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Uno studio per valutare l'efficacia e la sicurezza dell'esketamina per la riduzione dei sintomi del disturbo depressivo maggiore (AVENUE)

2 novembre 2026 aggiornato da: Janssen Research & Development, LLC

Uno studio in doppio cieco, randomizzato, controllato con placebo psicoattivo per valutare l'efficacia e la sicurezza dell'esketamina intranasale 84 mg in aggiunta allo standard di cura completo per la rapida riduzione dei sintomi del disturbo depressivo maggiore in partecipanti adolescenti con ideazione o comportamento suicidario acuto

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.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

258

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

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

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 12 anni a 17 anni (Bambino)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

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

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Doppio

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: 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.

Altri nomi:
  • JNJ-54135419

Placebo will be administered as oral solution.

Comparatore placebo: 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.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change from Baseline in Depressive Symptoms Measured by Children's Depression Rating Scale - Revised (CDRS-R) Total Score at 24 Hours Post First Dose
Lasso di tempo: 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)

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change from Baseline in CDRS-R Total Score at Day 25
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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)

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

8 gennaio 2026

Completamento primario (Stimato)

9 aprile 2031

Completamento dello studio (Stimato)

15 settembre 2031

Date di iscrizione allo studio

Primo inviato

11 novembre 2025

Primo inviato che soddisfa i criteri di controllo qualità

11 novembre 2025

Primo Inserito (Effettivo)

12 novembre 2025

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

3 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

2 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 54135419SUI3003
  • 54135419SUI3003 (Altro identificatore: Janssen Research & Development, LLC)
  • 2024-518615-19-00 (Identificatore di registro: EUCT number)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano 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

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

prodotto fabbricato ed esportato dagli Stati Uniti

Sì

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .