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A Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Study of CERC-301 in the Adjunctive Treatment of Subjects With Severe Depression and Recent Active Suicidal Ideation Despite Antidepressant Treatment

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CERC-301
Placebo
Sponsored by
Avalo Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female 18 to 70 years of age inclusive.
  2. Females must be either:

    1. Post-menopausal (amenorrhea for at least 12 consecutive months), surgically sterile -or-
    2. Women of childbearing potential (WOCBP) meeting the criteria below:

    i. Uses an acceptable double-barrier method of contraception as determined by the Investigator -and- ii. Is not lactating, has a negative serum beta human chorionic gonadotropin pregnancy test at screening and a negative urine pregnancy test prior to randomization on Day 0.

  3. Male subjects must agree to use a condom if partner is of childbearing potential.
  4. Diagnosis of MDD recurrent without psychotic features according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria with diagnosis confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders Clinical Trials Version (SCID-CT).
  5. Currently adhering to antidepressant drug regimen that consists of stable SSRI or SNRI therapy
  6. Inadequate antidepressant response to current antidepressant therapy despite adequate dose and duration
  7. HDRS-17 score ≥ 21 on the HDRS-17 performed by the site at screening
  8. Recent active suicidal ideation defined as a score of 2 on the intensity of ideation section on the Columbia-Suicide Severity Rating Scale (C-SSRS) during the four weeks prior to screening using the "Baseline/Screening" version of the C-SSRS.
  9. In otherwise good general health without any unstable medical conditions (as determined by medical history, physical examination, 12-lead ECG, clinical laboratory testing, etc.).

Exclusion Criteria:

  1. History of substance abuse or dependence within the 3 months prior to screening.
  2. Positive urine drug test at screening and prior to randomization on Day 0 unless due to a permitted medication that is documented in the subject's medication history.
  3. Positive ethanol breath test at screening and/or prior to randomization on Day 0.
  4. Elevated semi-recumbent blood pressure at screening and prior to randomization on Day 0, defined as systolic blood pressure > 140 mm Hg and diastolic blood pressure
  5. Active, comorbid disease that might limit the ability of the subject to participate in the study as determined by the Investigator (i.e. poorly controlled diabetes mellitus, unstable angina, coronary artery disease, congestive heart failure, etc.).
  6. Subjects with clinical laboratory test abnormality deemed clinically significant by the Investigator at screening.
  7. Axis I diagnosis of obsessive compulsive disorder, posttraumatic stress disorder, bipolar I or II mood disorders, eating disorders (e.g., anorexia nervosa, bulimia nervosa), psychotic disorders (e.g., schizoaffective disorder, schizophrenia), significant cognitive disorders (e.g., delirium, dementia, amnesia), or dissociative disorders.
  8. Subjects with Axis II diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal, or histrionic personality disorder.
  9. Subjects with a neurologic disorder that could cause or contribute to depression (e.g., Alzheimer's disease, Parkinson's disease).
  10. Female subjects currently experiencing postpartum depression.
  11. Subjects who, in the opinion of the Investigator, are not appropriate for a 35-day placebo-controlled study due to risk of significant threat to self or others during screening or study conduct.
  12. Use of other NMDA-receptor modulators (e.g., dextromethorphan, ketamine, amantadine, memantine) within 30 days of screening and throughout the study.
  13. The following concomitant medication use is excluded within six weeks prior to screening:

    • Bupropion or tricyclic antidepressants
    • Intermittent, symptomatic use of benzodiazepines (e.g. symptomatic treatment of anxiety or panic attacks)
    • Antipsychotics
    • Lithium
    • Any medications known to directly interact with central or peripheral serotonergic receptors, other than the permitted antidepressants.
    • Any medications known to directly interact with central noradrenergic receptors, other than the permitted antidepressants.
  14. Electroconvulsive therapy, transcranial magnetic stimulation, or vagal nerve stimulation during the current depressive episode.
  15. Participation in an investigational drug or device study within the 6 months prior to screening.
  16. Subjects with suicidal behavior within 6 months prior to screening as measured by the C-SSRS "Baseline/Screening" version.
  17. Subjects with a C-SSRS score > 2 on the intensity of ideation section at randomization (Visit 2a), using the "Since Last Visit" version of the C-SSRS.

Sites / Locations

  • University of Alabama at Birmingham
  • Arizona TMS Therapy Center
  • ProScience Research Group
  • Collaborative NeuroScience Network, Inc.
  • Behavioral Research Specialists
  • Synergy Clinical Research Center
  • Pacific Clinical Trials, LLC
  • Southern CA Psychiatrists
  • Artemis Institute for Clinical Research
  • Clinical Neuroscience Solutions
  • Scientific Clinical Research, Inc.
  • Clinical Neuroscience Solutions
  • Atlanta Center for Medical Research
  • Northwest Behavioral Research Center
  • Chicago Psychiatry Associates
  • Sheppard Pratt Health System
  • PCRC
  • Bioscience Research
  • The Medical Research Network
  • Finger Lakes Clinical Research
  • Neuro-Behavioral Clinical Research, Inc.
  • Suburban Research Associates
  • FutureSearch Trials of Dallas
  • Northwest Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

