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A Trial of GH001 in Patients With Treatment-resistant Depression

Primary Purpose

Treatment-resistant Depression

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
GH001
Placebo
Sponsored by
GH Research Ireland Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Treatment-resistant Depression focused on measuring Treatment-resistant depression, Major depressive disorder, Depression, GH001, 5-MeO-DMT, 5-methoxy-N,N-dimethyltryptamine, Mebufotenin

Eligibility Criteria

18 Years - 64 Years (Adult)All SexesDoes not accept healthy volunteers

Main Inclusion Criteria: Is in the age range between 18 and 64 years (inclusive) at the time of informed consent; Meets the trial criteria for TRD as assessed by a study psychiatrist: Meets the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) criteria for single-episode major depressive disorder (MDD) or recurrent MDD, without psychotic features confirmed by the Mini-International Neuropsychiatric Interview (MINI); The current major depressive episode must be deemed "valid" based upon the Massachusetts General Hospital State versus trait Assessability Face and Ecological validity Rule of 3Ps (MGH SAFER) criteria interview; Had nonresponse (≤25% improvement) to ≥2 and ≤5 oral antidepressant treatments administered during the current episode of depression. Main Exclusion Criteria: Has, based on history, psychiatric assessment, and evaluation of the MINI during the screening period, a first MDD episode after age 60, a current or prior diagnosis of a psychotic disorder, MDD, or other mood disorder with psychotic features, bipolar disorder, obsessive compulsive disorder, posttraumatic stress disorder, autism spectrum disorder, borderline personality disorder, schizophrenia, delusional disorder, paranoid personality disorder, schizoaffective disorder, clinically significant intellectual disability, antisocial personality disorder, schizotypal personality disorder, or any other psychiatric comorbidity that renders the patient unsuitable for the trial according to a study psychiatrist; Has significant suicide risk; Has 1 or more first degree relatives with a current or prior diagnosis of bipolar disorder, psychotic disorder, or other mood disorder (including MDD) with psychotic features; Undergoing systematic psychotherapy that is planned to be modified or planning to initiate psychotherapy during the trial; Has any current or past clinically significant condition that may interfere with the interpretation of the trial results, constitute a health risk for the patient, or that otherwise renders the patient unsuitable for the trial according to the investigator's judgement; Fulfils criteria for DSM-5 alcohol or substance use disorder (excluding tobacco and caffeine use disorders) within the preceding 1 year, as assessed via the MINI; Is taking antidepressants, antipsychotics, or any medication with monoamine oxidase inhibitors activity or takes or has taken other disallowed recent or concomitant treatments or it is anticipated that the patient will require treatment with at least 1 of the disallowed concomitant treatments during the trial; Has previously experienced a significant adverse reaction to a hallucinogenic or psychedelic drug (e.g., psilocybin, Psilocybe spp. mushrooms, 5-MeO-DMT, DMT, ayahuasca, lysergic acid diethylamide, mescaline) according to the investigator's judgement.

Sites / Locations

  • Investigational siteRecruiting
  • Investigational siteRecruiting
  • Investigational siteRecruiting
  • Investigational SiteRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Other

Arm Label

GH001 - Part 1

Placebo - Part 1

Open-Label Extension (OLE) - Part 2

Arm Description

GH001 is administered via inhalation, as an IDR consisting of up to 3 increasing doses of GH001 (6 mg, 12 mg, and 18 mg), on a single day. The second and third doses are only administered if the patient did not achieve intense psychoactive effects (a peak experience [PE]) at the previously administered dose.

Placebo is administered via inhalation, as an IDR consisting of up to 3 doses of Placebo, on a single day. The second and third doses are only administered if the patient did not achieve intense psychoactive effects (a PE) at the previously administered dose.

Patients can receive up to five GH001 IDRs as needed during the OLE based on the patient's clinical response.

Outcomes

Primary Outcome Measures

Mean change in MADRS from Baseline to Day 7
The assessment is done with the MADRS, a diagnostic questionnaire with ten items for measuring the severity of depressive episodes in patients with mood disorders. A higher MADRS score indicates more severe depression, and each item is scored from 0 to 6. The overall score ranges from 0 to 60.

Secondary Outcome Measures

Full Information

First Posted
March 22, 2023
Last Updated
August 11, 2023
Sponsor
GH Research Ireland Limited
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1. Study Identification

Unique Protocol Identification Number
NCT05800860
Brief Title
A Trial of GH001 in Patients With Treatment-resistant Depression
Official Title
A Randomized, Double-blind, Placebo-controlled, Phase 2b Trial With an Open-label Extension to Determine the Safety and Efficacy of GH001 in Patients With Treatment-resistant Depression
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 24, 2023 (Actual)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GH Research Ireland Limited

4. Oversight

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

5. Study Description

Brief Summary
The aim of this randomized, double-blind, placebo-controlled, phase 2b clinical trial is to investigate the safety and efficacy of GH001 (containing mebufotenin [5-methoxy-N,N-dimethyltryptamine; 5-MeO-DMT]) in patients with treatment-resistant depression (TRD). The study is comprised of a 7-day double-blind (DB) part (Part 1) and a 6-month open-label extension (OLE) part (Part 2). Patients will be randomized to receive GH001 or placebo in a 1:1 ratio. The primary endpoint is the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to Day 7.
Detailed Description
This is a phase 2b clinical trial in patients with TRD consisting of a 7-day randomized, placebo-controlled, DB Part 1 and a 6-month, single-arm, OLE Part 2. All patients who complete the DB Part 1 will directly transition into the OLE Part 2 on Day 7 of the DB Part 1. In both parts, GH001 is administered as an individualized dosing regimen (IDR) consisting of up to 3 increasing doses of GH001 (6 mg, 12 mg, and 18 mg) on a single day, where the second and third doses are only administered if the patient did not achieve intense psychoactive effects (a peak experience [PE]) at the previously administered dose. In the DB Part 1, patients receive a single GH001 IDR or placebo IDR; In the OLE Part 2, patients can receive up to 5 GH001 IDRs as needed across 6 months, based on the patient's clinical response. In both parts, an IDR clinic visit on Day (D)0 is followed by a telephone call on D1 and a clinic visit on D7 (±1 day). The primary objective of this study is to determine the efficacy of a single day IDR of GH001 compared with placebo in improving depressive symptoms as assessed by the MADRS at the end of the 7-day DB Part 1. Other efficacy objectives of this study are to assess the effects of the GH001 IDR on various measures of depression, anxiety and quality of life during the DB part and during the OLE. The safety of GH001 will also be assessed. GH001 is an inhalation formulation of synthetic mebufotenin (5-MeO-DMT). The study drug is administered as an aerosol via pulmonary inhalation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Treatment-resistant Depression
Keywords
Treatment-resistant depression, Major depressive disorder, Depression, GH001, 5-MeO-DMT, 5-methoxy-N,N-dimethyltryptamine, Mebufotenin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GH001 - Part 1
Arm Type
Experimental
Arm Description
GH001 is administered via inhalation, as an IDR consisting of up to 3 increasing doses of GH001 (6 mg, 12 mg, and 18 mg), on a single day. The second and third doses are only administered if the patient did not achieve intense psychoactive effects (a peak experience [PE]) at the previously administered dose.
Arm Title
Placebo - Part 1
Arm Type
Placebo Comparator
Arm Description
Placebo is administered via inhalation, as an IDR consisting of up to 3 doses of Placebo, on a single day. The second and third doses are only administered if the patient did not achieve intense psychoactive effects (a PE) at the previously administered dose.
Arm Title
Open-Label Extension (OLE) - Part 2
Arm Type
Other
Arm Description
Patients can receive up to five GH001 IDRs as needed during the OLE based on the patient's clinical response.
Intervention Type
Drug
Intervention Name(s)
GH001
Other Intervention Name(s)
5-Methoxy-N,N-dimethyltryptamine, 5-MeO-DMT, Mebufotenin
Intervention Description
GH001 administered via inhalation
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo administered via inhalation
Primary Outcome Measure Information:
Title
Mean change in MADRS from Baseline to Day 7
Description
The assessment is done with the MADRS, a diagnostic questionnaire with ten items for measuring the severity of depressive episodes in patients with mood disorders. A higher MADRS score indicates more severe depression, and each item is scored from 0 to 6. The overall score ranges from 0 to 60.
Time Frame
Baseline to Day 7

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
64 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Is in the age range between 18 and 64 years (inclusive) at the time of informed consent; Meets the trial criteria for TRD as assessed by a study psychiatrist: Meets the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) criteria for single-episode major depressive disorder (MDD) or recurrent MDD, without psychotic features confirmed by the Mini-International Neuropsychiatric Interview (MINI); The current major depressive episode must be deemed "valid" based upon the Massachusetts General Hospital State versus trait Assessability Face and Ecological validity Rule of 3Ps (MGH SAFER) criteria interview; Had nonresponse (≤25% improvement) to ≥2 and ≤5 oral antidepressant treatments administered during the current episode of depression. Main Exclusion Criteria: Has, based on history, psychiatric assessment, and evaluation of the MINI during the screening period, a first MDD episode after age 60, a current or prior diagnosis of a psychotic disorder, MDD, or other mood disorder with psychotic features, bipolar disorder, obsessive compulsive disorder, posttraumatic stress disorder, autism spectrum disorder, borderline personality disorder, schizophrenia, delusional disorder, paranoid personality disorder, schizoaffective disorder, clinically significant intellectual disability, antisocial personality disorder, schizotypal personality disorder, or any other psychiatric comorbidity that renders the patient unsuitable for the trial according to a study psychiatrist; Has significant suicide risk; Has 1 or more first degree relatives with a current or prior diagnosis of bipolar disorder, psychotic disorder, or other mood disorder (including MDD) with psychotic features; Undergoing systematic psychotherapy that is planned to be modified or planning to initiate psychotherapy during the trial; Has any current or past clinically significant condition that may interfere with the interpretation of the trial results, constitute a health risk for the patient, or that otherwise renders the patient unsuitable for the trial according to the investigator's judgement; Fulfils criteria for DSM-5 alcohol or substance use disorder (excluding tobacco and caffeine use disorders) within the preceding 1 year, as assessed via the MINI; Is taking antidepressants, antipsychotics, or any medication with monoamine oxidase inhibitors activity or takes or has taken other disallowed recent or concomitant treatments or it is anticipated that the patient will require treatment with at least 1 of the disallowed concomitant treatments during the trial; Has previously experienced a significant adverse reaction to a hallucinogenic or psychedelic drug (e.g., psilocybin, Psilocybe spp. mushrooms, 5-MeO-DMT, DMT, ayahuasca, lysergic acid diethylamide, mescaline) according to the investigator's judgement.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Fiona Ryan, PhD
Phone
+ 353 1 437 8334
Email
clinicaltrials@ghres.com
Facility Information:
Facility Name
Investigational site
City
Plzen
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Investigational site
City
Prague
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Investigational site
City
Dublin
Country
Ireland
Individual Site Status
Recruiting
Facility Name
Investigational Site
City
Galway
Country
Ireland
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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A Trial of GH001 in Patients With Treatment-resistant Depression

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