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Studie hodnotící účinnost a bezpečnost esketaminu při snižování příznaků těžké depresivní poruchy (AVENUE)

2. listopadu 2026 aktualizováno: Janssen Research & Development, LLC

Dvojitě zaslepená, randomizovaná, psychoaktivní placebem kontrolovaná studie k posouzení účinnosti a bezpečnosti intranazálního esketaminu 84 mg v doplňku ke komplexní standardní péči pro rychlé snížení příznaků velké depresivní poruchy u dospívajících účastníků s akutními sebevražednými myšlenkami nebo chováním

The purpose of this study is to evaluate how well JNJ-54135419 works (efficacy) in addition to comprehensive standard of care (SoC) in rapidly reducing the symptoms of major depressive disorder (MDD, a mental disorder characterized by a persistent feeling of sadness and loss of interest in activities) as compared with psychoactive placebo (does not contain JNJ-54135419) plus SoC in adolescent participants with acute suicidal ideation or behavior.

Přehled studie

Postavení

Nábor

Podmínky

Intervence / Léčba

Typ studie

Intervenční

Zápis (Odhadovaný)

258

Fáze

  • Fáze 3

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní místa

      • Criciúma, Brazílie, 88811 000
        • Nábor
        • Sociedade Literaria e Caritativa Santo Agostinho Hospital Sao Jose
      • Natal, Brazílie, 59012 300
        • Nábor
        • Universidade Federal do Rio Grande do Norte Hospital Universitario Onofre Lopes
      • Salvador, Brazílie, 40170 108
        • Nábor
        • Instituto Apice
      • São Bernardo do Campo, Brazílie, 09726 150
        • Nábor
        • Centro Integrado Facili
      • São Paulo, Brazílie, 01 227 200
        • Nábor
        • Instituto de Pesquisa Pensi Sandra Mutarelli Setubal
      • São Paulo, Brazílie, 05403-900
        • Nábor
        • Hospital Das Clinicas Da Faculdade De Medicina Da USP
      • Acireale, Itálie, 95024
        • Nábor
        • Presidio Ospedaliero Santa Marta e Santa Venera
      • Cagliari, Itálie, 09134
        • Nábor
        • Azienda Ospedaliera G. Brotzu
      • Florence, Itálie, 50134
        • Nábor
        • AOU Meyer
      • Foggia, Itálie, 71122
        • Nábor
        • Azienda Ospedaliera Universitaria Policlinico Riuniti di Foggia
      • Genova, Itálie, 16147
        • Nábor
        • G.Gaslini Institute
      • Merano, Itálie, 39012
        • Nábor
        • Ospedale di Merano
      • Naples, Itálie, 80131
        • Nábor
        • Azienda Ospedaliera Universitaria Federico II
      • Sassari, Itálie, 07100
        • Nábor
        • Azienda Ospedaliero Universitaria di Sassari
      • Budapest, Maďarsko, 1021
        • Nábor
        • Vadaskert Gyermek es Ifjusagpszichiatriai Korhaz es Szakambulancia
      • Debrecen, Maďarsko, 4031
        • Nábor
        • Debreceni Egyetem Klinikai Kozpont
      • Győr, Maďarsko, 9023
        • Nábor
        • Petz Aladar Megyei Oktato Korhaz
      • Szeged, Maďarsko, 6720
        • Nábor
        • Szegedi Tudomanyegyetem
      • Bucharest, Rumunsko, 041914
        • Nábor
        • Spitalul Clinic de Psihiatrie Prof Dr Alexandru Obregia
      • Cluj-Napoca, Rumunsko, 400347
        • Nábor
        • Spitalul Clinic de Urgenta pentru Copii Cluj Napoca
      • Sibiu, Rumunsko, 550082
        • Nábor
        • Spitalul Clinic De Psihiatrie Doctor Gheorghe Preda
      • Timișoara, Rumunsko, 300329
        • Nábor
        • Spitalul Clinic de Urgenta pentru Copii 'Louis Turcanu' Timisoara
    • Alabama
      • Birmingham, Alabama, Spojené státy, 35294
        • Nábor
        • University of Alabama at Birmingham
    • Connecticut
      • New Haven, Connecticut, Spojené státy, 06511
        • Nábor
        • Yale Child Study Center
    • District of Columbia
      • Washington D.C., District of Columbia, Spojené státy, 20010
        • Nábor
        • Children's National Medical Center
    • Georgia
      • Atlanta, Georgia, Spojené státy, 30338
        • Nábor
        • Peachford Hospital-Atlanta Behavioral Research
    • Illinois
      • Evanston, Illinois, Spojené státy, 60201
        • Nábor
        • Endeavor Health Evanston Hospital
    • Maryland
      • Baltimore, Maryland, Spojené státy, 21287
        • Nábor
        • Johns Hopkins University
    • Massachusetts
      • Boston, Massachusetts, Spojené státy, 02445
        • Nábor
        • Boston Childrens Hospital
    • Minnesota
      • Rochester, Minnesota, Spojené státy, 55905
        • Nábor
        • Mayo Clinic
    • North Carolina
      • Chapel Hill, North Carolina, Spojené státy, 27514
        • Nábor
        • University of North Carolina at Chapel Hill
    • Ohio
      • Cincinnati, Ohio, Spojené státy, 45219
        • Nábor
        • University of Cincinnati
    • Rhode Island
      • East Providence, Rhode Island, Spojené státy, 02915
        • Nábor
        • Bradley Hospital
    • Texas
      • Houston, Texas, Spojené státy, 77021
        • Nábor
        • John S Dunn Behavioral Sciences Center at UTHealth Houston
      • New Taipei City, Tchaj-wan, 251
        • Nábor
        • Mackay Memorial Hospital Tamsui Branch
      • Taipei, Tchaj-wan, 114
        • Nábor
        • Tri-Service General Hospital
      • Taipei, Tchaj-wan, 100
        • Nábor
        • National Taiwan University Hospital
      • Taipei, Tchaj-wan, 112
        • Nábor
        • Taipei Veterans General Hospital
      • Taipei, Tchaj-wan, 110
        • Nábor
        • Taipei Medical University Hospital
      • Barcelona, Španělsko, 08036
        • Nábor
        • Hosp. Clinic de Barcelona
      • Barcelona, Španělsko, 08035
        • Nábor
        • Hosp Univ Vall D Hebron
      • Esplugues de Llobregat, Španělsko, 08950
        • Nábor
        • Hosp. Sant Joan de Deu
      • Madrid, Španělsko, 28046
        • Nábor
        • Hosp. Univ. La Paz
      • Madrid, Španělsko, 28009
        • Nábor
        • Hosp. Gral. Univ. Gregorio Maranon
      • Manresa, Španělsko, 08243
        • Nábor
        • Fundacio Althaia Xarxa Assistencial Universitaria de Manresa
      • Oviedo, Španělsko, 33011
        • Nábor
        • Hosp. Univ. Central de Asturias
      • Pamplona, Španělsko, 31008
        • Nábor
        • Clinica Univ. de Navarra
      • Sabadell, Španělsko, 08208
        • Nábor
        • Hosp.Univ.Parc Tauli
      • Santander, Španělsko, 39008
        • Nábor
        • Hosp. Univ. Marques de Valdecilla

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

12 let až 17 let (Dítě)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

  • Must meet diagnostic and statistical manual of mental disorders (5th edition) (DSM-5) diagnostic criteria for major depressive disorder (MDD) based upon clinical assessment and confirmed by the mini-international neuropsychiatric interview for children and adolescents (MINI-KID)
  • Must have a clinical global impression - severity of suicidality - revised (CGI-SS-R) score of "Markedly" or greater (that is, greater than or equal to [>=] 4) at both screening and baseline (predose) visits
  • Must have a children's depression rating scale - revised (CDRS-R) total score >= 58 at baseline (predose)
  • In the physician's opinion, acute psychiatric hospitalization is clinically warranted due to subject's acute suicidality
  • Must be medically stable based on physical examination, medical history, vital signs, and 12-lead electrocardiogram (ECG) performed at screening

Exclusion Criteria:

