A Clinical Trial of Oral Ganaxolone in Women With Postpartum Depression

A Phase 2, Double-blind, Placebo-controlled, Multicenter Study to Evaluate Safety, Tolerability, and Efficacy of Oral Administration of Ganaxolone in Women With Postpartum Depression

A clinical study to evaluate safety, tolerability and efficacy of oral administration of ganaxolone in women with postpartum depression

Study Overview

• Status: Completed
• Conditions: Behavioral Symptoms; Depressive Disorder; Depression; Mood Disorders; Pregnancy Complications; Depression, Postpartum; Mental Disorder; Postpartum Disorder; PPD; Postpartum Blues
• Intervention / Treatment: Drug: Placebo; Drug: Ganaxolone

• Study Type: Interventional
• Enrollment (Actual): 84
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • California
    • Glendale, California, United States, 91206
      • Marinus Research Site
    • Lemon Grove, California, United States, 91945
      • Marinus Research Site
    • Long Beach, California, United States, 90806
      • Marinus Research Site
    • Oceanside, California, United States, 92056
      • Marinus Research Site
    • Panorama City, California, United States, 91402
      • Marinus Research Site
    • San Bernardino, California, United States, 92408
      • Marinus Research Site
    • San Marcos, California, United States, 92078
      • Marinus Research Site
    • Ventura, California, United States, 93003
      • Marinus Research Site
  • Florida
    • Gainesville, Florida, United States, 32607
      • Marinus Research Site
    • Hollywood, Florida, United States, 33021
      • Marinus Research Site
    • Jacksonville, Florida, United States, 32216
      • Marinus Research Site
    • North Miami, Florida, United States, 33161
      • Marinus Research Site
  • Georgia
    • Atlanta, Georgia, United States, 30328
      • Marinus Research Site
    • Atlanta, Georgia, United States, 30331
      • Marinus Research Site
    • Decatur, Georgia, United States, 30030
      • Marinus Research Site
    • Marietta, Georgia, United States, 30060
      • Marinus Research Site
  • Idaho
    • Idaho Falls, Idaho, United States, 83404
      • Marinus Research Site
  • Illinois
    • Hoffman Estates, Illinois, United States, 60169
      • Marinus Research Site
  • Kansas
    • Leawood, Kansas, United States, 66206
      • Marinus Research Site
    • Wichita, Kansas, United States, 67226
      • Marinus Research Site
  • Mississippi
    • Flowood, Mississippi, United States, 39232
      • Marinus Research Site
  • Nevada
    • Las Vegas, Nevada, United States, 89102
      • Marinus Research Site
  • New Mexico
    • Albuquerque, New Mexico, United States, 87102
      • Marinus Research Site
  • North Carolina
    • Raleigh, North Carolina, United States, 27612
      • Marinus Research Site
  • Ohio
    • Englewood, Ohio, United States, 45322
      • Marinus Research Site
  • Pennsylvania
    • Downingtown, Pennsylvania, United States, 19335
      • Marinus Research Site
    • Media, Pennsylvania, United States, 19063
      • Marinus Research Site
  • Texas
    • Houston, Texas, United States, 77058
      • Marinus Research Site
    • Irving, Texas, United States, 75062
      • Marinus Research Site
    • League City, Texas, United States, 77573
      • Marinus Research Site
    • San Antonio, Texas, United States, 78229
      • Marinus Research Site
  • Utah
    • Orem, Utah, United States, 84058-4939
      • Marinus Research Site
  • Virginia
    • Richmond, Virginia, United States, 23298
      • Marinus Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 48 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Experiencing a major depressive episode, which started between the start of the third trimester and 4 weeks following delivery. The major depressive episode must be diagnosed according to Mini International Neuropsychiatric Interview (MINI) 7.0 interview
• Given birth in the last 6 months
• HAMD17 score of ≥ 20 at screening but < 26
• Must agree to stop breastfeeding from start of study treatment or must agree to temporarily cease giving breast milk to her infant(s)

Exclusion Criteria:

• Current history of any psychotic illness, including major depressive episode with psychotic features
• History of suicide attempt within the past 3 years
• History of bipolar I disorder
• History of seizure discorder

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo; Oral	Drug: Placebo; Oral
Experimental: Ganaxolone; Oral	Drug: Ganaxolone; Oral

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Hamilton Depression Rating Scale 17-item Version (HAMD17) Through Treatment	The HAMD17 was a 17-item clinician-rated instrument used to assess the range of symptoms that were most frequently observed in participants with major depression. All items were scored on an ordinal scale between 0 and 4 (8 items) or 0 and 2 (9 items) of increasing severity. Each of 17 items was rated by clinician with rating of 0: absent, 1: doubtful to mild, 2: mild to moderate, 3: moderate to severe, and 4: very severe. A total score (0 to 52) was calculated by adding scores of all 17 items, where 0 indicated no depression and 52 indicated severe depression. Higher score represented more severe condition. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.	Baseline (Day 1) and through Day 10 for 2 week treatment group and Day 29 for 4 week treatment groups

