Phase 2
N=287
A Study to Evaluate the Efficacy and Safety of JNJ-42847922 as Adjunctive Therapy to Antidepressants in Adult Participants With Major Depressive Disorder Who Have Responded Inadequately to Antidepressant Therapy
Depressive Disorder, Major
Bottom Line
View on ClinicalTrials.gov: NCT03227224 ↗Enrolled (actual)
287
Serious AEs
0.2%
Results posted
Feb 2022
Primary outcome: Primary: Change From Baseline to Week 6 in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score — -12.3; -12.2; -15.0; -14.7 score on a scale — p=0.724
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Placebo (Drug); JNJ-42847922 (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Janssen Research & Development, LLC
- Primary completion
- Jan 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline to Week 6 in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score |
-12.3; -12.2; -15.0; -14.7 | 0.724 |
| PRIMARY Percentage of Participants With Treatment-emergent Adverse Events as a Measure of Safety and Tolerability |
40.9; 33.3; 41.0; 36.5 | — |
| PRIMARY Percentage of Participants With Clinically Significant Laboratory Abnormalities |
0; 0; 0; 1.9; 0; 0 | — |
| PRIMARY Change From Baseline in Vital Signs (Systolic Blood Pressure [SBP] and Diastolic Blood Pressure [DBP]) at Day 8 |
-0.7; -0.5; 0.7; 0.9; -0.4; -0.8 | — |
| PRIMARY Change From Baseline in Vital Signs (SBP and DBP) at Day 22 |
0.0; -1.2; -0.4; 2.4; 0.2; -1.2 | — |
| PRIMARY Change From Baseline in Vital Signs (SBP and DBP) at Day 42 |
-0.5; 0.3; -0.8; 2.9; -0.5; 1.1 | — |
| PRIMARY Change From Baseline in Vital Signs (SBP and DBP) at Endpoint (Week 6) |
-0.3; 0.6; -0.6; 2.8; -0.3; 1.0 | — |
| PRIMARY Change From Baseline in Vital Sign (Pulse Rate [PR]) at Day 8 |
-0.1; -0.7; 0.9; 1.3; 0; -1.2 | — |
| PRIMARY Change From Baseline in Vital Sign (PR) at Day 22 |
1.4; 0.7; 1.5; 0.3; 1.5; -0.7 | — |
| PRIMARY Change From Baseline in Vital Sign (PR) at Day 42 |
0.8; -1.4; 1.5; -0.6; 0.3; -2.8 | — |
| PRIMARY Change From Baseline in Vital Sign (PR) at Endpoint (Week 6) |
0.4; -1.6; 2.1; -0.5; 0.2; -2.4 | — |
| PRIMARY Change From Baseline in Vital Sign (Temperature) at Day 8 |
-0.01; -0.05; 0.02; 0.06 | — |
| PRIMARY Change From Baseline in Vital Sign (Temperature) at Day 22 |
-0.02; -0.01; -0.02; 0.02 | — |
| PRIMARY Change From Baseline in Vital Sign (Temperature) at Day 42 |
0.02; -0.04; -0.05; 0.05 | — |
| PRIMARY Change From Baseline in Vital Sign (Temperature) at Endpoint (Week 6) |
0.02; -0.03; -0.06; 0.06 | — |
| PRIMARY Change From Baseline in Physical Examination (Waist Circumference) at Day 42 |
0.31; -0.50; 0.00; -0.48 | — |
| PRIMARY Change From Baseline in Physical Examination (Body Weight) at Day 42 |
0.19; 0.01; 0.05; 0.61 | — |
| PRIMARY Change From Baseline in Physical Examination (Body Mass Index [BMI]) at Day 42 |
0.07; 0.01; 0.02; 0.22 | — |
| PRIMARY Percentage of Participants With Treatment-emergent Abnormal Electrocardiogram (ECG) Values Outside Pre-defined Limits |
0.7; 0; 3.4; 6.0; 0.7; 0 | — |
| PRIMARY Percentage of Participants With Most Severe Post-baseline Potentially Suicide-Related Category Using Columbia Suicide Severity Rating Scale (C-SSRS) |
94.9; 96.9; 96.7; 94.1; 5.1; 3.1 | — |
| PRIMARY Change From Baseline in Sexual Functioning as Measured by Arizona Sexual Experiences Scale (ASEX) Score at Day 42 |
-1.4; -2.2; -2.4; -2.5 | — |
| PRIMARY Physician Withdrawal Checklist-20 (PWC-20) Total Score at Day 43 |
0.9; 0.2; 0.7; 0.5 | — |
| PRIMARY Physician Withdrawal Checklist-20 (PWC-20) Total Score From Day 49 to Day 56 |
0.9; 0.4; 0.8; 0.7 | — |
| SECONDARY Change From Baseline in the MADRS Total Score by Baseline Insomnia Severity Index (ISI) Score at Day 42 |
