Department of Defense PTSD Adaptive Platform Trial - Master Protocol

NCT ID: NCT05422612

Last Updated: 2025-09-08

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

800 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-02

Study Completion Date

2026-09-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a Phase 2 randomized, double-blinded, placebo-controlled study that will evaluate multiple potential pharmacotherapeutic interventions for PTSD utilizing an adaptive platform trial design. Participants are randomized among the multiple cohorts in the study and the resulting randomization enables sharing/pooling of control participants, where all interventions may be compared to a common control (placebo). This master protocol describes the default procedures and analyses for all cohorts; treatment-specific procedures will be described in the Master Protocol cohort-specific appendices. Individual cohorts may have additional eligibility requirements, safety and efficacy procedures, or endpoints, which will be described in corresponding intervention-specific clinicaltrials.gov records.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The general structure of the Military and Veterans PTSD Adaptive Platform Clinical Trial (M-PACT) consists of a 30-day Screening Period, a 12-week Treatment Period, and a 4-week Safety Follow-up. The trial will include up to 5 open cohorts (it is possible for 1 of the cohorts to begin sooner than the others, as necessary). Importantly, the integration of multi-modal biomarker assessments within the M-PACT allows for defining future cohorts based on to-be-determined biomarker signatures in a multi-stage approach. Initial testing in non-biomarker-defined cohorts will be referred to as "main stage" testing, while testing in biomarker-defined cohorts will occur within "biomarker extensions." Initially designed as up to 5-arms versus control, the adaptive platform trial will continue enrollment until decisions are made to stop all cohorts. At quarterly interim analyses, unblinded data will be reviewed by an independent, firewalled Independent Statistical Analysis Committee (ISAC) and a Data and Safety Monitoring Board (DSMB). At each interim analysis, the possible cohort-level decisions that could be made by the prespecified adaptive plan include stopping enrollment to a cohort for futility, stopping enrollment to a cohort for anticipated success, or stopping enrollment to a cohort for reaching the maximum sample size. For cohort-specific interventions intending to pursue a labeling claim (which will be clearly stated in the cohort-specific appendix before cohort initiation), early stopping for success will not be considered. New cohorts for investigation can be added at any time. The DSMB may recommend stopping any cohort for safety reasons.

Candidate biomarker data will be retrospectively analyzed after each cohort has completed main stage testing, and cohort testing may be re-initiated for prospective evaluation of the treatment in a subject population enriched (eg, either only biomarker "positive" or only biomarker "negative" subjects would be enrolled) or stratified based on biomarker status. In addition, candidate biomarkers (which may also be characterized or validated externally to the M-PACT) may be used to stratify randomization across cohorts or as a prospective enrichment strategy at the initiation of a cohort. Exploratory biomarker data will be evaluated throughout the trial to identify additional candidate biomarkers for testing within the M-PACT.

For information specific to each intervention included in this platform trial, please refer to the below corresponding, separate, clinicaltrials.gov records:

Vilazodone NCT05948579; Fluoxetine NCT05948553; Daridorexant NCT05948540; SLS-002 NCT06816433.

Parties interested in having their intervention considered for testing within the M-PACT should complete a request for information form using this webpage https://citeline.qualtrics.com/jfe/form/SV\_8eTQKw6TNug4z42.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Post Traumatic Stress Disorder

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Multiple interventions will be tested in this adaptive platform trial and each will be described in Master Protocol cohort-specific platform appendices.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
The overall 2-stage randomization scheme will be implemented by an unblinded statistician who is otherwise uninvolved in study operations. Participants will be assigned a study number at Screening (Subject ID). In the first stage of randomization, eligible participants who complete screening will be randomly assigned to an open platform cohort for which they are eligible (both site PIs and participants are aware of the cohort assignment) and, within that cohort, the second stage of randomization is to intervention vs placebo (double-blind) using Interactive Response Technology (IRT).

