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Efficacy of Vortioxetine Versus Escitalopram on Cognitive Function in Patients With Inadequate Response to Current Antidepressant Treatment of Major Depressive Disorder

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Vortioxetine 10-20 mg
Escitalopram 10-20 mg
Sponsored by
H. Lundbeck A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring Vortioxetine, Cognition

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The patient has MDD, diagnosed according to DSM-IV-TR™ recurrent MDE (classification 296.3x) as confirmed using the Mini International Neuropsychiatric Interview (MINI).
  • The patient has depressive symptoms currently considered as non- or only partially responsive (inadequate response), to one adequate course of SSRI/SNRI antidepressant monotherapy and is candidate for a switch in the investigator's opinion.
  • The patient wants to stop taking his/her current SSRI/SNRI treatment due to inadequate response confirmed by the Antidepressant Treatment Response Questionnaire (ATRQ), <50% response to current treatment).
  • The patient must have been treated by SSRI/SNRI monotherapy (citalopram, paroxetine, sertraline, duloxetine, or venlafaxine) for at least 6 weeks at licensed doses prior to the Screening Visit.
  • The patient has a PHQ-9 total score ≥14.
  • The patient has a MADRS total score ≥ 22.
  • The patient has had the current MDE for ≤1 year.
  • The patient has a Perceived Deficits Questionnaire - Depression (PDQ-D) total score >25.
  • The patient is a man or woman aged ≥18 and ≤65 years.

Exclusion Criteria:

  • The patient has a score ≥70 on the DSST (Number of Correct Symbols) at the Baseline Visit.
  • The patient has physical, cognitive, or language impairment of such severity as to adversely affect the validity of the data derived from the neuropsychological tests.
  • The patient has any current psychiatric disorder or Axis I disorder (according to DSMIV-TR™ criteria) other than MDD, as assessed using MINI.
  • The patient has a current or has had a diagnosis of dysthymic disorder within 3 months preceding the onset of current episode (DSM-IV-TR™ criteria).
  • The patient has borderline, schizotypal, schizoid, paranoid, histrionic, antisocial personality disorders (axis II) as comorbid or primary diagnosis (DSM-IV-TR™ criteria).
  • The patient has history of previous MDEs considered as treatment resistant defined as inadequate response (incomplete or no therapeutic response) to two prior courses of at least 6 weeks of conventional antidepressant drugs in adequate dosages or, the patient has treatment-resistant depression in the investigator's judgement.
  • The patient suffers from personality disorders, mental retardation, pervasive development disorder, attention-deficit/hyperactivity disorder, organic mental disorders, or mental disorders due to a general medical condition (DSM-IV-TR™ criteria).
  • The patient has a diagnosis of alcohol or other substance abuse or dependence (excluding nicotine or caffeine) (DSM-IV-TR™ criteria) that has not been in sustained full remission at least 2 years prior to the Screening Visit.
  • The patient has a current diagnosis or history of manic or hypomanic episode, schizophrenia or any other psychotic disorder, including major depression with psychotic features (DSM-IV-TR™ criteria).

Other protocol defined inclusion and exclusion criteria may apply.

Sites / Locations

  • FI005
  • FI001
  • FI006
  • FI007
  • FI004
  • DE005
  • DE004
  • RS002
  • RS003
  • RS004
  • RS005
  • RS001
  • SK004
  • SK001
  • SK003
  • SK002

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Escitalopram 10-20 mg

Vortioxetine 10-20 mg

Arm Description

Encapsulated tablets once daily for 8 weeks

Encapsulated tablets once daily for 8 weeks

Outcomes

Primary Outcome Measures

Change in Digit Symbol Substitution Test (DSST)
The DSST is recognised as covering all of the cognitive performance aspects: speed of processing, executive functioning, and attention

