Trial Outcomes & Findings for A Study to Assess the Efficacy and Safety of TC-5214 as an Adjunct Therapy in Patients With Major Depressive Disorder (MDD) (NCT NCT01157078)

NCT ID: NCT01157078

Last Updated: 2014-04-11

Results Overview

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

319 participants

Primary outcome timeframe

Randomization (Week 8) to end of treatment (Week 16)

Results posted on

2014-04-11

Participant Flow

This multicenter study was conducted in the United States and India between 22 June 2010 and 17 November 2011.

The study had an up to 21-day screening/washout period, and an 8-week prospective open-label antidepressant treatment (ADT) period to identify the target patient population of inadequate responders to ADT (\<50% reduction in HAMD-17 total score during the prospective open-label ADT period, a HAMD-17 total score of ≥16 and a CGI-S score ≥4).

Participant milestones

Participant milestones
Measure
TC-5214
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Overall Study
STARTED
159
160
Overall Study
Received Treatment
157
159
Overall Study
COMPLETED
124
124
Overall Study
NOT COMPLETED
35
36

Reasons for withdrawal

Reasons for withdrawal
Measure
TC-5214
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Overall Study
Withdrawal by Subject
12
14
Overall Study
Eligibility criteria not fulfilled
2
0
Overall Study
Adverse Event
6
6
Overall Study
Severe non-compliance to protocol
2
4
Overall Study
Condition under investigation worsened
0
1
Overall Study
Lack of Efficacy
2
0
Overall Study
Study-specific withdrawal criteria
2
2
Overall Study
Lost to Follow-up
7
5
Overall Study
Other
2
4

Baseline Characteristics

A Study to Assess the Efficacy and Safety of TC-5214 as an Adjunct Therapy in Patients With Major Depressive Disorder (MDD)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
TC-5214
n=159 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=160 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Total
n=319 Participants
Total of all reporting groups
Age, Continuous
39.7 years
STANDARD_DEVIATION 11.37 • n=93 Participants
41.0 years
STANDARD_DEVIATION 11.53 • n=4 Participants
40.4 years
STANDARD_DEVIATION 11.45 • n=27 Participants
Sex: Female, Male
Female
101 Participants
n=93 Participants
99 Participants
n=4 Participants
200 Participants
n=27 Participants
Sex: Female, Male
Male
58 Participants
n=93 Participants
61 Participants
n=4 Participants
119 Participants
n=27 Participants
Race/Ethnicity, Customized
White
99 participants
n=93 Participants
100 participants
n=4 Participants
199 participants
n=27 Participants
Race/Ethnicity, Customized
Black or African American
11 participants
n=93 Participants
19 participants
n=4 Participants
30 participants
n=27 Participants
Race/Ethnicity, Customized
Asian
48 participants
n=93 Participants
37 participants
n=4 Participants
85 participants
n=27 Participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
0 participants
n=93 Participants
0 participants
n=4 Participants
0 participants
n=27 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 participants
n=93 Participants
1 participants
n=4 Participants
1 participants
n=27 Participants
Race/Ethnicity, Customized
Other
1 participants
n=93 Participants
3 participants
n=4 Participants
4 participants
n=27 Participants
Hamilton Rating Scale for Depression-17 items (HAMD-17) total score at randomization
22.0 Scores on a scale
STANDARD_DEVIATION 4.13 • n=93 Participants
21.1 Scores on a scale
STANDARD_DEVIATION 3.81 • n=4 Participants
21.5 Scores on a scale
STANDARD_DEVIATION 3.98 • n=27 Participants
Montgomery-Asberg Depression Rating Scale (MADRS) total score at randomization
27.4 Scores on a scale
STANDARD_DEVIATION 5.58 • n=93 Participants
26.6 Scores on a scale
STANDARD_DEVIATION 5.63 • n=4 Participants
27.0 Scores on a scale
STANDARD_DEVIATION 5.61 • n=27 Participants

PRIMARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=157 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in the Montgomery-Asberg Depression Rating Scale (MADRS) Total Score From Randomization to End of Treatment.
-12.7 units on a scale
Standard Error 0.80
-11.7 units on a scale
Standard Error 0.80

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score at end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=157 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Response in Depressive Symptoms of Major Depressive Disorder (MDD), Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score at End of Treatment (Week 16)
42.0 percentage of participants analyzed
47.0 percentage of participants analyzed

