Trial Outcomes & Findings for The Objective of This Study is to Evaluate the Efficacy, Safety and Tolerability of Cariprazine as an Adjunctive Treatment to Antidepressant Therapy (ADT) in Patients With Major Depressive Disorder (MDD) Who Have Had an Inadequate Response to Antidepressants Alone (NCT NCT03739203)

NCT ID: NCT03739203

Last Updated: 2022-09-21

Results Overview

The MADRS is a 10-item, clinician-rated scale that evaluates the participant's depressive symptomatology during the past week. Participants were rated on items assessing feelings of sadness, lassitude, pessimism, inner tension, suicidality, reduced sleep or appetite, difficulty in concentration, and lack of interest. Each item was scored on a 7-point scale with a score of 0 reflecting no symptoms and a score of 6 reflecting symptoms of maximum severity. The total score ranges from 0 to 60 with a higher score indicating more depression. A negative change from Baseline indicates improvement. Mixed-effects Model for Repeated Measures (MMRM) was used for analyses.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

752 participants

Primary outcome timeframe

Baseline and Week 6

Results posted on

2022-09-21

Participant Flow

A total of 752 participants were enrolled, of which 751 took ≥1 dose of double-blind investigational product and were included in the Safety Population. One participant was randomized but did not receive treatment and was excluded from the study analyses. At the end of treatment in the Double-blind Period, participants continued on their background antidepressant therapy (ADT) and entered the Safety Follow-up Period.

Participant milestones

Participant milestones
Measure
Placebo + ADT
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing antidepressant therapy (ADT) \[same antidepressant and dose of ADT they were on at the Baseline\] during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Double-blind Treatment Period (6 Weeks)
STARTED
250
250
251
Double-blind Treatment Period (6 Weeks)
Modified Intent-to Treat (mITT) Population
249
250
251
Double-blind Treatment Period (6 Weeks)
COMPLETED
235
233
226
Double-blind Treatment Period (6 Weeks)
NOT COMPLETED
15
17
25
Safety Follow-Up Period (4 Weeks)
STARTED
242
242
242
Safety Follow-Up Period (4 Weeks)
COMPLETED
240
240
238
Safety Follow-Up Period (4 Weeks)
NOT COMPLETED
2
2
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo + ADT
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing antidepressant therapy (ADT) \[same antidepressant and dose of ADT they were on at the Baseline\] during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Double-blind Treatment Period (6 Weeks)
Adverse Event
6
9
13
Double-blind Treatment Period (6 Weeks)
Lack of Efficacy
1
0
1
Double-blind Treatment Period (6 Weeks)
Lost to Follow-up
1
1
2
Double-blind Treatment Period (6 Weeks)
Withdrawal by Subject
4
4
6
Double-blind Treatment Period (6 Weeks)
Protocol Deviation
1
0
1
Double-blind Treatment Period (6 Weeks)
Non-compliance With Study Drug
1
3
1
Double-blind Treatment Period (6 Weeks)
Reason not Specified
1
0
1
Safety Follow-Up Period (4 Weeks)
Withdrawal by Subject
1
2
0
Safety Follow-Up Period (4 Weeks)
Lost to Follow-up
0
0
2
Safety Follow-Up Period (4 Weeks)
Death
1
0
0
Safety Follow-Up Period (4 Weeks)
Reason not Specified
0
0
2

