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Wirksamkeits-, Sicherheits- und Verträglichkeitsstudie von AVP-786 als Zusatztherapie bei Patienten mit Major Depression mit unzureichendem Ansprechen auf eine Behandlung mit Antidepressiva

Eine multizentrische, randomisierte, doppelblinde, Placebo-kontrollierte Studie der Phase 2 zur Bewertung der Wirksamkeit, Sicherheit und Verträglichkeit von AVP-786 (Deuterium-modifiziertes Dextromethorphan-Hydrobromid/Chinidinsulfat) als Zusatztherapie bei Patienten mit schwerer depressiver Störung mit an Unzureichendes Ansprechen auf eine Behandlung mit Antidepressiva

The objectives of this 10-week study are to evaluate the efficacy, safety, and tolerability of AVP 786 as an adjunctive therapy compared with placebo in patients with major depressive disorder (MDD) who have shown an inadequate response to standard antidepressant treatment. A secondary objective of this study is to assess the pharmacokinetics (PK) of AVP-786 and potential correlations with pharmacodynamic effects.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

It is estimated that up to approximately 200 patients will participate in the study at approximately 30 enrolling centers in the US.

Eligible patients for this study must have MDD as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria, and have shown an inadequate response to standard antidepressant treatment.

This is a multicenter, randomized, double-blind, placebo-controlled, study of 10 weeks duration.

Following screening procedures for assessment of inclusion and exclusion criteria, eligible patients will be randomized into the study. Study medication will be administered orally twice a day (BID) (1 capsule in the morning and 1 capsule in the evening, approximately 12 hours apart) throughout the treatment period.

Studientyp

Interventionell

Einschreibung (Tatsächlich)

206

Phase

  • Phase 2

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

    • Alabama
      • Birmingham, Alabama, Vereinigte Staaten, 35294
      • Birmingham, Alabama, Vereinigte Staaten, 35213
    • California
      • Bellflower, California, Vereinigte Staaten, 90706
      • Costa Mesa, California, Vereinigte Staaten, 92626
      • Garden Grove, California, Vereinigte Staaten, 92845
      • Lomita, California, Vereinigte Staaten, 90717
      • Oceanside, California, Vereinigte Staaten, 92056
      • Riverside, California, Vereinigte Staaten, 92506
      • Santa Ana, California, Vereinigte Staaten, 92706
      • Sherman Oaks, California, Vereinigte Staaten, 91403
    • Colorado
      • Denver, Colorado, Vereinigte Staaten, 80239
    • Florida
      • Bradenton, Florida, Vereinigte Staaten, 34201
      • Jacksonville, Florida, Vereinigte Staaten, 32256
      • Miami, Florida, Vereinigte Staaten, 33155
      • Orange City, Florida, Vereinigte Staaten, 32763
      • Orlando, Florida, Vereinigte Staaten, 32801
    • Georgia
      • Decatur, Georgia, Vereinigte Staaten, 30030
    • Illinois
      • Hoffman Estates, Illinois, Vereinigte Staaten, 60169
    • Indiana
      • Valparaiso, Indiana, Vereinigte Staaten, 46383
    • Maryland
      • Baltimore, Maryland, Vereinigte Staaten, 21285
      • Glen Burnie, Maryland, Vereinigte Staaten, 21061
    • Massachusetts
      • Boston, Massachusetts, Vereinigte Staaten, 02131
    • New York
      • Brooklyn, New York, Vereinigte Staaten, 11241
      • New York, New York, Vereinigte Staaten, 10003
      • Staten Island, New York, Vereinigte Staaten, 10312
    • Ohio
      • Garfield Heights, Ohio, Vereinigte Staaten, 44125
    • Oklahoma
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73112
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73103
      • Tulsa, Oklahoma, Vereinigte Staaten, 74101
    • Pennsylvania
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19139
    • Utah
      • Murray, Utah, Vereinigte Staaten, 84123

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Clinical diagnosis of major depressive episode ≤ 24 months in duration
  • HAM-D17 score ≥ 20.
  • Documented to not have a significant (25% or greater) change in QIDS-SR16 score between Screening and Baseline visits.
  • Patients have been deemed to have an inadequate response (less than 50% symptom reduction) to at least 1 but no more than 3 adequate antidepressant trials during the current depressive episode.
  • Patients must be receiving ongoing treatment with an adequate dose of antidepressants.
  • Body Mass Index (BMI) of 18-35 kg/m².

Exclusion Criteria:

  • History of myasthenia gravis.

