Trial Outcomes & Findings for Genomics Used to Improve DEpression Decisions (NCT NCT02109939)

NCT ID: NCT02109939

Last Updated: 2020-01-14

Results Overview

Evaluate the impact of GeneSight Psychotropic on response to psychotropic treatment as judged by the mean percent change in the 17-item Hamilton Depression (HAM-D17) score from baseline to end of Week 8 of the study. Scores range from 0 to 50, and lower scores are better outcomes. Percent change is defined as (week 8 score -baseline score) / (baseline score) x 100.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

1398 participants

Primary outcome timeframe

from baseline to end of Week 8

Results posted on

2020-01-14

Participant Flow

Participant milestones

Participant milestones
Measure
GeneSight Psychotropic Tested
Subjects being tested with GeneSight Psychotropic GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians to make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. tricyclic antidepressants, an MAOI, and typical and atypical antipsychotics are also represented.
Treatment As Usual
This group of subjects will not see their GeneSIght results or know whether or not they are in either arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians to make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. tricyclic antidepressants, an MAOI, and typical and atypical antipsychotics are also represented.
Overall Study
STARTED
681
717
Overall Study
COMPLETED
560
607
Overall Study
NOT COMPLETED
121
110

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Genomics Used to Improve DEpression Decisions

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
GeneSight Psychotropic Tested
n=681 Participants
Subjects being tested with GeneSight Psychotropic GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians to make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. tricyclic antidepressants, an MAOI, and typical and atypical antipsychotics are also represented.
Treatment As Usual
n=717 Participants
This group of subjects will not see their GeneSIght results or know whether or not they are in either arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians to make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. tricyclic antidepressants, an MAOI, and typical and atypical antipsychotics are also represented.
Total
n=1398 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
597 Participants
n=5 Participants
616 Participants
n=7 Participants
1213 Participants
n=5 Participants
Age, Categorical
>=65 years
84 Participants
n=5 Participants
101 Participants
n=7 Participants
185 Participants
n=5 Participants
Age, Continuous
46.9 years
STANDARD_DEVIATION 14.5 • n=5 Participants
48.0 years
STANDARD_DEVIATION 50.0 • n=7 Participants
47.5 years
STANDARD_DEVIATION 14.5 • n=5 Participants
Sex: Female, Male
Female
489 Participants
n=5 Participants
498 Participants
n=7 Participants
987 Participants
n=5 Participants
Sex: Female, Male
Male
192 Participants
n=5 Participants
219 Participants
n=7 Participants
411 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
5 Participants
n=5 Participants
3 Participants
n=7 Participants
8 Participants
n=5 Participants
Race (NIH/OMB)
Asian
12 Participants
n=5 Participants
17 Participants
n=7 Participants
29 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
114 Participants
n=5 Participants
94 Participants
n=7 Participants
208 Participants
n=5 Participants
Race (NIH/OMB)
White
538 Participants
n=5 Participants
589 Participants
n=7 Participants
1127 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
11 Participants
n=5 Participants
14 Participants
n=7 Participants
25 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
681 participants
n=5 Participants
717 participants
n=7 Participants
1398 participants
n=5 Participants
Baseline HAM-D17
21.1 units on a scale
STANDARD_DEVIATION 4.20 • n=5 Participants
21.4 units on a scale
STANDARD_DEVIATION 4.22 • n=7 Participants
21.3 units on a scale
STANDARD_DEVIATION 4.21 • n=5 Participants

PRIMARY outcome

Timeframe: from baseline to end of Week 8

Population: Per-Protocol

Evaluate the impact of GeneSight Psychotropic on response to psychotropic treatment as judged by the mean percent change in the 17-item Hamilton Depression (HAM-D17) score from baseline to end of Week 8 of the study. Scores range from 0 to 50, and lower scores are better outcomes. Percent change is defined as (week 8 score -baseline score) / (baseline score) x 100.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=607 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=560 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percent Change in the 17-item Hamilton Depression (HAM-D17) Score From Baseline to 8 Weeks
-24.39 percentage of change
Standard Error 1.22
-27.23 percentage of change
Standard Error 1.27

SECONDARY outcome

Timeframe: from baseline to end of Week 8

Population: Intent-to-Treat

Mean percent change in the 16-item Quick Inventory of Depression Symptomology (QIDS-C16) score from baseline to end of Week 8 of the study. Scores range from 0 to 27 with lower scores being better outcomes. Percent change is defined as (week 8 score - baseline score) / (baseline score) x 100.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=621 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=677 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percent Change in the 16-item Quick Inventory of Depression Symptomology (QIDS-C16) Score From Baseline to 8 Weeks
-35.107 percentage of change
Standard Error 1.189
-32.900 percentage of change
Standard Error 1.147

SECONDARY outcome

Timeframe: Week 8 visit info

Population: Per Protocol

Adjusted percentage of responders at Week 8 in each treatment group on the 17-item Hamilton Depression Rating Scale (HAM-D17). A responder is defined as a participant with at least a 50% decrease from baseline in total scale score. Scores range from 0 to 50, and lower scores are better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=560 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=607 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Responders at Week 8 for HAM-D17
26.00 percentage of subjects
19.92 percentage of subjects

SECONDARY outcome

Timeframe: Week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: week 8 visit info

Population: Per Protocol

Adjusted percentage of remitters at Week 8 defined as a score ≤7 in the 17-item Hamilton Depression Rating Scale (HAM-D17) in each treatment group. Scores range from 0 to 50, and lower scores are better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=560 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=607 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Remitters at Week 8 Defined as HAM-D17 ≤7 Each Treatment Group;
15.30 percentage of subjects
10.08 percentage of subjects

SECONDARY outcome

Timeframe: week 4 and 8 visit info

\*Comment\*: Time to response/remission is not an outcome measure that can accurately be reported from the way the data was collected. As specified in the updated SAP before the blind was broken, this was not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline to week 24 visits

Population: Per Protocol - Due to unblinding before week 12 there was no longer a treatment as usual and guided treatment arm and it was pre-specified in the Protocol to include only the GeneSight Psychotropic Tested Arm/Group for this Outcome Measure

Evaluate the impact of GeneSight Psychotropic on response to psychotropic treatment as judged by the mean percent change in the 17-item Hamilton Depression (HAM-D17) score from baseline to end of Week 24 of the study. Scores range from 0 to 50, and lower scores are better outcomes. Percent change is defined as (week 24 score -baseline score) / (baseline score) x 100.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=457 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percent Change in the 17-item Hamilton Depression (HAM-D17) Score From Baseline to 24 Weeks
42.5 percentage of change
Standard Error 1.52

SECONDARY outcome

Timeframe: Week 8 visit info

Population: Intent-to-treat

Adjusted percentage of responders at Week 8 in each treatment group on the 16-item Quick Inventory of Depression Symptomology (QIDS-C16). A responder is defined as a participant with at least 50% decrease from baseline in total scale score. Scores range from 0 to 27 with lower scores being better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=677 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=621 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Responders at Week 8 for QIDS-C16
34.14 percentage of subjects
31.36 percentage of subjects

SECONDARY outcome

Timeframe: Week 8 visit info

Population: Intent-to-treat

Adjusted percentage of responders at Week 8 in each treatment group on the 9-item Patient Health Questionnaire (PHQ-9). A responder is defined as a participant with at least 50% decrease from baseline in total scale score. Scores range from 0 to 27 with lower scores being better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=676 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=620 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Responders at Week 8 for PHQ-9
31.63 percentage of subjects
39.74 percentage of subjects

SECONDARY outcome

Timeframe: week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Week 12 visit info

\*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding might have occurred for some patients prior to week 12 assessments, data collected at week 12 were no longer considered blinded and are not analyzed or reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: week 8 visit info

Population: Intent-to-treat

Adjusted percentage of remitters at Week 8 in the 16-item Quick Inventory of Depression Symptomology (QIDS-C16) in each treatment group. A remitter is defined as a subject with a score ≤ 5. Scores range from 0 to 27 with lower scores being better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=677 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=621 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Remitters at Week 8 Defined as QIDS-C16 ≤ 5 in Each Treatment Group
15.62 percentage of subjects
20.89 percentage of subjects

SECONDARY outcome

Timeframe: week 8 visit info

Population: Intent-to-treat

Adjusted percentage of remitters at Week 8 in each treatment group on the 9-item Patient Health Questionnaire (PHQ-9). A remitter is defined as a participant with score \<5 on the PHQ-9. Scores range from 0 to 27 with lower scores being better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=677 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
n=620 Participants
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Remitters at Week 8 Defined as PHQ-9 <5 in Each Treatment Group
14.79 percentage of subjects
18.58 percentage of subjects

SECONDARY outcome

Timeframe: week 4, 8, and 12 visit info

\*Comment\*: Time to response/remission is not an outcome measure that can accurately be reported from the way the data was collected. As specified in the updated SAP before the blind was broken, this was not analyzed and reported. Additionally, for patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding may have occurred prior to week 12 assessments, data collected at week 12 were considered unblinded and are not reported.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Baseline to week 24 visit info

Population: Per Protocol

Adjusted percentage of responders at Week 24 in the GeneSight Psychotropic Tested treatment group on the 17-item Hamilton Depression Rating Scale (HAM-D17). A responder is defined as a participant with at least a 50% decrease from baseline in total scale score. Scores range from 0 to 50, and lower scores are better outcomes.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=457 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Responders at Week 24 for HAM-D17 in the GeneSight Psychotropic Tested Treatment Group
44.3 percentage of subjects

SECONDARY outcome

Timeframe: Baseline to week 24 visit info

Population: Per Protocol

Adjusted percentage of remitters at Week 8 defined as a score ≤7 in the 17-item Hamilton Depression Rating Scale (HAM-D17) in each treatment group. Scores range from 0 to 50, and lower scores are better outcomes. \*Comment\*: For patients in TAU, clinicians were blinded to the pharmacogenomic test result until after completion of the week 8 visit. Because unblinding may have occurred prior to week 12 assessments, all data collected at week 12 were considered unblinded and are not reported.

Outcome measures

Outcome measures
Measure
Treatment As Usual
n=457 Participants
This group of subjects will not have treatment guided by their GeneSight results or know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
GeneSight Psychotropic Tested
Subjects being tested with GeneSight Psychotropic. This group of subjects will not know whether they are in a particular arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. Tricyclic antidepressants, one MAOI, and typical and atypical antipsychotics are also represented.
Percentage of Remitters at Week 24 Defined as HAM-D17 ≤7 in the GeneSight Psychotropic Tested Treatment Group
31.1 percentage of subjects

OTHER_PRE_SPECIFIED outcome

Timeframe: week 12 to week 24

The mean change in Generalized Anxiety Disorder 7-item (GAD-7) scale from week 12 to week 24

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline to week 8

The mean change in Generalized Anxiety Disorder 7-item (GAD-7) scale from baseline to week 8

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline to week 12

The mean change in Generalized Anxiety Disorder 7-item (GAD-7) scale from baseline to week 12

Outcome measures

Outcome data not reported

Adverse Events

GeneSight Psychotropic Tested

Serious events: 3 serious events
Other events: 0 other events
Deaths: 0 deaths

Treatment As Usual

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
GeneSight Psychotropic Tested
n=681 participants at risk
Subjects being tested with GeneSight Psychotropic GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians to make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. tricyclic antidepressants, an MAOI, and typical and atypical antipsychotics are also represented.
Treatment As Usual
n=717 participants at risk
This group of subjects will not see their GeneSIght results or know whether or not they are in either arm. GeneSight Psychotropic: The GeneSight Psychotropic product is a pharmacogenomic decision support tool that helps clinicians to make informed, evidence-based decisions about proper drug selection, based on the testing for clinically important genetic variants in multiple pharmacokinetic and pharmacodynamic genes that affect a patient's ability to tolerate or respond to medications. The GeneSight Psychotropic product contains the most commonly prescribed antidepressant and antipsychotic medications, including a full representation of the SSRI and SNRI drug classes. tricyclic antidepressants, an MAOI, and typical and atypical antipsychotics are also represented.
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.15%
1/681 • Number of events 1 • 8 weeks
0.00%
0/717 • 8 weeks
Musculoskeletal and connective tissue disorders
Muscle twitching
0.15%
1/681 • Number of events 1 • 8 weeks
0.00%
0/717 • 8 weeks
Gastrointestinal disorders
Gastrointestinal hemorrhage
0.00%
0/681 • 8 weeks
0.14%
1/717 • Number of events 1 • 8 weeks
Metabolism and nutrition disorders
transient hypoglycemia
0.15%
1/681 • Number of events 1 • 8 weeks
0.00%
0/717 • 8 weeks
General disorders
non cardiac chest pains
0.00%
0/681 • 8 weeks
0.14%
1/717 • Number of events 1 • 8 weeks

Other adverse events

Adverse event data not reported

Additional Information

Lindsey Burns

Assurex Health

Phone: 5137015068

Results disclosure agreements

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