SECONDARY outcome

Timeframe: Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The percentage of patients with a MADRS total score of ≤8 at end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=157 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Remission in Depressive Symptoms of MDD, Defined as MADRS Total Score of ≤8 at End of Treatment (Week 16)
30.5 percentage of participants analyzed
24.2 percentage of participants analyzed

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16); Week 10, Week 12, Week 14, and Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score and a MADRS total score of ≤12 at Week 10, Week 12, Week 14, and end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=150 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=153 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Early and Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 10, Week 12, Week 14, and End of Treatment (Week 16)
6.0 percentage of participants analyzed
3.9 percentage of participants analyzed

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16); Week 12, Week 14, and Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The percentage of patients with a ≥50% reduction from randomization (Week 8) in MADRS total score and a MADRS total score of ≤12 at Week 12, Week 14, and end of treatment (Week 16) was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=148 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=152 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Sustained Response, Defined as a ≥50% Reduction From Randomization (Week 8) in MADRS Total Score and a MADRS Total Score of ≤12 at Week 12, Week 14, and End of Treatment (Week 16)
14.2 percentage of patients analyzed
11.8 percentage of patients analyzed

SECONDARY outcome

Timeframe: Week 12, Week 14, Week 16

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The percentage of patients with a MADRS total score of ≤8 at Week 12, Week 14, and end of treatment (Week 16)was calculated. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=148 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=153 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Sustained Remission, Defined as a MADRS Total Score of ≤8 at Week 12, Week 14, and End of Treatment (Week 16)
9.5 percentage of participants analyzed
6.5 percentage of participants analyzed

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 17-item, clinician-rated scale that assesses depressive symptoms. The HAMD-17 consists of 17 symptoms, each of which is rated from 0 to 2 or 0 to 4, where 0 is none/absent. The HAMD-17 total score is calculated as the sum of the 17 individual symptom scores; the total score can range from 0 to 52. Higher HAMD-17 scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
TC-5214
n=139 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=145 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Depressive Symptoms From Randomization (Week 8) to End of Treatment (Week 16) as Measured by Hamilton Rating Scale for Depression-17 Items (HAMD-17) Total Score
-9.7 units on a scale
Standard Error 0.96
-9.3 units on a scale
Standard Error 0.96

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 3-part, clinician-administered scale that rates the improvement or worsening of the patient's illness from randomization (baseline). Each item is scored on a 1 to 7 scale. Higher CGI-S scores indicate greater illness severity.

Outcome measures

Outcome measures
Measure
TC-5214
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=157 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in the Clinician-rated Global Outcome of Severity as Measured by the Clinical Global Impression-Severity (CGI-S) Score From Randomization (Week 8) to End of Treatment (Week 16)
-1.4 units on a scale
Standard Error 0.11
-1.3 units on a scale
Standard Error 0.11

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 3-part, clinician-administered scale that rates the improvement or worsening of the patient's illness from randomization (baseline). Each item is scored on a 1 to 7 scale. CGI-I scores \>4 indicate worsening, while scores \<4 indicate improvement.

Outcome measures

Outcome measures
Measure
TC-5214
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=157 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Response in the Clinical Global Impression-Improvement (CGI-I) Defined as CGI-I Rating of "Very Much Improved" or "Much Improved" From Randomization (Week 8) to End of Treatment (Week 16)
56.3 percentage of participants analyzed
51.0 percentage of participants analyzed

SECONDARY outcome

Timeframe: Randomization (Week 8) to Week 9

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms. MADRS is 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=142 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in MADRS Total Score From Randomization (Week 8) to Week 9
-3.6 units on a scale
Standard Error 0.45
-3.8 units on a scale
Standard Error 0.45

SECONDARY outcome

Timeframe: Randomization (Week 8) to Week 10

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=147 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=146 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in MADRS Total Score From Randomization (Week 8) to Week 10
-6.1 units on a scale
Standard Error 0.60
-6.8 units on a scale
Standard Error 0.60

SECONDARY outcome

Timeframe: Randomization (Week 8) to Week 12

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=139 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=144 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in MADRS Total Score From Randomization (Week 8) to Week 12
-8.7 units on a scale
Standard Error 0.68
-8.0 units on a scale
Standard Error 0.67

SECONDARY outcome

Timeframe: Randomization (Week 8) to Week 14

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 10-item scale for the evaluation of depressive symptoms. Each MADRS item is rated on a 0 to 6 scale. The MADRS total score is calculated as the sum of the 10 individual item scores; the total score can range from 0 to 60. Higher MADRS scores indicate higher levels of depressive symptoms.

Outcome measures

Outcome measures
Measure
TC-5214
n=133 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=136 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in MADRS Total Score From Randomization (Week 8) to Week 14
-11.1 units on a scale
Standard Error 0.72
-10.5 units on a scale
Standard Error 0.72

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

Sheehan Disability Scale (SDS) is 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The SDS total score is calculated as the sum of the score for the 3 inter-correlated domains (school/work, social life, and family life/home responsibilities) and ranges from 0 (unimpaired) to 30 (highly impaired).

Outcome measures

Outcome measures
Measure
TC-5214
n=143 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by the Sheehan Disability Scale (SDS) Total Score
-6.09 units on a scale
Standard Error 0.696
-5.47 units on a scale
Standard Error 0.700

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the work/school domain score is 0- 10, where 10 is considered to be 'highly impaired'.

Outcome measures

Outcome measures
Measure
TC-5214
n=124 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=134 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Work/School Domain Score
-2.0 units on a scale
Standard Error 0.24
-1.7 units on a scale
Standard Error 0.24

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the SDS social life domain score is 0- 10, where 10 is considered to be 'highly impaired'.

Outcome measures

Outcome measures
Measure
TC-5214
n=143 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Social Life Domain Score
-1.9 units on a scale
Standard Error 0.24
-1.9 units on a scale
Standard Error 0.24

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A 5-item, self-administered scale that measures the extent a patient is impaired by their disease. Higher scores indicate more severe impairment. The 3 inter-correlated domains are school/work, social life, and family life/home responsibilities. The numerical rating for the SDS family life/home responsibilities domain score is 0- 10, where 10 is considered to be 'highly impaired'.

Outcome measures

Outcome measures
Measure
TC-5214
n=143 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Functional Impairment From Randomization (Week 8) to End of Treatment (Week 16) as Measured by SDS Family Life/Home Responsibilities Domain Score
-2.1 units on a scale
Standard Error 0.28
-2.0 units on a scale
Standard Error 0.28

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form)total score is derived by summing item scores 1 to 14. Higher scores are indicative of greater enjoyment or satisfaction in each domain. The Q-LES-Q-SF % maximum total score is calculated as 100% × (Q-LES-Q-SF total score - 14) / 56, and can range from 0% to 100%.

Outcome measures

Outcome measures
Measure
TC-5214
n=141 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=148 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Overall Quality of Life and Satisfaction From Randomization (Week 8) to End of Treatment (Week 16) by Assessing the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) % Maximum Total Score
12.47 units on a scale
Standard Error 1.736
11.65 units on a scale
Standard Error 1.738

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) measures the patient's satisfaction with medication and overall quality of life. The 15th item queries respondents' satisfaction with the medication they are taking, rated on a 1 to 4 scale, score 0 indicates that no medication was taken. Higher scores are indicative of greater satisfaction.

Outcome measures

Outcome measures
Measure
TC-5214
n=123 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=126 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 15
0.2 units on a scale
Standard Error 0.08
0.3 units on a scale
Standard Error 0.08

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

The Q-LES-Q-SF (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form) measures the patient's satisfaction with medication and overall quality of life. The 16th item is a global rating of overall life satisfaction and contentment, rated on a 1 to 5 scale. Higher scores are indicative of greater satisfaction.

Outcome measures

Outcome measures
Measure
TC-5214
n=140 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=148 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change From Randomization (Week 8) to End of Treatment (Week 16) in Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q LES-Q-SF) Item 16
0.7 units on a scale
Standard Error 0.08
0.5 units on a scale
Standard Error 0.08

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A self-administered scale to be used by clinical subjects to rate suffering over the past week with regard to irritability symptoms. The total SIS score is the sum of 7 items, and ranges from 0 to 70. Each item is assessed on an 11-point scale where 0=not at all, 1-3=mildly, 4-6=moderately, 7-9=markedly, and 10=extremely. The SIS also records the number of days impaired by irritability.

Outcome measures

Outcome measures
Measure
TC-5214
n=144 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in Irritability Symptoms as Measured by the Sheehan Irritability Scale (SIS) Total Score From Randomization (Week 8) to End of Treatment (Week 16)
-12.6 units on a scale
Standard Error 1.96
-11.5 units on a scale
Standard Error 1.97

SECONDARY outcome

Timeframe: Randomization (Week 8) to end of treatment (Week 16)

Population: Modified intent-to-treat analysis set including all randomized patients who received at least 1 dose of investigational product (TC-5214 or placebo) and who had a randomization and at least 1 post-randomization MADRS total score.

A self-assessment questionnaire that provides 2 measures of health status. The EQ-5D index score is a weighted linear combination over 5 dimensions of health status. The score for each of the 5 dimensions can range from 1 to 3, and an equation is used to calculate the EQ-5D index score. The EQ-5D index score can range from possible negative values (minimum -0.415) to a maximum of 1.0. The EQ-VAS is a visual analog scale with a range of 0 to 100. For both variables, a higher score indicates a better health state.

Outcome measures

Outcome measures
Measure
TC-5214
n=144 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=151 Participants
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)
EQ-5D index score
0.113 units on a scale
Standard Error 0.0199
0.089 units on a scale
Standard Error 0.0199
Change in EuroQol - 5 Dimensions (EQ-5D) From Randomization (Week 8) to End of Treatment (Week 16)
EQ-5D VAS score
13.3 units on a scale
Standard Error 2.03
11.6 units on a scale
Standard Error 2.03

Adverse Events

TC-5214

Serious events: 1 serious events
Other events: 80 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 77 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
TC-5214
n=157 participants at risk
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=159 participants at risk
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Nervous system disorders
Headache
0.64%
1/157 • Number of events 1
0.00%
0/159

Other adverse events

Other adverse events
Measure
TC-5214
n=157 participants at risk
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + TC-5214, 1-4 mg BID
Placebo
n=159 participants at risk
Selective serotonin reuptake inhibitor (SSRI)/Serotonin/norepinephrine reuptake inhibitor (SNRI) + Placebo BID
Nervous system disorders
Headache
12.1%
19/157 • Number of events 22
10.7%
17/159 • Number of events 17
Gastrointestinal disorders
Constipation
12.1%
19/157 • Number of events 19
6.3%
10/159 • Number of events 12
Gastrointestinal disorders
Nausea
7.6%
12/157 • Number of events 13
3.8%
6/159 • Number of events 6
Gastrointestinal disorders
Dry Mouth
4.5%
7/157 • Number of events 7
3.8%
6/159 • Number of events 6
Vascular disorders
Orthostatic Hypotension
3.8%
6/157 • Number of events 7
3.1%
5/159 • Number of events 10
Nervous system disorders
Dizziness
4.5%
7/157 • Number of events 9
8.2%
13/159 • Number of events 18
Nervous system disorders
Somnolence
4.5%
7/157 • Number of events 7
5.0%
8/159 • Number of events 8
Gastrointestinal disorders
Diarrhoea
9.6%
15/157 • Number of events 18
6.3%
10/159 • Number of events 10
General disorders
Fatigue
5.7%
9/157 • Number of events 9
4.4%
7/159 • Number of events 7
Skin and subcutaneous tissue disorders
Hyperhidrosis
1.9%
3/157 • Number of events 3
2.5%
4/159 • Number of events 4
Infections and infestations
Nasopharyngitis
1.9%
3/157 • Number of events 3
3.8%
6/159 • Number of events 8
Nervous system disorders
Tremor
0.00%
0/157
2.5%
4/159 • Number of events 5
Psychiatric disorders
Insomnia
3.2%
5/157 • Number of events 5
6.3%
10/159 • Number of events 12
Nervous system disorders
Dizziness postural
1.3%
2/157 • Number of events 2
3.1%
5/159 • Number of events 7
Psychiatric disorders
Anxiety
2.5%
4/157 • Number of events 4
1.3%
2/159 • Number of events 2
Gastrointestinal disorders
Vomiting
2.5%
4/157 • Number of events 4
1.9%
3/159 • Number of events 3
Infections and infestations
Upper respiratory tract infection
5.1%
8/157 • Number of events 9
3.1%
5/159 • Number of events 5
Investigations
Weight increased
3.2%
5/157 • Number of events 5
1.9%
3/159 • Number of events 3
Musculoskeletal and connective tissue disorders
Musculoskeletal stiffness
0.64%
1/157 • Number of events 1
2.5%
4/159 • Number of events 5
Psychiatric disorders
Abnormal dreams
3.8%
6/157 • Number of events 6
5.0%
8/159 • Number of events 8
Psychiatric disorders
Agitation
1.3%
2/157 • Number of events 2
2.5%
4/159 • Number of events 5
Psychiatric disorders
Nightmare
1.3%
2/157 • Number of events 2
2.5%
4/159 • Number of events 4

Additional Information

Gerard Lynch

AstraZeneca

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60