Major Depressive DisorderEarly Phase 1NCT02362529
Biomarkers of Neuroinflammation and Anti-Inflammatory Treatments in Major Depressive Disorder
A Early Phase 1 study testing Minocycline and Celecoxib in people with Major Depressive Disorder, run by Centre for Addiction and Mental Health at 1 site in Canada.
Trial summary
The purpose of this study is to determine if translocator protein total distribution volume (TSPO VT) is elevated in major depressive disorder that is not responding to medication and if adding minocycline can affect TSPO VT. Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Major Depressive Disorder
- What is being tested?
- Minocycline and Celecoxib
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 115 participants
- Where
- 1 siteCanada
- Study dates
- Feb 2015to Apr 2019
- Phase
- Early Phase 1
- Are there results?
- None posted in the registry
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 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- good physical health with no active medical conditions
- non-cigarette smoking
- no past or current substance abuse or dependence
- negative urine pregnancy test at screening and scan days (for women)
- primary diagnosis of current major depressive episode (MDE) and major depressive disorder (MDD) verified by SCID for DSM IV
- score greater than 19 on the 17 item HDRS
Show all 14Show fewer
- non-response to a clinical trial of at least one antidepressant given at appropriate clinical dose
- willing to take medication for the duration of the trial and has previously taken antidepressants for the duration of the trial
- presently taking an antidepressant at a standard clinical dose.
- score below 8 on the 17 item HDRS
- good physical health
- non-cigarette smoking
- negative urine pregnancy test at screening and scan days (for women)
- negative urine screen for drugs of abuse
Who cannot join
- history of neurological illness or autoimmune disorders
- never taken a tricyclic antidepressant or an antidepressant that raises norepinephrine
- received treatment with electroconvulsive therapy or mechanical brain stimulation in the previous 6 months
- currently taking medication contraindicated or that may possibly interact with either minocycline or celecoxib
- known intolerance or allergy to minocycline, other tetracyclines, sulfonamides or NSAIDs
- taken diazepam or other benzodiazepine use within the past month, except for lorazepam and clonazepam
Show all 13Show fewer
- use of anti-inflammatory drugs or tetracyclines lasting ≥1 week within the past month
- history of severe hepatic or renal insufficiency, asthma, allergies, gastrointestinal disease, ischemic heart disease, cerebrovascular disease or congestive heart failure
- lactose intolerance
- Group 2 - Healthy Controls - Phase 1 (baseline scan) only
- past or current diagnosis of axis I or axis II disorder as determined by the SCID I and SCID II for DSM IV
- history of psychotropic medication use
- history of neurological illness or autoimmune disorder
Trial locations and contacts
1 site in 1 country.
About this study
The purpose of this study is to determine if translocator protein total distribution volume (TSPO VT) is elevated in major depressive disorder that is not responding to medication and if adding minocycline can affect TSPO VT. Many remain treatment resistant with common antidepressant treatments and the investigators think it may be due to poor targeting of brain pathologies.
Read the detailed description
There will be three Phases in the study. Only MDE subjects will be invited to continue to Phase 2 and 3. Subjects will be invited to continue to the subsequent Phase given they meet entry criteria described below:
Phase 1: The investigators will evaluate whether TSPO is elevated in individuals during a current MDE compared to healthy controls. Eligible participants will receive one [18F]FEPPA PET scan and one MRI scan. Other measures will include urine sample, blood samples for genetic and peripheral biomarker analysis, a neurocognitive battery, mood scales and questionnaires.
Phase 2: Participants who have elevated TSPO VT in Phase 1 and are agreeable to receiving minocycline will be invited to participate in Phase 2. Based on our previous results participants will be considered candidates for Phase 2 if TSPO VT ≥ 10.5 (HAB) or ≥8.5 (MAB) in any of the primary regions of interest (prefrontal cortex, anterior cingulate cortex or insula). Eligible participants will be invited to participate in a randomized, double blind, placebo controlled trial, to receive either minocycline or placebo. After the eight weeks of treatment, participants will receive one [18F]FEPPA PET scan. Other measures will include urine samples, blood samples, mood scales and questionnaires.
Phase 3: If, after the initial eight week treatment period with either minocycline or placebo, any participant continues to have depressive symptoms (17-item Hamilton Depression Rating Scale score ≥ 8) they will be invited to participate in an eight week open label trial of celecoxib. Participants not eligible for Phase 2 may also be invited to participate in Phase 3 directly from Phase 1.
