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- Klinische proef NCT02362529
Biomarkers of Neuroinflammation and Anti-Inflammatory Treatments in Major Depressive Disorder
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
There will be three Phases in the study. Only MDE subjects will be invited to continue to Phase 2 and 3. Subjects will be invited to continue to the subsequent Phase given they meet entry criteria described below:
Phase 1: The investigators will evaluate whether TSPO is elevated in individuals during a current MDE compared to healthy controls. Eligible participants will receive one [18F]FEPPA PET scan and one MRI scan. Other measures will include urine sample, blood samples for genetic and peripheral biomarker analysis, a neurocognitive battery, mood scales and questionnaires.
Phase 2: Participants who have elevated TSPO VT in Phase 1 and are agreeable to receiving minocycline will be invited to participate in Phase 2. Based on our previous results participants will be considered candidates for Phase 2 if TSPO VT ≥ 10.5 (HAB) or ≥8.5 (MAB) in any of the primary regions of interest (prefrontal cortex, anterior cingulate cortex or insula). Eligible participants will be invited to participate in a randomized, double blind, placebo controlled trial, to receive either minocycline or placebo. After the eight weeks of treatment, participants will receive one [18F]FEPPA PET scan. Other measures will include urine samples, blood samples, mood scales and questionnaires.
Phase 3: If, after the initial eight week treatment period with either minocycline or placebo, any participant continues to have depressive symptoms (17-item Hamilton Depression Rating Scale score ≥ 8) they will be invited to participate in an eight week open label trial of celecoxib. Participants not eligible for Phase 2 may also be invited to participate in Phase 3 directly from Phase 1.
Studietype
Inschrijving (Verwacht)
Fase
- Vroege fase 1
Contacten en locaties
Studie Locaties
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Ontario
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Toronto, Ontario, Canada, M5T 1R8
- Centre for Addiction and Mental Health
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Group 1 - Current major depressive episode (MDE) secondary to MDD
Inclusion Criteria:
- good physical health with no active medical conditions
- non-cigarette smoking
- no past or current substance abuse or dependence
- negative urine pregnancy test at screening and scan days (for women)
- primary diagnosis of current major depressive episode (MDE) and major depressive disorder (MDD) verified by SCID for DSM IV
- score greater than 19 on the 17 item HDRS
- non-response to a clinical trial of at least one antidepressant given at appropriate clinical dose
- willing to take medication for the duration of the trial and has previously taken antidepressants for the duration of the trial
- presently taking an antidepressant at a standard clinical dose.
Exclusion Criteria:
- history of neurological illness or autoimmune disorders
- never taken a tricyclic antidepressant or an antidepressant that raises norepinephrine
- received treatment with electroconvulsive therapy or mechanical brain stimulation in the previous 6 months
- currently taking medication contraindicated or that may possibly interact with either minocycline or celecoxib
- known intolerance or allergy to minocycline, other tetracyclines, sulfonamides or NSAIDs
- taken diazepam or other benzodiazepine use within the past month, except for lorazepam and clonazepam
- use of anti-inflammatory drugs or tetracyclines lasting ≥1 week within the past month
- history of severe hepatic or renal insufficiency, asthma, allergies, gastrointestinal disease, ischemic heart disease, cerebrovascular disease or congestive heart failure
- lactose intolerance
Group 2 - Healthy Controls - Phase 1 (baseline scan) only
Inclusion criteria:
- score below 8 on the 17 item HDRS
- good physical health
- non-cigarette smoking
- negative urine pregnancy test at screening and scan days (for women)
- negative urine screen for drugs of abuse
Exclusion criteria:
- past or current diagnosis of axis I or axis II disorder as determined by the SCID I and SCID II for DSM IV
- history of psychotropic medication use
- history of neurological illness or autoimmune disorder
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Fundamentele wetenschap
- Toewijzing: Gerandomiseerd
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Minocycline
The dose of minocycline would be 50mg per day on week 1, 50mg bid on week 2 and 100mg bid weeks 3-8.
For tapering, the dose will be reduced to 50mg bid for a week, and then stopped.
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50 mg and 100 mg capsule, oral administration
Andere namen:
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Placebo-vergelijker: Placebo
The number and appearance of the pills would be identical to those in the minocycline arm.
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Lactose monohydrate in identical gel capsules to minocycline, oral administration.
