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Study to Assess the Safety and Effectiveness of NMRA-335140-501

Primary Purpose

Major Depressive Disorder

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
NMRA-335140
Sponsored by
Neumora Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring Major Depressive Disorder, NMRA-335140, Long-term, Safety, Efficacy, Navacaprant

Eligibility Criteria

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

Key Inclusion Criteria: Rollover participants are eligible for the study if the following inclusion criteria are met: Completed a previous NMRA-335140 Phase 3 MDD study (NMRA-335140-301, NMRA-335140-302, or NMRA-335140-303) according to the completion definition in the parent study protocol. Signed an informed consent form (ICF) for this study. Willing to comply with the contraception requirements described in the inclusion criteria of the parent study protocol. Willing to comply with the concomitant medication/therapy restrictions described in the exclusion criteria of the parent study protocol. Key Exclusion Criteria: Rollover participants are excluded from the study if any of the following exclusion criteria are met: Diagnosed with another Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) disorder that would have been exclusionary in the parent study (eg, personality disorder, bipolar 1 or 2, schizophrenia, any other psychotic disorder, or moderate or severe substance or alcohol use disorder [excluding nicotine]). Considered to be at significant risk of suicide in the judgment of the Investigator. This includes participants who are actively suicidal (eg, any suicide attempts during the parent study) or are at serious suicidal risk as indicated by any current suicidal intent, including a plan, as assessed by the C-SSRS ("Since Last Visit" version, score of "YES" on suicidal ideation Item 4 or 5) and/or based on clinical evaluation by the Investigator; or are homicidal, in the opinion of the Investigator. Non-adherent with study medication (took less than 70% of study drug over any 2-week visit interval) or procedures during the parent study. Experienced treatment emergent adverse events (TEAEs) at least possibly related to the study medication from the parent study and judged by the Investigator to be clinically significant to render the participant ineligible for enrollment. Have an abnormality on ocular examination that would prohibit continued study participation as determined by the Investigator. Use of disallowed concomitant medication or therapy that would have been exclusionary in the parent study, may compromise the safety of the participant, and/or confound the interpretation of protocol assessments. Considered by the Investigator to be inappropriate for any other reason.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    NMRA-335140 80 milligrams (mg) once daily (QD)

    Arm Description

    Participants will receive a NMRA-335140 tablet at a dose of 80 mg once daily (QD) during a 52-week treatment period.

    Outcomes

    Primary Outcome Measures

    Safety and tolerability assessments based on Treatment Emergent Adverse Events (TEAEs) and validated clinical scales
    An AE is any untoward medical occurrence in a participant or clinical trial participant, temporally associated with the use of trial intervention, whether or not considered related to the trial intervention. Any AE occurring following the start of treatment or occurring before treatment but increasing in severity afterward were counted as treatment-emergent AE (TEAE). Clinically significant abnormalities in Clinical Laboratory Evaluations, ECGs, Vital Signs, Physical and Ophthalmological evaluations, Corneal Specular Microscopy, Columbia Suicide Severity Rating Scale (C-SSRS), and Sexual Functioning Questionnaire-14 (CSFQ-14) will be reported as TEAEs.

    Secondary Outcome Measures

    Change from Baseline in Montgomery-Asberg Depression Rating Scale (MADRS) total score over time.
    Change from baseline in MADRS total score over time will be reported. The MADRS is a clinician-rated scale designed to measure depression severity and detects changes due to antidepressant treatment. The scale consists of 10 items, each of which is scored from 0 (item not present or normal) to 6 (severe or continuous presence of the symptoms), for a total score of 60. Higher scores represent a more severe condition.
    Change from Baseline in the Snaith-Hamilton Pleasure Scale (SHAPS) total score over time
    The SHAPS is a 14-item participant-reported instrument which measures anhedonia. It has been shown to be valid and reliable in normal and clinical samples, with adequate construct validity, satisfactory test-retest reliability, and high internal consistency. The scale will be completed by the participant and reviewed by site personnel qualified to oversee completeness. Each of the 14 items has a set of 4 responses, 2 of which endorse agreement (Definitely Agree, Agree) and 2 of which endorse disagreement (Disagree, Strongly Disagree). A total score can be derived by summing the responses; items answered with strongly agree are coded as 1 while a strongly disagree response will be coded as 4. Therefore, scores on the SHAPS can range from 14 to 56, with higher scores corresponding to higher levels of anhedonia.
    Change from Baseline in the Patient Health Questionnaire-9 (PHQ-9) total score over time.
    Change from baseline in PHQ-9 total score over time will be reported. The 9-item PHQ-9 scale scores each of the 9 symptom domains of the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) diagnostic criteria for recurrent or single episode major depressive disorder (MDD) criteria and used both as a screening tool and a measure of response to treatment for depression. Each item is rated on a 4-point scale (0=not at all, 1=several days, 2=more than half the days, and 3=nearly every day). The participant's item responses are summed to provide a total score (range of 0 to 27), with higher scores indicating greater severity of depressive symptoms.
    Change from Baseline in PHQ-9 Anhedonia Item #1 over time.
    The PHQ-9 is a participant-rated assessment scale for the evaluation of depression symptoms over the past 2 weeks. The PHQ-9 is a reliable and valid measure of depression and depression severity. The questionnaire consists of 9 items and each item is scored from 0 to 3. Participants will be asked how often they have been bothered by symptoms over the past 2 weeks (Not at all [0], Several days [1], More than half the time [2], or Nearly every day [3]). Higher scores indicate higher levels of depression.
    Change from Baseline in the Hamilton Anxiety Rating Scale (HAM-A) total score over time.
    The HAM-A is a clinician-rated instrument administered to assess severity of anxiety, its improvement during the course of treatment, and the timing of such improvement. This instrument will be completed by qualified and trained Investigator site raters based on a semi-structured interview for his/her assessment of the participant. The scale consists of 14 items. Each item is rated on a scale of 0 (feeling not present) to 4 (very severe prevalence of the feeling). The HAM-A total score is the sum of the 14 items and the score ranges from 0 to 56.
    Change from Baseline in the Clinical Global Impression Scale of Severity (CGI-S)
    Change from baseline in the CGI-S total score over time will be reported. The CGI-S evaluates the severity of psychopathology on a scale of 0 to 7. Considering total clinical experience, a participant is assessed on severity of mental illness at the time of rating according to: 0=not assessed; 1=normal (not at all ill); 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill participants. The CGI-S permits a global evaluation of the participant's condition at a given time.
    Change from Baseline in the Clinical Global Impression Scale of Improvement (CGI-I)
    The CGI-I scale is a clinician-rated instrument that measures the improvement of the participant's symptoms of depression. It is a 7-point scale where a score of 1 indicates that the participant is "very much improved," a score of 4 indicates that the participant has experienced "no change," and a score of 7 indicates that the participant is "very much worse."
    Percentage of participants whose MADRS total score decreased by greater than or equal to 50% from Baseline.
    Percentage of participants whose MADRS total score decreased to 10 or less.
    Change from baseline in the Sheehan Disability Scale (SDS) over time.
    The SDS is a participant-rated instrument which was developed to assess functional impairment in 3 related domains of work/school, social, and family life. It is a brief self rated tool where the participant rates the 3 items on an anchored 10 point visual analog scale. Following the participant's self assessment, the rater should review the Work/School and Days Lost items to confirm appropriateness of the selected rating by evaluating the impact of MDD symptoms across those sectors. The SDS may be administered via telephone assessment; however, the participant must be provided with a portable document format (PDF) copy of the assessment for reference of the visual analog scale when selecting their ratings.

    Full Information

    First Posted
    September 1, 2023
    Last Updated
    September 1, 2023
    Sponsor
    Neumora Therapeutics, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06029439
    Brief Title
    Study to Assess the Safety and Effectiveness of NMRA-335140-501
    Official Title
    Long-term Study to Assess the Safety and Effectiveness of NMRA-335140 in Participants With Major Depressive Disorder
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 2023 (Anticipated)
    Primary Completion Date
    March 2026 (Anticipated)
    Study Completion Date
    September 2026 (Anticipated)

    3. Sponsor/Collaborators

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

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a 52-week open-label extension (OLE) study that will evaluate the safety, tolerability, and effectiveness of NMRA-335140 in participants with major depressive disorder (MDD). Participants who completed a parent study investigating the efficacy of NMRA-335140 as a treatment for MDD (ie, NMRA-335140-301, NMRA-335140-302, or NMRA-335140-303), who provide informed consent, and who have no evidence of safety concerns that would preclude treatment with NMRA-335140 may be enrolled into this extension study.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Major Depressive Disorder
    Keywords
    Major Depressive Disorder, NMRA-335140, Long-term, Safety, Efficacy, Navacaprant

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    650 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    NMRA-335140 80 milligrams (mg) once daily (QD)
    Arm Type
    Experimental
    Arm Description
    Participants will receive a NMRA-335140 tablet at a dose of 80 mg once daily (QD) during a 52-week treatment period.
    Intervention Type
    Drug
    Intervention Name(s)
    NMRA-335140
    Other Intervention Name(s)
    BTRX-335140, CYM-53093, Navacaprant
    Intervention Description
    Participants will receive NMRA-335140 at a dose of 80 mg once daily (QD), orally during a 52-week treatment period.
    Primary Outcome Measure Information:
    Title
    Safety and tolerability assessments based on Treatment Emergent Adverse Events (TEAEs) and validated clinical scales
    Description
    An AE is any untoward medical occurrence in a participant or clinical trial participant, temporally associated with the use of trial intervention, whether or not considered related to the trial intervention. Any AE occurring following the start of treatment or occurring before treatment but increasing in severity afterward were counted as treatment-emergent AE (TEAE). Clinically significant abnormalities in Clinical Laboratory Evaluations, ECGs, Vital Signs, Physical and Ophthalmological evaluations, Corneal Specular Microscopy, Columbia Suicide Severity Rating Scale (C-SSRS), and Sexual Functioning Questionnaire-14 (CSFQ-14) will be reported as TEAEs.
    Time Frame
    Up to 54 Weeks
    Secondary Outcome Measure Information:
    Title
    Change from Baseline in Montgomery-Asberg Depression Rating Scale (MADRS) total score over time.
    Description
    Change from baseline in MADRS total score over time will be reported. The MADRS is a clinician-rated scale designed to measure depression severity and detects changes due to antidepressant treatment. The scale consists of 10 items, each of which is scored from 0 (item not present or normal) to 6 (severe or continuous presence of the symptoms), for a total score of 60. Higher scores represent a more severe condition.
    Time Frame
    Baseline and up to Week 54
    Title
    Change from Baseline in the Snaith-Hamilton Pleasure Scale (SHAPS) total score over time
    Description
    The SHAPS is a 14-item participant-reported instrument which measures anhedonia. It has been shown to be valid and reliable in normal and clinical samples, with adequate construct validity, satisfactory test-retest reliability, and high internal consistency. The scale will be completed by the participant and reviewed by site personnel qualified to oversee completeness. Each of the 14 items has a set of 4 responses, 2 of which endorse agreement (Definitely Agree, Agree) and 2 of which endorse disagreement (Disagree, Strongly Disagree). A total score can be derived by summing the responses; items answered with strongly agree are coded as 1 while a strongly disagree response will be coded as 4. Therefore, scores on the SHAPS can range from 14 to 56, with higher scores corresponding to higher levels of anhedonia.
    Time Frame
    Baseline and up to Week 54
    Title
    Change from Baseline in the Patient Health Questionnaire-9 (PHQ-9) total score over time.
    Description
    Change from baseline in PHQ-9 total score over time will be reported. The 9-item PHQ-9 scale scores each of the 9 symptom domains of the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) diagnostic criteria for recurrent or single episode major depressive disorder (MDD) criteria and used both as a screening tool and a measure of response to treatment for depression. Each item is rated on a 4-point scale (0=not at all, 1=several days, 2=more than half the days, and 3=nearly every day). The participant's item responses are summed to provide a total score (range of 0 to 27), with higher scores indicating greater severity of depressive symptoms.
    Time Frame
    Baseline and up to Week 54
    Title
    Change from Baseline in PHQ-9 Anhedonia Item #1 over time.
    Description
    The PHQ-9 is a participant-rated assessment scale for the evaluation of depression symptoms over the past 2 weeks. The PHQ-9 is a reliable and valid measure of depression and depression severity. The questionnaire consists of 9 items and each item is scored from 0 to 3. Participants will be asked how often they have been bothered by symptoms over the past 2 weeks (Not at all [0], Several days [1], More than half the time [2], or Nearly every day [3]). Higher scores indicate higher levels of depression.
    Time Frame
    Baseline and up to Week 54
    Title
    Change from Baseline in the Hamilton Anxiety Rating Scale (HAM-A) total score over time.
    Description
    The HAM-A is a clinician-rated instrument administered to assess severity of anxiety, its improvement during the course of treatment, and the timing of such improvement. This instrument will be completed by qualified and trained Investigator site raters based on a semi-structured interview for his/her assessment of the participant. The scale consists of 14 items. Each item is rated on a scale of 0 (feeling not present) to 4 (very severe prevalence of the feeling). The HAM-A total score is the sum of the 14 items and the score ranges from 0 to 56.
    Time Frame
    Baseline and up to Week 54
    Title
    Change from Baseline in the Clinical Global Impression Scale of Severity (CGI-S)
    Description
    Change from baseline in the CGI-S total score over time will be reported. The CGI-S evaluates the severity of psychopathology on a scale of 0 to 7. Considering total clinical experience, a participant is assessed on severity of mental illness at the time of rating according to: 0=not assessed; 1=normal (not at all ill); 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill participants. The CGI-S permits a global evaluation of the participant's condition at a given time.
    Time Frame
    Baseline and up to Week 54
    Title
    Change from Baseline in the Clinical Global Impression Scale of Improvement (CGI-I)
    Description
    The CGI-I scale is a clinician-rated instrument that measures the improvement of the participant's symptoms of depression. It is a 7-point scale where a score of 1 indicates that the participant is "very much improved," a score of 4 indicates that the participant has experienced "no change," and a score of 7 indicates that the participant is "very much worse."
    Time Frame
    Baseline and up to Week 54
    Title
    Percentage of participants whose MADRS total score decreased by greater than or equal to 50% from Baseline.
    Time Frame
    Up to Week 54
    Title
    Percentage of participants whose MADRS total score decreased to 10 or less.
    Time Frame
    Up to Week 54
    Title
    Change from baseline in the Sheehan Disability Scale (SDS) over time.
    Description
    The SDS is a participant-rated instrument which was developed to assess functional impairment in 3 related domains of work/school, social, and family life. It is a brief self rated tool where the participant rates the 3 items on an anchored 10 point visual analog scale. Following the participant's self assessment, the rater should review the Work/School and Days Lost items to confirm appropriateness of the selected rating by evaluating the impact of MDD symptoms across those sectors. The SDS may be administered via telephone assessment; however, the participant must be provided with a portable document format (PDF) copy of the assessment for reference of the visual analog scale when selecting their ratings.
    Time Frame
    Baseline and up to Week 54