For this APT, participant assignment to a cohort will not be blinded. The tablets/capsules used in the cohorts may not be visually similar between cohorts and blinding to cohort assignment is not necessary to avoid bias. However, within each cohort, participants, site personnel, contract research personnel and the sponsor will be blind to treatment assignment (intervention vs. placebo).

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Intervention A: Fluoxetine HCl

Group Type EXPERIMENTAL

Intervention A Fluoxetine Hydrochloride (HCl)

Intervention Type DRUG

Fluoxetine will be administered at 10 to 60 mg daily. The initial dose for all participants will be 10 mg daily for 1 week, then increased to 20 mg daily for 2 weeks, then increased to 40 mg daily for 2 weeks, then increased to 60 mg daily for the remainder of the trial. One reduction in dose due to tolerability will be allowed. When a participant's dose is decreased due to tolerability, the dose will not be increased.

Intervention A Placebo

Group Type PLACEBO_COMPARATOR

Intervention A Placebo

Intervention Type DRUG

A matching placebo will be administered at 10 to 60 mg daily in the same regimen as the intervention.

Intervention B Vilazodone

Group Type EXPERIMENTAL

Intervention B Vilazodone Hydrochloride (HCl)

Intervention Type DRUG

Vilazodone HCl will be administered at 10 mg once daily for 7 days, followed by 20 mg for 7 days, followed by 40 mg for the remainder of the trial. There must be a minimum of 7 days between dosage increases. One reduction in dose due to tolerability will be allowed. After Week 8, dose reduction for tolerability is allowed, but dose increase is not allowed.

Intervention B Placebo

Group Type PLACEBO_COMPARATOR

Intervention B Placebo

Intervention Type DRUG

A matching placebo will be administered at 10 to 40 mg daily in the same regimen as the intervention.

Intervention C Daridorexant

Group Type EXPERIMENTAL

Intervention C Daridorexant

Intervention Type DRUG

Daridorexant will be administered 50 mg once daily.

Intervention C Placebo

Group Type PLACEBO_COMPARATOR

Intervention C Placebo

Intervention Type DRUG

A matching placebo will be administered at 50 mg daily in the same regimen as the intervention.

Intervention D SLS-002

Group Type EXPERIMENTAL

Intervention D SLS-002

Intervention Type DRUG

• SLS-002 will be administered via intranasal administration (one spray per nostril, per device) at 78 mg two times per week for the first eight weeks and then once a week for the last four weeks.

Intervention D Placebo

Group Type PLACEBO_COMPARATOR

Intervention D Placebo

Intervention Type DRUG

A matching placebo will be administered via intranasal administration (one spray per nostril, per device) two times per week for the first eight weeks and then once a week for the last four weeks.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Intervention A Fluoxetine Hydrochloride (HCl)

Fluoxetine will be administered at 10 to 60 mg daily. The initial dose for all participants will be 10 mg daily for 1 week, then increased to 20 mg daily for 2 weeks, then increased to 40 mg daily for 2 weeks, then increased to 60 mg daily for the remainder of the trial. One reduction in dose due to tolerability will be allowed. When a participant's dose is decreased due to tolerability, the dose will not be increased.

Intervention Type DRUG

Intervention A Placebo

A matching placebo will be administered at 10 to 60 mg daily in the same regimen as the intervention.

Intervention Type DRUG

Intervention B Vilazodone Hydrochloride (HCl)

Vilazodone HCl will be administered at 10 mg once daily for 7 days, followed by 20 mg for 7 days, followed by 40 mg for the remainder of the trial. There must be a minimum of 7 days between dosage increases. One reduction in dose due to tolerability will be allowed. After Week 8, dose reduction for tolerability is allowed, but dose increase is not allowed.

Intervention Type DRUG

Intervention B Placebo

A matching placebo will be administered at 10 to 40 mg daily in the same regimen as the intervention.

Intervention Type DRUG

Intervention C Daridorexant

Daridorexant will be administered 50 mg once daily.

Intervention Type DRUG

Intervention C Placebo

A matching placebo will be administered at 50 mg daily in the same regimen as the intervention.

Intervention Type DRUG

Intervention D SLS-002

• SLS-002 will be administered via intranasal administration (one spray per nostril, per device) at 78 mg two times per week for the first eight weeks and then once a week for the last four weeks.

Intervention Type DRUG

Intervention D Placebo

A matching placebo will be administered via intranasal administration (one spray per nostril, per device) two times per week for the first eight weeks and then once a week for the last four weeks.

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Is willing and able to provide written informed consent.
2. ≥18 and \<65 years of age at Screening.
3. Meets Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5) criteria for PTSD according to CAPS-5-R, Past Month assessment at Screening and Baseline.
4. The index trauma must have occurred more than 3 months prior to screening.
5. Has a CAPS-5-R, Past Month total score of ≥26 at Screening and Baseline. Note: The CAPS-5 scoring grid will be used to score answers and to calculate the total score to determine eligibility.
6. Is currently serving, or has previously served, in a branch of the US military service (ie, Air Force, Army, Navy, Marine Corps, and Coast Guard including Reserves and National Guard).
7. Agrees to consistently use an acceptable method of birth control as defined in Section 7.4.2 (required for both males and females who are of reproductive potential and sexually active with partners of the opposite sex) throughout the duration of participants' involvement in the study and for a minimum of 30 days after the last dose of study intervention or longer, as specified in the assigned cohort-specific appendices.

1. For females of reproductive potential, acceptable birth control methods are defined as: hormonal contraceptives, intrauterine device, or double barrier contraception (ie, male condom and diaphragm, male condom or diaphragm with spermicidal gel or foam). Hormonal contraceptives must have been started at least 2 months prior to the Baseline visit. In addition, agrees to no egg donation or harvesting for the duration of the study and for at least 30 days after the last dose of study treatment or as specified in the assigned cohort-specific appendices.
2. Non-reproductive potential for females is defined by a post-menopausal (12 consecutive months without menses or surgically sterile). If in question, an Follicle-stimulating hormone (FSH) of \>40 U/mL, per central laboratory testing must be documented. Surgical sterility (hysterectomy, bilateral oophorectomy, or bilateral tubal ligation) must be documented.
3. Females of reproductive potential must have a negative pregnancy test at the screening (serum) and baseline (urine) visits.
4. For males, adequate birth control methods will be defined as the use of double barrier contraception (eg, male condom and diaphragm, male condom or diaphragm with spermicidal gel or foam). In addition, male participants must agree not to donate sperm for the duration of the study and for at least 30 days after the last dose of study treatment or as specified in the assigned cohort-specific appendices.
5. Non-reproductive potential for males is defined as surgical sterility (ie, vasectomy) at least 3 months prior to baseline.
8. Is able and willing to participate in study assessments and undergo blood draws.
9. Is willing to undergo magnetic resonance imaging (MRI) eg, is not claustrophobic, has no contraindications to MRI.

Exclusion Criteria

1. Is pregnant or breastfeeding at the Screening or Baseline visits, or planning pregnancy during the study.
2. Is at risk for suicide based on any of the following:

