Depressive EpisodePhase 2NCT03543410
A Clinical Study to Test the Effectiveness of an Investigational Drug to Treat People That Have Major Depressive Episodes When They Have Bipolar 1 Depression
A Phase 2 study testing SEP-4199 200 mg and SEP-4199 400 mg in people with Depressive Episode and Bipolar 1 Depression, run by Sumitomo Pharma America, Inc. at 87 sites in 8 countries.
Trial summary
A clinical study to test the effectiveness of an investigational drug to treat people that have major depressive episodes when they have Bipolar 1 Depression Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Depressive Episode, Bipolar 1 Depression
- What is being tested?
- SEP-4199 200 mg and SEP-4199 400 mg
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 344 participants
- Where
- 87 sitesin 8 countries
- Study dates
- 26 Jun 2018to 23 Apr 2020
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Subject is 18 to 65 years of age, inclusive, at the time of informed consent with bipolar I disorder, current episode depressed with or without rapid cycling disease course (≥ 4 episodes of mood disturbance but < 8 episodes in the previous 12 months) with or without psychotic features (diagnosed by DSM 5 criteria, and confirmed by the SCID 5 CT). The current episode of major depression associated with bipolar I disorder must be confirmed by the Investigator and noted in the source records.
- Subject provides written informed consent and is willing and able to comply with the protocol in the opinion of the investigator.
- Subject or legally acceptable representative must possess an educational level and degree of understanding of English or the local language that enables them to communicate suitably with the Investigator and the study coordinator.
- Subject must have a lifetime history of at least one bipolar manic or mixed manic episode. It is strongly recommended that a reliable informant (e.g., family member or caregiver) be available to confirm this history.
- Subject's current major depressive episode is ≥ 4 weeks and less than 12 months in duration at Screening.
- Subject has a MADRS total score ≥ 22 at both Screening and Baseline.
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- Subject has a YMRS total score ≤ 12 at Screening.
- Female subjects of childbearing potential must have a negative serum ß-hCG test at Screening.
- Females who participate in this study must be . one of the following:
- unable to become pregnant (e.g., postmenopausal, surgically sterile, etc.) -OR-
- Practicing abstinence or part of an abstinent lifestyle
- using and willing to continue using a highly effective form of birth control for at least 28 days prior to administration of the first dose of study drug, during the treatment period, and 2 months after completion or premature discontinuation from the study drug.
- Male subjects with partners of child bearing potential must be practicing abstinence, part of an abstinent life style or using protocol-specified methods of birth control. See Section 10.4 for further information on acceptable methods of birth control.
- Subject is in good physical health on the basis of medical history, physical examination, and laboratory screening.
- Subjects with type 2 diabetes are eligible for study inclusion only if all of the following conditions are met within 30 days prior to Screening:
- Subject's random screening glucose is < 200 mg/dL (11.1 mmol/L).
- Subject's Hemoglobin A1c (HbA1c) ≤ 7.0%.
- If a subject is currently being treated with oral anti-diabetic medication(s), the dose must have been stable for at least 30 days prior to screening. Such medication may be adjusted or discontinued during the study, as clinically indicated.
- Subject has not required hospitalization for diabetes or related complications in the past 12 months.
- Note: Subjects with type 2 diabetes that is newly diagnosed during screening are ineligible for the study.
- Subject who requires concomitant medication treatment with the following agents may be included if they have been on stable doses for the specified times: 1) oral hypoglycemics must be stabilized for at least 30 days prior to baseline; 2) thyroid hormone replacement must be stable for at least 90 days prior to baseline; 3) anti hypertensive agents must be stable for at least 30 days prior to baseline. The subject's medical condition should be deemed clinically stable following consultation with the Medical Monitor as needed.
Who cannot join
- Subject has a lifelong history or presence of symptoms consistent with a major psychiatric disorder other than bipolar I disorder as defined by DSM 5. Exclusionary disorders include but are not limited to moderate to severe alcohol use disorder (within past 12 months), substance use disorder (other than nicotine or caffeine) within past 12 months, bipolar II disorder, schizoaffective disorder, obsessive compulsive disorder, posttraumatic stress disorder.
