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А Dose-finding Study to Assess the Efficacy and Safety of CD-008-0045 in Patients With Generalized Anxiety Disorder

Primary Purpose

Anxiety Disorder Generalized

Status
Completed
Phase
Phase 2
Locations
Russian Federation
Study Type
Interventional
Intervention
CD-008-0045
Placebo
Sponsored by
ChemRar Research and Development Institute, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anxiety Disorder Generalized focused on measuring Anti-Anxiety Agents, Anxiety Disorder Generalized

Eligibility Criteria

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

Inclusion criteria:

  1. Signed Informed Consent Form;
  2. Age 18 years and older;
  3. Generalized anxiety disorder diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria and International Classification of Diseases (ICD-10);
  4. Hamilton Anxiety Rating Scale (HARS) values at Screening and on Randomization Visit (Week 0): Total score ≥ 20; Item 1 (Anxious mood) and Item 2 (Tension) scores ≥ 2;
  5. The CGI-S score ≥ 4 (moderate severity and higher) at Screening and on Randomization visit (Week 0);
  6. Consent of patients to use adequate contraception methods throughout the study. Adequate contraception methods include:

    • Condoms with spermicide for males;
    • For females (at their discretion):

      • oral contraceptives
      • condoms with spermicide (for the partner)
      • diaphragm with spermicide
      • cervical cap with spermicide
      • intrauterine device
  7. Ability to comply with all Study Protocol requirements.

Exclusion criteria:

  1. Pregnant or lactating women, or women planning to get pregnant during the clinical study; women of childbearing potential (including those without history of surgical sterilization and women with <2 years of post-menopause) not using adequate contraception methods;
  2. Item 1 (Depressed mood) of the Hamilton Depression Rating Scale (HAMD) score ≥ 2;
  3. Hamilton Depression Rating Scale (HAMD) total score > 13;
  4. Confirmed diagnosis of depressive episode, recurrent depressive disorder, bipolar affective disorder in history or at Screening;
  5. Confirmed diagnosis of schizophrenia in history or at Screening;
  6. Confirmed diagnosis of panic disorder in history or at Screening;
  7. Phobic anxiety disorders (agoraphobia, social phobia, unspecified phobic anxiety disorder) in history or at Screening;
  8. Disorders of personality or behavior in history or at Screening;
  9. Post-traumatic stress disorder diagnosed within 12 months prior to Screening;
  10. Eating disorders diagnosed within 12 months prior to Screening;
  11. Somatoform disorders in history or at Screening;
  12. Obsessive-compulsive disorder in history or at Screening;
  13. Epilepsy, seizures, head trauma with loss of consciousness, tumors, inflammatory, or demyelinating diseases of the central nervous system, stroke in history;
  14. Pheochromocytoma;
  15. Malignancies diagnosed within the last 5 years (except for the cured basal cell carcinoma);
  16. Significant cardiovascular diseases diagnosed at present or within 12 months prior to Screening, including: Chronic heart failure, class III or IV (according to New York Heart Association classification); severe arrhythmia requiring treatment with class Ia, Ib, Ic, or III antiarrhythmic drugs; unstable angina; myocardial infarction; heart and coronary artery surgery; significant valvular heart disease; uncontrolled hypertension with systolic blood pressure > 180 mm Hg and diastolic blood pressure > 110 mm Hg; pulmonary embolism or deep vein thrombosis;
  17. Nephrotic syndrome; moderate to severe chronic renal failure or significant renal diseases with creatinine level >1.5 mg/dL (132 μM/L) in males and > 1.4 mg/dL (123 μM/L) in females, or glomerular filtration rate (GFR) < 60 mL/min;
  18. HIV, hepatitis B or C, liver cirrhosis in history; AST, ALT, or serum alkaline phosphatase ≥ 2.5 times above the upper limit of normal; total bilirubin level ≥ 2 times above the upper limit of normal at Screening;
  19. Significant dysfunctions of the thyroid gland in decompensation stage;
  20. Anemia (hemoglobin level ≤ 105 g/L in females or ≤ 115 g/L in males); significant blood loss, or collection of at least one volumetric unit of donated blood (≥ 500 ml), or blood transfusion within 12 weeks prior to Screening;
  21. Any uncontrolled concomitant somatic disease, including that with a stable treatment regimen;
  22. Drugs administered for generalized anxiety disorder, starting from Screening and throughout the study, including antidepressants, Pregabalin, benzodiazepines, antipsychotics;
  23. Fluoxetine use within 21 days prior to Screening and throughout the study;
  24. Known allergy, hypersensitivity or contraindications to CD-008-0045;
  25. Electroconvulsive therapy within 3 months prior to Screening;
  26. Psychotherapy within 3 months prior to Screening and/or at the time of enrollment into the study;
  27. Use of prohibited drug therapy from the moment of Screening and throughout the study;
  28. Administration of any study drug or participation in another clinical study within 3 months prior to Screening (except for cases when the patient was not administered the study drug during the study);
  29. Addiction to tranquilizers or psychoactive substance abuse, including alcohol (history of episodic use is acceptable);
  30. Inability to read or right; unwillingness to understand and comply with the Protocol procedures; non-compliance with drug dosage regimen or procedures which, in the Investigator's opinion, may affect the study results or the patient's safety and prevent the patient's participation in the study; any other concomitant diseases or severe mental disorders, which make the patient ineligible for participation in the study, limit the legal basis for Informed Consent procedure, or may affect the patient's ability to participate in the study.