Secondary Outcome Measures

Change in Rey Auditory Verbal Learning Test (RAVLT)
Learning [acquisition] and memory [delayed recall])
Change in Trail Making Test A (TMT-A)
Speed of processing
Change in Trail Making Test B (TMT-B)
Executive functioning
Change in Reaction time score; CRT attention
Change in reaction time score SRT - simple reaction time
Change in STROOP incongruent score
Executive functioning
Change in STROOP congruent score
Speed of processing
Change in Perceived Deficits Questionnaire - Depression (PDQ-D) total score
Patient-reported cognitive function outcome including attention concentration, retrospective memory, prospective memory, and, planning organization
Change in Patient Health Questionnaire-9 (depressive symptoms) (PHQ-9) total score
Patient-reported outcome
Change in Clinical Global Improvement - Severity (CGI-S)
Clinical Global Improvement (CGI-I)
Change in Functioning Assessment Short Test (FAST)
Change in University of San Diego Performance-based Skills Assessment - Brief (UPSA-B) total score

Full Information

First Posted
October 21, 2014
Last Updated
February 27, 2017
Sponsor
H. Lundbeck A/S
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1. Study Identification

Unique Protocol Identification Number
NCT02272517
Brief Title
Efficacy of Vortioxetine Versus Escitalopram on Cognitive Function in Patients With Inadequate Response to Current Antidepressant Treatment of Major Depressive Disorder
Official Title
An Interventional, Randomised, Double-blind, Parallel-group, Active-comparator, Flexible-dose Study on the Efficacy of Vortioxetine Versus Escitalopram on Cognitive Dysfunction in Patients With Inadequate Response to Current Antidepressant Treatment of Major Depressive Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
December 2014 (Actual)
Primary Completion Date
March 2016 (Actual)
Study Completion Date
March 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lundbeck A/S