- Subject demonstrates a decrease (improvement) of ≥ 25% in MADRS total score from Screening to Baseline, or subject's MADRS total score is < 22 at Baseline.
- Subject has received treatment with antidepressants within 3 days of randomization, fluoxetine at any time within 28 days, an MAO inhibitor within 21 days or clozapine within 120 days. All other psychotropic medications with the exceptions of lorazepam, temazepam,eszopiclone, zopiclone, zolpidem and zolpidem CR require 3 days minimum washout. Depot neuroleptics must be discontinued at least one treatment cycle prior to randomization.
- Subject has suspected/confirmed Borderline Personality Disorder
- Subject currently has a clinically significant neurological, metabolic (including type 1 diabetes), hepatic, renal, hematological, pulmonary, cardiovascular, gastrointestinal, and/or urological disorder such as unstable angina, congestive heart failure (uncontrolled), or central nervous system (CNS) infection that would pose a risk to the subject if they were to participate in the study or that might confound the results of the study. Subjects with a known history of HIV seropositivity will be excluded.
- Note: Active medical conditions that are minor or well-controlled are not exclusionary if they do not affect risk to the subject or the study results. In cases in which the impact of the condition upon risk to the subject or study results is unclear, the Medical Monitor should be consulted. Any subject with a known cardiovascular disease or condition (even if under control) must be discussed with the Medical Monitor before being randomized in the study.
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- Subject has evidence of any chronic organic disease of the CNS such as tumors, inflammation, active (or history of) seizure disorder, vascular disorder, Parkinson's disease, Alzheimer's disease or other forms of dementia, myasthenia gravis, or other degenerative processes. In addition, subjects must not have a history of intellectual disability or persistent neurological symptoms attributable to serious head injury. Past history of febrile seizure, is not exclusionary.
- Subject has a history of malignancy < 5 years prior to signing the informed consent, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer. Subjects with pituitary tumors of any duration are excluded.
- Subject demonstrates evidence of acute hepatitis, clinically significant chronic hepatitis, or evidence of clinically significant impaired hepatic function through clinical and laboratory evaluation (use screening values for laboratory evaluation). Subject has a history of stomach or intestinal surgery or any other condition that could interfere with absorption, distribution, metabolism, or excretion of medications.
- Subject has knowledge of any kind of cardiovascular disorder/condition known to increase the possibility of QT prolongation or history of additional risk factors for torsade de pointes (e.g., heart failure, hypokalemia, family history of Long QT Syndrome or Brugada Syndrome) or cardiac conduction disorders, or requires treatment with an antiarrhythmic medication.
- Subject has family history of QTc prolongation or of unexplainable sudden death at < 50 years of age.
- Abnormal 12 lead ECG at Screening, including:
- QTcF > 450 ms (male subjects) or > 470 ms (female subjects)
- QRS > 110 ms
- PR > 200 ms
- Second- or third-degree atrioventricular block
- Any rhythm other than sinus rhythm, which is interpreted by the Investigator to be clinically significant
- Subject has a history of neuroleptic malignant syndrome (NMS).
- Subject exhibits evidence of severe tardive dyskinesia, severe dystonia, or any other severe movement disorder. Severity is to be determined by the investigator.
- Subject has been diagnosed with type 1 diabetes, or insulin-dependent diabetics.
- Subject who has any abnormal laboratory parameter at screening that indicates a clinically significant medical condition as determined by the investigator. Subjects with fasting blood glucose at screening ≥ 126 mg/dL (7.0 mmol/L) will be excluded from the study. Subjects with fasting blood glucose from 100-125 mg/dL (5.6-6.9 mmol/L) may enter the study based on the approval of the Medical Monitor. Subjects with HbA1c > 7.0% will be excluded. Subjects who are found to have been non-fasting at Screening may be allowed if their blood glucose is < 200 mg/dL. Subjects with random (nonfasting) blood glucose at screening ≥ 200 mg/dL (11.1 mmol/L) must be retested in a fasted state. Subjects with HbA1c > 7.0% will be excluded.
- Subject has a prolactin concentration > 100 ng/mL at screening or have a history of pituitary adenoma.
