Depressive Disorder, MajorPhase 2NCT04521478
A Study to Test the Effect of Different Doses of BI 1358894 and Quetiapine in People With Depression
A Phase 2 study testing BI 1358894 and Quetiapine in people with Depressive Disorder, Major, run by Boehringer Ingelheim at 120 sites in 14 countries.
Trial summary
This study is open to adults with depression (major depressive disorder) for whom standard treatment with antidepressants alone does not work sufficiently. The purpose of the trial is to find out whether a medicine called BI 1358894 helps to improve symptoms of depression. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Depressive Disorder, Major
- What is being tested?
- BI 1358894 and Quetiapine
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 389 participants
- Where
- 120 sitesin 14 countries
- Study dates
- 20 Nov 2020to 2 Feb 2024
- Phase
- Phase 2
- 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- --Established diagnosis of Major Depressive Disorder (MDD), single episode or recurrent, as confirmed at the time of screening by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 5th version (DSM-5) (SCID-5), with a duration of current depressive episode ≥ 8 weeks and ≤ 24 months at the time of screening visit
- Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≥ 24 at screening, as confirmed by a trained site based rater AND interactive, computer administered MADRS. The difference in the rater and computer administered MADRS must not exceed more than 7 points (for details refer to section 6.2). In addition, trial participants must have a score of ≥ 3 on the Reported Sadness Item on both MADRS scales (computer administered and rater-administered MADRS)
- A documented ongoing monotherapy treatment of ≥ 4 weeks at the screening visit, with bupropion or a protocol specified Selective Serotonin Reuptake Inhibitor (SSRI) or Serotonin Norepinephrine Reuptake Inhibitor (SNRI) (refer to the ISF) at adequate dose (at least minimum effective dose as per prescribing information and as confirmed per detectable drug levels in the screening blood or urine sampling)
- Male and female participants, 18 to 65 years of age, both inclusively at the time of consent
- Women who are of child-bearing potential (WOCBP)1 must be able and willing, as confirmed by the investigator, to use two methods of contraception which include one highly effective method of birth control per ICH M3 (R2) that result in a low failure rate of less than 1%, plus one additional barrier
- Signed and dated written informed consent in accordance with ICH-GCP and local legislation prior to admission to the trial
- Able to communicate well, and to understand and comply with trial requirements
Who cannot join
- Per DSM-5, had ever met diagnostic criteria for schizophrenia, schizoaffective disorder, schizophreniform disorder, bipolar disorder, delusional disorder or MDD with psychotic features as assessed by the Structured Clinical Interview for DSM-5 Clinical Trials (SCID-5) at the time of screening
- Diagnosis of any other mental disorder (in addition to those as described in Exclusion Criterion #1) that was the primary focus of treatment within 6 months prior to screening or at baseline (as per clinical discretion of the investigator)
- Diagnosis with antisocial, paranoid, schizoid or schizotypal personality disorder as per DSM-5 criteria, at the time of screening visit. Any other personality disorder at screening visit that significantly affects current psychiatric status and likely to impact trial participation, as per the judgement of investigator
- Diagnosis of a substance related disorder within 3 months prior to screening visit (with exception of caffeine and tobacco)
- History of seizure disorders, stroke, brain tumor or any other major neurological illness that can impact participation in the trial
- History of more than 2 unsuccessful monotherapy treatments (at adequate dosage and duration, per local prescribing information of the product) with an approved antidepressant medication for the current ongoing major depressive episode. These include ongoing monotherapy treatment with bupropion or a protocol specified SSRI or SNRI as described in Inclusion Criterion #3
- Any suicidal behavior in the past 12 months prior to screening (per investigator judgement including an actual attempt, interrupted attempt, aborted attempt, or preparatory acts or behaviour)
- Any suicidal ideation of type 4 or 5 in the Columbia Suicide Severity Rating Scale (CSSRS) in the past 3 months prior to screening or at screening or baseline visit (i.e. active suicidal thought with method and intent but without specific plan, or active suicidal thought with method, intent and plan)
Trial locations and contacts
120 sites in 14 countries.