-13.3; -12.6; -13.0; -14.9; -11.6; -10.4 | — |
| SECONDARY Change From Baseline in ISI Total Score at DB Endpoint (Up to Week 6) |
-6.3; -4.9; -8.7; -8.5 | — |
| SECONDARY Percentage of Participants With Response on Depressive Symptoms Scale Based on MADRS Total Score |
28.5; 24.2; 41.0; 38.5 | — |
| SECONDARY Percentage of Participants With Remission of Depressive Symptoms Based on MADRS Total Score |
19.0; 15.2; 29.5; 26.9; 17.5; 9.1 | — |
| SECONDARY Change From Baseline in Structured Interview Guide for the Hamilton Anxiety Rating Scale (HAM-A) Total Score at Day 42 |
-8.7; -9.9; -9.6; -9.9 | — |
| SECONDARY Percentage of Participants With Response on Anxiety Symptoms Scale Based on HAM-A Total Score |
37.2; 57.6; 50.8; 46.2 | — |
| SECONDARY Change From Baseline in Clinical Global Impression-Severity (CGI-S) Score at DB Endpoint (Up to Week 6) |
-1.0; -1.0; -1.0; -1.0 | — |
| SECONDARY Change From Baseline in the Sheehan Disability Scale (SDS) Score at Day 42 |
-7.9; -7.5; -7.9; -5.9 | — |
| SECONDARY Change From Baseline in the MADRS Total Score at Day 42 in Participants With Major Depressive Disorder (MDD) With Anxious Distress Versus Participants With MDD Without Anxious Distress |
-13.9; -11.0; -16.9; -15.3; -9.7; -13.4 | — |
| SECONDARY Change From Baseline in Salivary Cortisol Levels, Measured Upon Awakening at Days 8, 22 and 42 |
0.2; 0.7; 0.0; -0.4; 0.4; 2.1 | — |
| SECONDARY Plasma Concentrations of Seltorexant and Its Metabolites (M12 and M16) |
181; 277; 535; 199; 374; 647 | — |
| SECONDARY Change From Baseline in Depressive Symptoms Using the Patient Health Questionnaire 9-Item (PHQ-9) at DB Endpoint (Up to Week 6) |
-7.3; -6.2; -8.6; -7.0 | — |
| SECONDARY Change From Baseline in Anhedonia Using the Snaith-Hamilton Pleasure Scale (SHAPS) Score at DB Endpoint (Up to Week 6) |
-3.6; -2.3; -4.2; -3.2 | — |
| SECONDARY Change From Baseline in Sleep Disturbance Using the Patient Reported Outcome Measurement Information System-Sleep Disturbance (PROMIS-SD) Short Form at DB Endpoint (Up to Week 6) |
-6.4; -5.1; -10.2; -10.9 | — |
| SECONDARY Change From Baseline in Fatigue Using the Patient Reported Outcome Measurement Information System-Fatigue (PROMIS-F) Short Form Subscale Score at DB Endpoint (Up to Week 6) |
-7.7; -7.4; -9.4; -8.0 | — |
| SECONDARY Change From Baseline in Severity of Depression Using the Patient Global Impression-Severity (PGI-S) Score at DB Endpoint (Up to Week 6) |
-1.0; 0.0; -1.0; -1.0 | — |
| SECONDARY Change From Baseline in European Quality of Life 5 Dimensions (EQ-5D-5L) Heath State Index Total Score at DB Endpoint (Up to Week 6) |
0.188; 0.143; 0.229; 0.158 | — |
| SECONDARY Change From Baseline in EQ-5D-5L Visual Analog Scale (VAS) Total Score at Endpoint (Up to Week 6) |
17.4; 8.9; 23.4; 20.1 | — |
| SECONDARY Change From Baseline in Work Productivity and Limitations Using the Work Limitations Questionnaire (WLQ) Short Form Score at DB Endpoint (Up to Week 6) |
-21.3; -18.2; -21.8; -20.8; -15.2; -23.5 | — |
Summary
The purpose of this study is to assess the dose-response relationship of 2 doses of JNJ-42847922 before interim analysis, and potentially 3 doses based on interim analysis results, compared to placebo as adjunctive therapy to an antidepressant drug in improving depressive symptoms in participants with Major Depressive Disorder (MDD) who have had an inadequate response to current antidepressant therapy with a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI); and to assess the safety and tolerability of JNJ-42847922 compared to placebo as adjunctive therapy to an antidepressant in participants with MDD.
