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    Clinical Trial Results:
    A Randomized, Placebo-Controlled, Double-Blind Study of LY2216684 Fixed-Dose 12 milligrams (mg) and 18 mg Once Daily as Adjunctive Treatment for Patients with Major Depressive Disorder Who Are Partial Responders to Selective Serotonin Reuptake Inhibitor Treatment

    Summary
    EudraCT number
    2010-021214-39
    Trial protocol
    LV  
    Global end of trial date
    21 Oct 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    06 Mar 2018
    First version publication date
    06 Mar 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    H9P-MC-LNBM
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01173601
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    Tral Alias: 11316
    Sponsors
    Sponsor organisation name
    Eli Lilly and Company
    Sponsor organisation address
    Lilly Corporate Center, Indianapolis, United States,
    Public contact
    Available Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Eli Lilly and Company, 1 877‐CTLilly,
    Scientific contact
    Available Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST), Eli Lilly and Company, 1 877‐285‐4559,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    21 Oct 2013
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Oct 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary purpose of this study is to assess whether at least 1 dose of LY2216684 (12 milligrams [mg] or 18 mg once daily) is superior to placebo once daily in the adjunctive treatment of participants with major depressive disorder (MDD) who were identified as partial responders to an adequate course of treatment with a selective serotonin reuptake inhibitor (SSRI) during an 8-week, double-blind, acute adjunctive treatment phase.
    Protection of trial subjects
    This study was conducted in accordance with International Conference on Harmonization (ICH) Good Clinical Practice, and the principles of the declaration of Helsinki, in addition to following the laws and regulations of the country or countries in which a study is conducted.
    Background therapy
    Selective Serotonin Reuptake Inhibitor (SSRI): Participants were treated with one of the following SSRIs that have been approved for MDD treatment within the participating country: escitalopram, citalopram, sertraline, fluoxetine, paroxetine, and fluvoxamine; and have been treated with their SSRI at least 6 weeks prior to Visit 2 with at least the last 4 consecutive weeks at a stable optimized dose prior to Visit 2. The SSRI prescribed, including dose, was maintained consistently with labeling guidelines within the participating country.
    Evidence for comparator
    -
    Actual start date of recruitment
    16 Dec 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 594
    Country: Number of subjects enrolled
    Poland: 220
    Country: Number of subjects enrolled
    Ukraine: 134
    Country: Number of subjects enrolled
    Russian Federation: 36
    Country: Number of subjects enrolled
    South Africa: 77
    Country: Number of subjects enrolled
    Latvia: 85
    Country: Number of subjects enrolled
    Japan: 270
    Worldwide total number of subjects
    1416
    EEA total number of subjects
    305
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    1363
    From 65 to 84 years
    53
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    First 3 weeks was double-blind adjunctive placebo lead-in Confirmation Phase during which participants(pts) continued SSRI with adjunctive placebo. If randomization criteria were met, pts were randomized to receive LY2216684 12 mg, 18 mg, or placebo. If criteria were not met, pts continued on placebo and remained in the study to maintain the blind.

    Period 1
    Period 1 title
    Confirmation (CF) Phase, 3 weeks
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Carer, Assessor

    Arms
    Arm title
    Placebo + SSRI (Pre-Randomized Participants)
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo taken by mouth once daily for 11 weeks.

    Number of subjects in period 1
    Placebo + SSRI (Pre-Randomized Participants)
    Started
    1416
    Entered Discontinuation Phase
    21 [1]
    Completed
    1328
    Not completed
    88
         Physician decision
    3
         Consent withdrawn by subject
    25
         Adverse event, non-fatal
    23
         Sponsor Decision
    6
         Lost to follow-up
    7
         Lack of efficacy
    9
         Protocol deviation
    15
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who discontinued the CF Phase had the option to enter the DC phase. Participants who completed the CF Phase entered the AT Phase.
    Period 2
    Period 2 title
    Adjunctive Treatment (AT) Phase, 8 weeks
    Is this the baseline period?
    Yes [2]
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    12 mg LY2216684 + SSRI (Randomized Participants)
    Arm description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a SSRI
    Arm type
    Experimental

    Investigational medicinal product name
    LY2216684
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Double-blind Study of LY2216684 Fixed-dose 12 mg and 18 mg Once Daily as Adjunctive Treatment for Patients With Major Depressive Disorder Who Are Partial Responders to Selective Serotonin Reuptake Inhibitor Treatment.

    Arm title
    18 mg LY2216684 + SSRI (Randomized Participants)
    Arm description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI
    Arm type
    Experimental

    Investigational medicinal product name
    LY2216684
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI

    Arm title
    Placebo + SSRI (Randomized Participants)
    Arm description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo taken by mouth once daily for 11 weeks.

    Arm title
    Placebo + SSRI (Non-Randomized Participants)
    Arm description
    Placebo: Administered orally, once daily for 8 weeks
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo taken by mouth once daily for 11 weeks.