1. Had any suicidal ideation or behavior (including preparatory behavior) that required psychiatric hospitalization in the 3 months prior to screening.
2. Had more than 2 actual suicide attempts within the last 3 years, not including interrupted or aborted attempts, preparatory acts or behaviors, or non-suicidal self-injurious behavior (as per C-SSRS response).
3. Has any history of suicidal ideation and/or intent following initiation of a medication used for psychiatric symptoms or disorders.
4. Has any history of suicide-related hospitalization following initiation of a medication used for psychiatric symptoms or disorders.
3. Is taking any prohibited medication per Section 8.5.1 or cohort-specific restrictions (see cohort-specific appendices), is unable/unwilling to discontinue medications, or in the PI's judgement, cannot discontinue medications. Subjects must agree to a washout period of at least 14 days or 5 half-lives, whichever is longer, prior to the first dose of study intervention. Note, the half-life of the parent drug (not metabolites) should be used in this calculation.
4. In the 3 months prior to the Baseline visit, has initiated or terminated individual or group PTSD specific psychotherapy (eg, Eye Movement Desensitization \& Reprocessing, Prolonged Exposure, Cognitive Processing Therapy, Stress Inoculation Training, Present Centered Therapy), or therapy is anticipated to conclude during the study. Completion of ≤2 sessions in the prior 3 months with no plans to continue is not exclusionary. Participants in stable trauma-focused or non-trauma focused therapy must agree to continue treatment for the duration of participation in the study.
5. Has undergone or plans to undergo gender reassignment surgery. Note: participants who are currently undergoing stable hormone replacement therapy are eligible for inclusion in the study.
6. Meets DSM-5 (American Psychiatric Association 2013) criteria for moderate or severe alcohol use disorder (AUD) or other substance use disorders (SUDs), including cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, or stimulants within 3 months of screening. Nicotine use disorder is allowed.
7. Has a positive screen for illicit drugs (excluding cannabis) or recent heavy alcohol consumption (as possibly indicated by an elevated gamma-glutamyl transferase (GGT) or an elevated aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio - to be interpreted in the context of other clinical information) at the Baseline visit.
8. Has a lifetime history or current symptoms of psychotic features, as determined by the Mini International Neuropsychiatric Interview (MINI) Psychotic Disorders and Mood Disorders with Psychotic Features screening questions.
9. Has a current diagnosis of obstructive sleep apnea (OSA) considered not well-managed (AHI ≥5) with C-, Bi-, or V PAP. Participants who have AHI ≥5 at Screening with the OSA screening device may repeat the OSA assessment prior to the Baseline visit or provide documentation from a physician stating that their C-, Bi-, or V-PAP machine AHI readings are \<5.
10. Has a history of neoplastic disease or completion of treatment in the last 5 years, except for treated basal cell or squamous cell carcinoma of the skin.
11. Has any clinically significant abnormal findings on the 12-lead electrocardiogram (ECG) at the Screening or Baseline visits, such as:.

1. Abnormal heart rhythm (such as atrial fibrillation, ventricular fibrillation, or torsade de pointes)
2. ECG with a QTc interval \>450 msec for males or \>470 msec for females (QT interval corrected with Fridericia correction \[QTcF\]).At Screening, eligibility will be based on the central ECG reading. At baseline, eligibility will be based on the local ECG reading by a qualified site investigator.
12. Has abnormal laboratory results at the Screening visit:

1. serum creatinine \>1.5 mg/dL OR
2. estimated creatinine clearance of \<50 mL/min calculated by the Cockcroft and Gault formula).
13. Has clinically significant abnormal laboratory results at the Screening visit that indicate impaired liver function:

1. ALT or AST \>2 × ULN
2. total bilirubin level \>1.5 × ULN (unless previously known Gilbert syndrome)
3. prolonged prothrombin time \>1.5 × ULN
14. Has a prior history of drug induced liver injury characterized by ALT or AST \>3 × upper limit of normal (ULN) AND total bilirubin level \>2 × ULN without cholestasis (ie, Alkaline Phosphatase \<2 × ULN).
15. Has any other clinically significant laboratory result at Screening that could impact the participant's safety or participation in the study, as determined by the Site PI.
16. Has any other concurrent psychiatric or medical condition that would impact the participant's safety, ability to appropriately complete evaluations, or participation in the study, as determined by the Site PI.
17. Does not have a stable method of contact over the duration of the study.
18. Is currently involved in litigation, medical evaluation for disability benefits or damages, or benefit examination related to the PTSD diagnosis.
19. Has participated in any interventional clinical trial or treatment with any investigational drug or other investigational intervention within 3 months or 5 half-lives, whichever is longer, of screening.

Note: Previous participation in an observational study is permitted.

Note: Subjects who are enrolled in the M-PACT, and who are eligible for re randomization, are permitted to remain in the study and receive alternative cohort intervention following a 14 day or 5 half-lives washout period, whichever is longer. The half-life of the parent drug (not metabolites) should be used in this calculation.
20. Is unavailable for the duration of the trial, unlikely to be compliant with the protocol, or deemed by the Site PI to be unsuitable for participation in the trial for any reason.
21. Systolic blood pressure \>140 mm Hg and/or diastolic blood pressure \>90 mm Hg or Systolic blood pressure \<90 mm Hg and/or diastolic blood pressure \<50 mm Hg.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

U.S. Army Medical Research and Development Command

FED

Sponsor Role collaborator

PPD Development, LP

INDUSTRY

Sponsor Role collaborator

Berry Consultants

OTHER

Sponsor Role collaborator

Idorsia Pharmaceuticals Ltd.

INDUSTRY

Sponsor Role collaborator

Cambridge Cognition Ltd

INDUSTRY

Sponsor Role collaborator

Citeline

INDUSTRY

Sponsor Role collaborator

Global Coalition for Adaptive Research

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Phoenix VA Healthcare System

Phoenix, Arizona, United States

Site Status RECRUITING

Homestead Associates in Research, Inc.

Miami, Florida, United States

Site Status RECRUITING

Advanced Discovery Research

Atlanta, Georgia, United States

Site Status RECRUITING

Tripler Army Medical Center (TAMC)

Tripler AMC, Hawaii, United States

Site Status RECRUITING

Cincinnati Veteran's Affairs Medical Center

Fort Thomas, Kentucky, United States

Site Status RECRUITING

Walter Reed National Military Medical Center (WRNMC)

Bethesda, Maryland, United States

Site Status RECRUITING

Upstate Clinical Research Associates, LLC

Williamsville, New York, United States

Site Status RECRUITING

Wilford Hall Ambulatory Surgical Center (WHASC)

San Antonio, Texas, United States

Site Status RECRUITING

Alexander T. Augusta Military Medical Center (ATAMMC):

Fort Belvoir, Virginia, United States

Site Status RECRUITING

Madigan Army Medical Center

Joint Base Lewis McChord, Washington, United States

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United States

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Please visit the website:

Role: CONTACT

ptsdclinicaltrial.org

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Dr. Shabnam Thompson

Role: primary

602-277-5551 ext. 7768

Connie Houser

Role: backup

602-277-5551 ext. 7768

Homestead Associates Research Contact

Role: primary

305-246-0873

Advanced Discovery Research Contact

Role: primary

470-777-8839

Department of Clinical Investigation

Role: primary

808-304-1143

Jada Turner

Role: primary

513-485-8934

Amber Hampton, MSN

Role: primary

301-295-2397

Payton Flores, MPH

Role: backup

301-295-9144

Amy Strombach

Role: primary

716-626-6320

Laura Liu, Clinical Coordinator II, BS, RN, CCRC

Role: primary

301-295-3790

Wafa Azgugu, Study Coordinator

Role: primary

571-231-1315

Aamina Khattak, Research Assistant

Role: backup

571-231-1314

Madigan Army Medical Center Contact

Role: primary

253-968-4263

References

Explore related publications, articles, or registry entries linked to this study.

Viele K. Allocation in platform trials to maintain comparability across time and eligibility. Stat Med. 2023 Jul 20;42(16):2811-2818. doi: 10.1002/sim.9750. Epub 2023 Apr 23.

Reference Type BACKGROUND
PMID: 37088912 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

S-21-02 / IND 157676

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

PROlonGed ExpoSure Sertraline
NCT01524133 COMPLETED PHASE4