Trial Outcomes & Findings for Study to Treat Major Depressive Disorder With a New Medication (NCT NCT03043560)

NCT ID: NCT03043560

Last Updated: 2020-10-23

Results Overview

change in activation during reward anticipation within the bilateral VS from baseline (Study Visit 0) to the primary outcome visit (Study Visit 5) as measured by functional MRI during the incentive flanker task (IFT). The IFT, like the Monetary Incentive Delay task, permits discrete modeling of brain activity during anticipation of an incentive. Functional scans were preprocessed and denoised for motion and physiological noise using multi-echo independent component analysis (ME-ICA). Task-based modeling was conducted using AFNI and FSL software. The primary outcome for reward anticipation was the contrast of reward cue compared to neutral cue (reward\>neutral cue). The primary imaging outcome was analyzed using a linear mixed model with a single random intercept term treating time as discrete or continuous as appropriate.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

45 participants

Primary outcome timeframe

baseline and 5 weeks

Results posted on

2020-10-23

Participant Flow

Participants recruited from Sept 2017 through August 2019

Participant milestones

Participant milestones
Measure
Ezogabine
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
Matching placebo pill daily for 5 weeks
Overall Study
STARTED
21
24
Overall Study
COMPLETED
20
21
Overall Study
NOT COMPLETED
1
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Ezogabine
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
Matching placebo pill daily for 5 weeks
Overall Study
Discontinued Intervention
1
2
Overall Study
Lost to Follow-up
0
1

Baseline Characteristics

Study to Treat Major Depressive Disorder With a New Medication

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Total
n=45 Participants
Total of all reporting groups
Age, Continuous
44.4 years
STANDARD_DEVIATION 13.6 • n=5 Participants
38.9 years
STANDARD_DEVIATION 14.3 • n=7 Participants
41.5 years
STANDARD_DEVIATION 14.1 • n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
12 Participants
n=7 Participants
22 Participants
n=5 Participants
Sex: Female, Male
Male
11 Participants
n=5 Participants
12 Participants
n=7 Participants
23 Participants
n=5 Participants
Race/Ethnicity, Customized
White/Caucasian
12 Participants
n=5 Participants
12 Participants
n=7 Participants
24 Participants
n=5 Participants
Race/Ethnicity, Customized
Black/African American
5 Participants
n=5 Participants
7 Participants
n=7 Participants
12 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic/Latino
6 Participants
n=5 Participants
9 Participants
n=7 Participants
15 Participants
n=5 Participants
Employment at least Part-Time
9 Participants
n=5 Participants
14 Participants
n=7 Participants
23 Participants
n=5 Participants
Educational Attainment - ast least some college
15 Participants
n=5 Participants
21 Participants
n=7 Participants
36 Participants
n=5 Participants
Relationship Status - Single, Never Married
8 Participants
n=5 Participants
13 Participants
n=7 Participants
21 Participants
n=5 Participants
Primary Diagnosis
Major Depressive Disorder
21 Participants
n=5 Participants
23 Participants
n=7 Participants
44 Participants
n=5 Participants
Primary Diagnosis
Persistent Depressive Disorder
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Current Major Depressive Episode
21 Participants
n=5 Participants
22 Participants
n=7 Participants
43 Participants
n=5 Participants
Age at Onset of Depression
28.3 years
STANDARD_DEVIATION 15.6 • n=5 Participants
21.7 years
STANDARD_DEVIATION 11.5 • n=7 Participants
24.3 years
STANDARD_DEVIATION 14.0 • n=5 Participants
Current Depressive Episode Duration
72 months
n=5 Participants
24 months
n=7 Participants
30 months
n=5 Participants
Generalized Anxiety Disorder
11 Participants
n=5 Participants
10 Participants
n=7 Participants
21 Participants
n=5 Participants
Posttraumatic Stress Disorder (PTSD)
4 Participants
n=5 Participants
8 Participants
n=7 Participants
12 Participants
n=5 Participants

PRIMARY outcome

Timeframe: baseline and 5 weeks

change in activation during reward anticipation within the bilateral VS from baseline (Study Visit 0) to the primary outcome visit (Study Visit 5) as measured by functional MRI during the incentive flanker task (IFT). The IFT, like the Monetary Incentive Delay task, permits discrete modeling of brain activity during anticipation of an incentive. Functional scans were preprocessed and denoised for motion and physiological noise using multi-echo independent component analysis (ME-ICA). Task-based modeling was conducted using AFNI and FSL software. The primary outcome for reward anticipation was the contrast of reward cue compared to neutral cue (reward\>neutral cue). The primary imaging outcome was analyzed using a linear mixed model with a single random intercept term treating time as discrete or continuous as appropriate.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Change in Ventral Striatum (VS) Activation
baseline
-0.26 Bold Oxygen-level Dependent (BOLD) Signa
Standard Deviation 0.69
0.95 Bold Oxygen-level Dependent (BOLD) Signa
Standard Deviation 0.79
Change in Ventral Striatum (VS) Activation
5 weeks
0.176 Bold Oxygen-level Dependent (BOLD) Signa
Standard Deviation 0.81
0.015 Bold Oxygen-level Dependent (BOLD) Signa
Standard Deviation 0.68

SECONDARY outcome

Timeframe: baseline and 5 weeks

The SHAPS is a well-validated 14-item self-report questionnaire commonly used to assess anhedonia. Each item on the SHAPS is worded so that higher scores indicate greater pleasure capacity. A total score can be derived by summing the responses to each item. Items answered with "strongly agree" are coded as "1", while a "strongly disagree" response was assigned a score of "4." Total scores on the SHAPS can range from 14 to 56, with higher scores corresponding to higher levels of anhedonia.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Change in Snaith-Hamilton Pleasure Scale (SHAPS)
Baseline
38.7 score on a scale
Standard Deviation 8.1
33.7 score on a scale
Standard Deviation 6
Change in Snaith-Hamilton Pleasure Scale (SHAPS)
5 weeks
27.5 score on a scale
Standard Deviation 8.5
30 score on a scale
Standard Deviation 10.9

SECONDARY outcome

Timeframe: baseline and 5 weeks

A widely administered clinician rated global measure of the degree of improvement from the initial assessment in subject overall illness severity. 7 point scale rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Clinical Global Impression - Improvement (CGI-I)
baseline
4 score on a scale
Standard Deviation 0.2
4 score on a scale
Standard Deviation 0.4
Clinical Global Impression - Improvement (CGI-I)
5 weeks
2.1 score on a scale
Standard Deviation 1
2.8 score on a scale
Standard Deviation 1.3

SECONDARY outcome

Timeframe: baseline and 5 weeks

Clinician rated global measure of subject overall illness severity. a 7-point scale rated as 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Clinical Global Impression - Severity (CGI-S)
baseline
4.4 score on a scale
Standard Deviation 0.5
4.6 score on a scale
Standard Deviation 0.6
Clinical Global Impression - Severity (CGI-S)
5 weeks
2.6 score on a scale
Standard Deviation 1.2
3.3 score on a scale
Standard Deviation 1.2

SECONDARY outcome

Timeframe: baseline and 5 weeks

A measure specifically designed to assess hedonic capacity for social and interpersonal pleasure.The ACIPS is a 17-item self-report measure scored on a likert scale, ranging from 1 (very false for me) to 6 (very true for me). Full scale from 17-102, higher score indicates higher hedonic capacity

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS)
baseline
46.1 score on a scale
Standard Deviation 15.1
53.7 score on a scale
Standard Deviation 15
Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS)
5 weeks
65.1 score on a scale
Standard Deviation 22.8
59 score on a scale
Standard Deviation 23.5

SECONDARY outcome

Timeframe: baseline and 5 weeks

A 10-item instrument used for the evaluation of depressive symptoms in adults and for the assessment of any changes to those symptoms. Each items is scored 0 (normal) to 6 (severe depression) with overall score ranges from 0 (normal) to 60 (severe depression).

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Montgomery-Asberg Depression Rating Scale (MADRS)
baseline
28.3 score on a scale
Standard Deviation 6.1
26.8 score on a scale
Standard Deviation 5.1
Montgomery-Asberg Depression Rating Scale (MADRS)
5 weeks
12.7 score on a scale
Standard Deviation 8.7
18.5 score on a scale
Standard Deviation 10.1

SECONDARY outcome

Timeframe: baseline and 5 weeks

A 12-item generic assessment instrument that measures the level of functioning. Each item is scored from 0 to 4 and the items are summed to provide a total score. The score therefore ranges from 0 to 48, with higher scores indicating greater disability.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)
baseline
15.5 score on a scale
Standard Deviation 7.5
16.5 score on a scale
Standard Deviation 9.4
World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)
5 weeks
10.2 score on a scale
Standard Deviation 9.5
11.6 score on a scale
Standard Deviation 9.8

SECONDARY outcome

Timeframe: baseline and 5 weeks

The TEPS is composed of 18-items rated on a likert-type scale ranging from 1 (Very True for me) to 6 (Very False for me), and yields two subscales. Ten items make up the TEPS-Anticipatory Pleasure (TEPS-ANT) scale with a range from 10 (not motivated) to 60 (highly motivated). The other eight TEPS items make up the TEPS-Consummatory Pleasure (TEPS-CON) scale; range from 8 (not responsive) to 48 (highly responsive). Total scores range is 18-108. Lower scores indicate greater levels of anhedonia.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Temporal Experience of Pleasure Scale (TEPS)
TEPS-ANT baseline
26.3 score on a scale
Standard Deviation 8.3
28.6 score on a scale
Standard Deviation 8.7
Temporal Experience of Pleasure Scale (TEPS)
TEPS-ANT 5 weeks
37.3 score on a scale
Standard Deviation 10.5
32.4 score on a scale
Standard Deviation 11.5
Temporal Experience of Pleasure Scale (TEPS)
TEPS-CON baseline
24.8 score on a scale
Standard Deviation 8.1
25.6 score on a scale
Standard Deviation 7.6
Temporal Experience of Pleasure Scale (TEPS)
TEPS-CON 5 weeks
32.2 score on a scale
Standard Deviation 6
29.9 score on a scale
Standard Deviation 10.5

SECONDARY outcome

Timeframe: baseline 5 weeks

The SLIPS is a recently developed and validated measure of anhedonia that is tailored to detect recent changes in anhedonia. A 23-item measure, each item range from 0-3. Full scale from 0 to 69, higher score indicates more recent changes.