    Notes
    [2] - Period 1 is not the baseline period. It is expected that period 1 will be the baseline period.
    Justification: Period 1 is the confirmatory phase, baseline and analytical data is based on Period 2 (Adjunctive phase).
    Number of subjects in period 2 [3]
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants) Placebo + SSRI (Non-Randomized Participants)
    Started
    231
    230
    240
    627
    Entered Taper Discontinuation Phase
    100 [4]
    107 [5]
    0 [6]
    0 [7]
    Entered Abrupt Discontinuation Phase
    100 [8]
    108 [9]
    221
    586
    Completed
    196
    197
    210
    559
    Not completed
    35
    33
    30
    68
         Physician decision
    2
    -
    2
    1
         Consent withdrawn by subject
    9
    7
    5
    24
         Adverse event, non-fatal
    10
    15
    7
    14
         Sponsor Decision
    -
    -
    2
    6
         Lost to follow-up
    3
    -
    2
    9
         Lack of efficacy
    10
    6
    8
    9
         Protocol deviation
    1
    5
    4
    5
    Notes
    [3] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC phase or abrupt DC phase.
    [4] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC phase or abrupt DC phase.
    [5] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC (discontinuation) phase or abrupt DC phase.
    [6] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC phase or abrupt DC phase.
    [7] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC phase or abrupt DC phase.
    [8] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC phase or abrupt DC phase.
    [9] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Participants who completed the AT Phase or discontinued early entered the taper DC phase or abrupt DC phase.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    12 mg LY2216684 + SSRI (Randomized Participants)
    Reporting group description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a SSRI

    Reporting group title
    18 mg LY2216684 + SSRI (Randomized Participants)
    Reporting group description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI

    Reporting group title
    Placebo + SSRI (Randomized Participants)
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI

    Reporting group title
    Placebo + SSRI (Non-Randomized Participants)
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks

    Reporting group values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants) Placebo + SSRI (Non-Randomized Participants) Total
    Number of subjects
    231 230 240 627 1328
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    44.95 ( 12.38 ) 46.06 ( 12.82 ) 44.38 ( 10.6 ) 44.73 ( 11.89 ) -
    Gender, Male/Female
    Units:
        Male
    86 81 85 176 428
        Female
    145 149 155 451 900
    Region of Enrollment
    Units: Subjects
        United States
    73 76 74 318 541
        Poland
    46 52 51 63 212
        Ukraine
    33 29 29 36 127
        Russian Federation
    6 6 6 15 33
        South Africa
    10 9 10 44 73
        Latvia
    16 14 17 34 81
        Japan
    47 44 53 117 261
    Race
    Units: Subjects
        American Indian or Alaska Native
    0 0 0 2 2
        Asian
    47 45 56 121 269
        Native Hawaiian or Other Pacific Islander
    0 0 0 0 0
        Black or African American
    14 14 19 65 112
        White
    164 170 164 429 927
        More than one race
    5 1 0 9 15
        Unknown or Not Reported
    1 0 1 1 3
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    9 7 7 28 51
        Not Hispanic or Latino
    181 172 188 520 1061
        Unknown or Not Reported
    41 51 45 79 216

    End points

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    End points reporting groups
    Reporting group title
    Placebo + SSRI (Pre-Randomized Participants)
    Reporting group description
    -
    Reporting group title
    12 mg LY2216684 + SSRI (Randomized Participants)
    Reporting group description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a SSRI

    Reporting group title
    18 mg LY2216684 + SSRI (Randomized Participants)
    Reporting group description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI

    Reporting group title
    Placebo + SSRI (Randomized Participants)
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI

    Reporting group title
    Placebo + SSRI (Non-Randomized Participants)
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks

    Subject analysis set title
    12 mg LY2216684 + SSRI (Randomized Participants)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a selective serotonin reuptake inhibitor (SSRI)

    Subject analysis set title
    18 mg LY2216684 + SSRI (Randomized Participants)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI

    Subject analysis set title
    Placebo + SSRI (Randomized Participants)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI

    Subject analysis set title
    Placebo + SSRI (Non-Randomized Participants)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI

    Subject analysis set title
    LY2216684 + SSRI
    Subject analysis set type
    Full analysis
    Subject analysis set description
    LY2216684: fixed doses of 12 milligrams (mg) administered orally, once daily for 8 weeks, adjunctive to a selective serotonin reuptake inhibitor (SSRI) or 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI

    Primary: Change from Randomization to Week 8 in the Montgomery-Asberg Depression Rating Scale (MADRS) total score

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    End point title
    Change from Randomization to Week 8 in the Montgomery-Asberg Depression Rating Scale (MADRS) total score [1]
    End point description
    The MADRS is a rating scale for severity of depressive mood symptoms. The MADRS had a 10-item checklist. Items were rated on a scale of 0 to 6, for a total score range of 0 (low severity of depressive symptoms) to 60 (high severity of depressive symptoms). Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Primary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: units on a scale
        least squares mean (standard error)
    -8.47 ( 0.52 )
    -8.7 ( 0.53 )
    -7.77 ( 0.51 )
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    12 mg LY2216684 + SSRI (Randomized Participants) v Placebo + SSRI (Randomized Participants)
    Number of subjects included in analysis
    470
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.338 [2]
    Method
    Mixed models analysis
    Confidence interval
    Notes
    [2] - In order to test the primary outcome between each LY2216684 dose and placebo while controlling the overall Type I error at 0.05, the significance level was a priori partitioned equally between the 2 LY2216684 dose-placebo comparisons at 0.025.
    Statistical analysis title
    Statistical Analysis 2
    Comparison groups
    18 mg LY2216684 + SSRI (Randomized Participants) v Placebo + SSRI (Randomized Participants)
    Number of subjects included in analysis
    470
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.201 [3]
    Method
    Mixed models analysis
    Confidence interval
    Notes
    [3] - In order to test the primary outcome between each LY2216684 dose and placebo while controlling the overall Type I error at 0.05, the significance level was a priori partitioned equally between the 2 LY2216684 dose-placebo comparisons at 0.025.

    Secondary: Change from Randomization to Week 8 in Sheehan Disability Scale (SDS) Global Functional Impairment Scale

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    End point title
    Change from Randomization to Week 8 in Sheehan Disability Scale (SDS) Global Functional Impairment Scale [4]
    End point description
    The SDS was completed by the participant and used to assess the effect of the participant's symptoms on their work (Item 1), social (Item 2), and family life (Item 3). Each item is measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption. The Global Function Impairment Score is the sum of the 3 items, and scores ranged from 0 to 30 with higher values indicating disruption in the participant's work life (work/school impairment score), social life (social life/leisure activities impairment score), and family life (family life/home responsibilities impairment score). Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    222
    236
    Units: units on a scale
        least squares mean (standard error)
    -5.36 ( 0.44 )
    -5.27 ( 0.44 )
    -4.47 ( 0.43 )
    No statistical analyses for this end point

    Secondary: Change from Randomization to Week 8 in Fatigue Associated with Depression (FAsD) Impact Subscale Score

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    End point title
    Change from Randomization to Week 8 in Fatigue Associated with Depression (FAsD) Impact Subscale Score [5]
    End point description
    The FAsD is a participant-rated scale with a total of 13 items. Six of the 13 items ask how often participants experience different aspects of fatigue with responses from 1 (never) to 5 (always). Seven of the 13 items ask how often fatigue impacts various aspects of the participant's lives with responses from 1 (not at all) to 5 (very much). The impact subscale score was derived by taking the mean of Items 7 through 13 (applicable items only). Item 12 applied only to participants with a spouse or significant other, and Item 13 applied to participants who had a job or who went to school. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline subscale score, treatment-by-visit and baseline subscale score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    221
    236
    Units: units on a scale
        least squares mean (standard error)
    -0.74 ( 0.06 )
    -0.66 ( 0.06 )
    -0.53 ( 0.06 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving a Montgomery-Asberg Depression Rating Scale (MADRS) Total Score of Less Than or Equal 10 up to Week 8

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    End point title
    Percentage of Participants Achieving a Montgomery-Asberg Depression Rating Scale (MADRS) Total Score of Less Than or Equal 10 up to Week 8 [6]
    End point description
    A MADRS total score of less than or equal to 10 was defined as remission criteria. The MADRS is a rating scale for severity of depressive mood symptoms. The MADRS had a 10-item checklist. Items were rated on a scale of 0 to 6 for a total score range of 0 (low severity of depressive symptoms) to 60 (high severity of depressive symptoms). Percentage of participants was calculated by dividing the number of participants who meet criteria for remission by the total number of participants analyzed, multiplied by 100%. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization up to 8 weeks
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: percentage of participants
        number (not applicable)
    27.83
    26.96
    26.67
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving a Montgomery-Asberg Depression Rating Scale (MADRS) Total Score of Less Than or Equal 10 for at Least 2 Consecutive Measurements, Including the Participant's Last Measurement

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    End point title
    Percentage of Participants Achieving a Montgomery-Asberg Depression Rating Scale (MADRS) Total Score of Less Than or Equal 10 for at Least 2 Consecutive Measurements, Including the Participant's Last Measurement [7]
    End point description
    A MADRS total score of less than or equal to 10 for at least 2 consecutive measurements, including the participant's last measurement, was defined as remission criteria at last 2 consecutive visits. The MADRS is a rating scale for severity of depressive mood symptoms. The MADRS had a 10-item checklist. Items were rated on a scale of 0 to 6 for a total score range of 0 (low severity of depressive symptoms) to 60 (high severity of depressive symptoms). Percentage of participants was calculated by dividing the number of participants who meet criteria for remission at last 2 consecutive visits by the total number of participants analyzed, multiplied by 100%. Analysis population included all randomized participants with a baseline and at least one post-baseline value.
    End point type
    Secondary
    End point timeframe
    Randomization up to 8 weeks
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: percentage of participants
        number (not applicable)
    16.96
    19.13
    19.58
    No statistical analyses for this end point

    Secondary: Change from Randomization to Week 8 in Hospital and Anxiety and Depression Scale (HADS) Anxiety Subscale Score

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    End point title
    Change from Randomization to Week 8 in Hospital and Anxiety and Depression Scale (HADS) Anxiety Subscale Score [8]
    End point description
    The HADS is a 14-item questionnaire with 2 subscales: anxiety and depression. Each item was rated on a 4-point scale (0-3), giving maximum scores of 21 for anxiety and depression subscale. Scores of 11 or more on either subscale were considered to be a significant 'case' of psychological morbidity, while scores of 8-10 represent 'borderline' and 0-7 represent 'normal'. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline subscale score, treatment-by-visit, and baseline subscale score-by-visit. Analysis population included all randomized participants with a baseline and at least one post-baseline value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    239
    Units: units on a scale
        least squares mean (standard error)
    -1.97 ( 0.22 )
    -2.05 ( 0.22 )
    -1.85 ( 0.22 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants Who Have a Greater Than or Equal to 50 Percent Improvement in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization up to Week 8

