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A Clinical Trial to Determine the Long-term Safety and Tolerability of an Investigational Drug in People With Major Depressive Episode Associated With Bipolar I Disorder (Bipolar I Depression).

Phase 3
Terminated
Conditions
Depressive Episodes, Bipolar I Depression
Interventions
Drug: SEP-4199 CR
Registration Number
NCT05227209
Lead Sponsor
Sumitomo Pharma America, Inc.
Brief Summary

This is a clinical trial to determine the long-term safety and tolerability of an investigational drug in people with Major Depressive Episode Associated with Bipolar I Disorder (Bipolar I Depression). Participants in the study will receive the drug being studied. This study is accepting male and female participants between 18 and 65 years old who have completed Study SEP380-301. This study will be conducted in approximately 90 study centers worldwide. The treatment duration for this study is one (1) year.

Detailed Description

This is a 12-month open-label safety extension study to evaluate the long-term safety, tolerability, and effectiveness of SEP-4199 CR 200-400 mg/day in the treatment of subjects with bipolar I depression who previously completed a lead-in study of SEP-4199 CR.

The study will consist of a 12-month open-label flexible-dose treatment period, and a safety follow-up period. There are 15 scheduled visits, including a Baseline visit, 13 visits during the open-label treatment period, and 1 safety follow-up visit 7 (± 2) days after the last dose of study drug. If necessary, subjects may return to the clinic at anytime for an unscheduled visit

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
64
Inclusion Criteria
  • Subject provides written informed consent and is willing and able to comply with the protocol in the opinion of the Investigator.
  • Subject has completed 6 weeks of double-blind treatment and all scheduled assessments from Visit 6/EOT (Day 42) of the lead-in study of SEP-4199 CR.
  • Subject is medically appropriate for long-term open-label treatment with SEP-4199 CR in the opinion of the Investigator.
  • Female subjects of childbearing potential must agree to use effective and reliable contraception throughout the study and for at least 30 days after the last dose of study drug has been taken. In the Investigator's judgment, the subject will adhere to this requirement.
  • Male subjects agree to avoid fathering a child and to use effective methods of birth control throughout the study and until at least 90 days after the last study drug administration.
Exclusion Criteria
  • Subject is at high risk of non-compliance in the opinion of the Investigator.
  • Subject plans to initiate treatment with a prohibited psychotropic medication during the study.
  • Subject plans to initiate treatment with transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), or deep brain stimulation (DBS) during the study.
  • Subject experienced a moderate or severe hyperprolactinemia-related AESI in the lead-in study of SEP-4199 CR.
  • Subject will require treatment with a drug that is associated with increases in QTc interval.
  • Subject had any of the following at Visit 6/EOT (Day 42) of the lead-in study of SEP-4199 CR based on machine reading:
  • increase in QTcF interval of ≥ 30 msec AND a QTcF interval ≥ 480 msec, from baseline of the lead-in study of SEP-4199 CR AND a QTCF interval ≥ 480msec
  • increase in QTcF interval ≥ 60 msec, from baseline of the lead-in study of SEP-4199 CR
  • QTcF interval ≥ 500 msec
  • treatment-emergent clinically significant ECG abnormality.
  • Subject is considered by the Investigator to be at imminent risk of suicide or injury to self or others, has a MADRS item 10 (suicidal ideation) score ≥ 4, or answers "yes" to "suicidal ideation" item 4 (active suicidal ideation with some intent to act, without specific plan) or item 5 (active suicidal ideation with specific plan and intent) on the C-SSRS assessment at Visit 6/EOT (Day 42) of the lead-in study of SEP-4199 CR.
  • Female subject of childbearing potential, has a positive urine pregnancy test at Visit 6/EOT (Day 42) of the lead-in study of SEP-4199 CR or plans to become pregnant during the current study.
  • Subject tests positive for any drug of abuse or cannabis at Visit 6/EOT (Day 42) of the lead-in study of SEP-4199 CR

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
SEP-4199 CRSEP-4199 CRSEP-4199 CR either 200 mg (one 200 mg tablet) or 400 mg (two 200 mg tablets) once daily during open-label flexible-dose treatment period.
Primary Outcome Measures
NameTimeMethod
Number of Subjects Who Experienced Adverse Events in Study12 months

Incidence of adverse events

Number of Subjects Who Discontinued Due to Adverse Events12 months

Incidence of adverse events leading to discontinuation

Number of Subjects Who Experienced Serious Adverse Events in Study12 months

Incidence of Serious Adverse Events

Secondary Outcome Measures
NameTimeMethod
Montgomery-Asberg Depression Rating Scale (MADRS) Total Score - Change From Baseline12 months

Open Label (OL) Month 12 (LOCF) is defined as the last non-missing post-OL Baseline measurement up to and including the OL Month 12 measurement and within 9 days post the last dose of open-label extension study medication. The MADRS is a clinician-rated assessment of the subject's level of depression. The measure contains 10 items that measure apparent and reported sadness, inner tension, reduced sleep and appetite, difficulty concentrating, lassitude, inability to feel, and pessimistic and suicidal thoughts. Each item is scored in a range of 0 to 6 points and total score range is of 0 to 60 with higher scores indicating increased depressive symptoms.Individual items are then summed to determine total score.

Clinical Global Impression Bipolar Version (CGI-BP-S) Depression Score - Change From Baseline12 months

Open Label (OL) Month 12 (LOCF) is defined as the last non-missing post-OL Baseline measurement up to and including the OL Month 12 measurement and within 9 days post the last dose of open-label extension study medication.The Clinical Global Impression Bipolar Version (CGI-BP-S) scale is a clinician-rated assessment of the subject's current illness state on a 7-point scale, where a higher score is associated with greater illness severity. Depression Score is one the individual item on CGI-BP-S Scale.The CGI-BP-S depression score takes one of the following values: 1 (normal, not at all ill), 2 (borderline mentally ill), 3 (mildly ill), 4 (moderately ill), 5 (markedly ill), 6 (severely ill), 7 (among the most extremely ill patients).

Trial Locations

Locations (68)

University of Alabama at Birmingham Huntsville Regional Medical Campus

🇺🇸

Huntsville, Alabama, United States

Advanced Research Center, Inc.

🇺🇸

Anaheim, California, United States

Sun Valley Research Center

🇺🇸

Imperial, California, United States

Tatsuta Clinic

🇯🇵

Kobe-shi, Hyogo-Ken, Japan

Clinical innovations, Inc.

🇺🇸

Riverside, California, United States

Collaborative Neuroscience Research, LLC

🇺🇸

Torrance, California, United States

Sarkis Clinical Trials

🇺🇸

Gainesville, Florida, United States

Clinical Neuroscience Solutions, Inc.

🇺🇸

Orlando, Florida, United States

Premier Clinical Research Institute, Inc

🇺🇸

Miami, Florida, United States

Cerisier Heart Clinic

🇯🇵

Kagoshima-shi, Kagoshima-Ken, Japan

Atlanta Behavioral Research, LLC

🇺🇸

Atlanta, Georgia, United States

Psych Atlanta, P.C.

🇺🇸

Marietta, Georgia, United States

AMR Conventions Research

🇺🇸

Warrenville, Illinois, United States

St. Charles Psychiatric Associates / Midwest Research Group

🇺🇸

Saint Charles, Missouri, United States

Alivation Research, LLC

🇺🇸

Lincoln, Nebraska, United States

Center for Emotional Fitness

🇺🇸

Cherry Hill, New Jersey, United States

Finger Lakes Clinical Research

🇺🇸

Rochester, New York, United States

Richmond Behavioral Associates ERG Clinical Research - New York PLLC

🇺🇸

Staten Island, New York, United States

New Hope Clinical Research

🇺🇸

Charlotte, North Carolina, United States

Quest Therapeutics of Avon Lake

🇺🇸

Avon Lake, Ohio, United States

Neuro-Behavioral Clinical Research, Inc

🇺🇸

North Canton, Ohio, United States

Sooner Clinical Research

🇺🇸

Oklahoma City, Oklahoma, United States

Lehigh Center for Clinical Research, LLC

🇺🇸

Allentown, Pennsylvania, United States

Community Clinical Research, Inc.

🇺🇸

Austin, Texas, United States

UTHealth Science Center at Houston

🇺🇸

Houston, Texas, United States

Family Psychiatry of The Woodlands

🇺🇸

The Woodlands, Texas, United States

State Psychiatric Hospital - Kardzhali First Women Department Third Men Department

🇧🇬

Kardzhali, Bulgaria

Medical Center Mentalcare OOD

🇧🇬

Plovdiv, Bulgaria

Mental Health Center- Ruse EOOD Men Department for treatment of persons with acute psychotic disorders; Women Department for treatment of persons with acute psychotic disorders; Department "Daily stationary"

🇧🇬

Ruse, Bulgaria

Mental Health Center - Sofia EOOD

🇧🇬

Sofia, Bulgaria

Medical Center Sveti Naum EOOD

🇧🇬

Sofia, Bulgaria

DCC St. Vrach and St. St. Kuzma and Damian OOD

🇧🇬

Sofia, Bulgaria

Medical Center Hera EOOD

🇧🇬

Sofia, Bulgaria

Medical Center Intermedica OOD

🇧🇬

Sofia, Bulgaria

State Psychiatric Hospital - s. Tsarev brod First Department for Active Treatment - Men Second Department for Active Treatment - Men Women Department - Rehabilitation Sector Women Department - Acute Sector

🇧🇬

Tsarevo, Bulgaria

DCC Mladost-M Varna OOD

🇧🇬

Varna, Bulgaria

Hiro Mental Clinic

🇯🇵

Fukuoka-shi, Fukuoka-Ken, Japan

Shinseikai Kaku Mental Clinic

🇯🇵

Fukuoka-Shi, Fukuoka-Ken, Japan

Mental Clinic Sakurazaka

🇯🇵

Fukuoka-shi, Fukuoka-Ken, Japan

Someikai Kanagami Clinic

🇯🇵

Kitakyushu-shi, Fukuoka-Ken, Japan

Kokura Mental Clinic

🇯🇵

Kitakyushu-shi, Fukuoka-Ken, Japan

Hatakeyama Clinic

🇯🇵

Kitakyushu, Fukuoka-Ken, Japan

Hirota Clinic

🇯🇵

Kurume-shi, Fukuoka-Ken, Japan

Shiranui Hospital

🇯🇵

Omuta-shi, Fukuoka-Ken, Japan

Jisenkai Nanko Psychiatric Institute

🇯🇵

Shirakawa-shi, Fukushima-Ken, Japan

Teine Keijinkai Hospital

🇯🇵

Sapporo-shi, Hokkaido, Japan

Musashikosugi J Kokorono Clinic

🇯🇵

Kawasaki, Kanagawa-Ken, Japan

Yutaka Clinic

🇯🇵

Sagamihara-shi, Kanagawa-Ken, Japan

Azamino Mental Clinic

🇯🇵

Yokohama-shi, Kanagawa-Ken, Japan

Yamatenomori Kokorono Clinic

🇯🇵

Yokohama-shi, Kanagawa-Ken, Japan

Satokai Yuge Hospital

🇯🇵

Kumamoto-shi, Kumamoto-ken, Japan

Shiroma Clinic

🇯🇵

Urasoe-shi, Okinawa-ken, Japan

Rainbow & Sea Hospital

🇯🇵

Karatsu-shi, Saga-Ken, Japan

Juntendo University Hospital

🇯🇵

Bunkyō-Ku, Tokyo-To, Japan

Senzoku Psychosomatic Clinic

🇯🇵

Meguro-ku, Tokyo-To, Japan

Minami-Aoyama Antique Street Clinic

🇯🇵

Minato-Ku, Tokyo-To, Japan

Heart Care Ginga Clinic

🇯🇵

Nakano-ku, Tokyo-To, Japan

Sangenjaya Nakamura Mental Clinic

🇯🇵

Setagaya-Ku, Tokyo-To, Japan

Sangenjaya Neurology- Psychosomatic Clinic

🇯🇵

Setagaya-Ku, Tokyo-To, Japan

Japanese Red Cross Medical Center

🇯🇵

Shibuya-ku, Tokyo-To, Japan

Maynds Tower Mental Clinic

🇯🇵

Shibuya-ku, Tokyo-To, Japan

Sangubashi Kokorono Clinic

🇯🇵

Shibuya-ku, Tokyo-To, Japan

Etoh Mental Clinic

🇯🇵

Shinagawa-ku, Tokyo-To, Japan

Tamaki Clinic

🇯🇵

Shinjuku-ku, Tokyo-To, Japan

Himorogi Psychiatric Institute

🇯🇵

Shinjuku-Ku, Tokyo-To, Japan

Uguisudani Mental Clinic

🇯🇵

Taito-ku, Tokyo-To, Japan

Ohwa Mental Clinic

🇯🇵

Toshima-ku, Tokyo-To, Japan

Kitaikebukuro Kokoro No Clinic

🇯🇵

Toshima-ku, Tokyo-To, Japan

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