- Conditions
- Major Depressive Disorder
- Being tested
- Minocycline, Placebo, Celecoxib
- 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.
MinocyclineDrug
Also called Mylan-minocycline
50 mg and 100 mg capsule, oral administration
PlaceboDrug
Also called Lactose monohydrate
Lactose monohydrate in identical gel capsules to minocycline, oral administration.
CelecoxibDrug
Also called Celebrex (Pfizer)
100 mg and 200 mg capsules, oral administration.
| Study group | Role | What they receive |
|---|---|---|
| Minocycline | Experimental | The dose of minocycline would be 50mg per day on week 1, 50mg bid on week 2 and 100mg bid weeks 3-8. For tapering, the dose will be reduced to 50mg bid for a week, and then stopped. Receives: Drug: Minocycline |
| Placebo | Placebo comparator | The number and appearance of the pills would be identical to those in the minocycline arm. Receives: Drug: Placebo |
| Celecoxib | Other | This will be an open label trial for those with Hamilton Depression Rating Scale score ≥ 8 following the minocycline v. placebo trial or those not eligible for Phase 2. Dose of celecoxib will be 100 mg bid for the first week and 200mg bid for weeks 2-8. For tapering, the dose of celecoxib will be reduced to 100mg bid for one week, and then stopped. Receives: Drug: Celecoxib |
What is being measured
The primary outcome is the main question the study is designed to answer.
Translocator total distribution volume (TSPO VT): Treatment Effect of Minocycline in MDE Subjects
TSPO VT will be measured using [18F]FEPPA positron emission tomography brain scans. Eligible MDE participants will be randomized to either minocycline or placebo. Following 8 weeks of either minocycline or placebo treatment, MDE participants will have a second PET scan .
Measured: Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans
Translocator total distribution volume (TSPO VT): Difference between MDE and healthy subjects
Compare baseline TSPO VT prior to treatment between MDE group and healthy group
Measured: Pre-treatment scan will take place up to 8 weeks from initial assessment
Secondary outcomes (1)
Change in Hamilton Depression Rating Scale Score
Change in HDRS score following minocycline vs. placebo treatment. Change in HDRS score following celecoxib treatment.
Measured: Pre- and post-minocycline treatment (8 weeks total between pre- and post-treatment). Pre- and post-celecoxib treatment (8 weeks total between pre- and post-treatment).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Feb 2015 (estimated)
- Study startFeb 2015
- Primary completionApr 2019
- Study completionApr 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Major Depressive DisorderStudies of the same condition, open and under way.
- More trials run by Centre for Addiction and Mental HealthThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Early Phase 1
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 115 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Centre for Addiction and Mental Health
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jeff Meyer, Centre for Addiction and Mental Health
- Investigators
- Jeffrey H Meyer, MD, PhD, Principal investigator, Centre for Addiction and Mental Health; University of Toronto
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02362529
- Sponsor's protocol ID
- REB056/2014
- Status last verified
- May 2019
- First submitted
- 4 Feb 2015
- Last updated
- 23 May 2019
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 23 May 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Biomarkers of Neuroinflammation and Anti-Inflammatory Treatments in Major Depressive Disorder
- ClinicalTrials.gov ID
- NCT02362529
- Acronym / sponsor ID
- REB056/2014
- Conditions
- Major Depressive Disorder
- Phase
- Early Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 115 participants (estimated)
- Lead sponsor
- Centre for Addiction and Mental HealthUniversity, hospital or other
- Study start
- Feb 2015
- Primary completion
- Apr 2019 (actual)
- Study completion
- Apr 2019 (actual)
- First posted
- 13 Feb 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine if translocator protein total distribution volume (TSPO VT) is elevated in major depressive disorder that is not responding to medication and if adding minocycline can affect TSPO VT. Many remain treatment resistant with common antidepressant treatments and the investigators think it may be due to poor targeting of brain pathologies.
Detailed description
There will be three Phases in the study. Only MDE subjects will be invited to continue to Phase 2 and 3. Subjects will be invited to continue to the subsequent Phase given they meet entry criteria described below:
Phase 1: The investigators will evaluate whether TSPO is elevated in individuals during a current MDE compared to healthy controls. Eligible participants will receive one [18F]FEPPA PET scan and one MRI scan. Other measures will include urine sample, blood samples for genetic and peripheral biomarker analysis, a neurocognitive battery, mood scales and questionnaires.
Phase 2: Participants who have elevated TSPO VT in Phase 1 and are agreeable to receiving minocycline will be invited to participate in Phase 2. Based on our previous results participants will be considered candidates for Phase 2 if TSPO VT ≥ 10.5 (HAB) or ≥8.5 (MAB) in any of the primary regions of interest (prefrontal cortex, anterior cingulate cortex or insula). Eligible participants will be invited to participate in a randomized, double blind, placebo controlled trial, to receive either minocycline or placebo. After the eight weeks of treatment, participants will receive one [18F]FEPPA PET scan. Other measures will include urine samples, blood samples, mood scales and questionnaires.
Phase 3: If, after the initial eight week treatment period with either minocycline or placebo, any participant continues to have depressive symptoms (17-item Hamilton Depression Rating Scale score ≥ 8) they will be invited to participate in an eight week open label trial of celecoxib. Participants not eligible for Phase 2 may also be invited to participate in Phase 3 directly from Phase 1.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Minocycline | Experimental | Drug: MinocyclineThe dose of minocycline would be 50mg per day on week 1, 50mg bid on week 2 and 100mg bid weeks 3-8. For tapering, the dose will be reduced to 50mg bid for a week, and then stopped. |
| Placebo | Placebo comparator | Drug: PlaceboThe number and appearance of the pills would be identical to those in the minocycline arm. |
| Celecoxib | Other | Drug: CelecoxibThis will be an open label trial for those with Hamilton Depression Rating Scale score ≥ 8 following the minocycline v. placebo trial or those not eligible for Phase 2. Dose of celecoxib will be 100 mg bid for the first week and 200mg bid for weeks 2-8. For tapering, the dose of celecoxib will be reduced to 100mg bid for one week, and then stopped. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- good physical health with no active medical conditions
- non-cigarette smoking
- no past or current substance abuse or dependence
- negative urine pregnancy test at screening and scan days (for women)
- primary diagnosis of current major depressive episode (MDE) and major depressive disorder (MDD) verified by SCID for DSM IV
Key exclusion criteria (13 listed)
- history of neurological illness or autoimmune disorders
- never taken a tricyclic antidepressant or an antidepressant that raises norepinephrine
- received treatment with electroconvulsive therapy or mechanical brain stimulation in the previous 6 months
- currently taking medication contraindicated or that may possibly interact with either minocycline or celecoxib
- known intolerance or allergy to minocycline, other tetracyclines, sulfonamides or NSAIDs
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MinocyclineAlso: Mylan-minocycline50 mg and 100 mg capsule, oral administration | Drug | Minocycline |
| PlaceboAlso: Lactose monohydrateLactose monohydrate in identical gel capsules to minocycline, oral administration. | Drug | Placebo |
| CelecoxibAlso: Celebrex (Pfizer)100 mg and 200 mg capsules, oral administration. | Drug | Celecoxib |
Primary outcome
Translocator total distribution volume (TSPO VT): Treatment Effect of Minocycline in MDE Subjects
Time frame: Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans
TSPO VT will be measured using [18F]FEPPA positron emission tomography brain scans. Eligible MDE participants will be randomized to either minocycline or placebo. Following 8 weeks of either minocycline or placebo treatment, MDE participants will have a second PET scan .
Translocator total distribution volume (TSPO VT): Difference between MDE and healthy subjects
Time frame: Pre-treatment scan will take place up to 8 weeks from initial assessment
Compare baseline TSPO VT prior to treatment between MDE group and healthy group
1 secondary outcome
Change in Hamilton Depression Rating Scale Score
Time frame: Pre- and post-minocycline treatment (8 weeks total between pre- and post-treatment). Pre- and post-celecoxib treatment (8 weeks total between pre- and post-treatment).
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 May 2019.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jeffrey H Meyer, MD, PhD principal investigator
Centre for Addiction and Mental Health; University of Toronto
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Early Phase 1 study testing Minocycline and Celecoxib in people with Major Depressive Disorder, run by Centre for Addiction and Mental Health at 1 site in Canada.
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 14 inclusion and 13 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 23 May 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. 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?
Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Translocator total distribution volume (TSPO VT): Treatment Effect of Minocycline in MDE Subjects (time frame: Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans). The study lists 2 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 23 May 2019.