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A Study of CX157 (TriRima) for the Treatment of Depression (CX157-200)

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CX157 (TriRima)
Placebo
Sponsored by
CeNeRx BioPharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring MDD

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female = 18 years of age and <60 years
  • Able to read, understand, converse in English
  • Willing to comply with diet restrictions, concomitant medication restrictions, & all study requirements
  • Good general health as ascertained by:Medical history, Physical exam, Supine & standing vital signs, Clinical lab evaluations, 12-lead Electrocardiogram (ECG)
  • Diagnosis of MDD;
  • A total score =>40 on the IDS-SR30 assessed via IVRS at Screening and Randomization

Exclusion Criteria:

  • Subject's current MDD episode is >2 years
  • History of Substance Use Disorder at Screening or 12 months prior (except for nicotine)
  • Current diagnosis of Obsessive-Compulsive Disorder;

    • Panic Disorder or Post-Traumatic Stress Disorder;
    • Anorexia nervosa, Bulimia nervosa, or eating disorder not otherwise specified;
    • Any Axis I Disorder clinically predominant to their MDD (within 6 mo);
    • Presence of psychotic features with current depressive episode;
    • Antisocial or Borderline Personality Disorder
  • At risk for suicide
  • Lack of response to >2 trials of adequate dose & duration of antidepressants of different mechanistic classes
  • Electroconvulsive therapy within 1 year of Screening
  • Subject has taken any psychoactive drug within 2 weeks of Randomization
  • History of cardiac abnormalities including abnormal vital sign measurements
  • Clinically significant abnormal ECG at Screening
  • History within past 2 years of: Significant head trauma;

    • Surgical procedure involving brain or meninges; Encephalitis or meningitis;
    • Degenerative CNS disorder (Alzheimer's or Parkinson's);
    • Epilepsy;
    • Mental retardation
  • Clinically significant Liver Function Test (LFT) and other lab abnormalities
  • A history of hypothyroidism and treatment with a stable dosage of thyroid replacement medication for <6 months prior to Screening
  • A history of hyperthyroidism treated (medically or surgically) <6 months prior to Screening
  • Participation in a clinical investigation of a psychotropic drug within 90 days prior to Screening OR used any other investigational drug within 60 days prior to Screening
  • Presence of any medical history which includes:

    • Hypersensitivity to CX157 or excipients, other MAO inhibitors, or other phenylethylamines;
    • Diabetes mellitus Type I, uncontrolled Type II, or controlled Type II managed with insulin; Malignancy/chemotherapy within 2 years prior to Screening;
    • Malignancy >2 yrs may not preclude participation if the malignancy was local and without metastasis or recurrence and, if treated with chemotherapy, had no nervous system complications (e.g basal cell carcinoma);
    • Pheochromocytoma
  • Positive urine test for drugs of abuse (blood for alcohol)
  • Female subject who is pregnant or lactating
  • Poor likelihood of subject's cooperation or compliance

Sites / Locations

  • Birmingham Research Group
  • Southwestern Research, Inc.
  • The George Washington University
  • Irving S. Kolin, M.D.
  • Midwest Center for Neurobehavioral Medicine
  • Capital Clinical Research Associates
  • McLean Hospital
  • CRI Worldwide, LLC
  • Fieve Clinical Services
  • Richard H. Weisler, M.D., P.A.
  • University of Pennsylvania School of Medicine
  • FutureSearch Trials
  • Summit Research Network (Seattle), LLC
  • Northbrooke Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

CX157 (TriRima)

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Change From Randomization in Montgomery and Asberg Depression Rating Scale (MADRS)
The Montgomery-Asberg Depression Rating Scale (MADRS) is a 10-item checklist designed to measure the overall severity of depressive symptoms in patients with MDD [Montgomery, 1979]. Items are rated on a scale of 0-6, with scores ranging from 0 to 60 with 0 being symptom free and 60 being the most severe depression. MADRS was assessed at randomization and Weeks 1, 2, 4 and 6 of the study.