Outcome measures

Outcome measures
Measure
Ezogabine
n=21 Participants
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 Participants
Matching placebo pill daily for 5 weeks
Specific Loss of Interest and Pleasure Scale (SLIPS)
baseline
32.3 score on a scale
Standard Deviation 9.8
28.8 score on a scale
Standard Deviation 10.4
Specific Loss of Interest and Pleasure Scale (SLIPS)
5 weeks
16.3 score on a scale
Standard Deviation 16.7
21.5 score on a scale
Standard Deviation 16.8

Adverse Events

Ezogabine

Serious events: 0 serious events
Other events: 21 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 19 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Ezogabine
n=21 participants at risk
Ezogabine up to 900mg/day daily for 5 weeks
Placebo
n=24 participants at risk
Matching placebo pill daily for 5 weeks
Gastrointestinal disorders
Abdominal Pain
9.5%
2/21 • 8 weeks
12.5%
3/24 • 8 weeks
Psychiatric disorders
Anxiety
4.8%
1/21 • 8 weeks
4.2%
1/24 • 8 weeks
Musculoskeletal and connective tissue disorders
Back Pain
0.00%
0/21 • 8 weeks
4.2%
1/24 • 8 weeks
Psychiatric disorders
Confusional state
19.0%
4/21 • 8 weeks
0.00%
0/24 • 8 weeks
Gastrointestinal disorders
Constipation
4.8%
1/21 • 8 weeks
8.3%
2/24 • 8 weeks
Respiratory, thoracic and mediastinal disorders
Cough
4.8%
1/21 • 8 weeks
4.2%
1/24 • 8 weeks
Gastrointestinal disorders
Diarrhea
23.8%
5/21 • 8 weeks
4.2%
1/24 • 8 weeks
Nervous system disorders
Disturbance in attention
14.3%
3/21 • 8 weeks
0.00%
0/24 • 8 weeks
Nervous system disorders
Dizziness
100.0%
21/21 • 8 weeks
20.8%
5/24 • 8 weeks
Gastrointestinal disorders
Dry mouth
4.8%
1/21 • 8 weeks
0.00%
0/24 • 8 weeks
Nervous system disorders
Headache
23.8%
5/21 • 8 weeks
29.2%
7/24 • 8 weeks
Metabolism and nutrition disorders
Increased appetite
4.8%
1/21 • 8 weeks
0.00%
0/24 • 8 weeks
General disorders
Malaise
4.8%
1/21 • 8 weeks
0.00%
0/24 • 8 weeks
Nervous system disorders
Memory impairment
4.8%
1/21 • 8 weeks
8.3%
2/24 • 8 weeks
Respiratory, thoracic and mediastinal disorders
Nasal Congestion
4.8%
1/21 • 8 weeks
0.00%
0/24 • 8 weeks
Gastrointestinal disorders
Nausea
14.3%
3/21 • 8 weeks
20.8%
5/24 • 8 weeks
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
4.8%
1/21 • 8 weeks
0.00%
0/24 • 8 weeks
Cardiac disorders
Palpitations
4.8%
1/21 • 8 weeks
4.2%
1/24 • 8 weeks
Psychiatric disorders
Panic attack
9.5%
2/21 • 8 weeks
0.00%
0/24 • 8 weeks
Renal and urinary disorders
Polyuria
0.00%
0/21 • 8 weeks
4.2%
1/24 • 8 weeks
Skin and subcutaneous tissue disorders
Rash
9.5%
2/21 • 8 weeks
0.00%
0/24 • 8 weeks
Psychiatric disorders
Restlessness
0.00%
0/21 • 8 weeks
4.2%
1/24 • 8 weeks
Nervous system disorders
Sedation
0.00%
0/21 • 8 weeks
4.2%
1/24 • 8 weeks
Nervous system disorders
Somnolence
9.5%
2/21 • 8 weeks
12.5%
3/24 • 8 weeks
Infections and infestations
Upper respiratory tract infection
0.00%
0/21 • 8 weeks
4.2%
1/24 • 8 weeks
Eye disorders
Vision blurred
14.3%
3/21 • 8 weeks
4.2%
1/24 • 8 weeks
Gastrointestinal disorders
Vomiting
9.5%
2/21 • 8 weeks
4.2%
1/24 • 8 weeks
General disorders
Other
42.9%
9/21 • 8 weeks
33.3%
8/24 • 8 weeks

Additional Information

Dr, James Murrough

Icahn School of Medicine at Mount Sinai

Phone: 212-585-4640

Results disclosure agreements

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