Sites / Locations

  • Clinical Center LLC "Center for Psychotherapy "Support"
  • "Research Center for Mental Health" Scientific Institution
  • Clinical Center LLC "University Headache Clinic"
  • Moscow Research Institute of Psychiatry "National Medical Research Center for Psychiatry and Narcology named after V.P. Serbsky"
  • Nizhny Novgorod Clinical Psychiatric Hospital No.1
  • Clinical Center LLC "TREATMENT AND REHABILITATION RESEARCH CENTER "PHOENIX "
  • Ryazan Medical University, Department of Psychiatry
  • Clinical Center LLC "Doctor SAN"
  • Clinical Center LLC "Dynasty"
  • Leningrad Regional Psychoneurological Dispensary
  • St. Petersburg "Psychoneurological dispensary #5"
  • Clinical Center LLC "LION-MED"
  • Clinical Center LLC "Medical practice"
  • Yaroslavl Regional Psychiatric Hospital
  • Clinical Center JSC "Medical Technologies"

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

CD-008-0045 60 mg/day

CD-008-0045 40 mg/day

Placebo

Arm Description

Patients assigned to the CD-008-0045 60 mg/day group will receive 1 capsule of CD-008-0045 (20 mg) before breakfast, lunch, and dinner for 8 weeks

Patients assigned to the CD-008-0045 40 mg/day group will receive 1 capsule of CD-008-0045 (20 mg) before breakfast and before dinner, and 1 placebo capsule before lunch for 8 weeks.

Patients assigned to the Placebo group will receive 1 placebo capsule before breakfast, lunch, and dinner for 8 weeks.

Outcomes

Primary Outcome Measures

Frequency of treatment response
Proportion of patients who demonstrate ≥ 50% decrease of the Hamilton Anxiety Rating Scale (HARS) [the values from 0 to 56; the higher scores mean a worse outcome] total score from baseline [% of patients]

Secondary Outcome Measures

Change of the HARS total score
Mean change of HARS score [score]
Change in the score sum of the mental and somatic anxiety subscales of HARS
Mean change of the score sum of the mental and somatic anxiety subscales of the HARS score [score]
Change of scores in items 1 (Anxious mood) and 2 (Tension) of HARS
Mean change of the score in items 1 (Anxious mood) and 2 (Tension) of HARS [score]
Change of the sum of Hamilton Depression Rating Scale (HAM-D) scores
Mean change of HAM-D [the values from 0 to 52; the higher scores mean a worse outcome] score [score]
Change in the Clinical Global Impression - Severity Scale (CGI-S)
Mean change of CGI-S score [the values from 1 to 7; the higher scores mean a worse outcome] [score]
Clinical Global Impression - Improvement Scale (CGI-I)
Mean CGI-I score [the values from 1 to 7; the higher scores mean a worse outcome] [score]
Change of daytime somnolence level based on Visual Analogue Scale (VAS)
Mean change of VAS [the values from 0 to 10; the higher scores mean a worse outcome] score [score]
CD-008-0045 concentration prior to the next drug administration (Ctrough)
Ctrough of CD-008-0045 [ng/ml]
M1 concentration prior to the next drug administration (Ctrough)
Ctrough of M1 [ng/ml]
CD-008-0045 concentration 1 hour post drug administration (Cmax)
Cmax of CD-008-0045 [ng/ml]
M1 concentration 1 hour post drug administration (Cmax)
Cmax of M1 [ng/ml]
CYP2D6 polymorphism
CYP2D6 polymorphism [type of metabolism]
Incidence of adverse events (AE) and serious adverse events (SAE)
Percent of patients with AEs and SAEs [% of patients]