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Key Inclusion Criteria: Rollover participants are eligible for the study if the following inclusion criteria are met: Completed a previous NMRA-335140 Phase 3 MDD study (NMRA-335140-301, NMRA-335140-302, or NMRA-335140-303) according to the completion definition in the parent study protocol. Signed an informed consent form (ICF) for this study. Willing to comply with the contraception requirements described in the inclusion criteria of the parent study protocol. Willing to comply with the concomitant medication/therapy restrictions described in the exclusion criteria of the parent study protocol. Key Exclusion Criteria: Rollover participants are excluded from the study if any of the following exclusion criteria are met: Diagnosed with another Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) disorder that would have been exclusionary in the parent study (eg, personality disorder, bipolar 1 or 2, schizophrenia, any other psychotic disorder, or moderate or severe substance or alcohol use disorder [excluding nicotine]). Considered to be at significant risk of suicide in the judgment of the Investigator. This includes participants who are actively suicidal (eg, any suicide attempts during the parent study) or are at serious suicidal risk as indicated by any current suicidal intent, including a plan, as assessed by the C-SSRS ("Since Last Visit" version, score of "YES" on suicidal ideation Item 4 or 5) and/or based on clinical evaluation by the Investigator; or are homicidal, in the opinion of the Investigator. Non-adherent with study medication (took less than 70% of study drug over any 2-week visit interval) or procedures during the parent study. Experienced treatment emergent adverse events (TEAEs) at least possibly related to the study medication from the parent study and judged by the Investigator to be clinically significant to render the participant ineligible for enrollment. Have an abnormality on ocular examination that would prohibit continued study participation as determined by the Investigator. Use of disallowed concomitant medication or therapy that would have been exclusionary in the parent study, may compromise the safety of the participant, and/or confound the interpretation of protocol assessments. Considered by the Investigator to be inappropriate for any other reason.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Study Contact
    Email
    Clinicaltrials@neumoratx.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Study to Assess the Safety and Effectiveness of NMRA-335140-501

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