Baseline Characteristics

mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo + ADT
n=250 Participants
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
n=250 Participants
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
n=251 Participants
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Total
n=751 Participants
Total of all reporting groups
Age, Continuous
46.2 years
STANDARD_DEVIATION 12.12 • n=250 Participants
45.0 years
STANDARD_DEVIATION 12.95 • n=250 Participants
45.8 years
STANDARD_DEVIATION 12.45 • n=251 Participants
45.7 years
STANDARD_DEVIATION 12.51 • n=751 Participants
Sex: Female, Male
Female
191 Participants
n=250 Participants
185 Participants
n=250 Participants
197 Participants
n=251 Participants
573 Participants
n=751 Participants
Sex: Female, Male
Male
59 Participants
n=250 Participants
65 Participants
n=250 Participants
54 Participants
n=251 Participants
178 Participants
n=751 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
30 Participants
n=250 Participants
38 Participants
n=250 Participants
34 Participants
n=251 Participants
102 Participants
n=751 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
220 Participants
n=250 Participants
212 Participants
n=250 Participants
217 Participants
n=251 Participants
649 Participants
n=751 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=250 Participants
0 Participants
n=250 Participants
0 Participants
n=251 Participants
0 Participants
n=751 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=250 Participants
0 Participants
n=250 Participants
2 Participants
n=251 Participants
2 Participants
n=751 Participants
Race (NIH/OMB)
Asian
4 Participants
n=250 Participants
0 Participants
n=250 Participants
5 Participants
n=251 Participants
9 Participants
n=751 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=250 Participants
1 Participants
n=250 Participants
0 Participants
n=251 Participants
1 Participants
n=751 Participants
Race (NIH/OMB)
Black or African American
29 Participants
n=250 Participants
32 Participants
n=250 Participants
22 Participants
n=251 Participants
83 Participants
n=751 Participants
Race (NIH/OMB)
White
217 Participants
n=250 Participants
216 Participants
n=250 Participants
221 Participants
n=251 Participants
654 Participants
n=751 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=250 Participants
1 Participants
n=250 Participants
1 Participants
n=251 Participants
2 Participants
n=751 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=250 Participants
0 Participants
n=250 Participants
0 Participants
n=251 Participants
0 Participants
n=751 Participants
Montgomery-Asberg Depression Rating Scale (MADRS) Total Score
32.99 score on a scale
STANDARD_DEVIATION 4.789 • n=249 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
32.00 score on a scale
STANDARD_DEVIATION 4.246 • n=250 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
32.25 score on a scale
STANDARD_DEVIATION 4.688 • n=251 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
32.41 score on a scale
STANDARD_DEVIATION 4.593 • n=750 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
Clinical Global Impression-Severity (CGI-S) Scale Score
4.67 score on a scale
STANDARD_DEVIATION 0.599 • n=249 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
4.61 score on a scale
STANDARD_DEVIATION 0.586 • n=250 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
4.65 score on a scale
STANDARD_DEVIATION 0.654 • n=251 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.
4.64 score on a scale
STANDARD_DEVIATION 0.614 • n=750 Participants • mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score.

PRIMARY outcome

Timeframe: Baseline and Week 6

Population: mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score. Overall number of participants analyzed are the number of participants with data available for analyses.

The MADRS is a 10-item, clinician-rated scale that evaluates the participant's depressive symptomatology during the past week. Participants were rated on items assessing feelings of sadness, lassitude, pessimism, inner tension, suicidality, reduced sleep or appetite, difficulty in concentration, and lack of interest. Each item was scored on a 7-point scale with a score of 0 reflecting no symptoms and a score of 6 reflecting symptoms of maximum severity. The total score ranges from 0 to 60 with a higher score indicating more depression. A negative change from Baseline indicates improvement. Mixed-effects Model for Repeated Measures (MMRM) was used for analyses.

Outcome measures

Outcome measures
Measure
Placebo + ADT
n=236 Participants
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
n=237 Participants
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
n=231 Participants
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Change From Baseline to Week 6 in the MADRS (Montgomery-Åsberg Depression Rating Scale) Total Score
-13.4 score on a scale
Standard Error 0.70
-13.8 score on a scale
Standard Error 0.69
-14.8 score on a scale
Standard Error 0.70

SECONDARY outcome

Timeframe: Baseline and Week 6

Population: mITT Population included all randomized participants who had ≥1 postbaseline assessment of the MADRS total score. Overall number of participants analyzed are the number of participants with data available for analyses.

The CGI-S is a clinician-rated scale used to rate the severity of the participant's current state of mental illness compared with MDD population. The participant was rated on a scale from 1 to 7, where 1=normal, not at all ill and 7=among the most extremely ill participants. Higher score indicates worsening of mental illness. A negative change from Baseline indicates improvement. MMRM was used for analyses.

Outcome measures

Outcome measures
Measure
Placebo + ADT
n=236 Participants
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
n=237 Participants
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
n=231 Participants
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Change From Baseline to Week 6 in the Clinical Global Impressions-Severity (CGI-S) Score
-1.4 score on a scale
Standard Error 0.09
-1.4 score on a scale
Standard Error 0.09
-1.6 score on a scale
Standard Error 0.09

Adverse Events

Placebo + ADT

Serious events: 2 serious events
Other events: 54 other events
Deaths: 1 deaths

Cariprazine 1.5 mg/Day + ADT

Serious events: 3 serious events
Other events: 70 other events
Deaths: 0 deaths

Cariprazine 3 mg/Day + ADT

Serious events: 1 serious events
Other events: 85 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Placebo + ADT
n=250 participants at risk
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
n=250 participants at risk
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
n=251 participants at risk
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Cardiac disorders
ATRIAL FIBRILLATION
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.40%
1/251 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Gastrointestinal disorders
INTESTINAL OBSTRUCTION
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
General disorders
DEATH
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Injury, poisoning and procedural complications
ANIMAL BITE
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Injury, poisoning and procedural complications
FALL
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Injury, poisoning and procedural complications
FIBULA FRACTURE
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Injury, poisoning and procedural complications
LIGAMENT SPRAIN
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Psychiatric disorders
SUICIDE ATTEMPT
0.00%
0/250 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.40%
1/250 • Number of events 1 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
0.00%
0/251 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.

Other adverse events

Other adverse events
Measure
Placebo + ADT
n=250 participants at risk
Cariprazine matching placebo capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 1.5 mg/Day + ADT
n=250 participants at risk
Cariprazine 1.5 mg capsules, orally, once daily in addition to their ongoing ADT (same antidepressant and dose of ADT they were on at the Baseline) during the Double-blind Treatment Period, up to Week 6.
Cariprazine 3 mg/Day + ADT
n=251 participants at risk
Cariprazine 1.5 mg capsules, orally, once daily for 2 weeks starting at the Baseline, titrated to 3.0 mg capsules, orally, once daily from Week 2 through Week 6 in addition to their ongoing ADT (same antidepressant and dose of ADT) during the Double-blind Treatment Period, up to Week 6.
Gastrointestinal disorders
NAUSEA
4.0%
10/250 • Number of events 15 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
5.6%
14/250 • Number of events 16 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
6.4%
16/251 • Number of events 21 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Nervous system disorders
AKATHISIA
3.6%
9/250 • Number of events 10 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
7.6%
19/250 • Number of events 19 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
11.6%
29/251 • Number of events 34 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Nervous system disorders
HEADACHE
10.8%
27/250 • Number of events 33 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
9.6%
24/250 • Number of events 32 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
10.8%
27/251 • Number of events 40 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Nervous system disorders
SOMNOLENCE
4.4%
11/250 • Number of events 11 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
4.8%
12/250 • Number of events 13 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
6.8%
17/251 • Number of events 17 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
Psychiatric disorders
INSOMNIA
3.6%
9/250 • Number of events 12 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
6.4%
16/250 • Number of events 18 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.
10.0%
25/251 • Number of events 29 • First dose of study drug until 30 days after the last dose of study drug (up to 12 weeks)
Safety Population included all participants in the randomized population who took ≥1 dose of double-blind investigational product.

Additional Information

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Phone: 800-633-9110

Results disclosure agreements

  • Principal investigator is a sponsor employee AbbVie requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. AbbVie requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if AbbVie needs to secure patent or proprietary protection.
  • Publication restrictions are in place

Restriction type: OTHER