120 sites in 14 countries
United States29 sites
Lehigh Center for Clinical Research
Allentown, Pennsylvania, 18104
Advanced Discovery Research LLC
Atlanta, Georgia, 30318
Atlanta Center
Atlanta, Georgia, 30331
University of Alabama at Birmingham
Birmingham, Alabama, 35294
Center For Emotional Fitness
Cherry Hill, New Jersey, 08002
Chicago Research Center, Incorporated
Chicago, Illinois, 60634
University of Cincinnati
Cincinnati, Ohio, 45219
The Ohio State University Wexner Medical Center
Columbus, Ohio, 43210
CT Clinical Research
Cromwell, Connecticut, 06416
Mountain Mind. LLC
Denver, Colorado, 80202
Core Clinical Research
Everett, Washington, 98201
Precise Research Centers
Flowood, Mississippi, 39232
Gulf Coast Clinical Research Center
Fort Myers, Florida, 33912
Sarkis Clinical Trials
Gainesville, Florida, 32607
Collaborative Neuroscience Network, LLC (CNS)
Garden Grove, California, 92845
Institute of Living
Hartford, Connecticut, 06106
Clinical Neuroscience Solutions, Inc
Jacksonville, Florida, 32256
Alliance Research
Long Beach, California, 90807
Hassman Research Institute
Marlton, New Jersey, 08053
Optimus U Corporation
Miami, Florida, 33135
Global Medical Institutes, LLC, Scranton Medical Institute
Moosic, Pennsylvania, 18507
Synexus Clinical Research US, Inc.
New York, New York, 10017
Psychiatric Care and Research Center
O'Fallon, Missouri, 63368
Asclepes Research Centers
Sherman Oaks, California, 91403
California Neuroscience Research
Sherman Oaks, California, 91403
Schuster Medical Research Institute
Sherman Oaks, California, 91403
Viking Clinical Research, Ltd.
Temecula, California, 92591
Collaborative Neuroscience Research, LLC
Torrance, California, 90504
University of Kansas School of Medicine-Wichita
Wichita, Kansas, 67214
Japan20 sites
National Center for Global Health and Medicine Kohnodai Hospital
Chiba, Ichikawa, 272-8516
Kaku Mental Clinic
Fukuoka, Fukuoka, 810-0022
Fukuoka University Hospital
Fukuoka, Fukuoka, 814-0180
Kuramitsu Hospital
Fukuoka, Fukuoka, 819-0037
Hokudai-dori Mental Health Clinic
Hokkaido, Sapporo, 001-0010
Arai Clinic
Hyogo, Amagasaki, 660-0882
Tatsuta Clinic
Hyogo, Kobe, 651-0097
Kishiro Mental Clinic
Kanagawa, Kawasaki, 214-0014
Yutaka Clinic
Kanagawa,Sagamihara, 252-0303
Yuge Neuropsychiatric Hospital
Kumamoto, Kumamoto, 861-8002
Arata Clinic
Nagasaki, Nagasaki, 852-8154
Nara Medical University Hospital
Nara, Kashihara, 634-8522
Rainbow and Sea Hospital
Saga, Karatsu, 847-0031
Inuo Hospital
Saga, Tosu, 841-0081
National Center of Neurology and Psychiatry
Tokyo, Kodaira, 187-8851
Tamachi mita cocoromi Clinic
Tokyo, Minato-ku, 108-0023
Sancha Mental Clinic
Tokyo, Setagaya-ku, 154-0004
Maynds Tower Mental Clinic
Tokyo, Shibuya-ku, 151-0053
Ichigaya Himorogi Clinic
Tokyo, Shinjuku-ku, 162-0843
Ohwa Mental Clinic
Tokyo, Toshima-ku, 170-0002
France9 sites
HOP Dijon-Bourgogne
Dijon, 21079
CAB Médical Psyché
Douai, 59500
CAB Ambroise Paré
Élancourt, 78990
HOP la Colombière
Montpellier, 34295
HOP Saint-Jacques
Nantes, 44093
HOP Pasteur
Nice, 06000
HOP Carémeau
Nîmes, 30029
CTR Psychiatrique Universitaire
Saint-Cyr-sur-Loire, 37540
HOP Purpan
Toulouse, 31059
Argentina8 sites
Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM)
CABA, C1133AAH
CEN (Centro Especializado Neurociencias)
Córdoba, 5004
Instituto DAMIC - Fundacion Rusculleda
Córdoba, X5003DCE
CENPIA-Centro de Estudios Neuropsiquiátricos y Psicológicos Integral Ambulatorio
La Plata, 1900
Clinica Privada de Salud Mental Santa Teresa de Avila
La Plata, 1900
Instituto de Neurociencias San Agustín
La Plata, 1900
Instituto Médico de la Fundación Estudios Clínicos
Rosario, S2000DEJ
Centro de Investigacion y Asistencia en Psiquiatria (CIAP)
Rosario, S2000QJI
Slovakia8 sites
MUDr. Beata Dupejová
Banská Bystrica, 974 04
J & J SMART, s.r.o., psychiatric clinic
Bratislava, 81107
MENTUM s.r.o.
Bratislava, 82007
EPAMED s.r.o.
Košice, 040 01
Psychiatricka klinika I.UN L. Pasteura
Košice, 4001
CENTRUM ZDRAVIA R.B.K, s.r.o., psychiatric clinic
Svidník, 089 01
Pro mente sana s.r.o., Psychiatric clinic
Trenčín, 911 01
Crystal Comfort s.r.o
Vranov nad Topľou, 093 01
Czechia7 sites
Neuropsychiatry, s.r.o.
Hradec Králové, 500 09
Clinical Research Foundation s.r.o
Kladno, 27201
MP Meditrine s.r.o.
Ostrava, 708 00
A-SHINE s.r.o
Pilsen, 31200
Clintrial s.r.o.
Prague, 10000
AD71 s.r.o.
Prague, 10900
INEP medical s.r.o.
Prague, 18600
Russia7 sites
Federal State Budget Institution "Mental Health Research Center"
Moscow, 115522
SBI of HC "Z. P. Solovyov Scientific&pract psychoneurolog.Cent"
Moscow, 129110
SBHI "Psychiatric Hospital #1 P.P.Kashchenko"
Saint Petersburg, 190121
FSBI Bekhterev Net.Med.Res.Cen.of Psych&Neuro
Saint Petersburg, 192019
LLC "MK-Med"
Saint Petersburg, 197373
SHI "Reg.Clin.Psychiatric Hosp.of Saint Sophia"
Saratov, 410060
FSBEI of HE Smolensk State Medical University
Smolensk, 214019
Germany6 sites
Zentrum für klinische Forschung Dr. med. I. Schöll GmbH
Bad Homburg, 61350
Universitätsklinikum Frankfurt
Frankfurt am Main, 60590
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Mainz, 55131
Zentralinstitut für seelische Gesundheit
Mannheim, 68159
Praxis für Psychiatrie und Psychotherapie
Stralsund, 18439
Studienzentrum Nord-West
Westerstede, 26655
Poland6 sites
Synexus Polska SCM Sp. z o.o. Gdansku, Gdansk
Gdansk, 80-382
Synexus Lodz Medical Center
Lodz, 90127
Specialist Psychiatric Healthcare Centre in Lodz
Lodz, 91-229
Clinical Best Solutions
Lublin, 20-078
Centrum Medyczne "Luxmed" Sp. z o.o.