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    End point title
    Percentage of Participants Who Have a Greater Than or Equal to 50 Percent Improvement in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization up to Week 8 [9]
    End point description
    A greater than or equal to 50 percent improvement (that is, a decrease from baseline) in the MADRS total score was defined as response criteria. The MADRS is a rating scale for severity of depressive mood symptoms. The MADRS had a 10-item checklist. Items were rated on a scale of 0 to 6, for a total score range of 0 (low severity of depressive symptoms) to 60 (high severity of depressive symptoms). Percentage of participants was calculated by dividing the number of participants meeting response criteria at last visit by the total number of participants analyzed, multiplied by 100%. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization up to 8 weeks
    Notes
    [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: percentage of participants
        number (not applicable)
    30.43
    34.35
    27.08
    No statistical analyses for this end point

    Secondary: Change from Randomization to Week 8 in Hospital Anxiety and Depression Scale (HADS) depression subscale score

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    End point title
    Change from Randomization to Week 8 in Hospital Anxiety and Depression Scale (HADS) depression subscale score [10]
    End point description
    The HADS is a 14-item questionnaire with 2 subscales: anxiety and depression. Each item was rated on a 4-point scale (0-3), giving maximum scores of 21 for anxiety and depression subscale. Scores of 11 or more on either subscale were considered to be a significant 'case' of psychological morbidity, while scores of 8-10 represent 'borderline' and 0-7 represent 'normal'. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline subscale score, treatment-by-visit and baseline subscale score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [10] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    239
    Units: units on a scale
        least squares mean (standard error)
    -3.19 ( 0.26 )
    -3.38 ( 0.27 )
    -2.76 ( 0.26 )
    No statistical analyses for this end point

    Secondary: Change from randomization to week 8 in Clinical Global Impressions of Severity (CGI-S)

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    End point title
    Change from randomization to week 8 in Clinical Global Impressions of Severity (CGI-S) [11]
    End point description
    CGI-S measures severity of depression at the time of assessment compared with the start of treatment. Scores range from 1 (normal, not at all ill) to 7 (among the most extremely ill participants). Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [11] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: units on a scale
        least squares mean (standard error)
    -1.01 ( 0.07 )
    -1.08 ( 0.07 )
    -0.95 ( 0.07 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Montgomery-Asberg Depression Rating Scale (MADRS) Individual Items

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    End point title
    Change From Randomization to Week 8 in Montgomery-Asberg Depression Rating Scale (MADRS) Individual Items [12]
    End point description
    The MADRS is a rating scale for severity of depressive mood symptoms. The MADRS had a 10-item checklist (sadness [apparent], sadness [reported], inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts). Items were rated on a scale of 0 to 6, for a total score range of 0 (low severity of depressive symptoms) to 60 (high severity of depressive symptoms). Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline item score, treatment-by-visit and baseline item score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [12] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: units on a scale
    least squares mean (standard error)
        Apparent sadness
    -1.18 ( 0.08 )
    -1.04 ( 0.08 )
    -1.01 ( 0.08 )
        Reported sadness
    -1.21 ( 0.08 )
    -1.2 ( 0.08 )
    -1 ( 0.08 )
        Inner tension
    -0.71 ( 0.07 )
    -0.74 ( 0.07 )
    -0.65 ( 0.07 )
        Reduced sleep
    -0.97 ( 0.09 )
    -0.94 ( 0.09 )
    -0.83 ( 0.08 )
        Reduced appetite
    -0.82 ( 0.08 )
    -0.74 ( 0.08 )
    -0.75 ( 0.08 )
        Concentration difficulties
    -0.88 ( 0.08 )
    -1.01 ( 0.08 )
    -0.94 ( 0.08 )
        Lassitude
    -1.04 ( 0.08 )
    -1.12 ( 0.08 )
    -0.89 ( 0.08 )
        Inability to feel
    -1.05 ( 0.08 )
    -1.07 ( 0.08 )
    -0.9 ( 0.08 )
        Pessimistic thoughts
    -0.77 ( 0.07 )
    -0.74 ( 0.07 )
    -0.74 ( 0.07 )
        Suicidal thoughts
    -0.09 ( 0.03 )
    -0.13 ( 0.03 )
    -0.15 ( 0.03 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Sheehan Disability Scale (SDS) Items

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    End point title
    Change From Randomization to Week 8 in Sheehan Disability Scale (SDS) Items [13]
    End point description
    The Sheehan Disability Scale (SDS) was completed by the participant and used to assess the effect of the participant's symptoms on their work (work/school impairment score), social life (social life/leisure activities impairment score), and family life (family life/home responsibilities impairment score). Each item is measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline item score, treatment-by-visit, and baseline item score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [13] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    222
    236
    Units: units on a scale
    least squares mean (standard error)
        Work impairment score (n=149, 145, 167)
    -1.77 ( 0.19 )
    -1.74 ( 0.2 )
    -1.44 ( 0.19 )
        Social life impairment score (n=224, 222, 236)
    -1.85 ( 0.16 )
    -1.81 ( 0.16 )
    -1.64 ( 0.16 )
        Family life impairment score (224, 222, 236)
    -1.72 ( 0.16 )
    -1.71 ( 0.16 )
    -1.43 ( 0.15 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Fatigue Associated with Depression (FAsD) Average Score and Experience Subscale Score

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    End point title
    Change From Randomization to Week 8 in Fatigue Associated with Depression (FAsD) Average Score and Experience Subscale Score [14]
    End point description
    The FAsD is a participant-rated scale with a total of 13 items. 6 of the 13 items ask how often participants experience different aspects of fatigue with responses from 1 (never) to 5 (always). 7 of the 13 items ask how often fatigue impacts various aspects of the participant's lives with responses from 1 (not at all) to 5 (very much). The experience subscale score was derived by taking the mean of Items 1 through 6, and the average score was the mean of Items 1 through 13(derived by taking the mean of all applicable items for each participant).Item 12 applied only to participants with a spouse or significant other, and Item 13 applied to participants who had a job or who went to school. LS means were calculated using MMRM adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [14] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    221
    236
    Units: units on a scale
    least squares mean (standard error)
        Average score
    -0.69 ( 0.05 )
    -0.67 ( 0.05 )
    -0.57 ( 0.05 )
        Experience score
    -0.66 ( 0.06 )
    -0.67 ( 0.06 )
    -0.6 ( 0.05 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in the EuroQol Questionnaire-5 Dimension (EQ-5D)

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    End point title
    Change From Randomization to Week 8 in the EuroQol Questionnaire-5 Dimension (EQ-5D) [15]
    End point description
    The EQ-5D Visual Analog Scale is a generic, multidimensional, health-related, quality-of-life instrument. Overall health state score is self-reported using a visual analogue scale, marked on a scale of 0 to 100 with 0 representing the worst imaginable health state and 100 representing best imaginable health state. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [15] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    222
    236
    Units: units on a scale
        least squares mean (standard error)
    12.201 ( 1.218 )
    12.762 ( 1.225 )
    9.756 ( 1.188 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF)

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    End point title
    Change From Randomization to Week 8 in the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) [16]
    End point description
    The Q-LES-Q-SF is a self-administered 16-item questionnaire that measures degree of enjoyment and satisfaction experienced in various areas of daily life during the past week on a 5-point, Likert scale (1=very poor and 5=very good). The total raw score is the sum of items 1 to 14 and ranges from 14 to 70. The raw scores are converted to and expressed as the percentage of the maximum possible score. Higher scores indicate higher levels of enjoyment/satisfaction. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [16] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    222
    236
    Units: percentage of maximum possible score
        least squares mean (standard error)
    10.51 ( 0.98 )
    9.93 ( 0.98 )
    8.47 ( 0.95 )
    No statistical analyses for this end point

    Secondary: Percentage of Treatment Emergent (TE) Suicidal Ideation and Behaviors Assessed by Columbia-Suicide Severity Rating Scale (C-SSRS)

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    End point title
    Percentage of Treatment Emergent (TE) Suicidal Ideation and Behaviors Assessed by Columbia-Suicide Severity Rating Scale (C-SSRS) [17]
    End point description
    The C-SSRS captured occurrence, severity, and frequency of suicide-related thoughts and behaviors.Suicidal ideation (SI) was defined as a 'yes' answer to any 1 of 5 SI questions, which included a wish to be dead and 4 different categories of active SI. Suicidal behavior was defined as a 'yes' answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide.SI and behavior are defined as TE if not present at baseline. Percentage of participants was calculated by dividing the number of participants with suicide-related TE events by the total number of participants at risk, multiplied by 100%. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Event module. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization through 8 weeks
    Notes
    [17] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: percentage of participants
    number (not applicable)
        TE of suicidal ideation (n=230, 230, 240)
    3.91
    3.91
    3.33
        TE of suicidal behavior (n=209, 214, 226)
    0
    0.47
    0.44
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Arizona Sexual Experiences (ASEX) Scale

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    End point title
    Change From Randomization to Week 8 in Arizona Sexual Experiences (ASEX) Scale [18]
    End point description
    The ASEX scale was used to assess sexual functioning in both males and females. The ASEX total score for the male and female version was calculated as the sum of the responses (rated from 1 [extremely] to 6 [no/never]) to the 5 items of the ASEX scale. Total scores ranged from 5 to 30 with higher scores indicating greater sexual dysfunction. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [18] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    222
    220
    233
    Units: units on a scale
        least squares mean (standard error)
    -1.32 ( 0.26 )
    -1.27 ( 0.26 )
    -0.79 ( 0.25 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ)

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    End point title
    Change From Randomization to Week 8 in Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) [19]
    End point description
    The CPFQ is a 7-item participant-rated questionnaire pertaining to a participant's cognitive and physical well-being. It assesses motivation, wakefulness, energy, focus, recall, word-finding difficulty, and mental acuity. Each item was scored on a 6-point scale ranging from 1 (greater than normal) to 6 (totally absent). Total scores ranged from 7 to 42. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline score, treatment-by-visit and baseline score-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [19] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    224
    222
    236
    Units: units on a scale
        least squares mean (standard error)
    -4.7 ( 0.37 )
    -4.41 ( 0.38 )
    -3.79 ( 0.36 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Blood Pressure (BP)