- Subject has a body mass index (BMI) ≥ 40 or < 18 kg/m2.
- Subject has a history of non-response to an adequate (6-week) trial of three or more antidepressants (with or without mood stabilizers) during the current episode.
- Subject is considered by the Investigator to be at imminent risk of suicide or injury to self, others, or answers "yes" to "Suicidal Ideation" item 4 (active suicidal ideation with some intent to act, without specific plan) or item 5 (active suicidal ideation with specific plan and intent) on the C-SSRS assessment at the Screening visit (in the past month [30 days]) or Baseline.
- Subject tests positive for drugs of abuse at screening or baseline. In the event a subject tests positive for cannabinoids (tetrahydrocannabinol), the investigator will evaluate the subject's ability to abstain from cannabis during the study. This information will be discussed with the Medical Monitor for study enrollment consideration.
- Subject has a history of hypersensitivity to more than two distinct chemical classes of drug (e.g., sulfas and penicillins).
- Subjects have received depot neuroleptics unless the last injection was at least one treatment cycle before randomization.
- Subject requires treatment with a drug that consistently prolongs the QTc interval
- Subject has received ECT within 90 days prior to randomization or is expected to require ECT during the study course.
- Subject is currently participating, or has participated in a study with an investigational or marketed compound or device within 6 months prior to signing the informed consent, or has participated in 3 or more studies within 18 months prior to signing the informed consent.
Trial locations and contacts
87 sites in 8 countries.
87 sites in 8 countries
Japan35 sites
Fukuoka University Hospital
Fukuoka
Hatakeyama Clinic, Department of Psychiatry
Fukuoka
Hiro Mental Clinic, Department of Psychiatry
Fukuoka
Kokura Mental Clinic
Fukuoka
Kuramitsu Hospital, Department of Psychiatry
Fukuoka
Shinseikai Kaku Mental Clinic, Department of Psychiatry
Fukuoka
Someikai Kanagami Clinic, Department of Psychiatry
Fukuoka
Jisenkai Nanko Psychiatric Institute, Department of Psychiatry
Fukushima
Takahashi Psychiatric Clinic
Hyōgo
Azamino Mental clinic, Department of Psychiatry
Kanagawa
Medical Corporation Seishinkai Kishiro Mental Clinic, Department of Psychiatry
Kanagawa
Musashikosugi J. Kokorono Clinic
Kanagawa
Yokohama Onoecho Clinic, Department of Psychiatry
Kanagawa
Yutaka Clinic
Kanagawa
SagaArashiyama / Tanaka Clinic, Department of Psychiatry
Kyoto
Minami-aoyama Anique Street Clinic, Department of Psychiatry
Minato-Ku, Tokyo
Clinic Sophia
Okayama
Nagaokai Neyagawa Sanitorium
Osaka, 572-0854
Asakayama Hospital
Osaka
Koshokai Ainhanazono Hospital
Osaka
Osaka Institute of Clinical Psychiatry Shin-abuyama Hospital
Osaka
Etoh Mental Clinic Meguro, Department of Psychiatry
Tokyo
Himorogi Psychiatric Institute, Department of Psychiatry
Tokyo
JCHO Yokyo Shinjuku Medical Center
Tokyo
Jisenkai Hozumi Himorogi Clinic, Department of Psychiatry
Tokyo
Maynds Tower Mental Clinic, Department of Psychiatry
Tokyo
Nishi-shinjuku Concieria Clnic
Tokyo
Ohwa Mental clinic, Department of Psychiatry
Tokyo
Sangenjaya Nakamura Mental Clinic, Department of Psychiatry
Tokyo
Sangenjaya Neurology-Psychosomatic Clinic, Department of Psychiatry
Tokyo
Senzoku Psychosomatic Clinic, Department of Psychiatry
Tokyo
Shinjuku Research Park Clinic
