E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Major Depressive Episode Associated with Bipolar I Disorder |
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E.1.1.1 | Medical condition in easily understood language |
Depression in Bipolar Disorder |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10004939 |
E.1.2 | Term | Bipolar I disorder |
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 objective of Study SEP380-301 is to evaluate the efficacy, safety, and tolerability of SEP 4199 controlled release (CR) formulation given as monotherapy at fixed doses of 200 mg/day and 400 mg/day compared with placebo in the treatment of subjects with Major Depressive Episode associated with Bipolar I Disorder (Bipolar I Depression).
Primary Efficacy: Evaluate the efficacy of SEP-4199 CR in the reduction of depression symptoms, as measured using the Montgomery-Asberg Depression Rating Scale (MADRS).
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E.2.2 | Secondary objectives of the trial |
Secondary Efficacy: Evaluate the efficacy of SEP-4199 CR in global improvement of bipolar depression severity, as measured using the Clinical Global Impression-Bipolar Version-Severity of Illness, Depression scale (CGI-BP-S depression).
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Subject provides written informed consent and is willing and able to comply with the protocol in the opinion of the Investigator. 2.Subject or legally acceptable representative must possess an educational level and degree of understanding of English or the local language that enables them to communicate suitably with the Investigator and the study coordinator. 3.Subject is 18 to 65 years of age, inclusive, at the time of informed consent. 4.Subject meets DSM-5 criteria, based on the SCID-5-CT, for bipolar I disorder, current episode depressed with or without rapid cycling disease course (≥ 4 episodes of mood disturbance but < 8 episodes in the previous 12 months) with or without psychotic features. 5.Subject has a lifetime history of at least 1 manic episode or manic episode with mixed features corroborated by medical records. 6.Subject’s current major depressive episode is corroborated by medical records. 7.Subject’s current major depressive episode is ≥ 4 weeks and less than 12 months in duration at Screening. 8.Subject has a MADRS-S total score ≥ 22 at Screening. 9.Subjecthas a MADRS total score ≥ 22 at both Screening and Baseline. 10.Subject has a CGI-BP-S depression score ≥ 4 at both Screening and Baseline. 11.Subject has a YMRS total score ≤ 12 at both Screening and Baseline.
Please refer to Protocol for the complete list. |
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E.4 | Principal exclusion criteria |
1.Subject currently has any DSM-5 defined psychiatric diagnosis other than bipolar I disorder that was the primary focus of treatment in the past 6 months prior to Screening. 2.Subject has a lifetime history of, or symptoms consistent with, a major psychiatric diagnosis other than bipolar I disorder. These include (but are not limited to): schizophrenia, schizoaffective disorder, obsessive-compulsive disorder, or post-traumatic stress disorder. (Note: Subjects with a previous diagnosis of major depressive disorder or bipolar II disorder that was subsequently changed to bipolar I disorder are allowed.) 3.Subject has a history within the past 12 months prior to Screening of substance use disorder or moderate-to-severe tobacco (nicotine) use disorder. (Note: mild tobacco use disorder is acceptable.) 4.Subject has confirmed or suspected borderline personality disorder. 5.Subject demonstrates a decrease (improvement) of ≥ 25% in MADRS total score from Screening to Baseline. 6.Subject is considered by the Investigator to be at imminent risk of suicide or injury to self or others, or has a score ≥ 4 on MADRS item 10 (suicidal ideation) or answers “yes” to “suicidal ideation” item 4 (active suicidal ideation with some intent to act, without specific plan) or item 5 (active suicidal ideation with specific plan and intent) on the C-SSRS assessment at the Screening Visit (in the past 3 months [90 days]) or at Baseline. 7.Subject has received any psychotropic medication or herbal supplement within 3 days or 5 half-lives (whichever is longer) prior to Baseline or anticipates the need for psychotropic medications or herbal supplements during participation in this study, with the exception of the medications specified in Protocol Section 10.3. The following treatments have additional restrictions as specified below: a.Monoamine oxidase inhibitors (MAOIs) must be discontinued at least 28 days prior to Baseline. b.Fluoxetine, and olanzapine/fluoxetine combination must be discontinued at least 28 days prior to Baseline. c.Clozapine used at 200 mg/day or less for insomnia, agitation, or anxiety must be discontinued at least 28 days prior to Baseline. Subjects with a history of treatment with clozapine for any reason at doses greater than 200 mg/day or at doses less than or equal to 200 mg/day for a usage other than insomnia, agitation, or anxiety are excluded from study participation. d.Depot neuroleptics must have been discontinued at least one treatment cycle or at least 30 days (whichever is longer) prior to Baseline. e.Subject has received esketamine within 60 days prior to Baseline. f.Electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS) within 90 days prior to Baseline. g.Subjects with a history of treatment with vagus nerve stimulation (VNS) or deep brain stimulation (DBS) are excluded from study participation. 8.Subject initiated a new psychotherapeutic intervention (eg, psychotherapy) focused on treatment of bipolar I depression within the past 12 weeks prior to Screening. (Note: Subjects who have participated in ongoing psychotherapy treatment for at least 12 weeks prior to Screening will be permitted to continue this treatment during the study.) 9.Subject has a history of non-response to an adequate (6-week) trial of 3 or more antidepressants (with or without mood stabilizers) during the current major depressive episode. 10.Subject was hospitalized during the Screening Period without explicit approval by the Medical Monitor. (Note: Hospitalization during the Screening Period will not be allowed, except where required by local regulations, or when determined to be clinically indicated based on the subject’s psychiatric history and current psychiatric symptoms. Medical justification must be provided to the Medical Monitor and the Medical Monitor must approve the request for hospitalization.) 11.Subject has any clinically significant unstable medical condition or any clinically significant chronic disease that would pose a risk to the subject or that might confound the results of the study. (Note: Active medical conditions that are minor or well-controlled are not exclusionary if they do not affect risk to subject or study results. In cases in which the impact of the condition upon risk to subject or study results is unclear, the Medical Monitor should be consulted.) a.Hematological (including deep vein thrombosis) or bleeding disorder, renal, metabolic, endocrine, pulmonary, gastrointestinal, urological, cardiovascular (including unstable hypertension), hepatic, neurologic, or allergic disease that is clinically significant or unstable (except for seasonal allergies at time of dosing). considered stable] must be discussed with the Medical Monitor before being randomized in the study.)
Please refer to Protocol for the complete list.
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary Efficacy Endpoint: •Change from Baseline to Week 6 in MADRS total score
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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) |
Secondary Efficacy Endpoints: •Change from Baseline to Week 6 in CGI-BP-S depression score
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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 | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | No |
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 |
Ukraine |
Bulgaria |
Japan |
Russian Federation |
Serbia |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |