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Trial to Evaluate Efficacy of Pharmacogenetic Information Obtained With NEUROPHARMAGEN in Treatment of MDD Patients

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
AB Biotics, SA
ClinicalTrials.gov Identifier:
NCT02529462
First received: August 19, 2015
Last updated: December 2, 2016
Last verified: December 2016
  Purpose
This study evaluates the efficacy of NEUROPHARMAGEN pharmacogenetic test in the selection of the pharmacological treatments for patients with Major Depressive Disorder (MDD), both with and without psychiatric comorbidities. Patients will be randomly asigned to test-guided treatment prescription or to treatment as usual ina a 1:1 ratio; the results of the test will not be disclosed to the later until the end of the 3-month follow-up period. The study will compare the rate of treatment responders among both groups, based on patient-reported improvement collected by blind telephone interview.

Condition Intervention Phase
Depressive Disorder, Major Genetic: NEUROPHARMAGEN-Guided Treatment Drug: Treatment As Usual Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Randomised, Controlled, Parallel Clinical Trial on the Efficacy of Pharmacogenetic Information Obtained With NEUROFARMAGEN in the Treatment of Patients With Mental Disorders

Further study details as provided by AB Biotics, SA:

Primary Outcome Measures:
  • Sustained response to treatment [ Time Frame: 3 months ]
    The PGI-I scale (Patient Global Impression of Improvement) reports the patient's own assessment of improvement after the therapeutic interventions. It is a single-item questionnaire that assesses the change experienced using a 7-point Likert scale that runs from 1 (very much better) to 7 (very much worse). A sustained response will be considered when the patient reports a PGI-I score of 2 or less, on at least two consecutive assessments, maintained until the end of the follow-up.


Secondary Outcome Measures:
  • Response to treatment [ Time Frame: 3 month ]
    The PGI-I scale (Patient Global Impression of Improvement) reports the patient's own assessment of improvement after the therapeutic interventions. It is a single-item questionnaire that assesses the change experienced using a 7-point Likert scale that runs from 1 (very much better) to 7 (very much worse). A patient will be considered a responder when reporting a PGI-I score of 2 or less (i.e. "much better"/"very much better").

  • Hamilton Rating Scale for Depression (HAM-D) [ Time Frame: 3 months ]
    HAM-D rates the clinical severity of depression. It has 17 questions, each with three to five possible answers, with scores ranging from 0 to 2 or from 0 to 4, respectively. The total score ranges from 0 to 52 and cut-off scores can be used to classify the depressive disorder.

  • FIBSER Scale (Frequency, Intensity and Burden of Side Effects Rating) [ Time Frame: 3 months ]
    The scale consists of 3 questions with scores ranging from 0 (no side effects / no impairment) to 6 (intolerable / unable to function / present all of the time).

  • Clinical Global Impression-Severity scale (CGI-S) [ Time Frame: 3 months ]
    CGI-S is a descriptive scale that provides qualitative information on the severity of the patient's illness. It assesses the severity of the illness using a 7-point Likert scale that runs from 1 (not at all ill) to 7 (among the most extremely ill patients). In this study, both the self-rated (whereby the patient rates his/her own situation) and the doctor-rated versions will be administered so that the doctor can assess the severity of the condition.

  • Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) [ Time Frame: 3 months ]
    It is a 17-item questionnaire and is a valid scale for any chronic or long-term condition. It is a self-administered questionnaire on treatment satisfaction and it assesses the following areas or dimensions: side effects; effectiveness of the medication; convenience of the medication; impact of the medication on everyday life; medical follow-up of the disease; and the patient's general opinion regarding his/her condition and the medication. All items are assessed using a 5-point Likert scale that runs from "no, not at all" with a value of 0 to "yes, very much" with a value of 4.

  • Sheehan Disability Inventory (SDI) [ Time Frame: 3 months ]
    SDI is a questionnaire that can be self-administered to measure the disability of patients with mental disorders. It has 3 sub-scales that are scored independently (disability - 3 items, stress - 1 item and perceived social support - 1 item). As each item is scored using a Likert scale from 0 to 10, the maximum possible score is 30.