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study aims at evaluating the effect of vortioxetine on cognitive dysfunction in major depressive disorder (MDD) patients with inadequate response to current antidepressant treatment.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
101 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Escitalopram 10-20 mg
Arm Type
Active Comparator
Arm Description
Encapsulated tablets once daily for 8 weeks
Arm Title
Vortioxetine 10-20 mg
Arm Type
Experimental
Arm Description
Encapsulated tablets once daily for 8 weeks
Intervention Type
Drug
Intervention Name(s)
Vortioxetine 10-20 mg
Other Intervention Name(s)
Brintellix®, Lu AA21004
Intervention Type
Drug
Intervention Name(s)
Escitalopram 10-20 mg
Primary Outcome Measure Information:
Title
Change in Digit Symbol Substitution Test (DSST)
Description
The DSST is recognised as covering all of the cognitive performance aspects: speed of processing, executive functioning, and attention
Time Frame
Baseline to Week 8
Secondary Outcome Measure Information:
Title
Change in Rey Auditory Verbal Learning Test (RAVLT)
Description
Learning [acquisition] and memory [delayed recall])
Time Frame
Baseline to Week 8
Title
Change in Trail Making Test A (TMT-A)
Description
Speed of processing
Time Frame
Baseline to Week 8
Title
Change in Trail Making Test B (TMT-B)
Description
Executive functioning
Time Frame
Baseline to Week 8
Title
Change in Reaction time score; CRT attention
Time Frame
Baseline to Week 8
Title
Change in reaction time score SRT - simple reaction time
Time Frame
Baseline to week 8
Title
Change in STROOP incongruent score
Description
Executive functioning
Time Frame
Baseline to Week 8
Title
Change in STROOP congruent score
Description
Speed of processing
Time Frame
Baseline to Week 8
Title
Change in Perceived Deficits Questionnaire - Depression (PDQ-D) total score
Description
Patient-reported cognitive function outcome including attention concentration, retrospective memory, prospective memory, and, planning organization
Time Frame
Baseline to Week 8
Title
Change in Patient Health Questionnaire-9 (depressive symptoms) (PHQ-9) total score
Description
Patient-reported outcome
Time Frame
Baseline to Week 8
Title
Change in Clinical Global Improvement - Severity (CGI-S)
Time Frame
Baseline to Week 8
Title
Clinical Global Improvement (CGI-I)
Time Frame
Week 8
Title
Change in Functioning Assessment Short Test (FAST)
Time Frame
Baseline to Week 8
Title
Change in University of San Diego Performance-based Skills Assessment - Brief (UPSA-B) total score
Time Frame
Baseline to Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient has MDD, diagnosed according to DSM-IV-TR™ recurrent MDE (classification 296.3x) as confirmed using the Mini International Neuropsychiatric Interview (MINI). The patient has depressive symptoms currently considered as non- or only partially responsive (inadequate response), to one adequate course of SSRI/SNRI antidepressant monotherapy and is candidate for a switch in the investigator's opinion. The patient wants to stop taking his/her current SSRI/SNRI treatment due to inadequate response confirmed by the Antidepressant Treatment Response Questionnaire (ATRQ), <50% response to current treatment). The patient must have been treated by SSRI/SNRI monotherapy (citalopram, paroxetine, sertraline, duloxetine, or venlafaxine) for at least 6 weeks at licensed doses prior to the Screening Visit. The patient has a PHQ-9 total score ≥14. The patient has a MADRS total score ≥ 22. The patient has had the current MDE for ≤1 year. The patient has a Perceived Deficits Questionnaire - Depression (PDQ-D) total score >25. The patient is a man or woman aged ≥18 and ≤65 years. Exclusion Criteria: The patient has a score ≥70 on the DSST (Number of Correct Symbols) at the Baseline Visit. The patient has physical, cognitive, or language impairment of such severity as to adversely affect the validity of the data derived from the neuropsychological tests. The patient has any current psychiatric disorder or Axis I disorder (according to DSMIV-TR™ criteria) other than MDD, as assessed using MINI. The patient has a current or has had a diagnosis of dysthymic disorder within 3 months preceding the onset of current episode (DSM-IV-TR™ criteria). The patient has borderline, schizotypal, schizoid, paranoid, histrionic, antisocial personality disorders (axis II) as comorbid or primary diagnosis (DSM-IV-TR™ criteria). The patient has history of previous MDEs considered as treatment resistant defined as inadequate response (incomplete or no therapeutic response) to two prior courses of at least 6 weeks of conventional antidepressant drugs in adequate dosages or, the patient has treatment-resistant depression in the investigator's judgement. The patient suffers from personality disorders, mental retardation, pervasive development disorder, attention-deficit/hyperactivity disorder, organic mental disorders, or mental disorders due to a general medical condition (DSM-IV-TR™ criteria). The patient has a diagnosis of alcohol or other substance abuse or dependence (excluding nicotine or caffeine) (DSM-IV-TR™ criteria) that has not been in sustained full remission at least 2 years prior to the Screening Visit. The patient has a current diagnosis or history of manic or hypomanic episode, schizophrenia or any other psychotic disorder, including major depression with psychotic features (DSM-IV-TR™ criteria). Other protocol defined inclusion and exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Email contact via H.Lundbeck A/S
Organizational Affiliation
LundbeckClinicalTrials@lundbeck.com
Official's Role
Study Director
Facility Information:
Facility Name
FI005
City
Helsinki
Country
Finland
Facility Name
FI001
City
Kuopio
Country
Finland
Facility Name
FI006
City
Kupio
Country
Finland
Facility Name
FI007
City
Tampere
Country
Finland
Facility Name
FI004
City
Turku
Country
Finland
Facility Name
DE005
City
Bochum
Country
Germany
Facility Name
DE004
City
Mittweida
Country
Germany
Facility Name
RS002
City
Belgrade
Country
Serbia
Facility Name
RS003
City
Belgrade
Country
Serbia
Facility Name
RS004
City
Belgrade
Country
Serbia
Facility Name
RS005
City
Belgrade
Country
Serbia
Facility Name
RS001
City
Kragujevac
Country
Serbia
Facility Name
SK004
City
Bratislava
Country
Slovakia
Facility Name
SK001
City
Hronovce
Country
Slovakia
Facility Name
SK003
City
Levice
Country
Slovakia
Facility Name
SK002
City
Rimavska Sobota
Country
Slovakia

12. IPD Sharing Statement

Citations:
PubMed Identifier
30439678
Citation
Christensen MC, Sluth LB, McIntyre RS. Validation of the University of California San Diego Performance-based Skills Assessment (UPSA) in major depressive disorder: Replication and extension of initial findings. J Affect Disord. 2019 Feb 15;245:508-516. doi: 10.1016/j.jad.2018.11.034. Epub 2018 Nov 5.
Results Reference
derived
Links:
URL
https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-000230-34/results
Description
EMA EudraCT Results: 2014-000230-34

Learn more about this trial

Efficacy of Vortioxetine Versus Escitalopram on Cognitive Function in Patients With Inadequate Response to Current Antidepressant Treatment of Major Depressive Disorder

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