Phase 3
N=431
A Study to Evaluate the Efficacy of FK949E in Bipolar Disorder Patients With Major Depressive Episodes
Bipolar Disorder
Bottom Line
View on ClinicalTrials.gov: NCT01725308 ↗Enrolled (actual)
431
Serious AEs
1.6%
Results posted
Feb 2017
Primary outcome: Primary: Change From Baseline to End of Treatment Period I in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score — -10.1; -14.4; -12.6 units on a scale — p=0.034
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- FK949E (Drug); Placebo (Drug)
- Age
- Adult · 20+ yrs
- Sex
- All
- Sponsor
- Astellas Pharma Inc
- Primary completion
- Aug 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline to End of Treatment Period I in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score |
-10.1; -14.4; -12.6 | 0.034 sig |
| SECONDARY Change From Baseline in MADRS Total Score (Treatment Period I) |
-3.5; -6.4; -5.1; -5.1; -10.0; -8.3 | — |
| SECONDARY Change From Baseline in MADRS Total Score (Combined Treatment Period I and II) |
-6.4; -5.1; -10.0; -8.5; -12.0; -10.6 | — |
| SECONDARY Number of Participants With MADRS Response (Treatment Period I) |
4; 6; 15; 13; 17; 41 | — |
| SECONDARY Number of Participants With MADRS Response (Combined Treatment Period I and II) |
6; 15; 16; 37; 23; 49 | — |
| SECONDARY Number of Participants With MADRS Remission (Treatment Period I) |
4; 4; 12; 9; 12; 28 | — |
| SECONDARY Number of Participants With MADRS Remission (Combined Treatment Period I and II) |
4; 12; 11; 25; 20; 36 | — |
| SECONDARY Change From Baseline in Hamilton Depression Rating Scale (HAM-D17) Total Score (Treatment Period I) |
-3.4; -5.9; -4.5; -5.1; -8.7; -7.0 | 0.033 sig |
| SECONDARY Change From Baseline in HAM-D17 (Combined Treatment Period I and II) |
-5.9; -4.5; -8.8; -7.1; -10.3; -8.4 | — |
| SECONDARY Number of Participants With HAM-D17 Response (Treatment Period I) |
10; 7; 14; 29; 22; 42 | — |
| SECONDARY Number of Participants With HAM-D17 Response (Combined Treatment Period I and II) |
7; 14; 22; 39; 27; 50 | — |
| SECONDARY Change From Baseline in Clinical Global Impression-Bipolar Disorder-Severity (CGI-BP-S): Mania (Treatment Period I) |
-0.0; 0.0; 0.0; -0.0; -0.0; 0.0 | — |
| SECONDARY Change From Baseline in CGI-BP-S: Mania (Combined Treatment Period I and II) |
0.0; 0.0; 0.0; -0.0; -0.0; 0.0 | — |
| SECONDARY Change From Baseline in CGI-BP-S: Depression (Treatment Period I) |
-0.3; -0.5; -0.4; -0.5; -0.8; -0.7 | — |
| SECONDARY Change From Baseline in CGI-BP-S: Depression (Combined Treatment Period I and II) |
-0.5; -0.4; -0.8; -0.7; -1.0; -1.0 | — |
| SECONDARY Change From Baseline in CGI-BP-S: Overall Bipolar Illness (Treatment Period I) |
-0.3; -0.4; -0.4; -0.5; -0.7; -0.7 | — |
| SECONDARY Change From Baseline in CGI-BP-S: Overall Bipolar Illness (Combined Treatment Period I and II) |
-0.4; -0.4; -0.7; -0.7; -0.9; -1.0 | — |
| SECONDARY Clinical Global Impression-Bipolar Disorder-Change (CGI-BP-C): Mania (Treatment Period I) |
4.0; 4.0; 4.0; 4.0; 4.0; 4.0 | — |
| SECONDARY CGI-BP-C: Mania (Combined Treatment Period I and II) |
4.0; 4.0; 4.0; 4.0; 4.0; 4.0 | — |
| SECONDARY CGI-BP-C: Depression (Treatment Period I) |
3.7; 3.5; 3.5; 3.6; 3.1; 3.2 | — |
| SECONDARY CGI-BP-C: Depression (Combined Treatment Period I and II) |
3.5; 3.5; 3.1; 3.1; 2.9; 2.9 | — |
| SECONDARY CGI-BP-C: Overall Bipolar Illness (Treatment Period I) |
3.7; 3.5; 3.5; 3.6; 3.1; 3.2 | — |
| SECONDARY CGI-BP-C: Overall Bipolar Illness (Combined Treatment Period I and II) |
3.5; 3.5; 3.1; 3.2; 2.9; 2.9 | — |
| SECONDARY Number of Participants With Adverse Events (Treatment Period I) |
81; 55; 149; 52; 50; 133 | — |
| SECONDARY Number of Participants With Adverse Events (Combined Treatment Period I and II) |
110; 63; 171; 100; 60; 159 | — |
| SECONDARY Change From Baseline in Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS): Total Score (Treatment Period I) |
0.0; 0.0; 0.2; 0.1; 0.0; 0.1 | — |
| SECONDARY Change From Baseline in DIEPSS: Total Score (Combined Treatment Period I and II) |
0.0; 0.2; 0.0; 0.1; 0.1; 0.1 | — |
| SECONDARY Change From Baseline in DIEPSS: Parkinsonism (Treatment Period I) |
0.0; -0.1; 0.0; 0.0; -0.1; -0.1 | — |
| SECONDARY Change From Baseline in DIEPSS: Parkinsonism (Combined Treatment Period I and II) |
-0.1; 0.0; -0.1; -0.1; 0.0; -0.1 | — |
| SECONDARY Change From Baseline in Young Mania Rating Scale (YMRS) (Treatment Period I) |
-0.1; -0.6; -0.6; -0.2; -1.0; -0.7 | — |
| SECONDARY Change From Baseline in YMRS (Combined Treatment Period I and II) |
-0.6; -0.6; -1.0; -0.7; -1.2; -0.7 | — |
| SECONDARY Number of Participants With an Affirmative Response to Columbia Suicide Severity Rating Scale (C-SSRS): Suicidal Ideation (Treatment Period I) |
39; 14; 34; 10; 3; 10 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Ideation - Wish to be Dead (Combined Treatment Period I and II) |
14; 34; 6; 15; 17; 9 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Ideation - Suicidal Thoughts (Combined Treatment Period I and II) |
3; 10; 2; 2; 4; 2 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Ideation - Suicidal Thoughts With Method (Combined Treatment Period I and II) |
0; 5; 0; 0; 1; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Ideation - Suicidal Intent Without a Plan (Combined Treatment Period I and II) |