Lublin, 20-109
Synexus Poland, Branch in Poznan
Poznan, 60-702
Spain6 sites
Hospital Universitario Fundación Alcorcón
Alcorcón, 28922
Hestia Palau
Barcelona, 08025
Hospital Clínic de Barcelona
Barcelona, 08036
Hospital Jerez de la Frontera
Jerez de la Frontera, 11407
Hospital Ramón y Cajal
Madrid, 28034
Centro de Salud de San Juan
Salamanca, 37005
Australia4 sites
Peninsula Therapeutic and Research Group
Frankston, Victoria, 3199
Albert Road Clinic
Melbourne, Victoria, 3004
Monash Alfred Psychiatry Research Centre
Melbourne, Victoria, 3004
Griffith Health
Southport, Queensland, 4125
Canada4 sites
University of Calgary
Calgary, Alberta, T2N 4Z6
OCT Research ULC
Kelowna, British Columbia, V1Y 1Z9
Braxia Scientific Corp. (CRTCE Mississauga)
Mississauga, Ontario, L5C 4E7
Centre for Addiction and Mental Health (CAMH)
Toronto, Ontario, M6J 1H4
Bulgaria3 sites
Mental Health Center "Prof. Dr. Ivan Temkov - Burgas" EOOD
Burgas, 9001
Filipopolis Ambulatory for Group Practice for Specialized Care in Psychiatry
Plovdiv, 4000
Medical Center Intermedica Ltd.
Sofia, 1680
Hungary3 sites
Obuda Health Center
Budapest, 1036
Semmelweis University
Budapest, 1083
Bugat Pal Hospital, Gyongyos
Gyöngyös, 3200
About this study
Official title: A Phase II, 6-week, Multicenter, Randomized, Double-blind, Double-dummy, Placebo-controlled, Parallel Group Trial With a Quetiapine Arm to Evaluate the Efficacy, Tolerability and Safety of Oral BI 1358894 in Patients With Major Depressive Disorder With Inadequate Response to Antidepressants.
This study is open to adults with depression (major depressive disorder) for whom standard treatment with antidepressants alone does not work sufficiently. The purpose of the trial is to find out whether a medicine called BI 1358894 helps to improve symptoms of depression. Four different doses of BI 1358894 are tested in the study. Participants continue their standard antidepressant therapy throughout the study. Participants are put into 6 groups by chance. Participants in 4 of the 6 groups take different doses of BI 1358894, and placebo. Participants in the fifth group take quetiapine, a medicine already used to treat depression, and placebo. Participants in the sixth group take placebo only.
Participants take BI 1358894, quetiapine, or placebo as tablets. Placebo tablets look like BI 1358894 or quetiapine tablets but do not contain any medicine. Each participant takes tablets twice a day. Participants are in the study for about 3 months. During this time, they visit the study site about 8 times and get about 2 phone calls. At the visits, doctors ask participants about their symptoms.
The results between the BI 1358894 groups, the quetiapine group, and the placebo group are then compared. The doctors also regularly check the general health of the participants.
- Conditions
- Depressive Disorder, Major
- Being tested
- BI 1358894, Placebo, Quetiapine
- 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.
BI 1358894Drug
BI 1358894
PlaceboDrug
Placebo
QuetiapineDrug
quetiapine
| Study group | Role | What they receive |
|---|---|---|
| 5 mg BI 1358894 | Experimental | Participants with an established diagnosis of MDD administered one 5 milligram (mg) dose of BI 1358894 in the morning as film-coated tablet, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks.
During the trial, participants also continued treatment with their OAD. Receives: Drug: BI 1358894 |
| Placebo | Placebo comparator | Participants with an established diagnosis of Major Depressive Disorder (MDD) administered one dose of placebo matching BI 1358894 in the morning as film-coated tablets, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks.
During the trial, participants also continued treatment with their Ongoing Antidepressants (OAD). Receives: Drug: Placebo |
| Quetiapine | Active comparator | Participants with an established diagnosis of MDD administered one dose of placebo matching BI 1358894 in the morning as film-coated tablets, and one 150 or 300 mg dose of quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks.
The daily active dose at the start of therapy was 50 mg on Day 1, 100 mg at Day 2 and 150 mg on Day 3 and 4. Beginning with Day 5, the recommended daily dose of 300 mg was taken. If not tolerated by a participant, the dose was reduced to 150 mg in Week 1. Thereafter, this finally chosen dose had to be stable until end of treatment at Week 6.
During the trial, participants also continued treatment with their OAD. Receives: Drug: Quetiapine |
| 25 mg BI 1358894 | Experimental | Participants with an established diagnosis of MDD administered one 25 mg dose of BI 1358894 in the morning as film-coated tablet, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks.
