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N/A N=1,460 Randomized Treatment

A Depression and Opioid Pragmatic Trial in Pharmacogenetics (Depression Trial)

Depression

Enrolled (actual)
1,460
Serious AEs
0.0%
Results posted
Jun 2025
Primary outcome: Primary: Change in Depression Symptom Control as Measured by PROMIS (Patient-Reported Outcomes Measurement Information System) — -4.3; -4.0 T-score — p=0.677

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Pharmacogenetic testing (Other); Clinical decisions support (Other)
Age
Pediatric, Adult, Older Adult · 8+ yrs
Sex
All
Sponsor
Duke University
Primary completion
Apr 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Change in Depression Symptom Control as Measured by PROMIS (Patient-Reported Outcomes Measurement Information System)
-4.3; -4.0 0.677
SECONDARY
Change in Depression Symptomatology as Measured by Patient Health Questionnaire (PHQ-8)
-3.3; -2.7 0.1264
SECONDARY
Side Effect Burden
8.2; 7.8 0.3692
SECONDARY
Medication Non-Adherence as Measured by the Voils Medication Adherence Survey
142; 137 0.8492
SECONDARY
Number of Participants With Depression Remission as Measured by PROMIS (Patient-Reported Outcomes Measurement Information System)
153; 122 0.0246 sig
SECONDARY
Number of Participants With Depression Remission as Measured by the Patient Health Questionnaire (PHQ-8)
95; 65 0.0111 sig
SECONDARY
Number of Participants With 50% Reduction in Patient Health Questionnaire (PHQ-8) Score
92; 71 0.0776
SECONDARY
Number of Participants With Drug-gene Concordance
273; 234 0.0014 sig

Summary

This study is comprised of three separate pharmacogenetic trials grouped into a single protocol due to similarities in the intervention, the hypotheses, and the trial design. The three trials are the Acute Pain Trial, the Chronic Pain Trial, and the Depression Trial. Participants can enroll in only one of the three trials. All three trials were registered on ClinicalTrials.gov under NCT04445792. In July 2023 each of the three treatment trials was registered under a separate NCT# and NCT04445792 was converted to a screening record per recent guidance on master protocol research programs (MPRPs). This record is specific to the Depression Trial within the ADOPT-PGx protocol. The Depression Trial is a prospective, multicenter, two arm randomized pragmatic trial. Participants meeting eligibility criteria will be randomly assigned to either immediate pharmacogenetic testing and genotype-guided anti-depressant therapy (Intervention arm) or standard care with 6-month delayed pharmacogenetic testing (Control arm). The investigators will test the hypothesis that pharmacogenetic testing and genotype-guided anti-depressant therapy will reduce depression symptoms in participants who's body processes some anti-depressants faster or slower than normal.

Eligibility Criteria

Inclusion Criteria

Depression Trial

  • Age ≥ 8 years
  • English speaking or Spanish speaking
  • Patients followed at psychiatry clinics or primary care clinics at an enrolling site (such as, but not limited to, Internal Medicine, Family Medicine, or Pediatrics)
  • Documentation of depression and/or provider report of depression
  • Evidence of depressive symptoms for at least 3 months based on patient interview or documentation in electronic health records
  • Recent initiation of SSRI therapy, recent revised SSRI therapy, or anticipated need for revised or new SSRI therapy per health care provider

Exclusion Criteria

Trial-wide:

  • Life expectancy less than 12 months
  • Are too cognitively impaired to provide informed consent and/or complete study protocol
  • Are institutionalized or too ill to participate (i.e. mental or nursing home facility or incarcerated)
  • Have a history of allogeneic stem cell transplant or liver transplant
  • People with prior clinical pharmacogenetic test results for genes relevant for the study in which they will enroll (CYP2D6 for the pain studies and CYP2D6 or CYP2C19 for depression) or already enrolled in an ADOPT PGx trial

Depression Trial

  • Plan to move out of the area within 6 months of enrollment
  • Have active psychosis or diagnosed psychotic disorders (schizophrenia, schizoaffective disorder, delusional disorder, psychotic depression, substance induced psychosis, schizophreniform disorder)
  • Have dementia or other neurocognitive disorders due to any cause, such as Alzheimer's disease, vascular/subcortical, lewy body disease, frontotemporal lobar degeneration
  • Have cognitive developmental delay and/or cognitive disability, including autism spectrum disorders (Note: ADHD is not an exclusion criteria)
  • Has a seizure disorder
  • Have bipolar disorder
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05966155). 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.

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