomisation in MADRS total score.

    Measured: From randomisation to end of Period B (24 weeks)

  10. Remission at Week 6 During the Randomised Treatment Period

    Remission is defined as a MADRS total score <=10 and a >=50% decrease from randomisation in MADRS total score.

    Measured: From randomisation to week 6

  11. Remission at Week 24 in the Randomised Treatment Period

    Remission is defined as a MADRS total score <=10 and a >=50% decrease from randomisation in MADRS total score.

    Measured: From randomisation to end of Period B (24 weeks)

  12. Change From Randomisation to Week 6 in SDS Total Score During the Randomised Treatment Period

    The SDS assesses functional impairment in 3 domains: work/school, social life or leisure activities, and home life or family responsibilities. The participant rates the extent to which each aspect is impaired on a 10-point visual analog scale, from 0 (not at all) to 10 (extremely). The 3 scores are added together to calculate the total score, which ranges from 0 to 30, with higher scores indicating more impairment.

    Measured: From randomisation to week 6

  13. Change From Randomisation to Week 24 in SDS Total Score During the Randomised Treatment Period

    The SDS assesses functional impairment in 3 domains: work/school, social life or leisure activities, and home life or family responsibilities. The participant rates the extent to which each aspect is impaired on a 10-point visual analog scale, from 0 (not at all) to 10 (extremely). The 3 scores are added together to calculate the total score, which ranges from 0 to 30, with higher scores indicating more impairment.

    Measured: From randomisation to end of Period B (24 weeks)

  14. Change From Randomisation to Week 6 in CGI-S Score During the Randomised Treatment Period

    The CGI-S is a 7-point scale where the clinician rates the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis on the following scale: 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

    Measured: From randomisation to week 6

  15. Change From Randomisation to Week 24 in CGI-S Score During the Randomised Treatment Period

    The CGI-S is a 7-point scale where the clinician rates the severity of the patient's illness at the time of assessment, relative to the clinician's past experience with patients who have the same diagnosis on the following scale: 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

    Measured: From randomisation to end of Period B (24 weeks)

  16. Change From Randomisation to Week 6 in Q-LES-Q (SF) Total Score During the Randomised Treatment Period

    The original Q-LES-Q is a patient self-rated scale designed to measure the degree of enjoyment and satisfaction experienced by patients in various areas of daily life. It consists of 93 items to measure: physical health, feelings, work, household duties, school, leisure time activities, social relations, and general activities. The Q-LES-Q short form (SF) contains 16 items from the general activities section. Each item is rated on a 5-point scale ranging from 1 (very poor) to 5 (very good). The total score is the sum of the first 14 items. The last two scores are stand-alone items. The total score ranges from 14 to 70.

    Measured: From randomisation to week 6

  17. Change From Randomisation to Week 24 in Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q (SF)) Total Score During the Randomised Treatment Period

    The original Q-LES-Q is a patient self-rated scale designed to measure the degree of enjoyment and satisfaction experienced by patients in various areas of daily life. It consists of 93 items to measure: physical health, feelings, work, household duties, school, leisure time activities, social relations, and general activities. The Q-LES-Q short form (SF) contains 16 items from the general activities section. Each item is rated on a 5-point scale ranging from 1 (very poor) to 5 (very good). The total score is the sum of the first 14 items. The last two scores are stand-alone items. The total score ranges from 14 to 70.

    Measured: From randomisation to end of Period B (24 weeks)

Timeline

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

  1. First posted24 Apr 2013 (estimated)
  2. Study startJun 2013
  3. Primary completionJun 2016
  4. Study completionJun 2016

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
1,986 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01838681
Sponsor's protocol ID
14570A
Other IDs
2012-001380-76
Status last verified
Jul 2017
First submitted
20 Apr 2013
Last updated
9 Aug 2017
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Brexpiprazole and ADT in people with Major Depressive Disorder, run by H. Lundbeck A/S at 107 sites in 16 countries.

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 4 inclusion and 11 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 9 Aug 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 107 sites in Germany, Poland, Russia, United States, Ukraine and 11 more countries. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 9 Aug 2017). 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?

Full Remission During the Randomised Treatment Period (time frame: From randomisation to end of Period B (24 weeks)). 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 9 Aug 2017.

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