During the trial, participants also continued treatment with their OAD. Receives: Drug: BI 1358894 |
| 75 mg BI 1358894 | Experimental | Participants with an established diagnosis of MDD administered one 75 mg dose of BI 1358894 in the morning as film-coated tablets, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks.
During the trial, participants also continued treatment with their OAD. Receives: Drug: BI 1358894 |
| 125 mg BI 1358894 | Experimental | Participants with an established diagnosis of MDD administered one 125 mg dose of BI 1358894 in the morning as film-coated tablets, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks.
During the trial, participants also continued treatment with their OAD. Receives: Drug: BI 1358894 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) Total Score at Week 6
Change from baseline in MADRS total score at Week 6 is reported. The MADRS evaluates core symptoms of depression and consists of 10 items. Nine of them are based upon participant reports, and one is on the rater's observation (apparent sadness) during the rating interview. MADRS items are rated on a 0-6 continuum (0=no abnormality, 6=severe). The possible total score could range from 0 (normal with absence of symptoms) to 60 (severe depression).
Least squares mean and adjusted standard error were estimated by Restricted Maximum Likelihood (REML)-based Mixed effects model for repeated measures (MMRM) including the fixed categorical effects of treatment, concomitant psychotherapy use (yes vs. no), and the fixed continuous effect of baseline MADRS total score. Visit was treated as a repeated measure with an unstructured covariance matrix. The Kenward-Roger approximation was used to estimate the denominator degrees of freedom and adjust standard errors.
Measured: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Secondary outcomes (4)
Number of Participants With Response Defined as ≥ 50% Montgomery-Åsberg Depression Rating Scale (MADRS) Reduction From Baseline at Week 6
Number of participants with response defined as ≥ 50% MADRS reduction from baseline at Week 6 is reported. Percent reduction from baseline was calculated as follows: [(MADRS total score at baseline - MADRS total score at week 6)/ MADRS total score at baseline] *100.
Measured: Prior to the first intake of the trial medication (week 0, baseline) and after 6 weeks of treatment.
Change From Baseline in State-Trait Anxiety Inventory (STAI) State and Trait Version Scores at Week 6
Change from baseline in STAI State and Trait version scores at Week 6 is reported. The STAI comprises separate self-report scales for measuring state and trait anxiety. Both consist of 20 statements. The S-Anxiety scale evaluates how respondents feel "right now, at this moment." The T-Anxiety scale assesses how people generally feel. Each STAI item is given a weighted score of 1 to 4. Scores for both scales can vary from 20 (minimum) to 80 (maximum). Higher scores indicate greater anxiety.
Least squares mean and adjusted standard error were estimated by REML-based MMRM including the fixed categorical effects of treatment, concomitant psychotherapy use (yes vs. no), and the fixed continuous effect of baseline score. Visit was treated as a repeated measure with an unstructured covariance matrix. The Kenward-Roger approximation was used to estimate the denominator degrees of freedom and adjust standard errors.
Measured: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Change From Baseline in Clinical Global Impression Severity Scale (CGI-S) Score at Week 6
Change from baseline in CGI-S score at Week 6 is reported. The CGI-S rating scale evaluates the severity of psychopathology on a scale of 1 to 7. Considering total clinical experience with the depression population, a participant is assessed on severity of illness at the time of rating according to: 1=normal (not at all ill); 2=borderline ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill participants.
Least squares mean and adjusted standard error were estimated by REML-based MMRM including the fixed categorical effects of treatment, concomitant psychotherapy use (yes vs. no), and the fixed continuous effect of the baseline score. Visit was treated as a repeated measure with an unstructured covariance matrix. The Kenward-Roger approximation was used to estimate the denominator degrees of freedom and adjust standard errors.
Measured: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Change From Baseline in Symptoms of Major Depressive Disorder Scale (SMDDS) Total Score at Week 6
Change from baseline in SMDDS total score at Week 6 is reported. The SMDDS is a 16-item, patient-reported outcome measure developed to capture the core symptoms of MDD. The SMDDS uses a recall of "over the past 7 days" and participants respond to each question using a rating scale between 0 ("Not at all" or "Never") to 4 ("Extremely" or "Always"). The total score ranges from 0 to 60 with a higher score indicating more severe depressive symptomatology.
Least squares mean and adjusted standard error were estimated by REML-based MMRM including the fixed categorical effects of treatment, concomitant psychotherapy use (yes vs. no), and the fixed continuous effect of the baseline score. Visit was treated as a repeated measure with an unstructured covariance matrix. The Kenward-Roger approximation was used to estimate the denominator degrees of freedom and adjust standard errors.
Measured: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Aug 2020
- Study start20 Nov 2020
- Primary completion10 Jan 2024
- Study completion2 Feb 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Depressive Disorder, MajorStudies of the same condition, open and under way.
- More trials run by Boehringer IngelheimThe 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
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 389 participants (actual)
Sponsor and investigators
- Lead sponsor
- Boehringer Ingelheim
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04521478
- Sponsor's protocol ID
- 1402-0011
- Other IDs
- 2019-004264-21, 2019
- Status last verified
- Feb 2025
- First submitted
- 18 Aug 2020
- Last updated
- 6 Mar 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: After the study is completed and the primary manuscript is accepted for publishing, researchers can use this following link https://www.mystudywindow.com/msw/datasharing to request access to the clinical study documents regarding this study, and upon a signed "Document Sharing Agreement". Also, Researchers can use the following link https://www.mystudywindow.com/msw/datasharing to find information in order to request access to the clinical study data, for this and other listed studies, after the submission of a research proposal and according to the terms outlined in the website. The data shared are the raw clinical study data sets.
Publications
Shelton RC, Pizzagalli DA, Cohen EA, Hori H, Dickschat U, Asafu-Adjei J, Feldbarg A, Just S, Roehrle M, Sommer S, Sussmuth SD. Efficacy, Tolerability, and Safety of TRPC4/5 Inhibitor BI 1358894 in Patients With Major Depressive Disorder and Inadequate Response to Antidepressants: A Phase 2 Randomized, Placebo-Controlled, Parallel Group, Dose-Ranging Trial. J Clin Psychiatry. 2025 Sep 3;86(3):25m15868. doi: 10.4088/JCP.25m15868.
PubMed 40900110
Study at a glance
From the registry record, last updated by the sponsor on 6 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II, 6-week, Multicenter, Randomized, Double-blind, Double-dummy, Placebo-controlled, Parallel Group Trial With a Quetiapine Arm to Evaluate the Efficacy, Tolerability and Safety of Oral BI 1358894 in Patients With Major Depressive Disorder With Inadequate Response to Antidepressants.
- ClinicalTrials.gov ID
- NCT04521478
- Acronym / sponsor ID
- 1402-0011
- Conditions
- Depressive Disorder, Major
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 389 participants (actual)
- Lead sponsor
- Boehringer IngelheimIndustry (pharma, biotech, devices)
- Study start
- 20 Nov 2020 (actual)
- Primary completion
- 10 Jan 2024 (actual)
- Study completion
- 2 Feb 2024 (actual)
- First posted
- 20 Aug 2020 (actual)
- Results
- Posted 6 Mar 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is open to adults with depression (major depressive disorder) for whom standard treatment with antidepressants alone does not work sufficiently. The purpose of the trial is to find out whether a medicine called BI 1358894 helps to improve symptoms of depression. Four different doses of BI 1358894 are tested in the study. Participants continue their standard antidepressant therapy throughout the study. Participants are put into 6 groups by chance. Participants in 4 of the 6 groups take different doses of BI 1358894, and placebo. Participants in the fifth group take quetiapine, a medicine already used to treat depression, and placebo. Participants in the sixth group take placebo only.
Participants take BI 1358894, quetiapine, or placebo as tablets. Placebo tablets look like BI 1358894 or quetiapine tablets but do not contain any medicine. Each participant takes tablets twice a day. Participants are in the study for about 3 months. During this time, they visit the study site about 8 times and get about 2 phone calls. At the visits, doctors ask participants about their symptoms.
The results between the BI 1358894 groups, the quetiapine group, and the placebo group are then compared. The doctors also regularly check the general health of the participants.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| 5 mg BI 1358894 | Experimental | Drug: BI 1358894Participants with an established diagnosis of MDD administered one 5 milligram (mg) dose of BI 1358894 in the morning as film-coated tablet, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks. During the trial, participants also continued treatment with their OAD. |
| Placebo | Placebo comparator | Drug: PlaceboParticipants with an established diagnosis of Major Depressive Disorder (MDD) administered one dose of placebo matching BI 1358894 in the morning as film-coated tablets, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks. During the trial, participants also continued treatment with their Ongoing Antidepressants (OAD). |
| Quetiapine | Active comparator | Drug: QuetiapineParticipants with an established diagnosis of MDD administered one dose of placebo matching BI 1358894 in the morning as film-coated tablets, and one 150 or 300 mg dose of quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks. The daily active dose at the start of therapy was 50 mg on Day 1, 100 mg at Day 2 and 150 mg on Day 3 and 4. Beginning with Day 5, the recommended daily dose of 300 mg was taken. If not tolerated by a participant, the dose was reduced to 150 mg in Week 1. Thereafter, this finally chosen dose had to be stable until end of treatment at Week 6. During the trial, participants also continued treatment with their OAD. |
| 25 mg BI 1358894 | Experimental | Drug: BI 1358894Participants with an established diagnosis of MDD administered one 25 mg dose of BI 1358894 in the morning as film-coated tablet, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks. During the trial, participants also continued treatment with their OAD. |
| 75 mg BI 1358894 | Experimental | Drug: BI 1358894Participants with an established diagnosis of MDD administered one 75 mg dose of BI 1358894 in the morning as film-coated tablets, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks. During the trial, participants also continued treatment with their OAD. |
| 125 mg BI 1358894 | Experimental | Drug: BI 1358894Participants with an established diagnosis of MDD administered one 125 mg dose of BI 1358894 in the morning as film-coated tablets, and one dose of placebo matching quetiapine in the evening as tablets. Each administration was performed orally once daily, for 6 weeks. During the trial, participants also continued treatment with their OAD. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- --Established diagnosis of Major Depressive Disorder (MDD), single episode or recurrent, as confirmed at the time of screening by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 5th version (DSM-5) (SCID-5), with a duration of current depressive episode ≥ 8 weeks and ≤ 24 months at the time of screening visit
- Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≥ 24 at screening, as confirmed by a trained site based rater AND interactive, computer administered MADRS. The difference in the rater and computer administered MADRS must not exceed more than 7 points (for details refer to section 6.2). In addition, trial participants must have a score of ≥ 3 on the Reported Sadness Item on both MADRS scales (computer administered and rater-administered MADRS)
- A documented ongoing monotherapy treatment of ≥ 4 weeks at the screening visit, with bupropion or a protocol specified Selective Serotonin Reuptake Inhibitor (SSRI) or Serotonin Norepinephrine Reuptake Inhibitor (SNRI) (refer to the ISF) at adequate dose (at least minimum effective dose as per prescribing information and as confirmed per detectable drug levels in the screening blood or urine sampling)
- Male and female participants, 18 to 65 years of age, both inclusively at the time of consent
- Women who are of child-bearing potential (WOCBP)1 must be able and willing, as confirmed by the investigator, to use two methods of contraception which include one highly effective method of birth control per ICH M3 (R2) that result in a low failure rate of less than 1%, plus one additional barrier
Key exclusion criteria (8 listed)
- Per DSM-5, had ever met diagnostic criteria for schizophrenia, schizoaffective disorder, schizophreniform disorder, bipolar disorder, delusional disorder or MDD with psychotic features as assessed by the Structured Clinical Interview for DSM-5 Clinical Trials (SCID-5) at the time of screening
- Diagnosis of any other mental disorder (in addition to those as described in Exclusion Criterion #1) that was the primary focus of treatment within 6 months prior to screening or at baseline (as per clinical discretion of the investigator)
