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    Clinical Trial Results:
    Interventional, Open-label Study Of Flexible Doses Of Vortioxetine On Depressive Symptoms In Patients With Major Depressive Disorder And Early Dementia

    Summary
    EudraCT number
    2019-001326-10
    Trial protocol
    ES   IT  
    Global end of trial date
    20 Jul 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    05 Aug 2023
    First version publication date
    05 Aug 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    18315A
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04294654
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    H. Lundbeck A/S
    Sponsor organisation address
    Ottiliavej 9, Valby, Denmark, 2500
    Public contact
    H. Lundbeck A/S, LundbeckClinicalTrials@lundbeck.com, +45 36301311, LundbeckClinicalTrials@lundbeck.com
    Scientific contact
    H. Lundbeck A/S, LundbeckClinicalTrials@lundbeck.com, +45 36301311, LundbeckClinicalTrials@lundbeck.com
    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
    20 Jul 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    20 Jul 2022
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary objective was to assess the effectiveness of 12-week acute treatment with flexible doses of 5-20 milligrams (mg) per day vortioxetine on depressive symptoms in participants with Major Depressive Disorder (MDD) and early dementia.
    Protection of trial subjects
    This study was conducted in compliance with Good Clinical Practice and in accordance with the ethical principles described in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Feb 2020
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 23
    Country: Number of subjects enrolled
    Estonia: 11
    Country: Number of subjects enrolled
    France: 2
    Country: Number of subjects enrolled
    Italy: 10
    Country: Number of subjects enrolled
    Poland: 37
    Worldwide total number of subjects
    83
    EEA total number of subjects
    83
    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)
    20
    From 65 to 84 years
    62
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 83 participants were screened. 82 participants received at least 1 dose of vortioxetine.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Vortioxetine
    Arm description
    Participants received vortioxetine daily for 12 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    vortioxetine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received vortioxetine daily for 12 weeks

    Number of subjects in period 1 [1]
    Vortioxetine
    Started
    82
    Received at least 1 dose of study drug
    82
    Completed
    69
    Not completed
    13
         Consent withdrawn by subject
    2
         Adverse event, non-fatal
    5
         Unspecified
    3
         Non-compliance with IMP
    1
         Lack of efficacy
    1
         Protocol deviation
    1
    Notes
    [1] - 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: A total of 83 participants were screened. 82 participants received at least 1 dose of vortioxetine.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Vortioxetine
    Reporting group description
    Participants received vortioxetine daily for 12 weeks.

    Reporting group values
    Vortioxetine Total
    Number of subjects
    82 82
    Age Categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    20 20
        From 65-84 years
    61 61
        85 years and over
    1 1
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    70.3 ( 7.25 ) -
    Gender Categorical
    Units: Subjects
        Female
    54 54
        Male
    28 28
    Montgomery and Åsberg Depression Rating Scale (MADRS) total score
    The MADRS is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptom) to 6 (severe symptom). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60.
    Units: score on a scale
        arithmetic mean (standard deviation)
    30.4 ( 3.85 ) -

    End points

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    End points reporting groups
    Reporting group title
    Vortioxetine
    Reporting group description
    Participants received vortioxetine daily for 12 weeks.

    Primary: Change from Baseline to Week 12 in Montgomery and Åsberg Depression Rating Scale (MADRS) Total Score

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    End point title
    Change from Baseline to Week 12 in Montgomery and Åsberg Depression Rating Scale (MADRS) Total Score [1]
    End point description
    The MADRS is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptom) to 6 (severe symptom). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60. The within-group p-value from Baseline to Week 12 was <0.0001 based on Mixed Model for Repeated Measures. The full-analysis set (FAS) included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Primary
    End point timeframe
    Baseline, Week 12
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Statistical analysis was entered in Description due to EudraCT system limitations for reporting on single-group studies.
    End point values
    Vortioxetine
    Number of subjects analysed
    70
    Units: score on a scale
        least squares mean (standard error)
    -12.4 ( 0.780 )
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 12 in Digit-Symbol Substitution Test (DSST) Total Score

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    End point title
    Change from Baseline to Week 12 in Digit-Symbol Substitution Test (DSST) Total Score
    End point description
    The DSST is a cognitive test designed to assess psychomotor speed of performance requiring visual perception, spatial decision-making and motor skills. The DSST is sensitive to cognitive impairments affecting attention, processing speed, and executive function (including working memory). The DSST consists of 133 digits and requires the participant to substitute each digit with a simple symbol in a 90-second period. Each correct symbol is counted, and the total score ranges from 0 (less than normal functioning) to 133 (greater than normal functioning). The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Secondary
    End point timeframe
    Baseline, Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    70
    Units: score on a scale
        least squares mean (standard error)
    4.9 ( 0.898 )
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 12 in Rey Auditory Verbal Learning Test (RAVLT) score

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    End point title
    Change from Baseline to Week 12 in Rey Auditory Verbal Learning Test (RAVLT) score
    End point description
    The RAVLT is a cognitive test intended to measure a participant's learning and memory. In this test, 2 lists of 15 nouns (List A and List B) are used. The maximum score is 15 per trial and is based on the number of words correctly recalled (0 to 15) for each trial. The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Secondary
    End point timeframe
    Baseline, Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    70
    Units: score on a scale
        least squares mean (standard error)
    2.1 ( 0.897 )
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 12 in Instrumental Activities of Daily Living (IADL) Total Score

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    End point title
    Change from Baseline to Week 12 in Instrumental Activities of Daily Living (IADL) Total Score
    End point description
    The IADL is a clinician-rated scale of a participant's daily functioning. The scale covers 8 functions: the participant’s ability to use the telephone, do the shopping, prepare food, do the housekeeping, laundry, take responsibility for their own medications and handle their own finances, and their mode of transportation. The scores for each function are then summed to yield a total score ranging from 0 (low function, dependent) to 8 (high function, independent). The rater assigns scores 1 to 3, 1 to 4, or 1 to 5, depending on the number of items in each function, and this yields a polytomous score ranging from 8 (high function, independent) to 31 (low function, dependent). The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Secondary
    End point timeframe
    Baseline, Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    73
    Units: score on a scale
        least squares mean (standard error)
    0.1 ( 0.123 )
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 12 in Clinical Global Impression – Severity of Illness (CGI-S) Score

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    End point title
    Change from Baseline to Week 12 in Clinical Global Impression – Severity of Illness (CGI-S) Score
    End point description
    The CGI-S provides the clinician’s impression of the participant's current state of mental illness. The clinician used his or her clinical experience of this participant's population to rate the severity of the participant's current mental illness on a 7-point scale ranging from 1 (Normal - not at all ill) to 7 (among the most extremely ill patients). The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Secondary
    End point timeframe
    Baseline, Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    73
    Units: score on a scale
        least squares mean (standard error)
    -1.0 ( 0.106 )
    No statistical analyses for this end point

    Secondary: Number of Participants Demonstrating Response (Defined as a ≥50% Decrease From Baseline in MADRS Total Score) at Week 12

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    End point title
    Number of Participants Demonstrating Response (Defined as a ≥50% Decrease From Baseline in MADRS Total Score) at Week 12
    End point description
    The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    82
    Units: Percentage of participants
        number (confidence interval 95%)
    35.7 (24.6 to 48.1)
    No statistical analyses for this end point

    Secondary: Clinical Global Impression – Improvement (CGI-I) Score at Week 12

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    End point title
    Clinical Global Impression – Improvement (CGI-I) Score at Week 12
    End point description
    The CGI-I provides the clinician’s impression of the participant's improvement (or worsening). The clinician assessed the participant’s condition relative to a baseline on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). In all cases, the assessment was made independent of whether the rater believed the improvement was drug-related. The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    73
    Units: score on a scale
        least squares mean (standard error)
    2.8 ( 0.107 )
    No statistical analyses for this end point

    Secondary: Change from Baseline to Week 12 in Bath Assessment of Subjective Quality of Life in Dementia (BASQID) Total Score

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    End point title
    Change from Baseline to Week 12 in Bath Assessment of Subjective Quality of Life in Dementia (BASQID) Total Score
    End point description
    The BASQID is a clinician-rated scale designed to assess subjective quality of life (QoL) in participants with dementia. The BASQID contains 14 core questions (Life Satisfaction and Feelings of Positive QoL), which are scored from 0 to 4, with 4 indicating a better QoL. The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score. Here, 'Overall number of subjects analyzed' signifies participants evaluable for this outcome measure
    End point type
    Secondary
    End point timeframe
    Baseline, Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    72
    Units: score on a scale
        least squares mean (standard error)
    5.7 ( 0.699 )
    No statistical analyses for this end point

    Secondary: Number of Participants with Remission (Defined as a MADRS Total Score ≤10) at Week 12

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    End point title
    Number of Participants with Remission (Defined as a MADRS Total Score ≤10) at Week 12
    End point description
    The FAS included all participants who had a valid baseline assessment and at least one valid post-baseline assessment of the MADRS total score.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Vortioxetine
    Number of subjects analysed
    82
    Units: Percentage of participants
        number (confidence interval 95%)
    17.1 (9.2 to 28.0)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From date of study drug administration (Day 1) up to Week 16
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Vortioxetine
    Reporting group description
    Participants received vortioxetine daily for 12 weeks.

    Serious adverse events
    Vortioxetine
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 82 (1.22%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    Infections and infestations
    Pneumonia bacterial
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    COVID-19 pneumonia
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Vortioxetine
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    38 / 82 (46.34%)
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    6 / 82 (7.32%)
         occurrences all number
    7
    Dizziness
         subjects affected / exposed
    3 / 82 (3.66%)
         occurrences all number
    3
    Psychomotor hyperactivity
         subjects affected / exposed
    2 / 82 (2.44%)
         occurrences all number
    2
    Somnolence
         subjects affected / exposed
    2 / 82 (2.44%)
         occurrences all number
    2
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    9 / 82 (10.98%)
         occurrences all number
    9
    Nausea
         subjects affected / exposed
    9 / 82 (10.98%)
         occurrences all number
    9
    Diarrhoea
         subjects affected / exposed
    3 / 82 (3.66%)
         occurrences all number
    3
    Abdominal pain upper
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Constipation
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Bronchitis chronic
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    3 / 82 (3.66%)
         occurrences all number
    3
    Psychiatric disorders
    Tension
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Thinking abnormal
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Anxiety
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Spinal pain
         subjects affected / exposed
    2 / 82 (2.44%)
         occurrences all number
    2
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    3 / 82 (3.66%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Hypercholesterolaemia
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1
    Decreased appetite
         subjects affected / exposed
    1 / 82 (1.22%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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