  • Have cardiovascular concerns such as:

    • History of complete heart block, QT interval corrected for heart rate (QTc) prolongation, or torsades de pointes.
    • QTc using the Fridericia's formula (QTcF) at screening > 450 msec for males and > 470 msec for females based on central review at the screening visit, unless due to ventricular pacing.
    • Any family history of congenital QT interval prolongation syndrome.
  • Known hypersensitivity/intolerance to DM, Q, opiate drugs (codeine, etc.), or any other ingredient of the study medication.

  • Pose a current suicide risk, as evidenced by any of the following:

    • It is the judgment of the investigator that the subject may be at risk for suicide.
    • The subject is rated a "yes" to question 4 or question 5 on the Baseline C-SSRS, if the most recent episode occurred within the past 12 months.
    • The subject has attempted suicide within the past 6 months
  • Presence of any other current DSM-IV-TR Axis I disorders with the exception of: generalized anxiety disorder (GAD: 300.02), social anxiety disorder (300.23), dysthymic disorder (300.4), or specific phobia (300.29). Patients with co-morbid GAD, social anxiety disorder, or specific phobia are ineligible if the co-morbid condition is clinically unstable, or has been the primary focus of treatment within the 6 month period prior to screening

  • Axis I diagnosis of:

    • Delirium, dementia, amnestic, or other cognitive disorder;
    • Schizophrenia or other psychotic disorder, based on the M.I.N.I.;
    • Bipolar I or II disorder, based on the M.I.N.I.
  • Clinically significant Axis II (DSM-IV-TR) diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal or histrionic personality disorder.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Vervierfachen

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: AVP-786

Participants receive AVP-786 capsules, orally, using a protocol-defined dose-escalation regimen (up to AVP-786 34/4.75 [34 milligrams (mg) deuterated (d6)-dextromethorphan (hydrobromide)/4.75 mg of quinidine (sulfate)] twice daily [BID]), in Periods 1 and 2 up to Day 35 and Day 70, respectively.

AVP-786 capsules administered orally.

Placebo-Komparator: Placebo

Participants receive placebo, orally, in Periods 1 and 2 up to Day 35 and Day 70, respectively.

Matching placebo capsules administered orally.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Montgomery-Ǻsberg Depression Rating Scale (MADRS) total score
Zeitfenster: Visit 5 (Day 70) Week 10

The MADRS consists of 10 items, each rated based on the structured interview. The dimensions assessed in the MADRS are as follows: 1. Apparent sadness 2. Reported sadness 3. Inner tension 4. Reduced sleep 5. Reduced appetite 6. Concentration difficulties 7. Lassitude 8. Inability to feel 9. Pessimistic thoughts 10. Suicidal thoughts. Each item is rated on a scale from 0 to 6. The MADRS total score is the sum of the scores for the 10 dimensions and can range from 0 to 60, with higher scores indicating a higher severity of depression.

Visit 5 (Day 70) Week 10

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
17-item Hamilton Rating Scale for Depression (HAM-D17)
Zeitfenster: Visit 5 (Day 70) Week 10

The HAM-D is a clinician-rated scale that evaluates the level of depression. The HAM-D consists of 17 items (with scale in parentheses) such as Depressed Mood (0-4), Guilt (0-4), Suicide (0-4), Insomnia, initial (0-2), Insomnia, middle (0-2), Insomnia, late (0-2), Work and Interests (0-4), Psychomotor Retardation (0-4), Psychomotor Agitation (0-4), Anxiety, psychic (0-4), Anxiety, somatic (0-4), Gastrointestinal Symptoms (0-2), Somatic Symptoms, general (0-2), Sexual Interest (0-2), Hypochondriasis (0-4), Insight (0-2), and Weight Loss (0-2). Summed subscales are combined to compute a total score. Total score ranges from 0 to 52, with a higher score indicating worse condition.

Visit 5 (Day 70) Week 10
Massachusetts General Hospital Antidepressant Treatment Response Questionnaire (MGH ATRQ)
Zeitfenster: Visit 5 (Day 70) Week 10

The MGH ATRQ is given in this study to assess treatment resistance in depression. Participants are to provide information on the questionnaire about the dose level and duration for each medication that has been taken during their current episode/stage of depression. Participants are also to provide the medication that helped them the most and answer a question about the degree of improvement.

Visit 5 (Day 70) Week 10
16-item Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR16)
Zeitfenster: Visit 5 (Day 70) Week 10

The 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) is a patient-reported questionnaire used to assess the severity of depressive symptoms over the previous 7 days. The questionnaire assesses sleep, mood, appetite/weight, concentration, self-perception, suicidal thoughts, interest, energy, and psychomotor changes. Each item is scored from 0 to 3, with higher scores indicating greater symptom severity. The total score is calculated using a standard algorithm that sums the highest-rated item within selected symptom domains and individual domain scores, resulting in a total score ranging from 0 to 27, with higher scores indicating more severe depressive symptoms.

Visit 5 (Day 70) Week 10
Sheehan Disability Scale (SDS)
Zeitfenster: Visit 5 (Day 70) Week 10

The participant is to assess how disruptive their depression symptoms have been on a 0 to 10 scale, as shown below: 0 Not at all, 1 to 3 Mildly, 4 to 6 Moderately, 7 to 9 Markedly, 10 Extremely. The 3 items will be summed to obtain a measure of global functional impairment that ranges from 0 (unimpaired) to 30 (highly impaired). Higher scores indicate worse conditions.

Visit 5 (Day 70) Week 10
Clinical Global Impression of Severity of Illness (CGI-S)
Zeitfenster: Visit 5 (Day 70) Week 10

The CGI-S is clinician's assessment of the participant's illness at the time of the assessment. The CGI-S is scored according to the following 7-point scale, with a higher score indicating a higher severity of illness (0 = not assessed): 1 = normal, not at all ill, 2 = borderline mentally ill, 3 = mildly ill, 4 = moderately ill, 5 = markedly ill, 6 = severely ill, 7 = extremely ill.

Visit 5 (Day 70) Week 10
Clinical Global Impression of Change (CGI-C)
Zeitfenster: Visit 5 (Day 70) Week 10

The CGI-C is clinician's assessment of the participant's change in illness at the time of the assessment, using the following 7-point scale (0 = not assessed): 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. A lower score indicates an improvement in illness.

Visit 5 (Day 70) Week 10
EuroQOL 5 Dimension 5 Level (EQ-5D-5L)
Zeitfenster: Visit 5 (Day 70) Week 10

The EQ-5D-5L, a scale used to measure quality of life, is divided into 2 parts, the descriptive system and the visual analog scale (VAS), reported as separate scores. The descriptive system is divided into five categories: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. For each category, the participant selects the one statement that best describes their health on the day of assessment. Each category is scored on a 5-point scale(1=no problems to 5=extreme problems or inability to perform the activity) [e.g., for mobility: 1 = no problems walking and 5 = unable to walk]. Missing values for a given category are imputed with a value of 9 and are excluded from the summary for that category. Higher scores for each category= worse health condition. The VAS is a 0 (worst health you can imagine) to 100 (best health you can imagine) vertical scale, where the participant places an X on the scale where they feel their health is today and then writes the number.

Visit 5 (Day 70) Week 10
Patient Global Impression of Change (PGIC)
Zeitfenster: Visit 5 (Day 70) Week 10

The PGI-C asks the participant to rate their overall impression of change in their depression symptoms from the time of study entry to the present. The PGI-C is scored on a 7-point scale, where 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse. Higher scores indicate worsening of depression symptoms.

Visit 5 (Day 70) Week 10
7-item Generalized Anxiety Disorder (GAD-7)
Zeitfenster: Visit 5 (Day 70) Week 10

The GAD-7 is a self-reported questionnaire used to assess symptoms of generalized anxiety disorder. It consists of 7 questions evaluating feelings of nervousness or anxiety, inability to stop or control worrying, excessive worrying, trouble relaxing, restlessness, irritability, and fear that something awful might happen. Each item is scored on a 4-point scale, where 0 = not at all, 1 = several days, 2 = more than half the days, and 3 = nearly every day. The scores for all seven items are summed to produce a total score ranging from 0 to 21, with higher scores indicating greater severity of anxiety symptoms.

Visit 5 (Day 70) Week 10

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. Juli 2014

Primärer Abschluss (Tatsächlich)

1. Februar 2016

Studienabschluss (Tatsächlich)

1. Februar 2016

Studienanmeldedaten

Zuerst eingereicht

29. Mai 2014

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

30. Mai 2014

Zuerst gepostet (Geschätzt)

3. Juni 2014

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

20. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

16. Oktober 2026

Zuletzt verifiziert

1. Oktober 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 14-AVP-786-201

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

Anonymized Individual participant data (IPD) that underlie the results of this study will be shared with researchers to achieve aims pre-specified in a methodologically sound research proposal. Small studies with less than 25 participants are excluded from data sharing.

IPD-Sharing-Zeitrahmen

Data will be available after marketing approval in global markets or beginning 1-3 years following article publication. There is no end date to the availability of the data.

IPD-Sharing-Zugriffskriterien

Otsuka will share data on the Vivli data sharing platform which can be found here: https://vivli.org/ourmember/Otsuka/

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ICF

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .