E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Major Depression Associated With Bipolar I Disorder |
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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 safety and tolerability of long term (6 months) armodafinil treatment as adjunctive therapy to mood-stabilizing medications in adults with bipolar I disorder whose most recent episode was a depressive episode.
For full details please refer to the Protocol. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of the study are as follows: • to evaluate long-term efficacy of armodafinil treatment as adjunctive therapy for adults who are experiencing a major depressive episode associated with bipolar I disorder, as assessed by the following: ― mean change from baseline in the total score from the 30-Item Inventory of Depressive Symptomatology–Clinician Rated (IDS-C30) to week 1 and months 1, 2, 4, and 6 ― the mean change from baseline in the total score from the 16-Item Quick Inventory of Depressive Symptomatology Clinician Rating (QIDS-C16) (which will be derived from the IDS-C30) to week 1 and months 1, 2, 4, and 6 • to evaluate the change from baseline in the Clinical Global Impression of Severity (CGI-S) for depression to week 1 and months 1, 2, 4, and 6 • to evaluate the efficacy of armodafinil treatment on patient functioning as ssessed by the Global Assessment of Functioning (GAF) Scale scores at month 6
For full details please refer to the Protocol. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients are included in the study if all of the following criteria are met (NOTE: All psychiatric diagnoses are made on the basis of DSM-IV-TR criteria.): (a)The patient has completed 8 weeks of treatment in a Cephalon-sponsored Phase 3, double-blind study of armodafinil treatment in patients with major depression associated with bipolar I disorder. (b1)The patient met criteria for enrollment in the previous double blind study and, in the opinion of the investigator, is in need of continued treatment for depression. (c1) The patient is being treated with 1 or 2 of the following drugs: lithium, valproic acid, olanzapine, aripiprazole, and/or ziprasidone. (These medications will be referred to as protocol-allowed mood stabilizers.) The mood stabilizer must be taken in an oral formulation. The patient may be taking 2 protocol-allowed mood stabilizers only if 1 of the drugs is lithium or valproic acid. The patient must be judged by the investigator to be compliant with treatment with the mood stabilizer(s). The patient must be willing to continue treatment with the same protocol-allowed mood stabilizer(s) at dosages considered appropriate by the investigator. If taking any of the following mood stabilizers, the patient must take minimum dosages as indicated: olanzapine (≥5 mg/day), aripiprazole (≥15 mg/day), or ziprasidone (≥80 mg/day). (d)The patient has a YMRS total score of 14 or less at the enrollment visit. Patients who have a YMRS score of 12 through 14 must be discussed with the medical monitor to determine their suitability for enrollment. (e)Written informed consent is obtained. (f)The patient is a man or woman 18 through 65 years of age at the time of enrollment in the double-blind study. (g)The patient is in good health (except for diagnosis of bipolar I disorder) as judged by the investigator, on the basis of medical and psychiatric history, medical examination, ECG, serum chemistry, hematology, and urinalysis results. (h1) Women of childbearing potential (women who have not reached menopause, women who are less than 2 years postmenopausal, and women who are not surgically sterile) who are sexually active must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for 30 days after participation in the study. Acceptable methods of contraception include barrier method with spermicide, intrauterine device (IUD), and steroidal contraceptive (oral, transdermal, implanted, and injected) in conjunction with a barrier method. (i)The patient is willing and able to comply with study restrictions and to attend regularly scheduled clinic visits as specified in this protocol. (j)The patient has permanent accommodations and means of being contacted by the study center. (k)The patient agrees not to enroll in any other clinical study while participating in this study.
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E.4 | Principal exclusion criteria |
Patients are excluded from participating in this study if 1 or more of the following criteria are met (NOTE: All psychiatric diagnoses are made on the basis of DSM-IV-TR criteria.): (a) The patient has any Axis I or Axis II disorder apart from bipolar I disorder that became the primary focus of treatment during the double-blind study. (b) The patient has psychotic symptoms or had psychosis during the double-blind study. (c) The patient has current active suicidal ideation, is at imminent risk of self harm, or has a history of significant suicidal ideation or suicide attempt at any time in the past that causes concern at present; or at enrollment has a score of 2 or more for item 18 on the IDS C30. (d) The patient met criteria for alcohol or substance abuse or dependence (with the exception of nicotine dependence) during the double-blind study. (e) The patient has any history of homicidal ideation or significant aggression or currently has homicidal or significant aggressive ideation. (f) The patient has a history of any cutaneous drug reaction or drug hypersensitivity reaction, a history of any clinically significant hypersensitivity reaction, or a history of multiple clinically relevant allergies. (g) The patient has a past or present seizure disorder (except history of a single febrile seizure), or a history of clinically significant head trauma (eg, brain damage) or of brain surgery. (h) The patient has left ventricular hypertrophy or the patient has mitral valve prolapse and has experienced mitral valve prolapse syndrome. (i) The patient has human immunodeficiency virus (HIV). (j) The patient has any clinically significant uncontrolled medical condition, treated or untreated. (k) In the judgment of the investigator, the patient has any clinically significant deviation from normal in the physical examination. (l) The patient has evidence of current non-medical substance use on urine drug screen (UDS) or by history. (m) The patient is a pregnant or lactating woman. (Any woman becoming pregnant during the study will be withdrawn from the study.) (n) The patient has any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (ADME) (including gastrointestinal surgery). (o) The patient is unlikely to comply with the study protocol or is unsuitable for any other reason, as judged by the investigator or medical monitor. (p) The patient is an inpatient with or without consent, is under arrest, or is institutionalized.
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E.5 End points |
E.5.1 | Primary end point(s) |
Efficacy measures and endpoints are as follows: • The IDS C30 assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • The QIDS-C16 (which will be derived from the IDS C30) assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • The CGI-S for depression assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • The GAF Scale assessed at month 6 (or last postbaseline observation)
The safety and tolerability of armodafinil treatment will be assessed by evaluating adverse events throughout the study and using the following additional safety and tolerability measures: • clinical laboratory tests (serum chemistry, hematology, and urinalysis) assessed at month 6 (or last postbaseline observation) • vital signs (blood pressure and pulse) assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • ECGs assessed at month 6 (or last postbaseline observation) • physical examinations assessed at month 6 (or last postbaseline observation) • body weight at month 6 (or last postbaseline observation) • concomitant medication usage throughout the study • YMRS assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • C SSRS SLV assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • ISI assessed at week 1 and months 1, 2, 4, and 6 (or last postbaseline observation) • HAM A assessed at month 6 (or last postbaseline observation) |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 22 |
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 | Yes |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |