A Phase 2a Randomized, Double-blind, Placebo-Controlled, Parallel-Group, Multi-center Study Investigating the Efficacy, Safety, Tolerability and Pharmacokinetics of JNJ-67953964 in Subjects With Major Depressive Disorder
Overview
- Phase
- Phase 2
- Intervention
- Placebo
- Conditions
- Depressive Disorder, Major
- Sponsor
- Janssen Research & Development, LLC
- Enrollment
- 181
- Locations
- 49
- Primary Endpoint
- Change From Treatment Baseline in Montgomery Asberg Depression Rating Scale (MADRS) Total Score at Treatment Week 6 in Participants Who Were Non-Responders During Placebo Lead-in Period
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The purpose of this study is to evaluate the efficacy of JNJ-67953964 compared to placebo when administered as adjunctive treatment in participants with Major Depressive Disorder (MDD) partially responsive to selective serotonin reuptake inhibitor/ serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) treatment in terms of reduction of symptoms of depression, as assessed by the change from baseline on the Montgomery Asberg Depression Rating Scale (MADRS) in non-responders during the placebo lead-in period.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Have a Body Mass Index (BMI) between 18 and 35 kilogram per meter square (kg/m\^2) inclusive (BMI = weight/height\^2)
- •Participants must be medically stable based on clinical laboratory tests, medical history, vital signs, and 12-lead electrocardiogram (ECG) performed at screening and baseline
- •Participants must have a primary Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) diagnosis of Major Depressive Disorder (MDD)
- •The current episode should be less than 18 months
- •Participants should be currently treated with an SSRI or SNRI at an adequate dose and for at least 6 weeks but no more than 12 months
- •Have a Montgomery-Asberg Depression Rating Scale (MADRS) total score greater than or equal to (\>=) 25 at screening
- •A woman of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test before the first dose
Exclusion Criteria
- •History of documented gastric disease (including documented peptic ulcer disease, gastritis, upper gastrointestinal \[GI\] bleeding, esophagitis, or any GI precancerous condition), current clinically evident GI complaints
- •Chronic use of a proton pump inhibitors (PPIs). History of incidental use of PPIs is allowed but should have been stopped at least 4 weeks before screening. A history of chronic nonsteroidal anti-inflammatory drug (NSAID) or aspirin use. (Low dose aspirin for example in cardiovascular disease prevention is allowed)
- •Has a history of alcohol use disorder within the past year
- •Has failed (no more than 25 percent \[%\] response on Antidepressant Treatment History Questionnaire \[ATRQ\]) three or more antidepressant treatments including the current Selective serotonin reuptake inhibitor/ serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) during the current depressive episode despite an adequate dose (per ATRQ) and duration (at least 6 weeks)
- •Has signs or symptoms of Cushing's Disease, Addison's Disease, primary amenorrhea, or other evidence of significant medical disorders of the hypothalamus pituitary adrenal (HPA) axis
- •Participant has received an investigational drug (including investigational vaccines) or used an invasive investigational medical device within 3 months before the planned first dose of study drug or has participated in any interventional clinical studies on MDD in the previous 1 year or is currently enrolled in an interventional study
- •Has one or more of the following diagnoses:
- •A primary DSM (5th edition) diagnosis of generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD). Participants with comorbid GAD, social anxiety disorder (SAD), or panic disorder for whom MDD is considered the primary diagnosis are not excluded
- •A current diagnosis or diagnosis in the past 1 year of psychotic disorder, MDD with psychosis, anorexia nervosa or bulimia nervosa, chronic fatigue syndrome, bipolar disorder (BD), mental retardation, antisocial or borderline personality disorder, autism spectrum disorder
- •Has a current or recent history of clinically significant suicidal ideation within the past 6 months, corresponding to a score of 4 (active suicidal ideation with some intent to act, without specific plan) or 5 (active suicidal ideation with specific plan and intent) for ideation on the Colombia suicide severity rating scale (C-SSRS), or a history of suicidal behavior within the past 1 year
Arms & Interventions
Lead-in Period: Placebo
Participants will receive matching placebo for the entire duration of the lead-in period.
Intervention: Placebo
Treatment Period: JNJ-67953964 or Placebo
Participants who respond or do not respond (based on reduction from lead-in baseline in MADRS) in the placebo lead-in period will receive either matching placebo or 10 (2\*5) milligram (mg) JNJ-67953964 capsules in a 1:1 ratio for 6 weeks.
Intervention: JNJ-67953964
Treatment Period: JNJ-67953964 or Placebo
Participants who respond or do not respond (based on reduction from lead-in baseline in MADRS) in the placebo lead-in period will receive either matching placebo or 10 (2\*5) milligram (mg) JNJ-67953964 capsules in a 1:1 ratio for 6 weeks.
Intervention: Placebo
Withdrawal Period: Placebo
Participants who complete the double-blind treatment period prior to the end of Week 11 will receive matching placebo for the remaining time of the treatment phase of the study.
Intervention: Placebo
Outcomes
Primary Outcomes
Change From Treatment Baseline in Montgomery Asberg Depression Rating Scale (MADRS) Total Score at Treatment Week 6 in Participants Who Were Non-Responders During Placebo Lead-in Period
Time Frame: Treatment Baseline up to Week 6 of DB-treatment period
The MADRS is a clinician-rated scale designed to measure depression severity and detects changes due to antidepressant treatment. The scale consists of 10 items, each of which is scored from 0 (item not present or normal) to 6 (severe or continuous presence of the symptoms), summed for a total possible score of 60. Higher scores represent a more severe condition. The MADRS evaluates apparent sadness, reported sadness, inner tension, sleep appetite, concentration, lassitude, inability to feel (interest level), pessimistic thoughts, and suicidal thoughts. Negative change from baseline indicates improvement.
Secondary Outcomes
- Change From Treatment Baseline in Snaith-Hamilton Pleasure Scale (SHAPS) Total Score at Treatment Week 6 (eITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in Symptoms of Major Depressive Disorder Scale (SMDDS) Total Score at Treatment Week 6 (eITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in MADRS Total Score at Treatment Week 6(Treatment Baseline up to Week 6 of DB-treatment period)
- Number of Participants With Treatment-emergent Adverse Events (TEAEs) During DB Treatment Period(Up to Week 6)
- Change From Treatment Baseline in SHAPS Total Score at Treatment Week 6 (fITT)(Treatment Baseline up to Week 6 of DB-treatment period)
- Number of Participants With Self-Assessment of Treatment Experience (SATE) Questionnaire at Treatment Week 6 (eITT Population)(Treatment Week 6)
- Number of Participants With SATE Questionnaire at Treatment Week 6 (fITT Population)(Treatment Week 6)
- Change From Treatment Baseline in CGI-S Score at Treatment Week 6 (fITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in HAM-A6 Total Score at Treatment Week 6 (fITT)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in SIGH-A Score at Treatment Week 6 (fITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in Clinical Global Impression - Severity (CGI-S) Score at Treatment Week 6 (eITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in SMDDS Total Score at Treatment Week 6 (fITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Change From Treatment Baseline in Hamilton Anxiety Scale 6 (HAM-A6) Total Score at Treatment Week 6 (eITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)
- Maximum Observed Plasma Concentration (Cmax) of JNJ-67953964(Week 1: Day 29, Week 3: Day 43, Week 6 (Day 64))
- Area Under the Plasma Concentration-Time Curve From Time of Administration to 24 Hours Post-dose (AUC[0-24h]) of JNJ-67953964(0 to 24 hours Post dose on Week 1: Day 29, Week 3: Day 43, Week 6: Day 64)
- Area Under Plasma Concentration-Time Curve at Steady State (AUCss) of JNJ-67953964(Week 1: Day 29, Week 3: Day 43, Week 6: Day 64)
- Predose (Trough) Plasma Concentration (C0h) of JNJ-67953964(Predose on Week 1: Day 29, Week 3: Day 43, Week 6: Day 64)
- Change From Treatment Baseline in Structured Interview Guide for the Hamilton Anxiety Rating Scale (SIGH-A) Score at Treatment Week 6 (eITT Population)(Treatment Baseline up to Week 6 of DB-treatment period)