A Study to Compare the Efficacy, Safety, and Tolerability of JNJ-42847922 Versus Quetiapine Extended-Release as Adjunctive Therapy to Antidepressants in Adult Participants With Major Depressive Disorder Who Have Responded Inadequately to Antidepressant Therapy

NCT ID: NCT03321526

Last Updated: 2025-04-29

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

107 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-12

Study Completion Date

2019-06-27

Brief Summary

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The purpose of this study is to assess the efficacy of flexibly dosed JNJ-42847922 (20 milligram \[mg\] or 40 mg) compared to flexibly dosed quetiapine extended-release (XR) (150 mg or 300 mg) as adjunctive therapy to an antidepressant drug in delaying time to all-cause discontinuation of study drug over a 6-months (24 weeks) treatment period, in participants with major depressive disorder (MDD) who have had an inadequate response to current antidepressant therapy with a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI).

Detailed Description

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Conditions

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Depressive Disorder, Major

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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JNJ-42847922

Participants will receive 20 mg of JNJ-42847922 as a starting dose and matching placebo (1 capsule of 20 mg JNJ-42847922 and 1 capsule of matching placebo) once daily for 14 days. After Day 14, if needed, JNJ-42847922 dose can be increased to 40 mg (2\*20 mg capsules) and flexible dose of JNJ-42847922 (20 or 40 mg) will be taken once daily until Day 167. Dose of JNJ-42847922 (20 or 40 mg) will be adjusted by investigator based on the participant's clinical response and tolerability. Participants will continue to take their baseline selective serotonin reuptake inhibitor (SSRI)/serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases.

Group Type EXPERIMENTAL

JNJ-42847922

Intervention Type DRUG

Participants will receive JNJ-42847922 capsule orally.

Placebo Matching to JNJ-42847922

Intervention Type DRUG

Participants will receive placebo capsule matching to JNJ-42847922 orally.

Selective Serotonin Reuptake Inhibitor (SSRI)

Intervention Type DRUG

Participants will receive SSRI antidepressant (such as, citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertraline, vilazodone or vortioxetine) as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases (approximately up to Week 26).

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Intervention Type DRUG

Participants will receive SNRI antidepressant (such as duloxetine, milnacipran, levomilnacipran, venlafaxine, desvenlafaxine) as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases (approximately up to Week 26).

Quetiapine Extended-Release (XR)

Participants will receive 1 capsule of quetiapine XR 50 mg along with 1 capsule of matching placebo once daily for 2 days, followed by 1 capsule of quetiapine XR 150 mg along with 1 capsule of matching placebo once daily from Day 3 to Day 14. After Day 14, if needed, quetiapine XR dose can be increased to 300 mg (2\*150 mg capsules) and flexible dose of quetiapine (150 or 300 mg) will be taken once daily until Day 167. Dose of quetiapine XR (150 or 300 mg) will be adjusted by investigator based on the participant's clinical response and tolerability. Participants will continue to take their baseline SSRI/SNRI antidepressant as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases.

Group Type ACTIVE_COMPARATOR

Quetiapine XR

Intervention Type DRUG

Participants will receive quetiapine XR capsule orally.

Placebo Matching to Quetiapine XR

Intervention Type DRUG

Participants will receive placebo capsule matching to quetiapine XR orally.

Selective Serotonin Reuptake Inhibitor (SSRI)

Intervention Type DRUG

Participants will receive SSRI antidepressant (such as, citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertraline, vilazodone or vortioxetine) as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases (approximately up to Week 26).

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Intervention Type DRUG

Participants will receive SNRI antidepressant (such as duloxetine, milnacipran, levomilnacipran, venlafaxine, desvenlafaxine) as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases (approximately up to Week 26).

Interventions

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JNJ-42847922

Participants will receive JNJ-42847922 capsule orally.

Intervention Type DRUG

Placebo Matching to JNJ-42847922

Participants will receive placebo capsule matching to JNJ-42847922 orally.

Intervention Type DRUG

Quetiapine XR

Participants will receive quetiapine XR capsule orally.

Intervention Type DRUG

Placebo Matching to Quetiapine XR

Participants will receive placebo capsule matching to quetiapine XR orally.

Intervention Type DRUG

Selective Serotonin Reuptake Inhibitor (SSRI)

Participants will receive SSRI antidepressant (such as, citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertraline, vilazodone or vortioxetine) as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases (approximately up to Week 26).

Intervention Type DRUG

Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Participants will receive SNRI antidepressant (such as duloxetine, milnacipran, levomilnacipran, venlafaxine, desvenlafaxine) as a part of background therapy (at the same dose, without change, every day and at approximately the same time as prior to entering the study) throughout the screening, double-blind, and follow-up phases (approximately up to Week 26).

Intervention Type DRUG

Other Intervention Names

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MIN-202; Seltorexant

Eligibility Criteria

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Inclusion Criteria

* Male or female of non-childbearing potential (WONCBP) outpatients, aged 18 to 70 years (inclusive). A WONCBP is defined as: a).Postmenopausal: A postmenopausal state is defined as no menses for 12 months without an alternative medical cause. b). Permanently sterile: Permanent sterilization methods include hysterectomy, bilateral salpingectomy, bilateral tubal occlusion/ligation procedures, and bilateral oophorectomy. c). If reproductive status is questionable, additional evaluation should be considered
* Meet Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) diagnostic criteria for major depressive disorder (MDD), without psychotic features, based upon clinical assessment and confirmed by the Structured Clinical Interview for DSM-5 Axis I Disorders- Clinical Trials Version (SCID-CT). The length of the current depressive episode must be less than or equal to (\<=) 18 months
* Have had an inadequate response to at least 1 but no more than 3 antidepressants, administered at an adequate dose and duration in the current episode of depression, as assessed by the Massachusetts General Hospital-Antidepressant Treatment Response Questionnaire (MGH-ATRQ). An inadequate response is defined as less than (\<)50 percent (%) reduction in depressive symptom severity, as assessed by the MGH-ATRQ. An adequate trial is defined as an antidepressant treatment for at least 4 weeks at or above the minimum therapeutic dose, as specified in the MGH-ATRQ, for any particular antidepressant. The inadequate response must include the participant's current antidepressant treatment
* Be receiving monotherapy treatment for depressive symptoms with 1 of the following selective serotonin reuptake inhibitor (SSRI)/serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants, in any formulation: citalopram, duloxetine, escitalopram, fluvoxamine, fluoxetine, milnacipran, levomilnacipran, paroxetine, sertraline, venlafaxine, desvenlafaxine, vilazodone, or vortioxetine at a stable dose (at or above the minimum therapeutic dose level) for at least 4 weeks, and for no greater than 12 months, at screening. Modification of an effective preexisting therapy should not be made for the explicit purpose of entering a participant into the study
* Have a Montgomery-Asberg Depression Rating Scale (MADRS) total score greater than or equal to (\>=)25 (performed by independent, centralized remote raters) at screening and must not demonstrate a clinically significant improvement (that is, an improvement of greater than (\>)20% on their MADRS total score) from the screening to baseline visit
* Have a Body Mass Index (BMI) between 18 and 35 kilogram per meter square (kg/m\^2) inclusive (BMI equal to \[=\] weight/height\^2)
* Must be otherwise healthy on the basis of physical examination, medical history, vital signs, 12-lead electrocardiogram (ECG), and clinical laboratory tests performed at screening. If there are abnormalities, they must be consistent with the underlying illness in the study population. If the results of the clinical laboratory tests are outside the normal reference ranges, the participant may be included only if the investigator judges the abnormalities or deviations from normal to be not clinically significant or to be appropriate and reasonable for the population under study. This determination must be recorded in the participant's source documents and initialed by the investigator

Exclusion Criteria

* Have Cushing's Disease, Addison's Disease, primary amenorrhea, or other evidence of significant medical disorders of the hypothalamic-pituitary-adrenal (HPA) axis
* Have a history of epilepsy, neuroleptic malignant syndrome (NMS) or Tardive Dyskinesia
* Have a history of previous non-response to an adequate trial of quetiapine as an adjunctive treatment for MDD (adequate trial defined as \>=150 mg for 4 weeks or more) and/or a history of lack of response to 3 or more adequate antidepressant treatments and/or a history or evidence of noncompliance with current antidepressant therapy
* Have taken a known moderate or strong inhibitor/inducer of cytochrome P450 (CYP)3A4 and CYP2C9 or a dual inhibitor/inducer of CYP3A4 and CYP2C9 within 14 days (or after washout that is, duration of 5 times the drug's half-life) before the first study drug administration on Day 1 until the follow-up visit. Fluvoxamine is a moderate CYP2C9 inhibitor and a mild CYP3A inhibitor, and will not be excluded from the study
* Have a history or current diagnosis of a psychotic disorder, bipolar disorder, intellectual disability, autism spectrum disorder, borderline personality disorder, somatoform disorders, or fibromyalgia
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Research & Development, LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Janssen Research & Development, LLC Clinical Trial

Role: STUDY_DIRECTOR

Janssen Research & Development, LLC

Locations

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NoesisPharma Research

Phoenix, Arizona, United States

Site Status

Clinical Research Consortium Arizona

Tempe, Arizona, United States

Site Status

Woodland Research Northwest

Rogers, Arkansas, United States

Site Status

Collaborative NeuroScience Network

Garden Grove, California, United States

Site Status

Pacific Institute of Medical Sciences

Los Angeles, California, United States

Site Status

National Research Institute

Los Angeles, California, United States

Site Status

Excell Research Inc

Oceanside, California, United States

Site Status

Desert Valley Research

Rancho Mirage, California, United States

Site Status

Anderson Clinical Research

Redlands, California, United States

Site Status

Artemis Institute for Clinical Research

San Diego, California, United States

Site Status

Syrentis Clinical Research

Santa Ana, California, United States

Site Status

Research Center for Clinical Studies, Inc.

Norwalk, Connecticut, United States

Site Status

Clinical Research of South Florida

Coral Gables, Florida, United States

Site Status

SIH Research

Kissimmee, Florida, United States

Site Status

Premier Clinical Research

Miami, Florida, United States

Site Status

Innova Clinical Trials

Miami, Florida, United States

Site Status

Arocha Research Center Inc

Miami, Florida, United States

Site Status

Suncoast Clinical Research

New Port Richey, Florida, United States

Site Status

Stedman Clinical Trials

Tampa, Florida, United States

Site Status

Northwest Behavioral Research Center

Marietta, Georgia, United States

Site Status

Suburban Clinical Research Group, Inc

Bolingbrook, Illinois, United States

Site Status

RxClinicals

Crystal Lake, Illinois, United States

Site Status

Alexian Brothers Health System

Hoffman Estates, Illinois, United States

Site Status

Psychiatric Medicine Associates LLC

Skokie, Illinois, United States

Site Status

American Research, LLC

Jeffersonville, Indiana, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

Phoenix Medical Research, Inc.

Prairie Village, Kansas, United States

Site Status

Johns Hopkins University School of Medicine

Baltimore, Maryland, United States

Site Status

BTC of New Bedford

New Bedford, Massachusetts, United States

Site Status

Boston Clinical Trials & Medical Research

Roslindale, Massachusetts, United States

Site Status

Rochester Center for Behavioral Medicine (RCBM)

Rochester Hills, Michigan, United States

Site Status

Midwest Research Group

Saint Charles, Missouri, United States

Site Status

PsychCare Consultants Research

St Louis, Missouri, United States

Site Status

Clinical Research Consortium

Las Vegas, Nevada, United States

Site Status

SPRI Clinical Trials, LLC

Brooklyn, New York, United States

Site Status

CNS Research Science, Inc.

Jamaica, New York, United States

Site Status

Hapworth Psychiatric Medical PLLC

New York, New York, United States

Site Status

Carolina Partners c/o Tripha Life Sciences

Raleigh, North Carolina, United States

Site Status

Patient Priority Clinical Sites LLC

Cincinnati, Ohio, United States

Site Status

Intend Research

Norman, Oklahoma, United States

Site Status

IPS Research Company

Oklahoma City, Oklahoma, United States

Site Status

Sooner Clinical Research

Oklahoma City, Oklahoma, United States

Site Status

BTC Network

Lincoln, Rhode Island, United States

Site Status

Hawkins Psychiatry, PC

Arlington, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Houston Endoscopy and Research Center, Inc.

Houston, Texas, United States

Site Status

Texas Center for Drug Development Inc

Houston, Texas, United States

Site Status

Pillar Clinical Research, LLC

Richardson, Texas, United States

Site Status

Ericksen Research and Development

Clinton, Utah, United States

Site Status

Northwest Clinical Research Center

Bellevue, Washington, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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42847922MDD2002

Identifier Type: OTHER

Identifier Source: secondary_id

CR108394

Identifier Type: -

Identifier Source: org_study_id

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