Confirm the Effectiveness of Predictix Genetics Antidepressant -Guided Treatment in Adults With MDD

A Prospective, Randomized, Double-Blind (Subject and Rater) Controlled Study to Confirm the Effectiveness of Predictix Genetics Antidepressant -Guided Treatment in Adults With Major Depressive Disorder (MDD)

A randomized, controlled, prospective, multicenter, patient and rater blinded study with 2 arms: Treatment as Usual (TAU) and Predictix Guided Treatment (PGT). The study will compare the rate of treatment response and remission among both groups; TAU vs PGT.

Study Overview

• Status: Recruiting
• Conditions: Major Depressive Disorder
• Intervention / Treatment: Device: Predictix Genetics Antidepressant

Detailed Description

A randomized, controlled, prospective, multicenter, patient and rater blinded study with 2 arms: Treatment as Usual (TAU) and Predictix Guided Treatment (PGT). The study will compare the rate of treatment response and remission among both groups; TAU vs PGT.

The study will enroll up to 354 eligible patients. An interim analysis is planned after 240 evaluable subjects complete the 8-week's visit. According to the interim analysis plan, the sample size may be increased to 522.

To participate in the study the subjects must be at least 18 years old and able to give a written informed consent after an oral and written explanation of the study aims and methods. The study sample will include female and male patients with major depression diagnosis according to DSM-5 and MINI criteria. For the detailed assessment of clinical severity of specific disorder and treatment effects, the following disorder-specific rating scales will be used: Montgomery-Asberg's Depression Rating Scale (MADRS), Clinical Global Impression scale (CGI), , Patient Health Questionnaire (PHQ-9) and Patient's Global Impression (PGI). Patients will be randomized into either the Predictix Guided Treatment (PGT) group or the Treatment as Usual (TAU) group. Randomization will be stratified based on the number of previous treatment failures for the current MDD episode to ensure balance of the treatment groups. Patients will be prospectively treated with approved antidepressant medication for a period of 8 weeks (defined as a treatment cycle) during and after which they will be assessed, and treatment success or failure will be determined. Maximum desired up-titration should be reached by week 2. Concomitant treatments that are permitted include: benzodiazepines for those who had no previous hypnotic treatment - Zolpidem 10 mg at night or for anxiety -no more than 10 mg/day Diazepam or equivalent; formal psychotherapy not started within a month before the beginning of the study; non-psychopharmacologic drugs with CNS effects if the patient has been receiving a stable dose of the drug for at least one month before baseline.

Patients will be defined as responders if the decrease in MADRS scores is at least 50% compared to baseline. The remitters will be defined if the scores are less than 10 on the MADRS. Patients who do not meet these criteria will be defined as non-responders and non-remitters respectively. Following the 8 weeks, patients in the TAU group will be offered PGT in an open-label extension of the study. Patients in the TAU and PGT groups will be followed for up to an additional 2 treatment cycles (of up to 8 weeks each).

A treatment cycle will include 4 visits: Screening, Baseline (on site visit), 4 and 8 weeks (Telephone visits). At least one completed cycle per patient is required for a patient to be included in the analysis as study completed.

• Study Type: Interventional
• Enrollment (Anticipated): 354
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Dalia Dickman, PhD; Phone Number: +972545595951; Email: dalia@taliazhealth.com
• Study Contact Backup: Name: Dekel Taliaz, PhD; Email: dekel@taliazhealth.com

Study Locations

• Belgium
  • Brussels, Belgium
    • Recruiting
    • Psy Pluriel
    • Contact: Daniel Souery, MD; Email: dsouery@psypluriel.be
    • Principal Investigator: Daniel Soury, Dr
  • Liège, Belgium
    • Not yet recruiting
    • Psy Pluriel
    • Contact: William Pitchot, Prof; Email: pitchotwilliam@gmail.com
    • Sub-Investigator: William Pitchot, Prof
• France
  • Paris, France
    • Not yet recruiting
    • Hospital Pitie Salpetriere
    • Contact: Bertrand Saudreau, Dr.
• Switzerland
  • Geneve, Switzerland
    • Not yet recruiting
    • Hôpitaux Universitaires de Genève
    • Contact: Othman Sentissi, MD; Email: O.Sentissi@hcuge.ch
    • Principal Investigator: Othman Sentissi, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Male or female at the age of 18-75 years old at time of screening.
2. Primary diagnosis of Major Depressive Disorder (without psychosis) based on DSM-5 criteria and MINI 7.0.
3. MADRS score ≥22
4. No other causes of depressive symptoms other than MDD.
5. Ability to read, understand and sign an informed consent document.
6. Not more than 2 past failed pharmacologic interventions for the current depressive episode.
7. If subject is female and at reproductive age, she must be tested negative for pregnancy.
8. If subject is female and at reproductive age with childbearing potential (i.e., not post-menopausal or surgically sterilized) she must agree to use adequate birth control methods during the whole study duration.

Exclusion Criteria:

EXCLUSION CRITERIA

1. Patient is diagnosed with other major psychopathologies (i.e. schizophrenia, bipolar disorder, psychotic depression, geriatric depression).
2. Patient requires antipsychotic medication or mood stabilizers (other than study medication), lithium, carbamazepine, valproate and other that may have an antidepressant effect.
3. Electroconvulsive therapy (ECT) or transcranial magnetic stimulation therapy (TMS) conducted in the past or started within 90 days of screening or planned during the study.
4. Nonpsychopharmacologic drugs with CNS effects that have been taken for less than 30 days prior to baseline.
5. Subjects with a vagus nerve or deep brain stimulator.
6. Patient is at substantial suicidal risk as determined by the Mini Neuropsychiatric Interview (MINI) Suicidality subscale for suicide attempts and/or judged by the treating physician.
7. Patient has any current unstable medical condition or surgical illness.
8. Patient has history of seizure or convulsions.
9. A current status of dependence to a drug or alcohol.
10. Inadequate communication with the patient.
11. Patient has participated in another clinical study in the last 30 days preceding this study.
12. In the investigator's judgement, patient is not able to provide written informed consent and follow protocol requirements.
13. Pregnant women.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: SUPPORTIVE_CARE
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: DOUBLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
NO_INTERVENTION: TAU; Treatment as Usual: The treating clinician will decide on what antidepressant to prescribe based on the clinical evaluation.
ACTIVE_COMPARATOR: PGT; Predictix Guided Treatment: The treating clinician will decide on what antidepressant to prescribe based on clinical evaluation and the Predictix report	Device: Predictix Genetics Antidepressant; Predictix Genetics Antidepressant (PGA) is a software tool that is intended to support a clinician in choosing the most suitable antidepressant treatment/s for an individual patient diagnosed with MDD.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Response rate	Response is defined as a reduction from baseline of at least 50% (≥50%) in Montgomery-Asberg Depression Rating Scale (MADRS).	8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Remission rate	Remission is defined as a Montgomery-Asberg Depression Rating Scale (MADRS) < 10	8 weeks
Change from baseline in Montgomery-Asberg Depression Rating Scale (MADRS) over time.	Efficacy over time	8 weeks
Time to response	Time to response	8 weeks
Clinician Global Impression (CGI) score over time	Efficacy over time	8 weeks

Collaborators and Investigators

• Sponsor: Taliaz Ltd.
• Investigators: Principal Investigator: Daniel Souery, MD, Psy Pluriel

Publications and helpful links

General Publications

• Taliaz D, Spinrad A, Barzilay R, Barnett-Itzhaki Z, Averbuch D, Teltsh O, Schurr R, Darki-Morag S, Lerer B. Optimizing prediction of response to antidepressant medications using machine learning and integrated genetic, clinical, and demographic data. Transl Psychiatry. 2021 Jul 8;11(1):381. doi: 10.1038/s41398-021-01488-3.
• Taliaz D, Souery D. A New Characterization of Mental Health Disorders Using Digital Behavioral Data: Evidence from Major Depressive Disorder. J Clin Med. 2021 Jul 14;10(14):3109. doi: 10.3390/jcm10143109.

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 4, 2021
• Primary Completion (ANTICIPATED): December 1, 2023
• Study Completion (ANTICIPATED): December 1, 2024

Study Registration Dates

• First Submitted: October 20, 2021
• First Submitted That Met QC Criteria: November 29, 2021
• First Posted (ACTUAL): November 30, 2021

Study Record Updates

• Last Update Posted (ACTUAL): November 30, 2021
• Last Update Submitted That Met QC Criteria: November 29, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Depression; Depressive Disorder; Depressive Disorder, Major; Psychotropic Drugs; Antidepressive Agents
• Other Study ID Numbers: CL-01-MCS-001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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