E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
major depressive disorder (MDD) |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Psychiatry and Psychology [F] - Mental Disorders [F03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10025454 |
E.1.2 | Term | Major depressive disorder, recurrent episode |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10025463 |
E.1.2 | Term | Major depressive disorder, single episode |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to evaluate the efficacy of 3 fixed doses of Lu AA21004 (5, 10 and 20 mg QD) compared with placebo as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS) after 8 weeks of treatment in subjects with MDD. |
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E.2.2 | Secondary objectives of the trial |
To evaluate the efficacy of 3 fixed doses of Lu AA21004 QD compared with placebo based on other parameters of efficacy after 8 weeks of treatment.
To evaluate the effect of 3 fixed doses of Lu AA21004 QD on subject functioning compared with placebo after 8 weeks of treatment.
To evaluate the safety and tolerability of Lu AA21004 compared with placebo during the course of treatment.
Additional Objectives:
To evaluate the efficacy of 3 fixed doses of Lu AA21004 QD compared with placebo during the 8-week treatment period.
To evaluate the effect of 3 fixed doses of Lu AA21004 QD on anxiety symptoms compared with placebo after 8 weeks of treatment.
To evaluate potential discontinuation symptoms after the end of the treatment period.
To assess the treatment effect (Lu AA21004 or placebo) on suicidal ideation and behavior.
To analyze plasma concentrations of Lu AA21004 and its metabolites Lu AA34443 and Lu AA39835 in subjects with MDD for population pharmacokinetic analysis.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subject eligibility is determined according to the following criteria:
1. In the opinion of the investigator, the subject is capable of understanding and complying with protocol requirements.
2. The subject signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
3. The subject suffers from MDD as the primary diagnosis according to DSM-IV-TR criteria (classification code 296.2x and 296.3x).
4. The subject is a man or woman aged between 20 and 64 years at time of informed consent, inclusive.
5. The reported duration of the current major depressive episode is at least 3 months at the Screening Visit.
6. The subject has a MADRS total score ≥26 at the Screening and Baseline Visits.
7. The subject has a CGI-S score ≥4 at the Screening and Baseline Visits.
8. A female subject of childbearing potential* who is sexually active with a nonsterilized* male partner agrees to use routinely adequate contraception* from signing of informed consent throughout the duration of the study.
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E.4 | Principal exclusion criteria |
Any subject who meets any of the following criteria will not qualify for entry into the study:
1. The subject has one or more of the following conditions:
- Any current psychiatric disorder other than MDD as defined in the DSM-IV-TR (assessed by the Mini International Neuropsychiatric Interview: MINI). A subject who exhibits symptoms of anxiety is eligible unless the subject fulfills the diagnostic criteria for a current anxiety disorder per DSM-IV-TR.
- Current diagnosis or history of manic or hypomanic episode, schizophrenia or any other psychotic disorder, including major depression with psychotic features, mental retardation, organic mental disorders, or mental disorders due to a general medical condition as defined in the DSM-IV-TR.
- Current diagnosis or history of any substance-related disorder (except nicotine and caffeine-related disorders) as defined in the DSM-IV-TR. Subject with confirmed positive urine drug screens (except prescribed medication or a medication that does not constitute drug abuse) will be excluded.
- Presence or history of a clinically significant neurological disorder (including epilepsy).
- Neurodegenerative disorder. (Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, Huntington’s disease, etc.)
- Any DSM-IV-TR axis II disorder that might compromise the study.
2. The subject has a chronic liver disease.
3. The subject has a history of severe drug allergy or hypersensitivity.
4. The subject has a clinically significant unstable illness, for example, hepatic impairment or renal insufficiency, or a cardiovascular, pulmonary, gastrointestinal, endocrine, neurological, rheumatologic, immunologic, infectious, neoplastic, skin and subcutaneous tissue disorders or metabolic disturbance.
5. The current depressive symptoms of the subject are considered by the investigator to have been resistant to 2 adequate antidepressant treatments of at least 6 weeks duration each.
6. The subject has received electroconvulsive, vagal nerve stimulation, or repetitive transcranial magnetic stimulation therapy within 6 months prior to the Screening Visit.
7. The subject is currently receiving formal cognitive or behavioral therapy, systematic psychotherapy, or plans to initiate such therapy during the study.
8. The subject is at significant risk of suicide or has a score ≥5 on Item 10 (suicidal thoughts) of the MADRS, or has attempted suicide within 6 months prior to the Screening Visit.
9. The subject takes or has taken disallowed recent or concomitant medication or it is anticipated that the subject will require treatment with at least one of the disallowed concomitant medications during the study.
10. The subject has received any investigational compound within 12 weeks prior to the first dose of the study drug (Day-84 ~).
11. The subject has clinically significant abnormal vital signs at the Screening Visit as determined by the investigator.
12. The subject has an abnormal ECG at the Screening Visit as determined clinically significant by the investigator.
13. The subject has one or more laboratory values outside the reference range, based on the blood or urine samples taken at the Screening Visit, that are, in the investigator’s opinion, of potential risk to the subject’s safety.
14. The subject has a value of thyroid stimulating hormone (TSH) outside the normal range at the Screening Visit and deemed clinically significant by the investigator.
15. If female, the subject is pregnant or lactating or intending to become pregnant before, during, or within 1 month after participating in this study; or intending to donate ova during such time period.
16. The subject has previously participated in this study.
17. The subject has received Lu AA21004 in a previous clinical study.
18. The subject is an immediate family member, study site employee, or is in a dependant relationship with a study site employee who is involved in conduct of this study (eg, spouse, parent, child, sibling) or may consent under duress.
19. The subject has a disease or takes medication that could, in the investigator’s opinion, interfere with the assessments of safety, tolerability, or efficacy.
20. The subject is, in the investigator’s opinion, unsuitable for any reason.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is change from baseline in the MADRS total score after 8 weeks (last observation carried forward: LOCF) of treatment. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- MADRS response at Week 8 (LOCF), with response defined as a >=50% decrease in the MADRS total score from Baseline.
- MADRS remission at Week 8 (LOCF), with remission defined as a MADRS total score <=10.
- Clinical Global Impression Scale-Improvement (CGI-I) score at Week 8 (LOCF).
- Change from Baseline in Sheehan Disability Scale (SDS) total score at Week 8 (LOCF). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 36 |
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 | No |
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 |
Croatia |
Finland |
Germany |
Hong Kong |
India |
Korea, Republic of |
Latvia |
Malaysia |
Philippines |
Poland |
Romania |
Russian Federation |
Serbia |
Taiwan |
Ukraine |
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E.8.7 | Trial has a data monitoring committee | No |
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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Last visit of last subject |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 7 |