- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01938859
Algorithm Guided Treatment Strategies for Bipolar Depression (AGTs-BD)
October 3, 2017 updated by: Yiru FANG M.D., Ph.D., Shanghai Mental Health Center
The purpose of the AGTs-BD study is to compare the treatment outcome and safety profiles between different mood stabilizers combination treatments in the patients with bipolar disorders, currently suffered from depression episode.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
The AGTs-BD study is a randomized, open-label, rater-blind, multicenter study, which including an 8-week acute treatment (Phase I), followed by a 24-week recurrence prevention treatment (Phase II), and a 24-week relapse prevention treatment (Phase III).
Patients initially enter an up to 4 weeks screening phase to confirm the randomization to whom met DSM-IV criteria of bipolar I or II disorder, currently depressed with Hamilton Depression Rating Scale-17 items (HAM-D) total score ≥17.
The protocol was approved by the each sites' appropriate institutional review boards and ethics committees.
After screening, patients were randomly allocated to one of three groups: (1) lithium monotherapy; (2) lithium plus quetiapine; (3) lithium plus a Traditional Chinese Medicine (TCM) named as Shuganjieyu capsule (SGJY, St. John's wort and acanthopanax senticosus combination).
After phase I, patients who met stable remission, defined as HAM-D total score ≤7 and Young Mania Rating Scale (YMRS) total score ≤10 in two consecutive visit at least 4 weeks, were qualified into phase II and III.
Patients remained on the allocated treatment for up to 48 weeks or until treatment failure.
The difference between phase II and phase III was that treatment dose could be decreased (within the study ranges) if side-effects became troublesome in phase III, but not for phase II.
All patients will be provided with free care (3 visits) by the investigators, for a period of up to 3 months after the end of the study, in order to help them make the transition into routine clinical care.
Study Type
Interventional
Enrollment (Anticipated)
360
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Shanghai
-
Shanghai, Shanghai, China, 200030
- Shanghai Mental Health Center
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age from 18 to 65 years old;
- Han Chinese;
- Outpatient and inpatient patients;
- Patients met DSM-IV criteria of bipolar I or II disorder, currently depressed, ascertained with the Mini International Neuropsychiatric Interview (MINI)
- HAM-D total score≥17, HAM-D item 1 (depressed mood) score≥2, and YMRS total score≤10 at baseline;
- Written informed consent was given;
- Junior high school education and above, with enough audio-visual ability to accomplish the visits;
- Normally resident in one country and had a residential address, able to follow-up.
Exclusion Criteria:
- Bipolar disorder rapid cycling or mixed episode;
- Experienced DSM-IV-TR axis I disorders in the 6 months prior to randomization;
- Severe personality disorder, metal retardation, anorexia/bulimia nervosa;
- Actively suicide ascertained by research psychiatrist or HAM-D item 3 score≥3(suicidality);
- Known history of intolerance or hypersensitivity to any of the medications involved in the study, including lithium, quetiapine and SGJY capsule;
- Female patients who were pregnant, planning to be pregnant or breast feeding;
- Severe medical or neurological problems.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Lithium combined with SGAs
SGAs (Second Generation Antipsychotics), quetiapine adjunctive to lithium therapy
|
Lithium plasma concentration was between 0.6-1.2
mmol/L, dose should be fixed at the end of week 4, and the maximum dosage was judged by the investigator based on the patients' tolerability.
Quetiapine adjunctively to lithium therapy, target 400 mg/d with a minimum dose of 200 mg/d.
Dose should be fixed at the end of week 4, and the maximum dosage was judged by the investigator based on the patients' tolerability.
|
Experimental: lithium combined with TCM
TCM (Traditional Chinese Medicine), Shuganjieyu capsule adjunctive to lithium therapy.
|
Lithium plasma concentration was between 0.6-1.2
mmol/L, dose should be fixed at the end of week 4, and the maximum dosage was judged by the investigator based on the patients' tolerability.
Shuganjieyu capsule adjunctively to lithium therapy, target dose 1440 mg/d.
Other Names:
|
Active Comparator: Lithium monotherpy
Lithium monotherapy
|
Lithium plasma concentration was between 0.6-1.2
mmol/L, dose should be fixed at the end of week 4, and the maximum dosage was judged by the investigator based on the patients' tolerability.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change of HAM-D total score only for the phase I
Time Frame: baseline and 8 weeks
|
baseline and 8 weeks
|
|
Time to new intervention for an emerging mood episode
Time Frame: up to 48 weeks
|
Time to new intervention for an emerging mood episode is only for Phase II and Phase III, including drug treatment (commencement of a new drug, increase in dose of concurrent drug, restarting of a discontinued drug, or increasing the investigational drug dose in response to an emergent mood episode) or admission to hospital.
|
up to 48 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
HAM-D total score ≤7
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
Remission rate
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
Mean changes from baseline to EOS in HAM-D total score ≥50%
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
Response rate
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
Mean changes from baseline to EOS in 16-item Quick Inventory of Depressive Symptomatology-Patient Self-Report (QIDS16-SR)
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
|
Mean changes from baseline to EOS in Clinical Global Impression scale of Bipolar Disorder-Severity (CGI-BP-S)
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
|
Mean changes from baseline to EOS in Sheehan Disability Scale (SDS)
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
Social function
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
Mean changes from baseline to EOS in 6-item Quality of Life scale (QOL-6)
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
Social function
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
Young Mania Rating Scale (YMRS) total score ≤10
Time Frame: 8 weeks for phase I, up to 48 weeks for phase II and III
|
Using YMRS total score to monitor the switching from depression to hypomania and mania
|
8 weeks for phase I, up to 48 weeks for phase II and III
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Yiru Fang, M.D., Ph.D., Shanghai Mental Health Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 1, 2012
Primary Completion (Anticipated)
December 1, 2017
Study Completion (Anticipated)
December 1, 2018
Study Registration Dates
First Submitted
September 5, 2013
First Submitted That Met QC Criteria
September 9, 2013
First Posted (Estimate)
September 10, 2013
Study Record Updates
Last Update Posted (Actual)
October 5, 2017
Last Update Submitted That Met QC Criteria
October 3, 2017
Last Verified
October 1, 2017
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2012BAI01B04-BD
- 2012BAI01B04 (Other Grant/Funding Number: 2012BAI01B04)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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