Full Information

First Posted
August 15, 2020
Last Updated
August 20, 2020
Sponsor
ChemRar Research and Development Institute, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04524975
Brief Title
А Dose-finding Study to Assess the Efficacy and Safety of CD-008-0045 in Patients With Generalized Anxiety Disorder
Official Title
A Multicenter, Randomized, Double-blind, Placebo-controlled, Dose-finding, Pilot Study to Assess the Efficacy and Safety of CD-008-0045 in Patients With Generalized Anxiety Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Completed
Study Start Date
October 2, 2018 (Actual)
Primary Completion Date
August 20, 2019 (Actual)
Study Completion Date
November 1, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ChemRar Research and Development Institute, LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a multicenter, randomized, double-blind, placebo-controlled, dose-finding pilot study to assess the efficacy and safety of CD-008-0045 in patients with Generalized Anxiety Disorder (GAD). Each patient will participate in the study for the period of approximately 10 weeks: Screening and Run-in period: 1 week; Study Treatment period: 8 weeks; Follow-up period: 1 week.
Detailed Description
The study drug CD-008-0045 has a multi-targeted activity, i.e., able to inhibit adrenergic, dopamine, serotonin, and histamine receptors, thus allowing to assume its wide therapeutic potential. At Screening, the patients who meet the inclusion/exclusion criteria will be included into one-week single-blind Placebo Run-in period. At Week 0 the patients will be randomized to receive CD-008-0045 60 mg daily, CD-008-0045 40 mg daily or Placebo for 8 weeks. The potential withdrawal syndrome will be assessed during one-week Follow-up Period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anxiety Disorder Generalized
Keywords
Anti-Anxiety Agents, Anxiety Disorder Generalized

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This is a multicenter, randomized, double-blind, placebo-controlled, dose-ranging pilot study to assess the efficacy and safety of CD-008-0045 in patients with GAD. The primary study objective is to select the dosage regimen for CD-008-0045 (20 mg BID or TID) based on preliminary assessment of its efficacy versus placebo according to frequency of treatment response at Week 8 in patients with GAD. Treatment response is considered as ≥ 50% decrease of the Hamilton Anxiety Rating Scale (HARS) total score from baseline.
Masking
ParticipantInvestigator
Masking Description
Dose blinding will be performed using Placebo. Patient will receive 3 vials labeled for study drug administration as follows: 1 capsule in the morning, afternoon, and evening. Package numbers were assigned via IWRS. Thus, during the Study Treatment period, neither the patient nor the Investigator knew the group to which the patient was allocated. Single blinding was performed during the Placebo Run-in and Follow-up periods.
Allocation
Randomized
Enrollment
129 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CD-008-0045 60 mg/day
Arm Type
Experimental
Arm Description
Patients assigned to the CD-008-0045 60 mg/day group will receive 1 capsule of CD-008-0045 (20 mg) before breakfast, lunch, and dinner for 8 weeks
Arm Title
CD-008-0045 40 mg/day
Arm Type
Experimental
Arm Description
Patients assigned to the CD-008-0045 40 mg/day group will receive 1 capsule of CD-008-0045 (20 mg) before breakfast and before dinner, and 1 placebo capsule before lunch for 8 weeks.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients assigned to the Placebo group will receive 1 placebo capsule before breakfast, lunch, and dinner for 8 weeks.
Intervention Type
Drug
Intervention Name(s)
CD-008-0045
Intervention Description
CD-008-0045 20 mg capsules
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo capsules
Primary Outcome Measure Information:
Title
Frequency of treatment response
Description
Proportion of patients who demonstrate ≥ 50% decrease of the Hamilton Anxiety Rating Scale (HARS) [the values from 0 to 56; the higher scores mean a worse outcome] total score from baseline [% of patients]
Time Frame
Baseline to Week 8
Secondary Outcome Measure Information:
Title
Change of the HARS total score
Description
Mean change of HARS score [score]
Time Frame
Baseline to Week 8, Week 8 to Week 9
Title
Change in the score sum of the mental and somatic anxiety subscales of HARS
Description
Mean change of the score sum of the mental and somatic anxiety subscales of the HARS score [score]
Time Frame
Baseline to Week 8
Title
Change of scores in items 1 (Anxious mood) and 2 (Tension) of HARS
Description
Mean change of the score in items 1 (Anxious mood) and 2 (Tension) of HARS [score]
Time Frame
Baseline to Week 8
Title
Change of the sum of Hamilton Depression Rating Scale (HAM-D) scores
Description
Mean change of HAM-D [the values from 0 to 52; the higher scores mean a worse outcome] score [score]
Time Frame
Baseline to Week 8, Week 8 to Week 9
Title
Change in the Clinical Global Impression - Severity Scale (CGI-S)
Description
Mean change of CGI-S score [the values from 1 to 7; the higher scores mean a worse outcome] [score]
Time Frame
Baseline to Week 8, Week 8 to Week 9
Title
Clinical Global Impression - Improvement Scale (CGI-I)
Description
Mean CGI-I score [the values from 1 to 7; the higher scores mean a worse outcome] [score]
Time Frame
Week 4, Week 8, Week 9
Title
Change of daytime somnolence level based on Visual Analogue Scale (VAS)
Description
Mean change of VAS [the values from 0 to 10; the higher scores mean a worse outcome] score [score]
Time Frame
Baseline to Week 8, Week 8 to Week 9
Title
CD-008-0045 concentration prior to the next drug administration (Ctrough)
Description
Ctrough of CD-008-0045 [ng/ml]
Time Frame
Week 4, Week 8
Title
M1 concentration prior to the next drug administration (Ctrough)
Description
Ctrough of M1 [ng/ml]
Time Frame
Week 4, Week 8
Title
CD-008-0045 concentration 1 hour post drug administration (Cmax)
Description
Cmax of CD-008-0045 [ng/ml]
Time Frame
Week 4, Week 8
Title
M1 concentration 1 hour post drug administration (Cmax)
Description
Cmax of M1 [ng/ml]
Time Frame
Week 4, Week 8
Title
CYP2D6 polymorphism
Description
CYP2D6 polymorphism [type of metabolism]
Time Frame
Week 4
Title
Incidence of adverse events (AE) and serious adverse events (SAE)
Description
Percent of patients with AEs and SAEs [% of patients]
Time Frame
Baseline to Week 9