0; 1; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Ideation - Suicidal Intent With a Plan (Combined Treatment Period I and II) |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors (Treatment Period I) |
0; 0; 0; 1; 0; 2 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Suicide Attempt (Combined Treatment Period I and II) |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Self-injury Behavior Without Intent (Combined Treatment Period I and II) |
0; 2; 0; 2; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Discontinued Attempt (Combined Treatment Period I and II) |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Interrupted Attempt (Combined Treatment Period I and II) |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Preliminary Act to Suicide (Combined Treatment Period I and II |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Suicidal Behavior (Combined Treatment Period I and II) |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With an Affirmative Response to C-SSRS: Suicidal Behaviors - Completed Suicide (Combined Treatment Period I and II) |
0; 0; 0; 0; 0; 0 | — |
Summary
In period I, the treatment effect of FK949E was compared with that of placebo in a blind manner in bipolar disorder patients with major depressive episodes. In period II, the long-term safety and efficacy of FK949E was evaluated.
Eligibility Criteria
Inclusion Criteria
- Diagnosis of bipolar I or II disorder as specified in the Diagnostic and Statistical Manual of Mental Disorders Ver. 4 Text Revision (DSM-IV-TR,) with a major depressive episode
- The Hamilton Depression Rating Scale (HAM-D17) total score of 20 points or more and HAM-D17 depressed mood score of 2 points or more
- Able to participate in the study with understanding of and compliance with subject requirements during the study in the investigator's or subinvestigator's opinion
Exclusion Criteria
- Concurrent or previous history of DSM-IV-TR Axis I disorders, except bipolar disorder, within the last 6 months before informed consent
- Concurrence of DSM-IV-TR Axis II disorder that is considered to greatly affect patient's current mental status
- The Young Mania Rating Scale (YMRS) total score of 13 points or more
- Nine or more mood episodes within the last 12 months before informed consent
- Lack of response to at least 6-week treatment with at least 2 antidepressants for the current major depressive episode in the investigator's or subinvestigator's opinion
- History of abuse or dependence of alcohol or substances other than caffeine and nicotine
- Treatment with a depot antipsychotic within the last 42 days before primary registration
- Unable to stop taking mood stabilizers (lithium carbonate and/or sodium valproate), lamotrigine, antipsychotics, or antidepressants from 7 days before secondary registration
- Unable to stop taking antiepileptics (except lamotrigine and sodium valproate), antianxiety agents, hypnotics, sedatives, psychostimulants, antiparkinsonian agents, cerebral ameliorators, antidementia agents, or anorectics, except those specified as conditionally-allowed concomitant drugs, after primary registration
- Electroconvulsive therapy within the last 76 days before primary registration
- The current major depressive episode persisting for more than 12 months or less than 4 weeks before informed consent
- A possible need of psychotherapy during the study period (unless the therapy has been commenced at least 76 days before primary registration and been maintained on a fixed level at fixed frequency)
- Documented or suspected conditions such as renal failure, hepatic failure, serious cardiac disease, hepatitis B, hepatitis C, or acquired immunodeficiency syndrome (AIDS) (or to be a carrier of hepatitis B, hepatitis C, or AIDS)
- Concurrence of malignancy or history of cured malignancy within 5 years
- Concurrence of uncontrolled hypertension (defined as a systolic blood pressure of 180 mmHg or more, or a diastolic blood pressure of 110 mmHg or more at primary registration) or unstable angina that may worsen with the study or may affect the study results based on the clinical judgment of the investigator or sub-investigator
- Concurrence of hypotension (defined as a systolic blood pressure of less than 100 mmHg at primary registration) or orthostatic hypotension
- History of transient, idiopathic orthostatic hypotension, with or without pre-syncope symptoms or syncope, or a current condition susceptible to transient hypotension, such as dehydration and decreased blood volume
- Concurrent or previous history of cerebrovascular disease or transient ischemic attack (TIA)
- Abnormal laboratory or electrocardiographic findings considered clinically significant in the investigator's or subinvestigator's opinion (in reference to grade 3 of the Adverse Drug Reactions Severity Grading Criteria [Notification No. 80 of the Safety Division, Pharmaceutical Affairs Bureau, Ministry of Health and Welfare dated 29 June 1992])
- Participation in another clinical study or post-marketing study within the last 12 weeks before informed consent
- History of quetiapine therapy during the current major depressive episode
- Pregnant or lactating women
Data sourced from ClinicalTrials.gov (NCT01725308). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.