Andere namen:
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Ander: Celecoxib
This will be an open label trial for those with Hamilton Depression Rating Scale score ≥ 8 following the minocycline v. placebo trial or those not eligible for Phase 2. Dose of celecoxib will be 100 mg bid for the first week and 200mg bid for weeks 2-8.
For tapering, the dose of celecoxib will be reduced to 100mg bid for one week, and then stopped.
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100 mg and 200 mg capsules, oral administration.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Translocator total distribution volume (TSPO VT): Treatment Effect of Minocycline in MDE Subjects
Tijdsspanne: Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans
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TSPO VT will be measured using [18F]FEPPA positron emission tomography brain scans.
Eligible MDE participants will be randomized to either minocycline or placebo.
Following 8 weeks of either minocycline or placebo treatment, MDE participants will have a second PET scan .
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Pre- and post-minocycline or placebo treatment= 8 weeks total between pretreatment and posttreatment scans
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Translocator total distribution volume (TSPO VT): Difference between MDE and healthy subjects
Tijdsspanne: Pre-treatment scan will take place up to 8 weeks from initial assessment
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Compare baseline TSPO VT prior to treatment between MDE group and healthy group
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Pre-treatment scan will take place up to 8 weeks from initial assessment
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change in Hamilton Depression Rating Scale Score
Tijdsspanne: Pre- and post-minocycline treatment (8 weeks total between pre- and post-treatment). Pre- and post-celecoxib treatment (8 weeks total between pre- and post-treatment).
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Change in HDRS score following minocycline vs. placebo treatment.
Change in HDRS score following celecoxib treatment.
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Pre- and post-minocycline treatment (8 weeks total between pre- and post-treatment). Pre- and post-celecoxib treatment (8 weeks total between pre- and post-treatment).
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Hopkins Verbal Learning Test-Revised
Tijdsspanne: Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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To assess verbal memory we will administer the Hopkins Verbal Learning Test-Revised to MDE participants before and after treatment.
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Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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Brief Visuospatial Memory Test-Revised
Tijdsspanne: Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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To assess visuospatial memory we will administer the Brief Visuospatial Memory Test-Revised to MDE participants before and after treatment.
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Pre- and post-minocycline or placebo treatment (8 weeks between pre- and post-treatment measure)
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Comprehensive Trails Making Test
Tijdsspanne: Pre- and post-minocycline or placebo treatment.
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To assess psychomotor speed and attention we will administer the Comprehensive Trails Making Test to MDE participants before and after treatment.
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Pre- and post-minocycline or placebo treatment.
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Genetic sample
Tijdsspanne: Phase 1-single sample
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The priority of the genetic sample is to analyze the alleles of polymorphism rs6971 which has an association with the affinity of most second generation TSPO ligands including [18F]FEPPA.
The genetic sample will also be used to study sequences of genes that are believed to affect TSPO expression, inflammation, mood and conditions that may predispose to mood disorders.
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Phase 1-single sample
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Blood samples (serum and plasma)
Tijdsspanne: Pre- and post-minocycline or placebo treatment (8 weeks between measures). Pre- and post-celecoxib treatment (8 weeks between measures).
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Analyses will include complete blood cell count (CBC), ESR, hepatic and renal function.
Peripheral marker analyses will include proteins related to TSPO expression and inflammation.
Plasma minocycline and celecoxib levels will be analyzed.
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Pre- and post-minocycline or placebo treatment (8 weeks between measures). Pre- and post-celecoxib treatment (8 weeks between measures).
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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Jeffrey H Meyer, MD, PhD, Centre for Addiction and Mental Health; University of Toronto
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Gedragssymptomen
- Psychische aandoening
- Stemmingsstoornissen
- Depressie
- Depressieve stoornis
- Depressieve stoornis, majoor
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Agenten van het perifere zenuwstelsel
- Enzymremmers
- Pijnstillers
- Sensorische systeemagenten
- Ontstekingsremmers, niet-steroïde
- Pijnstillers, niet-narcotisch
- Ontstekingsremmende middelen
- Antireumatische middelen
- Cyclo-oxygenaseremmers
- Antibacteriële middelen
- Cyclo-oxygenase 2-remmers
- Celecoxib
- Minocycline
Andere studie-ID-nummers
- REB056/2014
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