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Signed Informed Consent Form; Age 18 years and older; Generalized anxiety disorder diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria and International Classification of Diseases (ICD-10); Hamilton Anxiety Rating Scale (HARS) values at Screening and on Randomization Visit (Week 0): Total score ≥ 20; Item 1 (Anxious mood) and Item 2 (Tension) scores ≥ 2; The CGI-S score ≥ 4 (moderate severity and higher) at Screening and on Randomization visit (Week 0); Consent of patients to use adequate contraception methods throughout the study. Adequate contraception methods include: Condoms with spermicide for males; For females (at their discretion): oral contraceptives condoms with spermicide (for the partner) diaphragm with spermicide cervical cap with spermicide intrauterine device Ability to comply with all Study Protocol requirements. Exclusion criteria: Pregnant or lactating women, or women planning to get pregnant during the clinical study; women of childbearing potential (including those without history of surgical sterilization and women with <2 years of post-menopause) not using adequate contraception methods; Item 1 (Depressed mood) of the Hamilton Depression Rating Scale (HAMD) score ≥ 2; Hamilton Depression Rating Scale (HAMD) total score > 13; Confirmed diagnosis of depressive episode, recurrent depressive disorder, bipolar affective disorder in history or at Screening; Confirmed diagnosis of schizophrenia in history or at Screening; Confirmed diagnosis of panic disorder in history or at Screening; Phobic anxiety disorders (agoraphobia, social phobia, unspecified phobic anxiety disorder) in history or at Screening; Disorders of personality or behavior in history or at Screening; Post-traumatic stress disorder diagnosed within 12 months prior to Screening; Eating disorders diagnosed within 12 months prior to Screening; Somatoform disorders in history or at Screening; Obsessive-compulsive disorder in history or at Screening; Epilepsy, seizures, head trauma with loss of consciousness, tumors, inflammatory, or demyelinating diseases of the central nervous system, stroke in history; Pheochromocytoma; Malignancies diagnosed within the last 5 years (except for the cured basal cell carcinoma); Significant cardiovascular diseases diagnosed at present or within 12 months prior to Screening, including: Chronic heart failure, class III or IV (according to New York Heart Association classification); severe arrhythmia requiring treatment with class Ia, Ib, Ic, or III antiarrhythmic drugs; unstable angina; myocardial infarction; heart and coronary artery surgery; significant valvular heart disease; uncontrolled hypertension with systolic blood pressure > 180 mm Hg and diastolic blood pressure > 110 mm Hg; pulmonary embolism or deep vein thrombosis; Nephrotic syndrome; moderate to severe chronic renal failure or significant renal diseases with creatinine level >1.5 mg/dL (132 μM/L) in males and > 1.4 mg/dL (123 μM/L) in females, or glomerular filtration rate (GFR) < 60 mL/min; HIV, hepatitis B or C, liver cirrhosis in history; AST, ALT, or serum alkaline phosphatase ≥ 2.5 times above the upper limit of normal; total bilirubin level ≥ 2 times above the upper limit of normal at Screening; Significant dysfunctions of the thyroid gland in decompensation stage; Anemia (hemoglobin level ≤ 105 g/L in females or ≤ 115 g/L in males); significant blood loss, or collection of at least one volumetric unit of donated blood (≥ 500 ml), or blood transfusion within 12 weeks prior to Screening; Any uncontrolled concomitant