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    End point title
    Change From Randomization to Week 8 in Blood Pressure (BP) [20]
    End point description
    Blood pressure (BP) measurements were collected when the participant was in a sitting position. Three measurements of sitting BP collected at approximately 1-minute intervals at every visit were averaged and used as the value for the visit. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline value, treatment-by-visit and baseline value-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [20] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: millimeters of mercury (mmHg)
    least squares mean (standard error)
        Sitting systolic BP
    2.11 ( 0.57 )
    3.18 ( 0.57 )
    0.02 ( 0.55 )
        Sitting diastolic BP
    3.57 ( 0.43 )
    4 ( 0.43 )
    0.66 ( 0.42 )
    No statistical analyses for this end point

    Secondary: The Percentage of Participants Experiencing Treatment-Emergent Adverse Events as a Function of CYP2D6 Phenotype

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    End point title
    The Percentage of Participants Experiencing Treatment-Emergent Adverse Events as a Function of CYP2D6 Phenotype [21]
    End point description
    Treatment-emergent adverse events (TEAEs) were events that first occurred or worsened during the treatment phase. CYP2D6 functional phenotype was classified as poor metabolizer (PM) or non-poor metabolizer (non-PM). The percentage of participants who reported the TEAE is presented for each phenotype classification. Only TEAEs for which there was a statistically significant treatment-by-SSRI therapy interaction were included: tinnitus and influenza. A summary of serious and other non-serious adverse events regardless of causality is located in the Report of Adverse Events module. Analysis population included all randomized patients who do not discontinue from the study for the reason 'Lost to follow-up' at the first post-baseline visit.
    End point type
    Secondary
    End point timeframe
    Through 8 weeks
    Notes
    [21] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    144
    140
    157
    Units: percentage of participants
    number (not applicable)
        Tinnitus non-PM (n=144, 140, 157)
    0
    0
    1.27
        Tinnitus PM (n=77, 83, 76)
    0
    3.61
    0
        Influenza non-PM (n=144, 140, 157)
    1.39
    0
    0.64
        Influenza PM (n=77, 83, 76)
    0
    2.41
    0
    No statistical analyses for this end point

    Secondary: Pharmacokinetics: Plasma Concentrations of LY2216684

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    End point title
    Pharmacokinetics: Plasma Concentrations of LY2216684
    End point description
    A validated bioanalytical assay was used to determine plasma LY2216684 concentrations. Participants exposed to LY2216684 with evaluable plasma concentration values. Samples with concentrations below the lower quantification limit (BQL) of the assay were treated as missing values for the analysis and samples with incomplete dosing information were not included in the pharmacokinetics assessment. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    1 week, 4 weeks, and 8 weeks
    End point values
    LY2216684 + SSRI
    Number of subjects analysed
    442
    Units: nanograms per milliliter (ng/mL)
    arithmetic mean (standard deviation)
        12 mg dose (n=427)
    37.8 ( 20.7 )
        18 mg dose (n=202)
    55.3 ( 30.4 )
    No statistical analyses for this end point

    Secondary: Change From Randomization to Week 8 in Pulse Rate

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    End point title
    Change From Randomization to Week 8 in Pulse Rate [22]
    End point description
    Pulse measurements were collected when the participant was in a sitting position. Least Squares (LS) means were calculated using mixed model repeated measures (MMRM) adjusting for treatment, investigator, visit, baseline value, treatment-by-visit and baseline value-by-visit. Analysis population included all randomized participants who have non-missing values at the time of randomization and at least one post-randomization value.
    End point type
    Secondary
    End point timeframe
    Randomization, 8 weeks
    Notes
    [22] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistics are being reported for all randomized participants per the protocol or Statistical Analysis Plan.
    End point values
    12 mg LY2216684 + SSRI (Randomized Participants) 18 mg LY2216684 + SSRI (Randomized Participants) Placebo + SSRI (Randomized Participants)
    Number of subjects analysed
    230
    230
    240
    Units: beats per minute (bpm)
        least squares mean (standard error)
    8.66 ( 0.64 )
    9.12 ( 0.64 )
    -1.41 ( 0.62 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Entire Study
    Adverse event reporting additional description
    H9P-MC-LNBM
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    Placebo + SSRI (Pre-randomized) CF Phase
    Reporting group description
    Placebo: Administered orally, once daily for 3 weeks, adjunctive to a selective serotonin reuptake inhibitor (SSRI) Includes all enrolled participants who did not discontinue for the reason 'Lost to Follow-up' at the first post-baseline visit during the Confirmation (CF) Phase.

    Reporting group title
    12 mg LY2216684 + SSRI (Randomized) AT Phase
    Reporting group description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a SSRI, during the adjunctive treatment phase. Includes randomized participants who did not discontinue for the reason 'Lost to Follow-up' at the first post-randomization visit during the Adjunctive Treatment (AT) Phase.

    Reporting group title
    18 mg LY2216684 + SSRI (Randomized) AT Phase
    Reporting group description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI, during the adjunctive treatment phase. Includes randomized participants who did not discontinue for the reason 'Lost to Follow-up' at the first post-randomization visit during the Adjunctive Treatment (AT) Phase.

    Reporting group title
    Placebo + SSRI (Randomized) AT Phase
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI, during the adjunctive treatment phase Includes randomized participants who did not discontinue for the reason 'Lost to Follow-up' at the first post-randomization visit during the Adjunctive Treatment (AT) Phase.

    Reporting group title
    Placebo + SSRI (Non-randomized) AT Phase
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI, during the adjunctive treatment phase. Includes all non-randomized participants who did not discontinue for the reason 'Lost to Follow-up' at the first post-randomization visit during the Adjunctive Treatment (AT) Phase.

    Reporting group title
    Placebo + SSRI (Pre-randomized) Discontinuation Phase
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI, during the adjunctive treatment phase. Includes all enrolled participants who abruptly discontinued placebo after early withdrawal during the Confirmation (CF) Phase and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Reporting group title
    18 mg LY2216684 + SSRI (Taper Discontinuation Phase)
    Reporting group description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI, during the adjunctive treatment phase Includes all randomized participants who tapered discontinuation of LY2216684 either at the end of the study or after early withdrawal from the study and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Reporting group title
    12 mg LY2216684 + SSRI (Abrupt Discontinuation Phase)
    Reporting group description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a SSRI Includes all randomized participants who abruptly discontinued LY2216684 either at the end of the study or after early withdrawal from the study and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Reporting group title
    12 mg LY2216684 + SSRI (Taper Discontinuation Phase)
    Reporting group description
    LY2216684: 12 milligrams (mg), administered orally, once daily for 8 weeks, adjunctive to a SSRI Includes all randomized participants who tapered discontinuation of LY2216684 either at the end of the study or after early withdrawal from the study and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Reporting group title
    18 mg LY2216684 + SSRI (Abrupt Discontinuation Phase)
    Reporting group description
    LY2216684: 12 mg, administered orally, once daily for 1 week, followed by 18 mg, administered orally, once daily for 7 weeks, adjunctive to a SSRI, during the adjunctive treatment phase Includes all randomized participants who abruptly discontinued LY2216684 either at the end of the study or after early withdrawal from the study and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Reporting group title
    Placebo + SSRI (Randomized) Discontinuation Phase
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI, during the adjunctive treatment phase. Includes all randomized participants who discontinued placebo either at the end of the study or after early withdrawal from the study and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Reporting group title
    Placebo + SSRI (Non-randomized) Discontinuation Phase
    Reporting group description
    Placebo: Administered orally, once daily for 8 weeks, adjunctive to a SSRI, during the adjunctive treatment phase. Includes all non-randomized participants who discontinued placebo either at the end of the study or after early withdrawal from the study and who did not discontinue for the reason 'Lost to Follow-up' at the Discontinuation (DC) Phase visit.

    Serious adverse events
    Placebo + SSRI (Pre-randomized) CF Phase 12 mg LY2216684 + SSRI (Randomized) AT Phase 18 mg LY2216684 + SSRI (Randomized) AT Phase Placebo + SSRI (Randomized) AT Phase Placebo + SSRI (Non-randomized) AT Phase Placebo + SSRI (Pre-randomized) Discontinuation Phase 18 mg LY2216684 + SSRI (Taper Discontinuation Phase) 12 mg LY2216684 + SSRI (Abrupt Discontinuation Phase) 12 mg LY2216684 + SSRI (Taper Discontinuation Phase) 18 mg LY2216684 + SSRI (Abrupt Discontinuation Phase) Placebo + SSRI (Randomized) Discontinuation Phase Placebo + SSRI (Non-randomized) Discontinuation Phase
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 1413 (0.14%)
    3 / 231 (1.30%)
    2 / 230 (0.87%)
    1 / 240 (0.42%)
    5 / 627 (0.80%)
    1 / 20 (5.00%)
    1 / 107 (0.93%)
    1 / 108 (0.93%)
    1 / 100 (1.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    1 / 585 (0.17%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    0
    Investigations
    blood pressure increased
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    1 / 627 (0.16%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    electrocardiogram qt prolonged
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    1 / 627 (0.16%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    colon cancer metastatic
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    1 / 627 (0.16%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    1 / 585 (0.17%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    oesophageal carcinoma
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    1 / 1413 (0.07%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    1 / 20 (5.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    arteriosclerosis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    1 / 230 (0.43%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    1 / 107 (0.93%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    gastritis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    1 / 231 (0.43%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    oesophageal achalasia
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    1 / 1413 (0.07%)
    1 / 231 (0.43%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    1 / 108 (0.93%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    cholecystitis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    1 / 100 (1.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    cholelithiasis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    1 / 627 (0.16%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    depression
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    1 / 230 (0.43%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    suicidal ideation
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    1 / 231 (0.43%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    suicide attempt
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    1 / 240 (0.42%)
    0 / 627 (0.00%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    sialoadenitis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    0 / 1413 (0.00%)
    0 / 231 (0.00%)
    0 / 230 (0.00%)
    0 / 240 (0.00%)
    1 / 627 (0.16%)
    0 / 20 (0.00%)
    0 / 107 (0.00%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo + SSRI (Pre-randomized) CF Phase 12 mg LY2216684 + SSRI (Randomized) AT Phase 18 mg LY2216684 + SSRI (Randomized) AT Phase Placebo + SSRI (Randomized) AT Phase Placebo + SSRI (Non-randomized) AT Phase Placebo + SSRI (Pre-randomized) Discontinuation Phase 18 mg LY2216684 + SSRI (Taper Discontinuation Phase) 12 mg LY2216684 + SSRI (Abrupt Discontinuation Phase) 12 mg LY2216684 + SSRI (Taper Discontinuation Phase) 18 mg LY2216684 + SSRI (Abrupt Discontinuation Phase) Placebo + SSRI (Randomized) Discontinuation Phase Placebo + SSRI (Non-randomized) Discontinuation Phase
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    240 / 1413 (16.99%)
    71 / 231 (30.74%)
    73 / 230 (31.74%)
    36 / 240 (15.00%)
    100 / 627 (15.95%)
    3 / 20 (15.00%)
    19 / 107 (17.76%)
    17 / 108 (15.74%)
    15 / 100 (15.00%)
    18 / 108 (16.67%)
    39 / 221 (17.65%)
    106 / 585 (18.12%)
    Cardiac disorders
    tachycardia
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    4 / 1413 (0.28%)
    16 / 231 (6.93%)
    23 / 230 (10.00%)
    0 / 240 (0.00%)
    3 / 627 (0.48%)
    0 / 20 (0.00%)
    1 / 107 (0.93%)
    0 / 108 (0.00%)
    0 / 100 (0.00%)
    0 / 108 (0.00%)
    0 / 221 (0.00%)
    0 / 585 (0.00%)
         occurrences all number
    4
    16
    24
    0
    4
    0
    1
    0
    0
    0
    0
    0
    Nervous system disorders
    dizziness
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    45 / 1413 (3.18%)
    8 / 231 (3.46%)
    12 / 230 (5.22%)
    5 / 240 (2.08%)
    13 / 627 (2.07%)
    0 / 20 (0.00%)
    8 / 107 (7.48%)
    3 / 108 (2.78%)
    5 / 100 (5.00%)
    3 / 108 (2.78%)
    7 / 221 (3.17%)
    34 / 585 (5.81%)
         occurrences all number
    48
    9
    13
    10
    16
    0
    11
    3
    5
    4
    9
    42
    headache
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    116 / 1413 (8.21%)
    22 / 231 (9.52%)
    18 / 230 (7.83%)
    14 / 240 (5.83%)
    39 / 627 (6.22%)
    3 / 20 (15.00%)
    10 / 107 (9.35%)
    13 / 108 (12.04%)
    7 / 100 (7.00%)
    10 / 108 (9.26%)
    26 / 221 (11.76%)
    69 / 585 (11.79%)
         occurrences all number
    136
    28
    18
    16
    47
    3
    18
    29
    9
    14
    36
    108
    Reproductive system and breast disorders
    erectile dysfunction
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed [1]
    3 / 447 (0.67%)
    2 / 86 (2.33%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
    2 / 176 (1.14%)
    1 / 6 (16.67%)
    0 / 37 (0.00%)
    0 / 37 (0.00%)
    0 / 41 (0.00%)
    0 / 38 (0.00%)
    0 / 81 (0.00%)
    0 / 168 (0.00%)
         occurrences all number
    3
    2
    1
    0
    2
    1
    0
    0
    0
    0
    0
    0
    Gastrointestinal disorders
    nausea
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    55 / 1413 (3.89%)
    11 / 231 (4.76%)
    17 / 230 (7.39%)
    1 / 240 (0.42%)
    13 / 627 (2.07%)
    0 / 20 (0.00%)
    6 / 107 (5.61%)
    2 / 108 (1.85%)
    1 / 100 (1.00%)
    5 / 108 (4.63%)
    4 / 221 (1.81%)
    19 / 585 (3.25%)
         occurrences all number
    57
    11
    21
    1
    13
    0
    6
    2
    1
    7
    4
    21
    Skin and subcutaneous tissue disorders
    hyperhidrosis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    17 / 1413 (1.20%)
    19 / 231 (8.23%)
    16 / 230 (6.96%)
    2 / 240 (0.83%)
    6 / 627 (0.96%)
    0 / 20 (0.00%)
    4 / 107 (3.74%)
    0 / 108 (0.00%)
    1 / 100 (1.00%)
    1 / 108 (0.93%)
    1 / 221 (0.45%)
    3 / 585 (0.51%)
         occurrences all number
    17
    20
    16
    2
    6
    0
    7
    0
    1
    3
    1
    3
    Infections and infestations
    nasopharyngitis
    alternative dictionary used: MedDRA 16.1
         subjects affected / exposed
    43 / 1413 (3.04%)
    18 / 231 (7.79%)
    10 / 230 (4.35%)
    15 / 240 (6.25%)
    34 / 627 (5.42%)
    0 / 20 (0.00%)
    2 / 107 (1.87%)
    3 / 108 (2.78%)
    2 / 100 (2.00%)
    3 / 108 (2.78%)
    11 / 221 (4.98%)
    10 / 585 (1.71%)
         occurrences all number
    45
    18
    10
    15
    37
    0
    2
    3
    2
    3
    11
    10
    Notes
    [1] - The number of subjects exposed to this adverse event is less than the total number of subjects exposed for the reporting group. These numbers are expected to be equal.
    Justification: This event is gender specific and that's why the total number of subjects exposed in this reporting group is less than the total number of subjects exposed.

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 May 2012
    Moved Fatigue Associated with Depression (FAsD) subscale from the secondary gatekeeper objective to additional secondary objective; changed statistical methodology; added information on potential interim analysis; Updated the details of how the sample size and power calculations are provided to ERBs.
    02 Aug 2012
    Added language for "re-screening"; Made modifications to interim analysis based on regulatory input and updated statistical methods.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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