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Badanie oceniające skuteczność i bezpieczeństwo esketaminy w zmniejszaniu objawów ciężkiego zaburzenia depresyjnego (AVENUE)

2 listopada 2026 zaktualizowane przez: Janssen Research & Development, LLC

Podwójnie ślepa, randomizowana, kontrolowana psychoaktywną placebo próba badająca skuteczność i bezpieczeństwo donosowej esketaminy w dawce 84 mg w dodatku do kompleksowej standardowej opieki w celu szybkiej redukcji objawów ciężkiego zaburzenia depresyjnego u nastoletnich uczestników z ostrymi myślami samobójczymi lub zachowaniami samobójczymi

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.

Przegląd badań

Status

Rekrutacyjny

Warunki

Interwencja / Leczenie

Typ studiów

Interwencyjne

Zapisy (Szacowany)

258

Faza

  • Faza 3

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

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

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

12 lat do 17 lat (Dziecko)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

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

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Podwójnie

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: 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.

Inne nazwy:
  • JNJ-54135419

Placebo will be administered as oral solution.

Komparator 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.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Change from Baseline in Depressive Symptoms Measured by Children's Depression Rating Scale - Revised (CDRS-R) Total Score at 24 Hours Post First Dose
Ramy czasowe: 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)

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Change from Baseline in CDRS-R Total Score at Day 25
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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)

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

8 stycznia 2026

Zakończenie podstawowe (Szacowany)

9 kwietnia 2031

Ukończenie studiów (Szacowany)

15 września 2031

Daty rejestracji na studia

Pierwszy przesłany

11 listopada 2025

Pierwszy przesłany, który spełnia kryteria kontroli jakości

11 listopada 2025

Pierwszy wysłany (Rzeczywisty)

12 listopada 2025

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

3 listopada 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

2 listopada 2026

Ostatnia weryfikacja

1 listopada 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • 54135419SUI3003
  • 54135419SUI3003 (Inny identyfikator: Janssen Research & Development, LLC)
  • 2024-518615-19-00 (Identyfikator rejestru: EUCT number)

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

TAK

Opis planu 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

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Tak

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

produkt wyprodukowany i wyeksportowany z USA

Tak

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .