Clinical Study Evaluating Effects of Pharmacogenetic-guided vs Standard-of-Care Treatment on Depression and/or Anxiety

NCT ID: NCT02878928

Last Updated: 2016-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

579 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-05-31

Study Completion Date

2016-12-31

Brief Summary

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A prospective, multi-center, randomized, subject and outcome evaluator blind , parallel-group study evaluating the effect of pharmacogenetic-guided versus standard of care treatment for subjects diagnosed with depression and/or anxiety disorders.

Detailed Description

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A substantial number of patients taking anti-depressant and anti-anxiety medications suffer from either a lack of benefit from drug therapy or severe side effects. Clinical features often fail to predict the drug response and tolerability of a patient to a prescription medication. Genetics can help guide therapeutic decisions for patients exhibiting neuropsychiatric disorders and potentially improve patient outcomes by maximizing drug efficacy and minimizing the risk of adverse events. Genetics and drug interactions can alter both the pharmacokinetics and pharmacodynamics of a multitude of drug compounds and in turn influence both the safety and efficacy of selected therapeutic regimens.

This study is designed to evaluate the clinical impact of pharmacogenetic (PGx)-directed treatment. Pharmacogenetic-guided therapy selection using the IDgenetix Neuropsychiatric Test Panel can enhance patient response and tolerability by facilitating the selection of the most appropriate medication at the most effective dose in the shortest possible time.

In this prospective, multi-center, randomized, subject and outcome evaluator blind, parallel-group study patients presenting to the clinical site with evidence of depression and/or anxiety as determined by a qualified clinician will be invited to participate. Study participants will be randomized to one of two groups with respect to the IDgenetix Neuropsychiatric Test Panel result: group with testing results revealed to the medical provider prior to treatment selection (Experimental Group) or group without testing results prior to treatment selection (Control Group). Participant outcomes will be measured at baseline and throughout the 3-month duration of the study.

Conditions

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Depression Anxiety

Keywords

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Pharmacogenetic testing PGx Depression Neuropsychiatric diseases IDgenetix AltheaDx

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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IDgenetix Neuropsychiatric Test Panel Intervention

Medical providers for IDgenetix Neuropsychiatric Test Panel-guided group will make treatment recommendations based on test results. Patient outcomes will be measured throughout the duration of the study.

Group Type EXPERIMENTAL

IDgenetix Neuropsychiatric Test Panel

Intervention Type GENETIC

The IDgenetix Neuropsychiatric Test Panel is used to make recommendations on the medication therapy that might be impacted by the genetic background of the patient.

Control Group

Medical providers for the Control Group will not receive IDgenetix Neuropsychiatric Test Panel results and will make treatment recommendations as usual. Patient outcomes will be measured throughout the duration of the study.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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IDgenetix Neuropsychiatric Test Panel

The IDgenetix Neuropsychiatric Test Panel is used to make recommendations on the medication therapy that might be impacted by the genetic background of the patient.

Intervention Type GENETIC

Other Intervention Names

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PGx Testing

Eligibility Criteria

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Inclusion Criteria

* Male or female subjects 18 years of age or older.
* Subjects diagnosed with depression and/or anxiety as per the DSM-V criteria or standard of care site procedures and meeting at least one of the following:

* Diagnosed with depression and/or anxiety either new to treatment or currently taking medications for less than 6 weeks.
* Inadequately controlled with medications defined as inadequate efficacy after 6 weeks of a psychotropic treatment or have discontinued psychotropic treatment due to adverse events or intolerability.
* Willing and able to comply with study procedures.
* Able to provide written informed consent.

Exclusion Criteria

* Unwilling or unable to provide written informed consent and to comply with study procedures.
* Any patient for whom providing a buccal swab sample would be contraindicated or not possible.
* Subjects diagnosed as not having anxiety or depression.
* Patients at significant risk for suicide and/or in need of immediate hospitalization as judged by the investigator.
* Diagnosis of Bipolar Disorder, as assessed by patient history or M.I.N.I. response.
* Diagnosis of Schizophrenia or Schizoaffective disorder, as assessed by patient history or M.I.N.I. response.
* History or diagnosis of a personality disorder, as assessed by patient history or M.I.N.I. response.
* History of physical traumatic injury (i.e., TBI) resulting in depression.
* Patients new to psychotherapy (provided by licensed and trained mental health professionals) or have not been on a stable psychotherapy regimen for at least 8 weeks.
* Patients receiving other alternative treatments such as Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (TMS), Vagal Nerve Stimulation (VNS), and Deep Brain Stimulation (DBS).
* Patients with a history of chronic renal dysfunction, Chronic Kidney Disease (Stage 4 or 5).
* Patients with abnormal hepatic function within the last 2 years, (INR \>1.2 not attributable to anticoagulant medications, AST/aspartate aminotransferase or ALT/alanine aminotransferase \>1.5x normal, or suspected cirrhosis).
* Patients with a history of malabsorption (short gut syndrome).
* Patients with any gastric or small bowel surgery less than 3 months prior to study enrollment.
* Patients with significant unstable medical condition, neurological disorders (e.g. epilepsy, Parkinson's disease or stroke) or life threatening disease.
* Patients who are currently being treated for anxiety and /or depression incorporating pharmacogenetic information.
* History of hypothyroidism unless taking a stable dose of thyroid medication and asymptomatic for 6 months.
* Patients with any significant substance use disorder as assessed by M.I.N.I. response and judged by the investigator.
* Pregnant or lactating women.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Innovis LLC

INDUSTRY

Sponsor Role collaborator

AltheaDx

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joel Centeno

Role: STUDY_DIRECTOR

AltheaDx

Locations

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Adnab Research

Rolling Hills, California, United States

Site Status

Artemis Clinical Research

San Diego, California, United States

Site Status

Adnab Research

Torrance, California, United States

Site Status

Collaborative Neuroscience Network

Torrance, California, United States

Site Status

Innovative Clinical Research

Lauderhill, Florida, United States

Site Status

Innova Clinical Trials

Miami, Florida, United States

Site Status

APG Research

Orlando, Florida, United States

Site Status

iResearch Atlanta

Decatur, Georgia, United States

Site Status

Meridian Clinical Research

Savannah, Georgia, United States

Site Status

Medpharmics

Metairie, Louisiana, United States

Site Status

Meridian Clinical Research

Norfolk, Nebraska, United States

Site Status

United Medical Associates

Binghamton, New York, United States

Site Status

Richmond Behavioral Associates

Staten Island, New York, United States

Site Status

Carolina Partners in Mental HealthCare

Raleigh, North Carolina, United States

Site Status

Detweiler Family Medicine

Lansdale, Pennsylvania, United States

Site Status

Relaro Medical Trials

Dallas, Texas, United States

Site Status

Tidewater Clinical Research

Virginia Beach, Virginia, United States

Site Status

Countries

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United States

References

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Bradley P, Shiekh M, Mehra V, Vrbicky K, Layle S, Olson MC, Maciel A, Cullors A, Garces JA, Lukowiak AA. Improved efficacy with targeted pharmacogenetic-guided treatment of patients with depression and anxiety: A randomized clinical trial demonstrating clinical utility. J Psychiatr Res. 2018 Jan;96:100-107. doi: 10.1016/j.jpsychires.2017.09.024. Epub 2017 Sep 23.

Reference Type DERIVED
PMID: 28992526 (View on PubMed)

Other Identifiers

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CLP-0009

Identifier Type: -

Identifier Source: org_study_id