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Hamilton Depression Rating Scale 17-item Version Post Treatment	The HAMD17 was a 17-item clinician-rated instrument used to assess the range of symptoms that were most frequently observed in participants with major depression. All items were scored on an ordinal scale between 0 and 4 (8 items) or 0 and 2 (9 items) of increasing severity. Each of 17 items was rated by clinician with rating of 0: absent, 1: doubtful to mild, 2: mild to moderate, 3: moderate to severe, and 4: very severe. A total score (0 to 52) was calculated by adding scores of all 17 items, where 0 indicated no depression and 52 indicated severe depression. Higher score represented more severe condition. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.	Baseline (Day 1) and Through Day 38 for 2 week treatment group and Day 71 and 119 for 4 week treatment groups
Number of Participants With Response to Hamilton Depression Rating Scale 17 Item (HAMD17)	HAMD17 Response was defined as ≥50% reduction from Baseline in total score. The HAMD-17 is a 17-item assessment used to assess the severity of depression and its improvement during the course of therapy. Each item was evaluated and scored using either a 5-point scale of 0 (not present/absent) to 4 (very severe) or a 3-point scale of 0 (not present/absent) to 2 (marked). Items rated on the 3-point scale include: insomnia early, middle, late; somatic symptoms gastrointestinal and general; genital symptoms; loss of weight; insight. Items rated on 5-point scale include: depressed mood; feelings of guilt; suicide; work and activities; retardation; agitation; anxiety psychic and somatic; hypochondriasis. The total score was the sum of the scores from HAMD-17 Items 1 through 17 and ranged from 0 (not at all depressed) to 52 (severely depressed). Higher scores indicate greater symptom severity. Number of participants with response to HAMD-17 has been presented.	Day 2 (all treatment groups), Day 7 (TID & QHS), Day 8/10 (all treatment groups), Day 15/17 (all treatment groups), Day 22 and 29 (QHS, 1125mg), Day 36/38 (all treatment groups), Day 57/59 (QHS, 1125mg), Day 71 (1125mg), Day 89 (QHS), Day 119 (QHS)
Number of Participants With Hamilton Depression Rating Scale 17-item Remission	Remission was defined as an observed total score of 0 to 7. The HAMD-17 is a 17-item assessment used to assess the severity of depression and its improvement during the course of therapy. Each item was evaluated and scored using either a 5-point scale of 0 (not present/absent) to 4 (very severe) or a 3-point scale of 0 (not present/absent) to 2 (marked). Items rated on the 3-point scale include: insomnia early, middle, late; somatic symptoms gastrointestinal and general; genital symptoms; loss of weight; insight. Items rated on 5-point scale include: depressed mood; feelings of guilt; suicide; work and activities; retardation; agitation; anxiety psychic and somatic; hypochondriasis. The total score was the sum of the scores from HAMD-17 Items 1 through 17 and ranged from 0 (not at all depressed) to 52 (severely depressed). Higher scores indicate greater symptom severity. Number of participants with HAMD-17 remission has been presented.	Day 8/10 (all treatment arms), Day 15/17 (all treatment arms), Day 22 and 29 (QHS & 1125mg), Day 36/38 (all treatment arms), Day 57/59 (QHS & 1125mg), Day 71 (1125mg), Day 89 & 119 (QHS)
Change From Baseline in Edinburgh Postnatal Depression Scale (EPDS) Total Score	The EPDS is a validated 10-question depression assessment for postpartum women, which includes anxiety symptoms and excludes constitutional symptoms associated with depression common in the postpartum period, such as changes in sleeping patterns. It consists of 10 multiple choice questions with scores for each question ranging from 0-3. Questions 1, 2, & 4 are scored 0, 1, 2 or 3 with top box scored as 0 and the bottom box scored as 3. Questions 3 and 5 to 10 are reverse scored, with the top box scored as a 3 and the bottom box scored as 0. Scores are then summed for a total score, which ranges from 0: no depression to 30: severe depression. Higher score indicates severe depression. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.	Baseline (Day 1) through Day 119
Change From Baseline in Spielberger State-Trait Anxiety Inventory, 6-item Version	The Spielberger State-Trait Anxiety Inventory was a 6-item questionnaire designed and validated. It is a reliable and sensitive measure of anxiety. The 6-item version has been shown to have acceptable reliability, producing similar scores as the full 20-item inventory for those with normal and raised levels of anxiety. Participants are prompted to respond to indicate "how [the participant] feel right now, at this moment", followed by a list of common experiences like "I feel calm, I am tense, I feel upset, I am relaxed I feel content and I am worried." Responses range from Not at all (1) to Very much (4), with overall scores ranging from 20-80, where higher scores reflected higher states of anxiety. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.	Baseline (Day 1) through Day 119
Number of Participants With Clinical Global Impression-Improvement	The CGI-I scale is a clinician-rated 7-point scale used to assess how much the participant's illness had improved or worsened relative to a Baseline state at the beginning of the intervention. It was rated as: 1. "very much improved" 2. "much improved" 3. "minimally improved" 4. "no change" 5. "minimally worse" 6. "much worse" 7. "very much worse". Higher scores indicated worse condition. Only those participants with CGI- improvement have been presented.	Baseline through Day 119

Collaborators and Investigators

• Sponsor: Marinus Pharmaceuticals
• Investigators: Study Director: Joseph Hulihan, MD, Marinus Pharmaceuticals

Study record dates

Study Major Dates

• Study Start (Actual): December 28, 2017
• Primary Completion (Actual): July 5, 2019
• Study Completion (Actual): July 5, 2019

Study Registration Dates

• First Submitted: January 18, 2018
• First Submitted That Met QC Criteria: March 4, 2018
• First Posted (Actual): March 9, 2018

Study Record Updates

• Last Update Posted (Actual): August 18, 2023
• Last Update Submitted That Met QC Criteria: August 2, 2023
• Last Verified: August 1, 2023

More Information

Terms related to this study

• Keywords: Postpartum Depression; Postpartum Care
• Additional Relevant MeSH Terms: Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Depression; Depressive Disorder; Mental Disorders; Depression, Postpartum; Mood Disorders; Pregnancy Complications; Behavioral Symptoms; Puerperal Disorders; Physiological Effects of Drugs; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; GABA Modulators; GABA Agents; Neurosteroids; Ganaxolone
• Other Study ID Numbers: 1042-PPD-2003

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No