Tokyo
Tamaki Clinic, Department of Psychiatry
Tokyo
Uguisudani Mental Clinic, Department of Psychiatry
Tokyo
Yoyogi Mental Clinic
Tokyo
Russia10 sites
Lipetsk regional psychoneurological hospital
Lipetsk, 398007
State Budgetary Institution of Healthare of the City of Moscow "Psychiatric clinical Hospital #4 n.a. P.B. Gannushkin of the Department of Healthcare of the City o Moscow" Branch "Psychiatric hospital n.a. V.A. Gilyarovsky"
Moscow, 107076
State Budgetary Institution of Healthcare of Nizhniy Novgorod region "Clinical Psychiatric Hospital #1 of Nizhniy Novgorod"
Nizhny Novgorod, 603155
Budgetary Institution of Healthcare of Omsk region "Clinical Psychiatric Hospital named after N.N. Solodnikov"
Omsk, 644070
Limited Liability Company "Treatment and Rehabilitational Scientific Center Phoenix"
Rostov-on-Don, 344000
Saint Petersburg State Institution of Healthcare "Psychiatric Hospital of Sain Nikolai hudotvorets "
Saint Petersburg, 190121
Federal State Budgetary Institution "National Medical Research Centre of psychiatry and nuerology named after V.M. Bekhterev" of the Ministry of Healthcare of the Russian Federation, department #12
Saint Petersburg, 192019
Stain Petersburg State Budgetary Institution of Healthcare "Psychoneurological Dispensary #1"
Saint Petersburg, 199106
State Institution of Healtcare "Regional Clinical Psychiatric Hospital of Saint Sofia"
Saratov, 410060
Limited Liability Company "Clinic StoLet"
Tomsk, 634009
Ukraine10 sites
Regional Psychoneurological Hospital #3, Department of Neurosis and Borderline States # 8
Ivano-Frankivsk, 76011
State Institution Institue of Neurology, Psychiatry and Narcology of NAMS of Ukraine, Unit of Emergency sychiatry and Narcology
Kharkiv, 61068
State Institution Institute of Neurology, Psychiatry and Narcology of NAMS of Ukraine, Unit of Borderline Psychiatry
Kharkiv, 61068
CI Kherson Regional Psychiatric Hospital of Kherson Regional Council, Male Dep of Psychiatry #3, Female Dep of Psychiatry #10
Kherson, 73488
Communal Institution (CI) of Kyiv Regional Council regional Psychiatric and Narcological Medical Assocation, Dep #10 (male), Dep #2 (female)
Kyiv, 08631
Communal Institution Odesa regional Medical Center of Mental Health, Dep #6 (Male), Dep #12 (Female)
Odesa, 65006
Communal Institution Odesa Regional Psychiatric Hospital #2, Department #14 (female), Department #16 (male)
Odesa, 67513
Communal Institution Cherkasy regional Psychiatric Hospital of Cherkasy Regional Council, Female Department #11, Male Department #12
Smila, 20708
Transcarpathian Regional Narcological Dispensary, Department of Psychiatry
Uzhhorod, 88000
communal Institution Acad. O.I. Yushchenko Vinnytsia Regional Psychoneurological hosital, Male Deparmtent #14, Female Department #15, Vinnytsia M.I. Pyrogov National Medical University, Chair of Psychiatry, Narcology and Psychotherapy with the Course of P
Vinnytsia, 21005
United States7 sites
Atlanta Center for Medical Research
Atlanta, Georgia, 30331
CNS Research Science, Inc.
Cerritos, California, 90703
Eastside Therapeutic Resource dba Core Clinical Research
Everett, Washington, 98201
Collaborative Neuroscience Network, LLC
Garden Grove, California, 92845
Clinical Neuroscience Solutions, Inc.
Jacksonville, Florida, 32256
Clinical Neuroscience Solutions, Inc.
Orlando, Florida, 32801
Artemis Insitute for Clinical Research
San Diego, California, 92103
Poland7 sites
Przychodnia Srodmiescie Sp. z.o.o.