Eligibility Criteria
Inclusion Criteria
- Men or women of non-childbearing potential (WONCBP), aged 18 to 70 years (inclusive). A WONCBP is defined as: a).Postmenopausal: A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. b). Permanently sterile: Permanent sterilization methods include hysterectomy, bilateral salpingectomy, bilateral tubal occlusion/ligation procedures, and bilateral oophorectomy. c). If reproductive status is questionable, additional evaluation should be considered
- Meet Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) diagnostic criteria for major depressive disorder (MDD), without psychotic features, based upon clinical assessment and confirmed by the Structured Clinical Interview for DSM-5 Axis I Disorders- Clinical Trials Version (SCID-CT). In addition their major depressive episode must be deemed "valid" using the SCID Screening Questionnaire (SSQ) interview administered by remote, independent raters. The length of the current depressive episode must be less than or equal to ( =)25 (performed by independent, centralized remote raters) at screening and must not demonstrate a clinically significant improvement (that is, an improvement of greater than [>]20% on their MADRS total score) from the screening to baseline visit
- Must be otherwise healthy on the basis of physical examination, medical history, vital signs, 12-lead electrocardiogram (ECG), and clinical laboratory tests performed at screening. If the results of the clinical laboratory tests are outside the normal reference ranges, the participant could be included only if the investigator judges the abnormalities or deviations from normal to be not clinically significant or to be appropriate and reasonable for the population under study. This determination must be recorded in the participant's source documents and initialed by the investigator
Exclusion Criteria
- Has a history of, or current signs and symptoms of, severe renal insufficiency (creatinine clearance <30 milliliter per minute [mL/min]); moderate to severe hepatic insufficiency (Child-Pugh Score 7-9), significant or unstable cardiovascular, respiratory, gastrointestinal, neurologic (including narcolepsy), hematologic, rheumatologic, immunologic or endocrine disorders (including uncontrolled hypo- or hyperthyroidism or diabetes, or insulin-dependent diabetes mellitus). Participants with non-insulin dependent diabetes mellitus who are well-controlled (hemoglobin A1C [HbA1C] <=7.5% and fasting glucose <126 milligram per deciliter [mg/dL] at screening) could be eligible to participate if otherwise medically healthy, and if on a stable regimen of glucose-lowering medications for at least 2 months prior to screening
- Has signs and symptoms of Cushing's Disease, Addison's Disease, primary amenorrhea, or other evidence of significant medical disorders of the hypothalamic-pituitary-adrenal (HPA) axis
- Has a history of lack of response to 3 or more adequate antidepressant treatments, as indicated by no or minimal (<= 25% improvement in symptoms) when treated with an antidepressant of adequate dose (per MGH-ATRQ) and duration (at least 4 weeks)
- Has history or current diagnosis of a psychotic disorder, bipolar disorder, mental retardation, autism spectrum disorder, or borderline personality disorder, somatoform disorders, chronic fatigue syndrome or fibromyalgia
- Has any significant primary sleep disorder, including but not limited to obstructive sleep apnea, restless leg syndrome, or parasomnias
Data sourced from ClinicalTrials.gov (NCT03227224). 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.