- Diagnosis with antisocial, paranoid, schizoid or schizotypal personality disorder as per DSM-5 criteria, at the time of screening visit. Any other personality disorder at screening visit that significantly affects current psychiatric status and likely to impact trial participation, as per the judgement of investigator
- Diagnosis of a substance related disorder within 3 months prior to screening visit (with exception of caffeine and tobacco)
- History of seizure disorders, stroke, brain tumor or any other major neurological illness that can impact participation in the trial
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 |
|---|---|---|
| BI 1358894BI 1358894 | Drug | 125 mg BI 1358894, 25 mg BI 1358894, 5 mg BI 1358894, 75 mg BI 1358894 |
| PlaceboPlacebo | Drug | Placebo |
| Quetiapinequetiapine | Drug | Quetiapine |
Primary outcome
Change From Baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) Total Score at Week 6
Time frame: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Change from baseline in MADRS total score at Week 6 is reported. The MADRS evaluates core symptoms of depression and consists of 10 items. Nine of them are based upon participant reports, and one is on the rater's observation (apparent sadness) during the rating interview. MADRS items are rated on a 0-6 continuum (0=no abnormality, 6=severe). The possible total score could range from 0 (normal with absence of symptoms) to 60 (severe depression). Least squares mean and adjusted standard error were estimated by Restricted Maximum Likelihood (REML)-based Mixed effects model for repeated measures (MMRM) including the fixed categorical effects of treatment, concomitant psychotherapy use (yes vs. no), and the fixed continuous effect of baseline MADRS total score. Visit was treated as a repeated measure with an unstructured covariance matrix. The Kenward-Roger approximation was used to estimate the denominator degrees of freedom and adjust standard errors.
4 secondary outcomes
Number of Participants With Response Defined as ≥ 50% Montgomery-Åsberg Depression Rating Scale (MADRS) Reduction From Baseline at Week 6
Time frame: Prior to the first intake of the trial medication (week 0, baseline) and after 6 weeks of treatment.
Change From Baseline in State-Trait Anxiety Inventory (STAI) State and Trait Version Scores at Week 6
Time frame: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Change From Baseline in Clinical Global Impression Severity Scale (CGI-S) Score at Week 6
Time frame: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Change From Baseline in Symptoms of Major Depressive Disorder Scale (SMDDS) Total Score at Week 6
Time frame: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Mar 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40900110Shelton RC, Pizzagalli DA, Cohen EA, Hori H, Dickschat U, Asafu-Adjei J, Feldbarg A, Just S, Roehrle M, Sommer S, Sussmuth SD. Efficacy, Tolerability, and Safety of TRPC4/5 Inhibitor BI 1358894 in Patients With Major Depressive Disorder and Inadequate Response to Antidepressants: A Phase 2 Randomized, Placebo-Controlled, Parallel Group, Dose-Ranging Trial. J Clin Psychiatry. 2025 Sep 3;86(3):25m15868. doi: 10.4088/JCP.25m15868.
- Related InfoLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. After the study is completed and the primary manuscript is accepted for publishing, researchers can use this following link https://www.mystudywindow.com/msw/datasharing to request access to the clinical study documents regarding this study, and upon a signed "Document Sharing Agreement". Also, Researchers can use the following link https://www.mystudywindow.com/msw/datasharing to find information in order to request access to the clinical study data, for this and other listed studies, after the submission of a research proposal and according to the terms outlined in the website. The data shared are the raw clinical study data sets.
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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.
The record lists no contact. Use the official record to reach the sponsor.
120 sites in 14 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing BI 1358894 and Quetiapine in people with Depressive Disorder, Major, run by Boehringer Ingelheim at 120 sites in 14 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 7 inclusion and 8 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 6 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 120 sites in United States, Japan, France, Argentina, Slovakia and 9 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 6 Mar 2025). 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?
Change From Baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) Total Score at Week 6 (time frame: MMRM included measurements from baseline (Week 0) and at Weeks 1, 2, 4 and 6 after first drug administration. MMRM estimates of change from baseline to Week 6 is reported.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04521478, which also lists 1 linked publication.
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 6 Mar 2025.