Secondary Outcome Measures

Montgomery and Asberg Depression Rating Scale (MADRS) Response Rate
MADRS is a 10-item checklist designed to measure the overall severity of depressive symptoms in patients with MDD [Montgomery, 1979]. Items are rated on a scale of 0-6, with scores ranging from 0 to 60 with 0 being symptom free and 60 being the most severe depression. Percentage of participants who achieved a reduction in total MADRS score of at least 50% or more as compared to baseline. MADRS was assessed at randomization and Weeks 1, 2, 4, and 6 of the study. MADRS Responder rate at Week 6 or the last available post treatment result (LOCF) is reported here.
Montgomery and Asberg Depression Rating Scale (MADRS) Remitter Rate
Percentage of participants with total MADRS score of 11 or less. MADRS was assessed at randomization and Weeks 1, 2, 4, and 6 of the study. MADRS Remitter rate at Week 6 or the last available post treatment result (LOCF)is reported here.
The Hospital Anxiety and Depression Scale (HADS)
HADS is a subject-rated questionnaire designed to detect states of anxiety and depression. The HADS consists of 14 questions relating to anxiety or depression, each with a choice of four responses [Zigmond, 1983]. These responses are numerically scored 0-3, with 0 representing the least severe response and 3 representing the most severe response. The highest possible total score is 42. HADS was assessed at randomization and Weeks 1, 2, 4, and 6 of the study. Change from randomization in the HADS total score at Week 6 or the last available post treatment result (LOCF) is reported here.
Inventory of Depressive Symptomatology 30 Item -Self Report (IDS -SR 30 Items)
IDSR-SR 30 measures the severity of depressive symptoms by subjects. This scale has 30 items. The minimum score is 0 and the maximum possible IDS-30 score is 90 (the highest severity). IDS-SR30 was administered at screening, randomization and Weeks 1, 2, 4, and 6. Change from randomization in the IDS-SR30 total score at Week 6 or the last available post treatment result (LOCF) is reported here.
Clinical Global Impression - Improvement of Illness (CGI-I)
The Clinical Global Impression - Improvement of Illness (CGI-I) was rated on a 7-point scale by the investigator to measure subject's total improvement compared to his/her condition at randomization according to the following scale: 0 = not assessed, 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse. CGI-I was measured at Weeks 1, 2, 4 and 6. Percentage of participants "very much improved" and "much improved" at Week 6 or the last available post treatment result (LOCF) is reported here.
Clinical Global Impression - Severity of Illness (CGI-S)
CGI-S measures the study rater's assessment of the severity of depression illness. CGI-S is rated on a scale of 1-7 as follows: 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, and 7 = among the most extremely ill patients. CGI-S was measured at randomization and Weeks 1, 2, 4 and 6. Percentage of subjects reported as normal, not at all ill; borderline mentally ill; and mildly ill is reported here at Week 6 or the last available post treatment result (LOCF).

Full Information

First Posted
August 20, 2008
Last Updated
June 26, 2012
Sponsor
CeNeRx BioPharma Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00739908
Brief Title
A Study of CX157 (TriRima) for the Treatment of Depression
Acronym
CX157-200
Official Title
A Randomized, Double-Blind, Placebo-Controlled Parallel-Group, Assessment of the Efficacy, Safety and Tolerability of CX157 (TriRima) 60mg Three Times a Day (TID) in Subjects With Major Depressive Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
June 2012
Overall Recruitment Status
Completed
Study Start Date
September 2008 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
July 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CeNeRx BioPharma Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to examine the efficacy of CX157 60 mg administered three times a day (180 mg daily dose) as compared to placebo in subjects with Major Depressive Disorder (MDD). Secondary objectives are to evaluate the safety and tolerability and steady state pharmacokinetic profile of CX157 in these subjects.
Detailed Description
This is a Phase II, randomized, double-blind, placebo-controlled, parallel-group, multi-center study comparing the efficacy, safety and tolerability of CX157 60mg TID and placebo. This study will be conducted at approximately 12 investigative sites in the US. Subjects with suspected Major Depressive Disorder (MDD) and experiencing a Major Depressive Episode (MDE) who the investigator wishes to consider for enrollment in the study and who provide written informed consent will initially be evaluated by the Inventory of Depressive Symptomatology 30 item -Self Report (IDS-SR30) administered via Interactive Voice Response System (IVRS). Subjects who meet the minimum score of 40 on the IDS-SR30 will proceed with the remaining study related assessments at the Screening visit. Those subjects who meet all inclusion criteria and none of the exclusion criteria will enter a one to two week Screening period to confirm eligibility and to capture Screening data prior to Randomization. At the Randomization visit, all eligibility requirements will be reconfirmed. The subjects who meet all criteria will be randomized to study medication and enter into a six-week treatment period and a subsequent one week Follow-Up period. The total duration of participation for subjects who complete all phases of the study will be approximately 8-9 weeks. During the treatment period, clinic visits will occur at Week 1, Week 2, Week 4, and Week 6. A subsequent clinic visit will occur at the end of the one week Follow-Up period. The clinical site will contact the subjects via telephone at Weeks 3 and 5 to inquire about their wellbeing, query about adverse events and administer the suicidality scale. Eligible subjects will be randomized (1:1) to receive: CX157 60mg three times a day (TID) for a total daily dose of 180 mg, or Placebo administered three times a day. Subjects who discontinue from the study for any reason will not be replaced.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CX157 (TriRima)
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
CX157 (TriRima)
Intervention Description
Six capsules administered three times a day for six weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Sugar Pill
Intervention Description
Six capsules administered three times a day for six weeks.
Primary Outcome Measure Information:
Title
Change From Randomization in Montgomery and Asberg Depression Rating Scale (MADRS)
Description
The Montgomery-Asberg Depression Rating Scale (MADRS) is a 10-item checklist designed to measure the overall severity of depressive symptoms in patients with MDD [Montgomery, 1979]. Items are rated on a scale of 0-6, with scores ranging from 0 to 60 with 0 being symptom free and 60 being the most severe depression. MADRS was assessed at randomization and Weeks 1, 2, 4 and 6 of the study.
Time Frame
Randomization and study end (Week 6).
Secondary Outcome Measure Information:
Title
Montgomery and Asberg Depression Rating Scale (MADRS) Response Rate
Description
MADRS is a 10-item checklist designed to measure the overall severity of depressive symptoms in patients with MDD [Montgomery, 1979]. Items are rated on a scale of 0-6, with scores ranging from 0 to 60 with 0 being symptom free and 60 being the most severe depression. Percentage of participants who achieved a reduction in total MADRS score of at least 50% or more as compared to baseline. MADRS was assessed at randomization and Weeks 1, 2, 4, and 6 of the study. MADRS Responder rate at Week 6 or the last available post treatment result (LOCF) is reported here.
Time Frame
Week 6 or the last available post treatment result (LOCF)
Title
Montgomery and Asberg Depression Rating Scale (MADRS) Remitter Rate
Description
Percentage of participants with total MADRS score of 11 or less. MADRS was assessed at randomization and Weeks 1, 2, 4, and 6 of the study. MADRS Remitter rate at Week 6 or the last available post treatment result (LOCF)is reported here.
Time Frame
Week 6 or the last available post treatment result (LOCF)
Title
The Hospital Anxiety and Depression Scale (HADS)
Description
HADS is a subject-rated questionnaire designed to detect states of anxiety and depression. The HADS consists of 14 questions relating to anxiety or depression, each with a choice of four responses [Zigmond, 1983]. These responses are numerically scored 0-3, with 0 representing the least severe response and 3 representing the most severe response. The highest possible total score is 42. HADS was assessed at randomization and Weeks 1, 2, 4, and 6 of the study. Change from randomization in the HADS total score at Week 6 or the last available post treatment result (LOCF) is reported here.
Time Frame
Randomization and Week 6 or the last available post treatment result (LOCF)
Title
Inventory of Depressive Symptomatology 30 Item -Self Report (IDS -SR 30 Items)
Description
IDSR-SR 30 measures the severity of depressive symptoms by subjects. This scale has 30 items. The minimum score is 0 and the maximum possible IDS-30 score is 90 (the highest severity). IDS-SR30 was administered at screening, randomization and Weeks 1, 2, 4, and 6. Change from randomization in the IDS-SR30 total score at Week 6 or the last available post treatment result (LOCF) is reported here.
Time Frame
Randomization and Week 6 or the last available post treatment result (LOCF)
Title
Clinical Global Impression - Improvement of Illness (CGI-I)
Description
The Clinical Global Impression - Improvement of Illness (CGI-I) was rated on a 7-point scale by the investigator to measure subject's total improvement compared to his/her condition at randomization according to the following scale: 0 = not assessed, 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse. CGI-I was measured at Weeks 1, 2, 4 and 6. Percentage of participants "very much improved" and "much improved" at Week 6 or the last available post treatment result (LOCF) is reported here.
Time Frame
Week 6 or the last available post treatment result (LOCF)
Title
Clinical Global Impression - Severity of Illness (CGI-S)
Description
CGI-S measures the study rater's assessment of the severity of depression illness. CGI-S is rated on a scale of 1-7 as follows: 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, and 7 = among the most extremely ill patients. CGI-S was measured at randomization and Weeks 1, 2, 4 and 6. Percentage of subjects reported as normal, not at all ill; borderline mentally ill; and mildly ill is reported here at Week 6 or the last available post treatment result (LOCF).
Time Frame
Week 6 or the last available post treatment result (LOCF)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female = 18 years of age and <60 years Able to read, understand, converse in English Willing to comply with diet restrictions, concomitant medication restrictions, & all study requirements Good general health as ascertained by:Medical history, Physical exam, Supine & standing vital signs, Clinical lab evaluations, 12-lead Electrocardiogram (ECG) Diagnosis of MDD; A total score =>40 on the IDS-SR30 assessed via IVRS at Screening and Randomization Exclusion Criteria: Subject's current MDD episode is >2 years History of Substance Use Disorder at Screening or 12 months prior (except for nicotine) Current diagnosis of Obsessive-Compulsive Disorder; Panic Disorder or Post-Traumatic Stress Disorder; Anorexia nervosa, Bulimia nervosa, or eating disorder not otherwise specified; Any Axis I Disorder clinically predominant to their MDD (within 6 mo); Presence of psychotic features with current depressive episode; Antisocial or Borderline Personality Disorder At risk for suicide Lack of response to >2 trials of adequate dose & duration of antidepressants of different mechanistic classes Electroconvulsive therapy within 1 year of Screening Subject has taken any psychoactive drug within 2 weeks of Randomization History of cardiac abnormalities including abnormal vital sign measurements Clinically significant abnormal ECG at Screening History within past 2 years of: Significant head trauma; Surgical procedure involving brain or meninges; Encephalitis or meningitis; Degenerative CNS disorder (Alzheimer's or Parkinson's); Epilepsy; Mental retardation Clinically significant Liver Function Test (LFT) and other lab abnormalities A history of hypothyroidism and treatment with a stable dosage of thyroid replacement medication for <6 months prior to Screening A history of hyperthyroidism treated (medically or surgically) <6 months prior to Screening Participation in a clinical investigation of a psychotropic drug within 90 days prior to Screening OR used any other investigational drug within 60 days prior to Screening Presence of any medical history which includes: Hypersensitivity to CX157 or excipients, other MAO inhibitors, or other phenylethylamines; Diabetes mellitus Type I, uncontrolled Type II, or controlled Type II managed with insulin; Malignancy/chemotherapy within 2 years prior to Screening; Malignancy >2 yrs may not preclude participation if the malignancy was local and without metastasis or recurrence and, if treated with chemotherapy, had no nervous system complications (e.g basal cell carcinoma); Pheochromocytoma Positive urine test for drugs of abuse (blood for alcohol) Female subject who is pregnant or lactating Poor likelihood of subject's cooperation or compliance
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Burch, MD
Organizational Affiliation
CeNeRx BioPharma Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Birmingham Research Group
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35216
Country
United States
Facility Name
Southwestern Research, Inc.
City
Beverly Hills
State/Province
California
Country
United States
Facility Name
The George Washington University
City
Washington
State/Province
District of Columbia
Country
United States
Facility Name
Irving S. Kolin, M.D.
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789
Country
United States
Facility Name
Midwest Center for Neurobehavioral Medicine
City
Oakbrook Terrace
State/Province
Illinois
Country
United States
Facility Name
Capital Clinical Research Associates
City
Rockville
State/Province
Maryland
Country
United States
Facility Name
McLean Hospital
City
Belmont
State/Province
Massachusetts
Country
United States
Facility Name
CRI Worldwide, LLC
City
Clementon
State/Province
New Jersey
Country
United States
Facility Name
Fieve Clinical Services
City
New York
State/Province
New York
Country
United States
Facility Name
Richard H. Weisler, M.D., P.A.
City
Raleigh
State/Province
North Carolina
Country
United States
Facility Name
University of Pennsylvania School of Medicine
City
Philadelphia
State/Province
Pennsylvania
Country
United States
Facility Name
FutureSearch Trials
City
Austin
State/Province
Texas
ZIP/Postal Code
78756
Country
United States
Facility Name
Summit Research Network (Seattle), LLC
City
Seattle
State/Province
Washington
Country
United States
Facility Name
Northbrooke Research Center
City
Brown Deer
State/Province
Wisconsin
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
28926793
Citation
Targum SD. Early symptomatic improvement affects treatment outcome in a study of major depressive disorder. J Psychiatr Res. 2017 Dec;95:276-281. doi: 10.1016/j.jpsychires.2017.09.009. Epub 2017 Sep 8.
Results Reference
derived

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A Study of CX157 (TriRima) for the Treatment of Depression

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