Phase 2
Completed N=107
A Study to Compare the Efficacy, Safety, and Tolerability of JNJ-42847922 Versus Quetiapine Extended-Release as Adjunctive Therapy to Antidepressants in Adult Participants With Major Depressive Disorder Who Have Responded Inadequately to Antidepressant Therapy
Depressive Disorder, Major
Source: ClinicalTrials.gov NCT03321526 ↗
Enrolled (actual)
107
Serious AEs
1.4%
Results posted
Aug 2022
Primary outcomePrimary: Time to All-Cause Discontinuation of Study Drug — NA; NA days — p=0.5355
Summary
The purpose of this study is to assess the efficacy of flexibly dosed JNJ-42847922 (20 milligram [mg] or 40 mg) compared to flexibly dosed quetiapine extended-release (XR) (150 mg or 300 mg) as adjunctive therapy to an antidepressant drug in delaying time to all-cause discontinuation of study drug over a 6-months (24 weeks) treatment period, 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).
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Time to All-Cause Discontinuation of Study Drug |
NA; NA | 0.5355 |
| SECONDARY Percentage of Participants With Sustained Remission up to Week 24 |
13.2; 19.4 | — |
| SECONDARY Percentage of Participants With Sustained Response up to Week 24 |
13.2; 22.2 | — |
| SECONDARY Change From Baseline in MADRS Total Score in Participants With Significant Insomnia (Baseline Insomnia Severity Index [ISI] Score >=15) Versus Those Without Significant Insomnia (Baseline ISI Score Less Than [<] 15) at Week 12 |
-10.4; -12.8; -13.4; -17.3 | — |
| SECONDARY Change From Baseline in MADRS Total Score in Participants With Significant Insomnia (Baseline ISI Score >=15) Versus Those Without Significant Insomnia (Baseline ISI Score <15) at Week 18 |
-13.9; -16.2; -10.3; -12.9 | — |
| SECONDARY Change From Baseline in MADRS Total Score in Participants With Significant Insomnia (Baseline ISIscore >=15) Versus Those Without Significant Insomnia (Baseline ISI Score 15) at Week 24 |
-14.3; -15.6; -13.5; -15.4 | — |
| SECONDARY Change From Baseline in the Hamilton Anxiety Rating Scale (HAM-A) Total Score at Weeks 12, 18, and 24 |
-8.7; -6.6; -8.5; -10.0; -10.9; -9.5 | — |
| SECONDARY Percentage of Participants With Weight Gain of >=7% of Baseline Body Weight at Week 24 |
4.3; 8.5 | — |
| SECONDARY Percentage of Participants With Shifts in Triglycerides From Normal to High |
7.1; 13.6 | — |
| SECONDARY Percentage of Participants With Shifts in Triglycerides From Borderline to High |
25.0; 37.5 | — |
| SECONDARY Percentage of Participants With Shifts in Triglycerides From Normal to Very High |
0; 0 | — |
| SECONDARY Percentage of Participants With Shifts in Triglycerides From Borderline to Very High |
0; 0 | — |
| SECONDARY Percentage of Participants With Shifts in Triglycerides From High to Very High |
16.7; 0 | — |
| SECONDARY Percentage of Participants With Shifts in Fasting Blood Glucose From Normal to Borderline |
38.7; 36.0 | — |
| SECONDARY Percentage of Participants With Shifts in Fasting Blood Glucose From Borderline to High |
9.1; 25.0 | — |
| SECONDARY Percentage of Participants With Shifts in Fasting Blood Glucose From Normal to High |
3.2; 4.0 | — |
| SECONDARY Change From Baseline in the Clinical Global Impression-Severity (CGI-S) Scale Score at Weeks 12 and 24 |
-1.2; -1.7; -1.4; -1.7 | — |
| SECONDARY Change From Baseline in the Patient Global Impression Severity (PGI-S) Scale Score at Weeks 12 and 24 |
-1.0; -1.1; -1.2; -1.5 | — |
| SECONDARY Change From Baseline in Quality of Life in Depression Scale (QLDS) Score at Weeks 12 and 24 |
-8.1; -8.3; -9.5; -9.9 | — |
| SECONDARY Change From Baseline in Patient Reported Outcomes Measurement Information System-Sleep Disturbance (PROMIS-SD) Short Form 8a at Weeks 12 and 24 |
-8.22; -11.87; -11.45; -12.91 | — |
| SECONDARY Change From Baseline in Patient Reported Outcomes Measurement Information System-Sleep Related Impairment (PROMIS-SRI) Short Form 8a at Weeks 12 and 24 |
-7.25; -9.09; -11.02; -10.74 | — |
| SECONDARY Change From Baseline in Symptoms of Major Depressive Disorder Scale (SMDDS) Score at Weeks 12 and 24 |
-13.9; -15.7; -15.6; -19.6 | — |
| SECONDARY Change From Baseline in Symbol Digit Modalities Test (SDMT) at Weeks 6, 12, and 24 |
5.0; -2.9; 5.5; 0.1; 4.7; 0.0 | — |
| SECONDARY Change From Baseline in Trail Making Test - Part B (TMT-Part B) at Weeks 6, 12, and 24 |
0.4; 0.0; 0.2; 0.6; 0.5; -0.3 | — |
| SECONDARY Change From Baseline in Hopkins Verbal Learning Test-Revised (HVLT-R) at Weeks 6, 12, and 24 |
0.6; -0.1; 1.9; 1.3; 2.0; 1.4 | — |
| SECONDARY Change From Baseline in Salivary Cortisol Levels as Measured at Home Upon Awakening and During the Evening at Weeks 6 and 24 |
1.3; -2.8; 1.4; -1.7; -0.7; 0.5 | — |
| SECONDARY Percentage of Participants With Treatment-emergent Adverse Events as a Measure of Safety and Tolerability |
65.4; 80.8 | — |
| SECONDARY Percentage of Participants With Treatment-emergent Serious Adverse Events (SAEs) and Events of Special Interest |
1.9; 3.8; 13.5; 5.8 | — |
| SECONDARY Percentage of Participants With Abnormalities in Vital Sign Parameters |
0; 2.0; 2.0; 3.9; 0; 0 | — |
| SECONDARY Percentage of Participants With Abnormalities in Electrocardiogram (ECG) Parameters |
0; 0 | — |
| SECONDARY Percentage of Participants With Abnormalities in Clinical Laboratory Parameters |
0; 0 | — |
| SECONDARY Percentage of Participants With Sexual Dysfunction as Determined by Arizona Sexual Experiences Scale (ASEX) Total Score |
64.3; 75.6 | — |
| SECONDARY Percentage of Participants With Clinically Relevant Changes in Extrapyramidal Symptoms Assessed by the Extrapyramidal Symptom Rating Scale-Abbreviated (ESRS-A) Score |
0; 0 | — |
| SECONDARY Percentage of Participants With Suicidality Assessed Using Columbia Suicide Severity Rating Scale (C-SSRS) Score |
100; 100; 0; 0; 0; 0 | — |
| SECONDARY Percentage of Participant With Potential Withdrawal Effects Assessed by the Physician Withdrawal Checklist (PWC) |
75.0; 33.3; 33.3; 53.6; 0; 0 | — |
| SECONDARY Change From Baseline in MADRS Total Score Over Time |
-6.7; -6.4; -8.7; -10.8; -9.9; -11.4 | — |
| SECONDARY Change From Baseline in MADRS Total Score Over Time, by Mode Dose |
-7.3; -2.4; -4.5; -3.6; -7.7; -4.4 | — |
| SECONDARY Change From Baseline in MADRS-6 Score Over Time |
-4.4; -4.1; -5.8; -6.9; -6.7; -7.5 | — |
Eligibility Criteria
Inclusion Criteria
- Male or female of non-childbearing potential (WONCBP) outpatients, 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). 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
- Have a Body Mass Index (BMI) between 18 and 35 kilogram per meter square (kg/m^2) inclusive (BMI equal to [=] weight/height^2)
- 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 there are abnormalities, they must be consistent with the underlying illness in the study population. If the results of the clinical laboratory tests are outside the normal reference ranges, the participant may 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
- Have Cushing's Disease, Addison's Disease, primary amenorrhea, or other evidence of significant medical disorders of the hypothalamic-pituitary-adrenal (HPA) axis
- Have a history of epilepsy, neuroleptic malignant syndrome (NMS) or Tardive Dyskinesia
- Have a history of previous non-response to an adequate trial of quetiapine as an adjunctive treatment for MDD (adequate trial defined as >=150 mg for 4 weeks or more) and/or a history of lack of response to 3 or more adequate antidepressant treatments and/or a history or evidence of noncompliance with current antidepressant therapy
- Have taken a known moderate or strong inhibitor/inducer of cytochrome P450 (CYP)3A4 and CYP2C9 or a dual inhibitor/inducer of CYP3A4 and CYP2C9 within 14 days (or after washout that is, duration of 5 times the drug's half-life) before the first study drug administration on Day 1 until the follow-up visit. Fluvoxamine is a moderate CYP2C9 inhibitor and a mild CYP3A inhibitor, and will not be excluded from the study
- Have a history or current diagnosis of a psychotic disorder, bipolar disorder, intellectual disability, autism spectrum disorder, borderline personality disorder, somatoform disorders, or fibromyalgia
Data sourced from ClinicalTrials.gov (NCT03321526). 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. Informational only — not medical advice.