  • Participant has a current DSM-5 diagnosis of bipolar (or related disorders), intellectual disability, autism spectrum disorder, conduct disorder, oppositional defiant disorder
  • Participant currently meets DSM-5 criteria for borderline personality disorder
  • Participant has a current or prior DSM-5 diagnosis of a psychotic disorder, or MDD with psychosis
  • Participant has a history of seizure disorder
  • Participant has known allergies, hypersensitivity, intolerance or contraindications to midazolam, esketamine or ketamine, or their excipients

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Dvojnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Intranasal Esketamine + Oral Placebo

Participants will receive intranasal esketamine 84 milligrams (mg) along with oral placebo solution twice weekly for 4 weeks (Days 1, 4, 8, 11, 15, 18, 22, and 25). On Day 4 a decrease to intranasal esketamine 56 mg (in a blinded fashion per investigator's judgment) is permitted. Thereafter, dose may be flexed between 56 mg and 84 mg during the treatment period.

Esketamine will be administered as intranasal solution.

Ostatní jména:
  • JNJ-54135419

Placebo will be administered as oral solution.

Komparátor placeba: Intranasal Placebo + Oral Midazolam

Participants will receive oral midazolam (0.0625 milligrams per kilograms [mg/kg]) and intranasal placebo twice weekly for 4 weeks (Days 1, 4, 8, 11, 15, 18, 22, and 25). On Day 4 a sham decrease to esketamine 56 mg dose (in a blinded fashion per investigator's judgment) is permitted. Thereafter, sham dose may be flexed between 56 mg and 84 mg during the treatment period.

Midazolam will be administered as oral solution.

Intranasal placebo will be administered as nasal solution.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change from Baseline in Depressive Symptoms Measured by Children's Depression Rating Scale - Revised (CDRS-R) Total Score at 24 Hours Post First Dose
Časové okno: Baseline (pre-dose on Day 1) and 24 hours post first dose (i.e., Day 2)

The CDRS-R is a 17-item, clinician-reported outcome measure of children's depressive symptom severity. Out of the 17-item, 3 items were non-verbal behavior (listless speech, hypoactivity, and depressed affect) rated on a 5 point scale from 1 (no depression) to 5 (severe depression) and 14 items were rated on a 7-point scale from 1 (no depression) to 7 (severe depression), where higher score indicated more severe depression. The CDRS-R total score was the sum of the 17-tems score and it ranged from 17 (normal) to 113 (severe depression). Higher score indicated more severe depression and worse outcome.

Baseline (pre-dose on Day 1) and 24 hours post first dose (i.e., Day 2)

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change from Baseline in CDRS-R Total Score at Day 25
Časové okno: Baseline (predose on Day 1) and Day 25 (4 hours post dose)

The CDRS-R is a 17-item, clinician-reported outcome measure of children's depressive symptom severity. Out of the 17-item, 3 items were non-verbal behavior (listless speech, hypoactivity, and depressed affect) rated on a 5-point scale from 1 (no depression) to 5 (severe depression) and 14 items were rated on a 7-point scale from 1 (no depression) to 7 (severe depression), where higher score indicated more severe depression. The CDRS-R total score was the sum of the 17-tems score and it ranged from 17 (normal) to 113 (severe depression). Higher score indicated more severe depression and worse outcome.

Baseline (predose on Day 1) and Day 25 (4 hours post dose)
Change from Baseline in Clinical Global Impression - Severity of Suicidality - Revised (CGI-SS-R) Score at 24 Hours Post First Dose
Časové okno: Baseline (pre-dose on Day 1) and 24 hours post first dose (i.e., Day 2)

The CGI-SS-R is a single item clinician-rated measure of the severity of participants' suicidality. The CGI-SS-R asks clinicians to rate the severity of a participant's suicidality using a 7-point scale that ranges from 0 (normal, not at all suicidal) to 6 (among the most extremely suicidal patients). Higher scores indicate greater severity.

Baseline (pre-dose on Day 1) and 24 hours post first dose (i.e., Day 2)
Change From Baseline in Symptoms of MDD During the Double-Blind (DB) Treatment Phase as Measured by CDRS-R Total Score
Časové okno: From Baseline up to Day 25

The CDRS-R is a 17-item, clinician-reported outcome measure of children's depressive symptom severity. Out of the 17-item, 3 items were non-verbal behavior (listless speech, hypoactivity, and depressed affect) rated on a 5-point scale from 1 (no depression) to 5 (severe depression) and 14 items were rated on a 7-point scale from 1 (no depression) to 7 (severe depression), where higher score indicated more severe depression. The CDRS-R total score was the sum of the 17-tems score and it ranged from 17 (normal) to 113 (severe depression). Higher score indicated more severe depression and worse outcome.

From Baseline up to Day 25
Percentage of Participants with Remission of Depressive Symptoms During the DB Treatment Phase
Časové okno: Up to Day 25

Remission of depressive symptoms is defined as a CDRS-R total score of both less than or equal to (<=) 28 and <= 34 during the DB treatment phase. The CDRS-R is a 17-item, clinician-reported outcome measure of children's depressive symptom severity. Out of the 17-item, 3 items were non-verbal behavior (listless speech, hypoactivity, and depressed affect) rated on a 5 point scale from 1 (no depression) to 5 (severe depression) and 14 items were rated on a 7-point scale from 1 (no depression) to 7 (severe depression), where higher score indicated more severe depression. The CDRS-R total score was the sum of the 17-tems score and it ranged from 17 (normal) to 113 (severe depression). Higher score indicated more severe depression and worse outcome.

Up to Day 25
Percentage of Responders on Depressive Symptoms During the DB Treatment Phase
Časové okno: Up to Day 25

Responders on depressive symptoms is defined as >= 50 percent (%) improvement in CDRS-R total score from baseline during the DB treatment phase. The CDRS-R is a 17-item, clinician-reported outcome measure of children's depressive symptom severity. Out of the 17-item, 3 items were non-verbal behavior (listless speech, hypoactivity, and depressed affect) rated on a 5 point scale from 1 (no depression) to 5 (severe depression) and 14 items were rated on a 7-point scale from 1 (no depression) to 7 (severe depression), where higher score indicated more severe depression. The CDRS-R total score was the sum of the 17-tems score and it ranged from 17 (normal) to 113 (severe depression). Higher score indicated more severe depression and worse outcome.

Up to Day 25
Percentage of Participants with Resolution of Suicidality During the DB Treatment Phase
Časové okno: Up to Day 25

Participants with resolution of suicidality is defined as a score of 0 (normal, not at all suicidal) or 1 (questionably suicidal) on CGI SS-R, during the DB treatment phase. The CGI-SS-R asks clinicians to rate the severity of a participant's suicidality using a 7-point scale that ranges from 0 (normal, not at all suicidal) to 6 (among the most extremely suicidal patients). Higher score indicate greater severity.

Up to Day 25
Change From Baseline in Severity of Suicidality As Measured by Clinical Global Impression - Severity of Suicidality - Revised (CGI-SS-R) During the DB Treatment Phase
Časové okno: From Baseline up to Day 25

The CGI-SS-R is a single item clinician-rated measure of the severity of participants' suicidality. The CGI-SS-R asks clinicians to rate the severity of a participant's suicidality using a 7-point scale that ranges from 0 (normal, not at all suicidal) to 6 (among the most extremely suicidal patients). Higher score indicate greater severity.

From Baseline up to Day 25
Change From Baseline in Clinician-Reported Frequency of Suicidal Thinking (FoST-ClinRO) During the DB Treatment Phase
Časové okno: From Baseline up to Day 25

FoST-ClinRO is a clinician-rated measure used to assess a participant's frequency of suicidal thinking assessed during the DB treatment phase. The measure uses a 6-point Likert scale that ranges from 0=Never, to 5=All of the time to assess suicidal thinking frequency, where higher scores indicate a more severe condition.

From Baseline up to Day 25
Change from baseline in Patient-Reported Frequency of Suicidal Thinking (FoST-PRO) During the DB Treatment Phase
Časové okno: From Baseline up to Day 25

FoST-PRO is a single item participant reported measure of the frequency of one's suicidal thinking right now. The single item asks participants to rate the frequency with which they have suicidal thoughts (0 = I have no suicidal thoughts, 1 = I have suicidal thoughts a little of the time, 2 = I have suicidal thoughts some of the time, 3 = I have suicidal thoughts most of the time, and 4 = I have suicidal thoughts all of the time). Higher scores indicate greater severity.

From Baseline up to Day 25
Change from Baseline in Patient Health Questionnaire, 9-item Modified for Adolescents (PHQ-A) Total Score During the DB Treatment Phase
Časové okno: From Baseline up to Day 25

The PHQ-A is a modified version of the PHQ-9 scale, specifically designed to measure depressive symptom severity in adolescents. A 10-item version of the PHQ-A will be used in this study; the first 9 items assess depressive symptoms. Adolescents use a 4 point Likert scale to rate the severity of their symptoms over the past 2 weeks (range: 0 = not at all to 3 = nearly every day). The PHQ-A total score is the sum of all item responses. The total score can be used to classify adolescents based on the severity of their depressive symptoms: 0-4 (no or minimal depression), 5-9 (mild depression), 10-14 (moderate depression), 15-19 (moderately severe depression), and 20-27 (severe depression). The tenth PHQ-A item measures the degree to which adolescents experience functional difficulties due to their depressive symptoms. Higher scores indicate greater depressive symptoms.

From Baseline up to Day 25
Change From Baseline in KIDSCREEN-10 Total Score During the DB Treatment Phase
Časové okno: From Baseline up to Day 25

KIDSCREEN-10 is a global patient-reported outcome (PRO) measure of well-being and health-related quality of life in children and adolescents aged 8-18 years. It includes 10 items that measure the subjective health and psychological, mental and social well-being experiences of children and adolescents over the past week. The scores for the 10 items are summed to produce a total score. This total score can then be transformed into a T-score or percentile rank, based on normative data, to facilitate interpretation. The higher the total score, the better the reported health-related quality of life (HRQoL).

From Baseline up to Day 25
Change from Baseline in Patient Global Impression of Severity (PGI-S) Depressive Symptoms at 24 Hours Post First Dose
Časové okno: Baseline (predose on Day 1) and 24 hours post first dose (i.e., Day 2)

The PGI-S is a single PRO item that captures one's perceptions of the severity of his/her depressive symptoms over the past 24 hours. Participants will be asked to rate their disease severity using the following 5-point scale: 1 = None, 2 = Mild, 3 = Moderate, 4 = Severe, and 5 = Very severe. Higher scores indicate greater disease severity.

Baseline (predose on Day 1) and 24 hours post first dose (i.e., Day 2)
Change from Baseline in Clinical Global Impression - Severity Scale (CGI-S) Depressive Symptoms at 24 Hours Post First Dose
Časové okno: Baseline (pre-dose on Day 1) and 24 hours post first dose (i.e., Day 2)

The CGI-S provides an overall clinician-determined summary measure of the severity of the participant's illness that considers all available information, including knowledge of the participant's history, psychosocial circumstances, symptoms, behavior, and the impact of the symptoms on the participant's ability to function. The CGI-S will be used to rate the overall severity of illness 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 the following scale: 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 patients. Higher scores indicate greater severity.

Baseline (pre-dose on Day 1) and 24 hours post first dose (i.e., Day 2)

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

8. ledna 2026

Primární dokončení (Odhadovaný)

9. dubna 2031

Dokončení studie (Odhadovaný)

15. září 2031

Termíny zápisu do studia

První předloženo

11. listopadu 2025

První předloženo, které splnilo kritéria kontroly kvality

11. listopadu 2025

První zveřejněno (Aktuální)

12. listopadu 2025

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

3. listopadu 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

2. listopadu 2026

Naposledy ověřeno

1. listopadu 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • 54135419SUI3003
  • 54135419SUI3003 (Jiný identifikátor: Janssen Research & Development, LLC)
  • 2024-518615-19-00 (Identifikátor registru: EUCT number)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

ANO

Popis plánu IPD

The data sharing policy of Johnson & Johnson Innovative Medicine is available at innovativemedicine.jnj.com/our-innovation/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through Yale Open Data Access (YODA) Project site at yoda.yale.edu

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ano

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

produkt vyrobený a vyvážený z USA

Ano

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .