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Study of Efficacy and Safety of MIJ821 in Addition to Comprehensive Standard of Care on the Rapid Reduction of Symptoms of Major Depressive Disorder in Subjects Who Have Suicidal Ideation With Intent

Primary Purpose

Major Depressive Disorder With Suicidal Ideation With Intent

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
MIJ821 Intravenous Injection
Placebo Intravenous Injection
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder With Suicidal Ideation With Intent focused on measuring Major Depressive Disorder, Mental disorder, Mood disorder, Depression, Suicide, Suicidal Ideation, Suicidal intent, Suicidal risk, Self-Injurious Behavior, MIJ821, Antidepressive Agent, Psychotropic Drug, Hospitalization, Intravenous, Placebo, Adult

Eligibility Criteria

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

Inclusion Criteria:

  1. Signed informed consent must be obtained prior to participation in the study
  2. Male and female participants, 18 to 65 years of age (inclusive) at screening
  3. DSM-5 defined major depressive disorder (MDD) with a current major depressive episode (MDE) without psychotic features at the time of screening based upon clinical assessment and confirmed by the Mini International Neuropsychiatric Interview (M.I.N.I.) assessed at Screening
  4. Participants must have current suicidal ideation with intent, confirmed by a "Yes" response to Question B3 AND either Question B10 or Question B11 obtained from the M.I.N.I., assessed at Screening
  5. Current suicidal ideation with intent, confirmed by "Yes" response to Question 3 AND either Question 9 or Question 10 obtained from the SSTS at Baseline
  6. Montgomery-Åsberg Depression Rating Scale (MADRS) score > 28 at Screening and before randomization on Day 1
  7. Participants must agree to receive pharmacological standard of care treatment to treat their MDD (as determined by the treating physician(s) based on clinical judgement and local treatment guidelines) during the trial duration
  8. In the physician's opinion, acute psychiatric hospitalization is clinically warranted to treat the patient's condition, and the patient is either already in the hospital or agrees to be hospitalized voluntarily for the required per protocol period

Exclusion Criteria:

  1. Any prior or current diagnosis of bipolar disorder, MDD with psychotic features, schizophrenia, or schizoaffective disorder as obtained from M.I.N.I. at Screening
  2. Patients with acute alcohol or substance use disorder or withdrawal symptoms requiring detoxification, or patients who went through detoxification treatment (inpatient or outpatient) within 1 month before Screening.
  3. Participant has a current clinical diagnosis of autism, dementia, or intellectual disability
  4. History of seizures. Note: childhood febrile seizures are not exclusionary
  5. Participants with borderline personality disorder as obtained from M.I.N.I. at Screening.
  6. Participants with suicidal ideation or behavior caused primarily by another non-MDD condition as obtained from M.I.N.I. at Screening
  7. Participants taking medications prohibited by the protocol
  8. Intake of the following medications/ psychotherapy:

    1. Esketamine or Ketamine 2 months before Screening
    2. Monoamine oxidase inhibitors (MAOIs) 14 days before Screening
    3. Non-stable psychotherapy regimen and/or started less than 6 weeks before Screening
  9. Any other condition (e.g. known liver disease/liver dysfunction, active malignancy, etc.) which in the opinion of the investigator would put the safety of the participant at risk, impede compliance or hinder completion of the study.

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

MIJ821 (mg/kg) - very low dose

MIJ821 (mg/kg) - low dose

MIJ821(mg/kg) - high dose

MIJ821 (mg/kg) - very high dose

Placebo

MIJ821 (mg/kg) - high dose/Placebo

MIJ821 (mg/kg) - very high dose/Placebo

Arm Description

MIJ821 (mg/kg) very low dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29

MIJ821 (mg/kg) low dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29

MIJ821 (mg/kg) high dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29

MIJ821 (mg/kg) very high dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29

40 minutes IV infusion of 0.9% sodium chloride on Day 1, Day 15 and Day 29

MIJ821 (mg/kg) high dose for 40 minutes IV infusion on Day 1/0.9% sodium chloride for 40 minutes IV infusion on Day 15 and Day 29

MIJ821 (mg/kg) very high dose for 40 minutes IV infusion on Day 1/0.9% sodium chloride for 40 minutes IV infusion on Day 15 and Day 29

Outcomes

Primary Outcome Measures

Change from baseline in the total score of the Montgomery Åsberg Depression Rating Scale (MADRS)
The Montgomery Åsberg Depression Rating Scale (MADRS, SIGMA version), is a clinician rated scale designed to measure depression severity and detects changes due to antidepressant treatment. The test 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 possible score of 60. Higher scores represent a more severe condition. The MADRS evaluates apparent sadness, reported sadness, inner tension, sleep, appetite, concentration, lassitude, interest level, pessimistic thoughts and suicidal thoughts. The MADRS will be collected electronically by qualified personnel

Secondary Outcome Measures

Number and severity of treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESI)
Treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESIs) will be collected at all study visits
Pharmacokinetics (PK) of MIJ821 in plasma
PK parameters of MIJ821 in plasma after 1st infusion described by AUClast, Cmax, Tmax and after each other infusion described by Cmax and Tmax. In order to better define the PK profile, the timing of the PK sample collection may be altered based on emergent data.
Percentage of participants meeting response criteria of ≥50% reduction
Response criteria of ≥50% reduction from baseline in MADRS total score over time in the Core Period.
Percentage of participants meeting criteria for sustained response of ≥50% reduction
Sustained response from baseline in MADRS total score for a period of at least four weeks in the Core Period
Percentage of participants meeting remission criteria of MADRS total score of ≤12
Remission criteria of MADRS total score of ≤12 over time in the Core Period
Percentage of participants meeting sustained remission criteria of MADRS total score of ≤12
Remission criteria of MADRS total score of ≤12 sustained for a period of at least four weeks in the Core Period
Percentage of participants meeting criteria for relapse in the Extension Period
Relapse for all patients meeting criteria for relapse over fixed period in the Extension Period
Percentage of relapsing participants meeting response criteria or remission criteria after the first infusion
Relapsing participants meeting response criteria or remission criteria after the first infusion of MIJ821 retreatment in the Extension Period

Full Information

First Posted
January 21, 2021
Last Updated
October 4, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT04722666
Brief Title
Study of Efficacy and Safety of MIJ821 in Addition to Comprehensive Standard of Care on the Rapid Reduction of Symptoms of Major Depressive Disorder in Subjects Who Have Suicidal Ideation With Intent
Official Title
A Double-blind, Placebo-controlled, Randomized Dose-ranging Trial to Investigate Efficacy and Safety of Intravenous MIJ821 Infusion in Addition to Comprehensive Standard of Care on the Rapid Reduction of Symptoms of Major Depressive Disorder in Subjects Who Have Suicidal Ideation With Intent
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Terminated
Why Stopped
Terminated by sponsor
Study Start Date
July 20, 2021 (Actual)
Primary Completion Date
July 20, 2023 (Actual)
Study Completion Date
July 20, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

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
Study of efficacy and safety of MIJ821 in addition to comprehensive standard of care on the rapid reduction of symptoms of Major Depressive Disorder (MDD) in subjects who have suicidal ideation with intent
Detailed Description
The main purpose of this study is to support the dose selection for future Phase III clinical trials by evaluating efficacy and safety of four MIJ821 doses (very low, low, high and very high) administered every other week by intravenous infusion on top of pharmacological antidepressant treatment, compared with placebo, for the rapid reduction of the symptoms of MDD in participants who have suicidal ideation with intent. In addition, the study will explore the effect of single dose administration of very high and high doses to treat MDD in participants who have suicidal ideation with intent. The study consists of three periods: a Screening Period (up to 48 hrs), a double-blind Core Period (6 weeks) and Extension Period (up to 52 weeks). The Extension Period will explore durability of the effect of the study treatment and the effect of MIJ821 on relapse rate, as well as safety of repeated MIJ821 administration. All patients in the extension period will receive active treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder With Suicidal Ideation With Intent
Keywords
Major Depressive Disorder, Mental disorder, Mood disorder, Depression, Suicide, Suicidal Ideation, Suicidal intent, Suicidal risk, Self-Injurious Behavior, MIJ821, Antidepressive Agent, Psychotropic Drug, Hospitalization, Intravenous, Placebo, Adult

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MIJ821 (mg/kg) - very low dose
Arm Type
Experimental
Arm Description
MIJ821 (mg/kg) very low dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29
Arm Title
MIJ821 (mg/kg) - low dose
Arm Type
Experimental
Arm Description
MIJ821 (mg/kg) low dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29
Arm Title
MIJ821(mg/kg) - high dose
Arm Type
Experimental
Arm Description
MIJ821 (mg/kg) high dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29
Arm Title
MIJ821 (mg/kg) - very high dose
Arm Type
Experimental
Arm Description
MIJ821 (mg/kg) very high dose for 40 minutes IV infusion on Day 1, Day 15 and Day 29
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
40 minutes IV infusion of 0.9% sodium chloride on Day 1, Day 15 and Day 29
Arm Title
MIJ821 (mg/kg) - high dose/Placebo
Arm Type
Experimental
Arm Description
MIJ821 (mg/kg) high dose for 40 minutes IV infusion on Day 1/0.9% sodium chloride for 40 minutes IV infusion on Day 15 and Day 29
Arm Title
MIJ821 (mg/kg) - very high dose/Placebo
Arm Type
Experimental
Arm Description
MIJ821 (mg/kg) very high dose for 40 minutes IV infusion on Day 1/0.9% sodium chloride for 40 minutes IV infusion on Day 15 and Day 29
Intervention Type
Drug
Intervention Name(s)
MIJ821 Intravenous Injection
Intervention Description
MIJ821 supplied in vials to be prepared on a mg/kg basis and to be administered for 40 minutes IV infusion on Day 1, Day 15 and Day 29
Intervention Type
Drug
Intervention Name(s)
Placebo Intravenous Injection
Intervention Description
40 minutes IV infusion of 0.9% sodium chloride solution on Day1, Day 15 and Day 29
Primary Outcome Measure Information:
Title
Change from baseline in the total score of the Montgomery Åsberg Depression Rating Scale (MADRS)
Description
The Montgomery Åsberg Depression Rating Scale (MADRS, SIGMA version), is a clinician rated scale designed to measure depression severity and detects changes due to antidepressant treatment. The test 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 possible score of 60. Higher scores represent a more severe condition. The MADRS evaluates apparent sadness, reported sadness, inner tension, sleep, appetite, concentration, lassitude, interest level, pessimistic thoughts and suicidal thoughts. The MADRS will be collected electronically by qualified personnel
Time Frame
Baseline (first infusion) at 24 hours and up to 52 weeks
Secondary Outcome Measure Information:
Title
Number and severity of treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESI)
Description
Treatment-emergent adverse events (TEAEs) and adverse events of special interest (AESIs) will be collected at all study visits
Time Frame
Baseline up to 6 weeks
Title
Pharmacokinetics (PK) of MIJ821 in plasma
Description
PK parameters of MIJ821 in plasma after 1st infusion described by AUClast, Cmax, Tmax and after each other infusion described by Cmax and Tmax. In order to better define the PK profile, the timing of the PK sample collection may be altered based on emergent data.
Time Frame
Baseline up to 52 weeks
Title
Percentage of participants meeting response criteria of ≥50% reduction
Description
Response criteria of ≥50% reduction from baseline in MADRS total score over time in the Core Period.
Time Frame
Baseline up to 6 weeks
Title
Percentage of participants meeting criteria for sustained response of ≥50% reduction
Description
Sustained response from baseline in MADRS total score for a period of at least four weeks in the Core Period
Time Frame
Baseline up to 6 weeks
Title
Percentage of participants meeting remission criteria of MADRS total score of ≤12
Description
Remission criteria of MADRS total score of ≤12 over time in the Core Period
Time Frame
Baseline up to 6 weeks
Title
Percentage of participants meeting sustained remission criteria of MADRS total score of ≤12
Description
Remission criteria of MADRS total score of ≤12 sustained for a period of at least four weeks in the Core Period
Time Frame
Baseline up to 6 weeks
Title
Percentage of participants meeting criteria for relapse in the Extension Period
Description
Relapse for all patients meeting criteria for relapse over fixed period in the Extension Period
Time Frame
From 6 weeks up to 52 weeks
Title
Percentage of relapsing participants meeting response criteria or remission criteria after the first infusion
Description
Relapsing participants meeting response criteria or remission criteria after the first infusion of MIJ821 retreatment in the Extension Period
Time Frame
From 6 weeks up to 52 weeks

