E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Major Depressive Disorder (MDD). |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to evaluate the efficacy of quetiapine fumarate sustained release in combination with an antidepressant versus an antidepressant alone in patients with Major Depressive Disorder (MDD).
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E.2.2 | Secondary objectives of the trial |
1.If quetiapine SR in combination with an antidepressant improves the health-related quality of life of patients with MDD. 2.If quetiapine SR in combination with an antidepressant reduces anxiety symptoms in patients with MDD. 3.If quetiapine SR in combination with an antidepressant improves sleep quality in patients with MDD. 4.If quetiapine SR in combination with an antidepressant is effective in reducing suicidal ideation in patients with MDD. 5.If quetiapine SR in combination with an antidepressant improves somatic symptoms in patients with MDD. 6.If quetiapine SR in combination with an antidepressant improves satisfaction with medication in patients with MDD. 7.Safety and tolerability of quetiapine SR in combination with an antidepressant. 8.If quetiapine SR changes the plasma level of antidepressant. |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
1.Provision of written informed consent before initiation of any study related procedures. 2.Male and female patients aged 18 to 65 years, inclusive. 3.Documented clinical diagnosis meeting criteria from the DSM-IV for any of the following;296.2x Major Depressive Disorder, Single Episode, or 296.3x Major Depressive Disorder, Recurrent as confirmed by the MINI. 4.HAM-D total score of ≥20 and HAM-D item 1 score ≥2 both at enrolment (Visit 1) and randomisation (Visit 2). 5.Female patients of childbearing potential must have a negative serum pregnancy test at enrolment and be willing to use a reliable method of birth control (i.e. barrier method, oral contraceptive, implant, dermal contraception, long-term injectable contraceptive, intrauterine device, or tubal ligation) during the study. 6.Have a history during the current depressive episode of an in-adequate response to one of the following antidepressants: amitryptyline, bupropion, citralopram, duloxetine, escitralopram, fluoxetine, paroxetine, sertraline or venlafaxine. An inadequate response is defined as having at least minimum effective antidepressant dose according to label for 6 weeks including at least one dose increase when permitted according to label at enrolment. 7.Be able to understand and comply with the requirements of the study, as judged by the investigator. 8.Outpatient status at enrolment. |
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E.4 | Principal exclusion criteria |
1.Patients with a DSM-IV Axis I disorder other than MDD within 6 months of enrolment. 2.Patients with a diagnosis of DSM-IV Axis II disorder which has a major impact on the patient's current psychiatric status. 3.Patients whose current episode of depression exceeds 12 months or is less than 4 weeks prior to enrolment. 4.Substance or alcohol abuse or dependence within 6 months prior to enrolment. 5.Use of drugs that induce or inhibit the hepatic metabolising cytochrome P450 3A4 enzymes within 2 weeks prior to randomisation. 6.Pregnancy or lactation. 7.Evidence of clinically relevant disease, e.g. renal or hepatic impairment, significant coronary artery disease, cerebrovascular disease, viral hepatitis B or C, acquired immunodeficiency syndrome (AIDS). 8.A clinical finding that is unstable or that, in the opinion of the investigator, would be negatively affected by the study medication or that would affect the study medication. 9.Conditions that could affect absorption and metabolism of study medication. 10.A current diagnosis of cancer (except basal or squamous cell skin carcinoma), unless in remission for at least 5 years. 11.Current or past diagnosis of stroke or Transient Ischemic Attacks (TIA). 12.History of seizure disorder, except febrile convulsions. 13.Receipt of electroconvulsive therapy (ECT) within 90 days prior to randomisation. 14.Use of mood stabiliser other than allowed, or other antipsychotic or psychoactive drugs within 7 days before randomisation, or use of MAO inhibitors, anxiolytic drugs or hypnotics (except medications specified in Table 5) within 14 days before randomisation, or use of a depot antipsychotic injection within two dosing interval before randomisation. 15.Patients who in the investigators opinion will require psychotherapy (other than supportive psychotherapy) during the study period, unless psychotherapy has been ongoing for a minimum of 3 months prior to randomisation. 16.Patients who, in the investigator’s judgement pose a current serious suicidal or homicidal risk, have a HAM-D item 3 score of 3 or greater, or have made a suicide attempt within the past 6 months. 17.A patient with diabetes mellitus. 18.Clinically significant deviation from the reference range in clinical laboratory test results as judged by the investigator. 19.An absolute neutrophil count (ANC) of ≤1.5 x 109 per litre. 20.A thyroid-stimulating hormone (TSH) concentration more than 10% above the upper limit of the normal range of the laboratory used for sample analysis at enrolment, whether or not the patient is being treated for hypothyroidism. 21.Liver function tests (AST or ALT) three times the upper normal limit. 22.ECG results considered being clinically significant as determined by the investigator based on assessment by a centrally located experienced cardiologist interpreting the ECG. 23.Use of quetiapine in doses ≤25 mg/day for insomnia within 7 days before randomisation. 24.Known history of intolerance or hypersensitivity to quetiapine or to any other component in the tablets. 25.Known lack of response to quetiapine in the treatment of depression in a dosage of at least 50 mg/day for 4 weeks (at any time before study start), as judged by the investigator. 26.Treatment with quetiapine with a dosage of at least 50 mg/day at enrolment (visit 1). 27.Contraindications as detailed in the country-specific prescribing information for quetiapine. 28.Involvement in the planning and conduct of the study (applies to all AstraZeneca, investigational site staff or third vendor). 29.Previous randomisation in the present study or any AstraZeneca- sponsored MDD study on quetiapine. 30.Participation in another clinical study or compassionate use programme within 4 weeks of randomisation or longer in accordance with local requirements. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from randomisation to Week 6 in the MADRS total score. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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End of study is defined as Database Lock, (estimated as July 2007) which is the time point after which no patient will be exposed to study related activities. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 2 |