CERC-301, Treatment Sequence 1

CERC-301, Treatment Sequence 2

Placebo, Treatment Sequence 3

Arm Description

Treatment Sequence 1 - 7 days on placebo and 28 days on study drug (either 12mg or 8mg)

Treatment Sequence 2 - Placebo for 7 days and study drug for 28 days (8 mgs)

Treatment Sequence 3 - Placebo for 35 Day treatment period

Outcomes

Primary Outcome Measures

HDRS-17 after 7 days of dosing with study drug
The overall between-treatment difference will be computed as the weighted average of the differences (drug vs. placebo)

Secondary Outcome Measures

HDRS-17 Averaged between 7 and 28 days of treatment with study drug
This will be analyzed using the mixed effects model for repeated measures. The between-group (drug vs. placebo) differences will be estimated by the least squares mean for the contrast in the main effect.
HDRS-17 after 28 days of dosing with study drug
This will be analyzed using the mixed effects model for repeated measures . The between-group difference will be estimates by the least squares mean difference at Day 28 as a simple contrast from the model.

Full Information

First Posted
September 5, 2013
Last Updated
December 19, 2017
Sponsor
Avalo Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01941043
Brief Title
A Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Study of CERC-301 in the Adjunctive Treatment of Subjects With Severe Depression and Recent Active Suicidal Ideation Despite Antidepressant Treatment
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Study of CERC-301 in the Adjunctive Treatment of Subjects With Severe Depression and Recent Active Suicidal Ideation Despite Antidepressant Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Completed
Study Start Date
November 2013 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Avalo Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The current study will evaluate the antidepressant effect of CERC-301 during 28 days of treatment in subjects with MDD who are currently experiencing a severe depressive episode despite stable ongoing treatment with selective serotonin- or serotonin-norepinephrine reuptake inhibitors (SSRI or SNRI). The study population will be enriched for subjects that would benefit most from rapid onset, those with recent active suicidal ideation, but not a risk to themselves or others and are deemed appropriate for an out-patient study with careful safety surveillance. This will allow the study to focus on the antidepressant effects of CERC-301 but also explore effects on suicidal ideation. To explore rapid onset, the primary endpoint will be at 7 days, but effects over the 28 days of treatment will be examined as a secondary endpoint.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1357 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CERC-301, Treatment Sequence 1
Arm Type
Experimental
Arm Description
Treatment Sequence 1 - 7 days on placebo and 28 days on study drug (either 12mg or 8mg)
Arm Title
CERC-301, Treatment Sequence 2
Arm Type
Experimental
Arm Description
Treatment Sequence 2 - Placebo for 7 days and study drug for 28 days (8 mgs)
Arm Title
Placebo, Treatment Sequence 3
Arm Type
Placebo Comparator
Arm Description
Treatment Sequence 3 - Placebo for 35 Day treatment period
Intervention Type
Drug
Intervention Name(s)
CERC-301
Intervention Type
Other
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
HDRS-17 after 7 days of dosing with study drug
Description
The overall between-treatment difference will be computed as the weighted average of the differences (drug vs. placebo)
Time Frame
Screening & Days 0, 4, 7, 11, 14, 21,28, & 35
Secondary Outcome Measure Information:
Title
HDRS-17 Averaged between 7 and 28 days of treatment with study drug
Description
This will be analyzed using the mixed effects model for repeated measures. The between-group (drug vs. placebo) differences will be estimated by the least squares mean for the contrast in the main effect.
Time Frame
Screening, Days 0, 4, 7, 11, 14, 21, 28, & 35
Title
HDRS-17 after 28 days of dosing with study drug
Description
This will be analyzed using the mixed effects model for repeated measures . The between-group difference will be estimates by the least squares mean difference at Day 28 as a simple contrast from the model.
Time Frame
Screening, Days 0, 4, 7, 11, 14, 21, 28, 35

