Prophylactic Effects of Agomelatine for Poststroke Depression (PRAISED)

July 26, 2022 updated by: Jinsheng Zeng, MD, PhD, First Affiliated Hospital, Sun Yat-Sen University

A Multicenter, Randomized, Double-blind, Placebo-controlled Study Evaluating the Efficacy and Safety of Agomelatine in the Prevention of Poststroke Depression

The incidence of depression in stroke patients with frontal lobe involvement was reported to be as high as 42%. Agomelatin, a type 1/2 melatonin receptor agonist and serotonin 2C receptor antagonist, is effective in treatment of depression, but whether it can prevent poststroke depression (PSD) remains unknown. The PRAISED trial is a multicenter, randomized, double-blind trial and is designed to evaluate the efficacy and safety of agomelatine in the prevention of PSD in stroke patients with frontal lobe involvement. The primary outcome is the rate of post-stroke depression for 180 days.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This PRAISED trial is a multicenter, randomized, double-blind trial to evaluate the efficacy and safety of agomelatine in the prevention of PSD in patients with acute ischemic stroke. The sample size is 420. The participants will be randomized to receive a 6-month treatment of agomelatine 25mg/d or placebo 25mg/d. The primary end point is the proportion of PSD within 180 days. PSD is defined as the Hamilton Depression Rating Scale-17 (HAMD-17) ≥7 or diagnosis of depression by the Diagnostic and Statistical Manual of mental disorders-V (DSM-V). The second end point are rate of recurrence of ischemic stroke within 90 days, modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), vascular death, transient ischemic attack (TIA)/stroke or myocardial infarction during the 6-months, cognitive function(Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), Stroke Specific Quality Of Life (SS-QOL) scale, adherence to medication, adverse events. The study consists of five visits including the day of randomization, day 14±3 days, day 28±3 days, day 90±7 days, day 180±7 days.

Study Type

Interventional

Enrollment (Anticipated)

420

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 Contact

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 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. aged 18~75 years;
  2. within 7 days after stroke onset;
  3. CT or MRI showed lesions involving the frontal lobe;
  4. mRS≤2 before onset for recurrent ischemic stroke;
  5. HAMD-17<8 before enrollment;
  6. NIHSS<16;
  7. be consious and able to complete the relevant assessment scales.

Exclusion Criteria:

  1. hemorrhagic stroke;
  2. with major depressive disorder, or have taken antidepressants within 30 days before stroke onset, or HAMD-17 ≥8;
  3. with other mental illnesses;
  4. history of drug abuse or alcohol dependence in the past 1 year
  5. with life-threatening illnesses or disorders which may affect the completion of the relevant assessment scale (e.g., hearing, language, visual impairment, etc.)
  6. with cognitive impairment who cannot complete the relevant assessment scale
  7. with serious neurodegeneration diseases (such as Parkinson's disease, Alzheimer's disease, etc.)
  8. infection or carriers of hepatitis B virus (HBV) or hepatitis C virus (HCV)
  9. serum ALT level ≥ 2 times of the upper limit of the reference interval or TBIL level > 1.5 times of the upper limit of the reference interval
  10. renal dysfunction (creatinine clearance < 90 ml/min/1.73 m2)
  11. allergic to or contra-indicated to agomelatine
  12. lactose intolerance
  13. pregnant or breast-feeding women
  14. withdraw from other clinical trials within 4 weeks or participating in other clinical trials
  15. unsuitable for inclusion considered by the investigators

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Agomelatine
The Agomelatine group will be received agomelatine (25 mg/day) for 180 days.
Drug: Agomelatine
agomelatine 25 mg/day for 180 days
Other Names:
  • Agomelatine Tablets
Placebo Comparator: Placebo
The Placebo group will be received placebo (25 mg/day) for 180 days.
Drug: Placebo Tablets
placebo 25 mg/day for 180 days
Other Names:
  • Placebo Placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
rate of PSD within 180 days
Time Frame: 180 days
PSD is defined as Hamilton Depression Rating Scale-17 (HAMD-17) ≥7 or diagnosis of depression by DSM-V.
180 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
rate of recurrence of ischemic stroke within 90 days
Time Frame: 90±7 days
  1. Acute onset of focal neurological deficit, a few can be comprehensive neurological deficit. 2. Brain CT/MRI confirms the corresponding infarct focus in the brain, or the symptoms and signs continue for more than 24h, or cause death within 24h. 3. Exclude non-ischemic causes.
  2. brain ct/mri confirmed the corresponding infarct focus in the brain, or the symptoms and signs continued for more than 24h, or caused death within 24h.
  3. exclude non ischemic causes.
90±7 days
variation of HAMD-17 score from baseline
Time Frame: 14±3 days, 28±3 days, 90±7 days, and 180±7 days
range from 0 to 50; the higher, the worse
14±3 days, 28±3 days, 90±7 days, and 180±7 days
rate of sleep disorder
Time Frame: 180 days
range from 0 to 21; > 7, having sleep disorder
180 days
variation of Pittsburgh Sleep Quality Index (PSQI) score from baseline
Time Frame: 14±3 days, 28±3 days, 90±7 days and 180±7 days
range from 0 to 21; the higher, the worse; > 7, having sleep disorder
14±3 days, 28±3 days, 90±7 days and 180±7 days
variation of Stroke Specific Quality of Life (SS-QOL) score from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
range from 50 to 248; the higher, the better
28±3 days, 90±7 days, and 180±7 days
variation of Modified Rankin Scale (mRS) score from baseline
Time Frame: 28±3 days, 90±7 days and 180±7 days
range from 0 to 5; the higher, the worse
28±3 days, 90±7 days and 180±7 days
variation of National Institutes of Health Stroke Scale (NIHSS) from baseline
Time Frame: 28±3 days, 90±7 days and 180±7 days
range from 0 to 42; the higher, the worse
28±3 days, 90±7 days and 180±7 days
variation of Montreal Cognitive Assessment (MOCA) from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
range from 0 to 30; the lower, the worse
28±3 days, 90±7 days, and 180±7 days
variation of Mini Mental State Examination (MMSE) score from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
range from 0 to 30; the lower, the worse
28±3 days, 90±7 days, and 180±7 days
variation of Epworth Sleepiness Scale (ESS) from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
range from 9 to 63; the higher, the worse
28±3 days, 90±7 days, and 180±7 days
rate of all-caused mortality
Time Frame: 180 days
death due to all causes
180 days
variation of Fatigue Severity Scale (FSS) from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
range from 0 to 24; >=24, having drowsiness tendency
28±3 days, 90±7 days, and 180±7 days
rate of vascular events
Time Frame: 180 days
defined as the composite of stroke, transient ischemic attack (TIA), myocardial infarction and vascular death
180 days
rate of liver injury
Time Frame: 28±3 days, 90±7 days
defend as the level of ALT 2 times higher than the upper limit of normal range
28±3 days, 90±7 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

First Affiliated Hospital, Sun Yat-Sen University

Investigators

  • Study Chair: Jinsheng Zeng, First Affiliated Hospital, Sun Yat-Sen University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Anticipated)

October 1, 2022

Primary Completion (Anticipated)

May 31, 2024

Study Completion (Anticipated)

May 31, 2024

Study Registration Dates

First Submitted

May 2, 2022

First Submitted That Met QC Criteria

June 16, 2022

First Posted (Actual)

June 21, 2022

Study Record Updates

Last Update Posted (Actual)

July 27, 2022

Last Update Submitted That Met QC Criteria

July 26, 2022

Last Verified

July 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PRAISED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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