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: Signed informed consent must be obtained prior to participation in the study Male and female participants, 18 to 65 years of age (inclusive) at screening DSM-5 defined major depressive disorder (MDD) with a current major depressive episode (MDE) without psychotic features at the time of screening based upon clinical assessment and confirmed by the Mini International Neuropsychiatric Interview (M.I.N.I.) assessed at Screening Participants must have current suicidal ideation with intent, confirmed by a "Yes" response to Question B3 AND either Question B10 or Question B11 obtained from the M.I.N.I., assessed at Screening Current suicidal ideation with intent, confirmed by "Yes" response to Question 3 AND either Question 9 or Question 10 obtained from the SSTS at Baseline Montgomery-Åsberg Depression Rating Scale (MADRS) score > 28 at Screening and before randomization on Day 1 Participants must agree to receive pharmacological standard of care treatment to treat their MDD (as determined by the treating physician(s) based on clinical judgement and local treatment guidelines) during the trial duration In the physician's opinion, acute psychiatric hospitalization is clinically warranted to treat the patient's condition, and the patient is either already in the hospital or agrees to be hospitalized voluntarily for the required per protocol period Exclusion Criteria: Any prior or current diagnosis of bipolar disorder, MDD with psychotic features, schizophrenia, or schizoaffective disorder as obtained from M.I.N.I. at Screening Patients with acute alcohol or substance use disorder or withdrawal symptoms requiring detoxification, or patients who went through detoxification treatment (inpatient or outpatient) within 1 month before Screening. Participant has a current clinical diagnosis of autism, dementia, or intellectual disability History of seizures. Note: childhood febrile seizures are not exclusionary Participants with borderline personality disorder as obtained from M.I.N.I. at Screening. Participants with suicidal ideation or behavior caused primarily by another non-MDD condition as obtained from M.I.N.I. at Screening Participants taking medications prohibited by the protocol Intake of the following medications/ psychotherapy: Esketamine or Ketamine 2 months before Screening Monoamine oxidase inhibitors (MAOIs) 14 days before Screening Non-stable psychotherapy regimen and/or started less than 6 weeks before Screening Any other condition (e.g. known liver disease/liver dysfunction, active malignancy, etc.) which in the opinion of the investigator would put the safety of the participant at risk, impede compliance or hinder completion of the study.
Facility Information:
Facility Name
Novartis Investigative Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294-3300
Country
United States
Facility Name
Novartis Investigative Site
City
Culver City
State/Province
California
ZIP/Postal Code
90230
Country
United States
Facility Name
Novartis Investigative Site
City
Farmington
State/Province
Connecticut
ZIP/Postal Code
06030-3100
Country
United States
Facility Name
Novartis Investigative Site
City
Oakland Park
State/Province
Florida
ZIP/Postal Code
33334
Country
United States
Facility Name
Novartis Investigative Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30331
Country
United States
Facility Name
Novartis Investigative Site
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20850
Country
United States
Facility Name
Novartis Investigative Site
City
DeSoto
State/Province
Texas
ZIP/Postal Code
75115
Country
United States
Facility Name
Novartis Investigative Site
City
Buenos Aires
ZIP/Postal Code
C1429DUC
Country
Argentina
Facility Name
Novartis Investigative Site
City
Fortaleza
State/Province
Ceara
ZIP/Postal Code
60430-270
Country
Brazil
Facility Name
Novartis Investigative Site
City
Sao Bernardo do Campo
State/Province
Sao Paulo
ZIP/Postal Code
09726-150
Country
Brazil
Facility Name
Novartis Investigative Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1W8
Country
Canada
Facility Name
Novartis Investigative Site
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
Facility Name
Novartis Investigative Site
City
Muenchen
ZIP/Postal Code
81377
Country
Germany
Facility Name
Novartis Investigative Site
City
Toyoake-city
State/Province
Aichi
ZIP/Postal Code
470-1168
Country
Japan
Facility Name
Novartis Investigative Site
City
Bunkyo-ku
State/Province
Tokyo
ZIP/Postal Code
113-8519
Country
Japan
Facility Name
Novartis Investigative Site
City
Kodaira
State/Province
Tokyo
ZIP/Postal Code
187-8551
Country
Japan
Facility Name
Novartis Investigative Site
City
Seremban
State/Province
Negeri Sembilan
ZIP/Postal Code
70300
Country
Malaysia
Facility Name
Novartis Investigative Site
City
Kuala Lumpur
ZIP/Postal Code
59100
Country
Malaysia
Facility Name
Novartis Investigative Site
City
Monterrey
State/Province
Nuevo Leon
ZIP/Postal Code
64460
Country
Mexico
Facility Name
Novartis Investigative Site
City
Mazatlan
State/Province
Sinaloa
ZIP/Postal Code
82140
Country
Mexico
Facility Name
Novartis Investigative Site
City
San Luis Potosi
ZIP/Postal Code
78213
Country
Mexico
Facility Name
Novartis Investigative Site
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Lodz
State/Province
Lodzkie
ZIP/Postal Code
91-229
Country
Poland
Facility Name
Novartis Investigative Site
City
Pruszkow
State/Province
Mazowieckie
ZIP/Postal Code
05-802
Country
Poland
Facility Name
Novartis Investigative Site
City
Bialystok
ZIP/Postal Code
15 276
Country
Poland
Facility Name
Novartis Investigative Site
City
Gdansk
ZIP/Postal Code
80 952
Country
Poland
Facility Name
Novartis Investigative Site
City
Swiecie n/W
ZIP/Postal Code
86-100
Country
Poland
Facility Name
Novartis Investigative Site
City
Moscow
ZIP/Postal Code
107258
Country
Russian Federation
Facility Name
Novartis Investigative Site
City
Moscow
ZIP/Postal Code
115419
Country
Russian Federation
Facility Name
Novartis Investigative Site
City
Barcelona
State/Province
Catalunya
ZIP/Postal Code
08003
Country
Spain
Facility Name
Novartis Investigative Site
City
Barcelona
State/Province
Catalunya
ZIP/Postal Code
08035
Country
Spain
Facility Name
Novartis Investigative Site
City
Palma De Mallorca
State/Province
Islas Baleares
ZIP/Postal Code
07120
Country
Spain
Facility Name
Novartis Investigative Site
City
Vitoria-Gasteiz
State/Province
Pais Vasco
ZIP/Postal Code
01004
Country
Spain
Facility Name
Novartis Investigative Site
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Novartis Investigative Site
City
Barcelona
ZIP/Postal Code
08041
Country
Spain
Facility Name
Novartis Investigative Site
City
Taipei
ZIP/Postal Code
10048
Country
Taiwan
Facility Name
Novartis Investigative Site
City
Taipei
ZIP/Postal Code
11217
Country
Taiwan
Facility Name
Novartis Investigative Site
City
Nilufer
State/Province
Bursa
ZIP/Postal Code
16285
Country
Turkey
Facility Name
Novartis Investigative Site
City
Bursa
State/Province
Gorukle
ZIP/Postal Code
16059
Country
Turkey
Facility Name
Novartis Investigative Site
City
Istanbul
State/Province
TUR
ZIP/Postal Code
34098
Country
Turkey
Facility Name
Novartis Investigative Site
City
Izmir
ZIP/Postal Code
35100
Country
Turkey

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on https://www.clinicalstudydatarequest.com/

Learn more about this trial

Study of Efficacy and Safety of MIJ821 in Addition to Comprehensive Standard of Care on the Rapid Reduction of Symptoms of Major Depressive Disorder in Subjects Who Have Suicidal Ideation With Intent

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