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female 18 to 70 years of age inclusive. Females must be either: Post-menopausal (amenorrhea for at least 12 consecutive months), surgically sterile -or- Women of childbearing potential (WOCBP) meeting the criteria below: i. Uses an acceptable double-barrier method of contraception as determined by the Investigator -and- ii. Is not lactating, has a negative serum beta human chorionic gonadotropin pregnancy test at screening and a negative urine pregnancy test prior to randomization on Day 0. Male subjects must agree to use a condom if partner is of childbearing potential. Diagnosis of MDD recurrent without psychotic features according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria with diagnosis confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders Clinical Trials Version (SCID-CT). Currently adhering to antidepressant drug regimen that consists of stable SSRI or SNRI therapy Inadequate antidepressant response to current antidepressant therapy despite adequate dose and duration HDRS-17 score ≥ 21 on the HDRS-17 performed by the site at screening Recent active suicidal ideation defined as a score of 2 on the intensity of ideation section on the Columbia-Suicide Severity Rating Scale (C-SSRS) during the four weeks prior to screening using the "Baseline/Screening" version of the C-SSRS. In otherwise good general health without any unstable medical conditions (as determined by medical history, physical examination, 12-lead ECG, clinical laboratory testing, etc.). Exclusion Criteria: History of substance abuse or dependence within the 3 months prior to screening. Positive urine drug test at screening and prior to randomization on Day 0 unless due to a permitted medication that is documented in the subject's medication history. Positive ethanol breath test at screening and/or prior to randomization on Day 0. Elevated semi-recumbent blood pressure at screening and prior to randomization on Day 0, defined as systolic blood pressure > 140 mm Hg and diastolic blood pressure Active, comorbid disease that might limit the ability of the subject to participate in the study as determined by the Investigator (i.e. poorly controlled diabetes mellitus, unstable angina, coronary artery disease, congestive heart failure, etc.). Subjects with clinical laboratory test abnormality deemed clinically significant by the Investigator at screening. Axis I diagnosis of obsessive compulsive disorder, posttraumatic stress disorder, bipolar I or II mood disorders, eating disorders (e.g., anorexia nervosa, bulimia nervosa), psychotic disorders (e.g., schizoaffective disorder, schizophrenia), significant cognitive disorders (e.g., delirium, dementia, amnesia), or dissociative disorders. Subjects with Axis II diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal, or histrionic personality disorder. Subjects with a neurologic disorder that could cause or contribute to depression (e.g., Alzheimer's disease, Parkinson's disease). Female subjects currently experiencing postpartum depression. Subjects who, in the opinion of the Investigator, are not appropriate for a 35-day placebo-controlled study due to risk of significant threat to self or others during screening or study conduct. Use of other NMDA-receptor modulators (e.g., dextromethorphan, ketamine, amantadine, memantine) within 30 days of screening and throughout the study. The following concomitant medication use is excluded within six weeks prior to screening: Bupropion or tricyclic antidepressants Intermittent, symptomatic use of benzodiazepines (e.g. symptomatic treatment of anxiety or panic attacks) Antipsychotics Lithium Any medications known to directly interact with central or peripheral serotonergic receptors, other than the permitted antidepressants. Any medications known to directly interact with central noradrenergic receptors, other than the permitted antidepressants. Electroconvulsive therapy, transcranial magnetic stimulation, or vagal nerve stimulation during the current depressive episode. Participation in an investigational drug or device study within the 6 months prior to screening. Subjects with suicidal behavior within 6 months prior to screening as measured by the C-SSRS "Baseline/Screening" version. Subjects with a C-SSRS score > 2 on the intensity of ideation section at randomization (Visit 2a), using the "Since Last Visit" version of the C-SSRS.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Vornov, MD, PhD
Organizational Affiliation
Avalo Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Arizona TMS Therapy Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85032
Country
United States
Facility Name
ProScience Research Group
City
Culver City
State/Province
California
ZIP/Postal Code
90230
Country
United States
Facility Name
Collaborative NeuroScience Network, Inc.
City
Garden Grove
State/Province
California
ZIP/Postal Code
92845
Country
United States
Facility Name
Behavioral Research Specialists
City
Glendale
State/Province
California
ZIP/Postal Code
91206
Country
United States
Facility Name
Synergy Clinical Research Center
City
National City
State/Province
California
ZIP/Postal Code
91950
Country
United States
Facility Name
Pacific Clinical Trials, LLC
City
Oakland
State/Province
California
ZIP/Postal Code
94612
Country
United States
Facility Name
Southern CA Psychiatrists
City
Oceanside
State/Province
California
ZIP/Postal Code
92056
Country
United States
Facility Name
Artemis Institute for Clinical Research
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Clinical Neuroscience Solutions
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32256
Country
United States
Facility Name
Scientific Clinical Research, Inc.
City
North Miami
State/Province
Florida
ZIP/Postal Code
33161
Country
United States
Facility Name
Clinical Neuroscience Solutions
City
Orlando
State/Province
Florida
ZIP/Postal Code
32806
Country
United States
Facility Name
Atlanta Center for Medical Research
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
Facility Name
Northwest Behavioral Research Center
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
Facility Name
Chicago Psychiatry Associates
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60602
Country
United States
Facility Name
Sheppard Pratt Health System
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21285
Country
United States
Facility Name
PCRC
City
O'Fallon
State/Province
Missouri
ZIP/Postal Code
63368
Country
United States
Facility Name
Bioscience Research
City
Mount Kisco
State/Province
New York
ZIP/Postal Code
10549
Country
United States
Facility Name
The Medical Research Network
City
New York
State/Province
New York
ZIP/Postal Code
10128
Country
United States
Facility Name
Finger Lakes Clinical Research
City
Rochester
State/Province
New York
ZIP/Postal Code
14618
Country
United States
Facility Name
Neuro-Behavioral Clinical Research, Inc.
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Facility Name
Suburban Research Associates
City
Media
State/Province
Pennsylvania
ZIP/Postal Code
19063
Country
United States
Facility Name
FutureSearch Trials of Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Facility Name
Northwest Clinical Research Center
City
Bellevue
State/Province
Washington
ZIP/Postal Code
98007
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Study of CERC-301 in the Adjunctive Treatment of Subjects With Severe Depression and Recent Active Suicidal Ideation Despite Antidepressant Treatment

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