Bydgoszcz, 85-080
Niepubliczny Zaklad Opieki Psychiatrycznej MENTIS
Leszno, 64-100
Specjalistyczna Praktyka Lekarska Marek Domanski
Lublin
Filip Rybakowski Specjalistyczna Praktka Lekarska
Poznan, 60-744
Poradnia Zdrowia Psychicznego "Syntonia"
Pruszcz Gdański, 83-000
Gabinet Lekarski Torunskie Centrum PsychiatriI NEUROMED
Torun, 87-100
Osrodek Badan Klinicznych Clinsante Spolka Cywilna
Torun, 87-100
Serbia7 sites
Bel Medic General Hospital
Belgrade, 11000
Clinical Center "Dr. Dragisa Misovic-Dedinje"
Belgrade, 11000
Clinical Center of Serbia
Belgrade, 11000
General Hospital Euromedik
Belgrade, 11000
Institute of Mental Health
Belgrade, 11000
Special Hospital for Psychiatric Diseases "Kovin"
Kovin, 26220
Clinical Center Kragujevac
Kragujevac, 34000
Bulgaria6 sites
Mental Health Centre -Prof. Dr. Ivan Temkov - Burgas EOOD
Burgas, 8000
State Psychiatric Hospital-Kardzhali
Kardzhali, 6600
MHAT-Dr. Hristo Stambolski EOOD, Department of Psychiatry
Kazanlak, 6100
Mental Health Center - Ruse EOOD
Rousse, 7003
Neli Nikolova Todorova, MD ,State Psychatric Hospital - s. Tsarev brod
Shumen, 9747
Mental Health Center - Sofia EOOD
Sofia, 1202
Slovakia5 sites
Vavrusova Consulting s.r.o. Psychiatricka ambulancia
Bratislava, 85101
Investa spol. s.r.o., Kosice Psychiatricka ambulancia
Košice, 04001
Psycholine s.r.0. Psychiatricka ambulancia
Rimavská Sobota, 97901
Centrum zdravia R.B.K. Psychiatricka ambulancia
Svidník, 08901
Crystal Comfort s.r.o. Psychiatricka ambulancia
Vranov nad Topľou, 09301
About this study
Official title: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study of SEP-4199 for the Treatment of Major Depressive Episode Associated With Bipolar I Disorder (Bipolar I Depression)
A clinical study to test the effectiveness of an investigational drug to treat people that have major depressive episodes when they have Bipolar 1 Depression
Read the detailed description
This is a randomized, double-blind, placebo-controlled, parallel-group, fixed-dose study designed to evaluate the efficacy, safety, and tolerability of treatment with SEP-4199 monotherapy given as 200 mg/day or 400 mg/day compared with placebo for the treatment of major depressive episodes associated with bipolar I disorder (bipolar I depression).
- Conditions
- Depressive Episode, Bipolar 1 Depression
- Being tested
- SEP-4199 200 mg, SEP-4199 400 mg, Placebo
- Keywords
- Depression, Depressive episode, Bipolar, Bipolar 1, Bipolar 1 depression
- Medical subject headings
- Depression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SEP-4199 200 mgDrug
SEP-4199 200 mg/day (supplied in two 100mg tablets)
SEP-4199 400 mgDrug
SEP-4199 400 mg/day (supplied in two 200mg tablets
PlaceboDrug
Placebo (supplied in two tablets/day)
| Study group | Role | What they receive |
|---|---|---|
| SEP-4199 200 mg | Experimental | SEP-4199 200 mg/day (supplied in two 100mg tablets) Receives: Drug: SEP-4199 200 mg |
| SEP-4199 400 mg | Experimental | SEP-4199 400 mg/day (supplied in two 200mg tablets) Receives: Drug: SEP-4199 400 mg |
| Placebo | Placebo comparator | Placebo (supplied in two tablets/day Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score at Week 6
MADRS is a clinician-rated assessment of the subject's level of depression. The measure contains 10 items that measure apparent and reported sadness, inner tension, reduced sleep and appetite, difficulty concentrating, lassitude, inability to feel, and pessimistic and suicidal thoughts, each ranging from 0 to 6. The MADRS total score ranges from 0 to 60, with higher scores indicating increased depressive symptoms
Measured: 6 Weeks
Secondary outcomes (1)
Change From Baseline in Global Severity Assessed by the Clinical Global Impressions - Severity: Bipolar Version (CGI-BP-S) Score (Depression) at Week 6
Clinical Global Impressions - Severity: Bipolar Version (CGI-BP-S) score (depression) is a single value, clinician-rated assessment of illness severity, and 7-point scale with range from 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; 7 = among the most extremely ill subjects. A higher score is associated with greater illness severity.
Measured: 6 Weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Jun 2018
- Study start26 Jun 2018
- Primary completion23 Apr 2020
- Study completion23 Apr 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Depressive EpisodeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 344 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sumitomo Pharma America, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- CNS Medical Director, Study chair, Sumitomo Pharma America, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03543410
- Sponsor's protocol ID
- SEP380-201
- Other IDs
- 2018-000103-16, 2018
- Status last verified
- Apr 2023
- First submitted
- 21 May 2018
- Last updated
- 18 May 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: IPD for this study may be made available upon request via the Vivli Center for Global Clinical Research Data website.
Publications
Hopkins SC, Tomioka S, Szabo ST, Koblan KS. A clinical trial inclusion criteria to enrich for patients presenting with canonical symptom structure in bipolar depression. Contemp Clin Trials. 2024 Oct;145:107644. doi: 10.1016/j.cct.2024.107644. Epub 2024 Aug 3.
PubMed 39098761Hopkins SC, Wilkinson S, Corriveau TJ, Nishikawa H, Nakamichi K, Loebel A, Koblan KS. Discovery of Nonracemic Amisulpride to Maximize Benefit/Risk of 5-HT7 and D2 Receptor Antagonism for the Treatment of Mood Disorders. Clin Pharmacol Ther. 2021 Sep;110(3):808-815. doi: 10.1002/cpt.2282. Epub 2021 Jun 12.
PubMed 33961287
Study at a glance
From the registry record, last updated by the sponsor on 18 May 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study of SEP-4199 for the Treatment of Major Depressive Episode Associated With Bipolar I Disorder (Bipolar I Depression)
- ClinicalTrials.gov ID
- NCT03543410
- Acronym / sponsor ID
- SEP380-201
- Conditions
- Depressive Episode, Bipolar 1 Depression
- Keywords
- Depression, Depressive episode, Bipolar, Bipolar 1, Bipolar 1 depression
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 344 participants (actual)
- Lead sponsor
- Sumitomo Pharma America, Inc.Industry (pharma, biotech, devices)
- Study start
- 26 Jun 2018 (actual)
- Primary completion
- 23 Apr 2020 (actual)
- Study completion
- 23 Apr 2020 (actual)
- First posted
- 1 Jun 2018 (actual)
- Results
- Posted 18 May 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A clinical study to test the effectiveness of an investigational drug to treat people that have major depressive episodes when they have Bipolar 1 Depression
Detailed description
This is a randomized, double-blind, placebo-controlled, parallel-group, fixed-dose study designed to evaluate the efficacy, safety, and tolerability of treatment with SEP-4199 monotherapy given as 200 mg/day or 400 mg/day compared with placebo for the treatment of major depressive episodes associated with bipolar I disorder (bipolar I depression).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| SEP-4199 200 mg | Experimental | Drug: SEP-4199 200 mgSEP-4199 200 mg/day (supplied in two 100mg tablets) |
| SEP-4199 400 mg | Experimental | Drug: SEP-4199 400 mgSEP-4199 400 mg/day (supplied in two 200mg tablets) |
| Placebo | Placebo comparator | Drug: PlaceboPlacebo (supplied in two tablets/day |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (21 listed)
- Subject is 18 to 65 years of age, inclusive, at the time of informed consent with bipolar I disorder, current episode depressed with or without rapid cycling disease course (≥ 4 episodes of mood disturbance but < 8 episodes in the previous 12 months) with or without psychotic features (diagnosed by DSM 5 criteria, and confirmed by the SCID 5 CT). The current episode of major depression associated with bipolar I disorder must be confirmed by the Investigator and noted in the source records.
- Subject provides written informed consent and is willing and able to comply with the protocol in the opinion of the investigator.
- Subject or legally acceptable representative must possess an educational level and degree of understanding of English or the local language that enables them to communicate suitably with the Investigator and the study coordinator.
- Subject must have a lifetime history of at least one bipolar manic or mixed manic episode. It is strongly recommended that a reliable informant (e.g., family member or caregiver) be available to confirm this history.
- Subject's current major depressive episode is ≥ 4 weeks and less than 12 months in duration at Screening.
Key exclusion criteria (31 listed)
- Subject has a lifelong history or presence of symptoms consistent with a major psychiatric disorder other than bipolar I disorder as defined by DSM 5. Exclusionary disorders include but are not limited to moderate to severe alcohol use disorder (within past 12 months), substance use disorder (other than nicotine or caffeine) within past 12 months, bipolar II disorder, schizoaffective disorder, obsessive compulsive disorder, posttraumatic stress disorder.
- Subject demonstrates a decrease (improvement) of ≥ 25% in MADRS total score from Screening to Baseline, or subject's MADRS total score is < 22 at Baseline.
- Subject has received treatment with antidepressants within 3 days of randomization, fluoxetine at any time within 28 days, an MAO inhibitor within 21 days or clozapine within 120 days. All other psychotropic medications with the exceptions of lorazepam, temazepam,eszopiclone, zopiclone, zolpidem and zolpidem CR require 3 days minimum washout. Depot neuroleptics must be discontinued at least one treatment cycle prior to randomization.
- Subject has suspected/confirmed Borderline Personality Disorder
- Subject currently has a clinically significant neurological, metabolic (including type 1 diabetes), hepatic, renal, hematological, pulmonary, cardiovascular, gastrointestinal, and/or urological disorder such as unstable angina, congestive heart failure (uncontrolled), or central nervous system (CNS) infection that would pose a risk to the subject if they were to participate in the study or that might confound the results of the study. Subjects with a known history of HIV seropositivity will be excluded.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SEP-4199 200 mgSEP-4199 200 mg/day (supplied in two 100mg tablets) | Drug | SEP-4199 200 mg |
| SEP-4199 400 mgSEP-4199 400 mg/day (supplied in two 200mg tablets | Drug | SEP-4199 400 mg |
| PlaceboPlacebo (supplied in two tablets/day) | Drug | Placebo |
Primary outcome
Change From Baseline in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score at Week 6
Time frame: 6 Weeks
MADRS is a clinician-rated assessment of the subject's level of depression. The measure contains 10 items that measure apparent and reported sadness, inner tension, reduced sleep and appetite, difficulty concentrating, lassitude, inability to feel, and pessimistic and suicidal thoughts, each ranging from 0 to 6. The MADRS total score ranges from 0 to 60, with higher scores indicating increased depressive symptoms
1 secondary outcome
Change From Baseline in Global Severity Assessed by the Clinical Global Impressions - Severity: Bipolar Version (CGI-BP-S) Score (Depression) at Week 6
Time frame: 6 Weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 May 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39098761Hopkins SC, Tomioka S, Szabo ST, Koblan KS. A clinical trial inclusion criteria to enrich for patients presenting with canonical symptom structure in bipolar depression. Contemp Clin Trials. 2024 Oct;145:107644. doi: 10.1016/j.cct.2024.107644. Epub 2024 Aug 3.
- Derived from this study: PubMed 33961287Hopkins SC, Wilkinson S, Corriveau TJ, Nishikawa H, Nakamichi K, Loebel A, Koblan KS. Discovery of Nonracemic Amisulpride to Maximize Benefit/Risk of 5-HT7 and D2 Receptor Antagonism for the Treatment of Mood Disorders. Clin Pharmacol Ther. 2021 Sep;110(3):808-815. doi: 10.1002/cpt.2282. Epub 2021 Jun 12.
- Individual participant dataSharing planned: Yes. IPD for this study may be made available upon request via the Vivli Center for Global Clinical Research Data website.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
CNS Medical Director study chair
Sumitomo Pharma America, Inc.
87 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing SEP-4199 200 mg and SEP-4199 400 mg in people with Depressive Episode and Bipolar 1 Depression, run by Sumitomo Pharma America, Inc. at 87 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 21 inclusion and 31 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 May 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 87 sites in Japan, Russia, Ukraine, United States, Poland and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 18 May 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change From Baseline in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score at Week 6 (time frame: 6 Weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03543410, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2023.