somatic disease, including that with a stable treatment regimen; Drugs administered for generalized anxiety disorder, starting from Screening and throughout the study, including antidepressants, Pregabalin, benzodiazepines, antipsychotics; Fluoxetine use within 21 days prior to Screening and throughout the study; Known allergy, hypersensitivity or contraindications to CD-008-0045; Electroconvulsive therapy within 3 months prior to Screening; Psychotherapy within 3 months prior to Screening and/or at the time of enrollment into the study; Use of prohibited drug therapy from the moment of Screening and throughout the study; Administration of any study drug or participation in another clinical study within 3 months prior to Screening (except for cases when the patient was not administered the study drug during the study); Addiction to tranquilizers or psychoactive substance abuse, including alcohol (history of episodic use is acceptable); Inability to read or right; unwillingness to understand and comply with the Protocol procedures; non-compliance with drug dosage regimen or procedures which, in the Investigator's opinion, may affect the study results or the patient's safety and prevent the patient's participation in the study; any other concomitant diseases or severe mental disorders, which make the patient ineligible for participation in the study, limit the legal basis for Informed Consent procedure, or may affect the patient's ability to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Margarita A Morozova, MD,PhD,Prof
Organizational Affiliation
"Research Center for Mental Health" Scientific Institution
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinical Center LLC "Center for Psychotherapy "Support"
City
Stavropol
State/Province
Stavropol Region
Country
Russian Federation
Facility Name
"Research Center for Mental Health" Scientific Institution
City
Moscow
Country
Russian Federation
Facility Name
Clinical Center LLC "University Headache Clinic"
City
Moscow
Country
Russian Federation
Facility Name
Moscow Research Institute of Psychiatry "National Medical Research Center for Psychiatry and Narcology named after V.P. Serbsky"
City
Moscow
Country
Russian Federation
Facility Name
Nizhny Novgorod Clinical Psychiatric Hospital No.1
City
Nizhny Novgorod
Country
Russian Federation
Facility Name
Clinical Center LLC "TREATMENT AND REHABILITATION RESEARCH CENTER "PHOENIX "
City
Rostov-on-Don
Country
Russian Federation
Facility Name
Ryazan Medical University, Department of Psychiatry
City
Ryazan
Country
Russian Federation
Facility Name
Clinical Center LLC "Doctor SAN"
City
Saint Petersburg
Country
Russian Federation
Facility Name
Clinical Center LLC "Dynasty"
City
Saint Petersburg
Country
Russian Federation
Facility Name
Leningrad Regional Psychoneurological Dispensary
City
Saint Petersburg
Country
Russian Federation
Facility Name
St. Petersburg "Psychoneurological dispensary #5"
City
Saint Petersburg
Country
Russian Federation
Facility Name
Clinical Center LLC "LION-MED"
City
Voronezh
Country
Russian Federation
Facility Name
Clinical Center LLC "Medical practice"
City
Voronezh
Country
Russian Federation
Facility Name
Yaroslavl Regional Psychiatric Hospital
City
Yaroslavl
Country
Russian Federation
Facility Name
Clinical Center JSC "Medical Technologies"
City
Yekaterinburg
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No

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А Dose-finding Study to Assess the Efficacy and Safety of CD-008-0045 in Patients With Generalized Anxiety Disorder

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