Enrollment: 521
Study Start Date: July 2014
Study Completion Date: October 2015
Primary Completion Date: October 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: NEUROPHARMAGEN-Guided Treatment
In the study patient group, the psychiatrist will have the results of the NEUROPHARMAGEN genetic test as supporting information to help him/her select the best treatment for the patient.
Genetic: NEUROPHARMAGEN-Guided Treatment
NEUROPHARMAGEN is a pharmacogenetic test developed by AB-BIOTICS S.A. that enables the specific analysis of Single-Nucleotide Polymorphisms related to the pharmacokinetics and pharmacodynamics of multiple psychoactive drugs. In this arm, psychiatrists have access to the results of the NEUROPHARMAGEN test to support their medication choices
Other Name: Supportive prescription information from Neuropharmagen test
Active Comparator: Treatment As Usual
In the control patient group, "treatment as usual" will be selected and prescribed in accordance with routine clinical practice .
Drug: Treatment As Usual
Clinicians treat psychiatric patients in a naturalistic way, following their routine procedures, without access to the pharmacogenetic information provided by the NEUROPHARMAGEN test
Other Name: Usual practice

Detailed Description:

NEUROPHARMAGEN is a genetic test developed by AB-BIOTICS S.A. that enables the specific analysis of Single-Nucleotide Polymorphisms related to the pharmacokinetics and pharmacodynamics of different psychoactive drugs. The aim of the test is to provide the psychiatrist with information that can help him/her identify the most suitable medication for each patient.

In the study group, the psychiatrist will have the results of the NEUROPHARMAGEN test as supporting information to help him/her select the best treatment for the patient. In the control patient group, the treatment will be selected and prescribed in accordance with routine clinical practice.

This is a naturalistic, double-blind, randomized, multicentric clinicaltrial carried out in Spain at psychiatry departments of several public hospitals. The study aims to include a total of 520 patients with MDD, including patient with significant psychiatric comorbidities such as anxiety or substance abuse.

The study will compare groups based on the rate of treatment responders, defined as a score of 2 or less (i.e. "Much better"/"Very much better") in the Patient Global Impression of Improvement scale (PGI-I). This scale will be collected by blind telephone interviewers, so as to have a double-blind assessment (patient and interviewer).

  Eligibility

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria at pre-randomization visit:

  • Patients with diagnosed for major depressive disorder according to DSM-IV-TR criteria
  • Patients who give their written informed consent to participate in the study. In the case of disabled patients, informed consent from the legal representative or responsible relative.
  • Patients with a doctor-rated Clinical Global Impression - Severity Scale (CGI-S) score equal to or greater than 4.
  • Patients who are diagnosed de novo who, in the doctor's opinion, require medication or are receiving treatment and require an antidepressant, antipsychotic or mood stabiliser as a replacement or additional medication

Exclusion Criteria at pre-randomization visit:

  • Patients who, in the investigator's opinion, will not be able to complete the study follow-up.
  • Patients who are actively taking part in or who have taken part in another clinical trial in the past 3 months.
  • Patients who are pregnant or breast-feeding, or patients who plan to become pregnant within the next 12 months.
  • Patients who are or who require treatment with quinidine, cinacalcet and/or terbinafine (potent CYP2D6 inhibitors).

Inclusion criteria at randomization visit:

Patients who meet the screening criteria at the pre-randomisation visit must meet the following criteria at visit 1 to be randomised. Otherwise, they will be excluded from the active follow-up phase. The criteria are:

  • Patients with a PGI-I score of 4 or more.
  • Patients with a CGI score of 4 or more.
  • Patients whose dose of pharmacological treatment, in the doctor's opinion, requires suppression, replacement, addition or modification with an antidepressant, antipsychotic or mood stabiliser.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT02529462

Locations
Spain
Hospital Universitario Central de Asturias
Oviedo, Asturias, Spain
Hospital Bellvitge
L'Hospitalet de Llobregat, Barcelona, Spain
Consorci Sanitari del Maresme
Mataro, Barcelona, Spain
Hospital Mutua de Terrassa
Tarrasa, Barcelona, Spain
Institut Pere Mata
Reus, Tarragona, Spain
Hospital Clinic
Barcelona, Spain
Hospital de la Santa Creu i Sant Pau
Barcelona, Spain
Hospital de Mar
Barcelona, Spain
Hospital de Jerez
Jerez, Spain
Hospital 12 de Octubre
Madrid, Spain
Hospital Ramon y Cajal
Madrid, Spain
Complejo Hospitalario Universitario de Vigo
Vigo, Spain
Sponsors and Collaborators
AB Biotics, SA
Investigators
Principal Investigator: José Manuel Menchón, MD Hospital Universitari de Bellvitge
Principal Investigator: Víctor Pérez, MD Hospital del Mar in Barcelona
  More Information

Responsible Party: AB Biotics, SA
ClinicalTrials.gov Identifier: NCT02529462     History of Changes
Other Study ID Numbers: AB-GEN-2013
Study First Received: August 19, 2015
Last Updated: December 2, 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Additional relevant MeSH terms:
Depressive Disorder
Depression
Depressive Disorder, Major
Mood Disorders
Mental Disorders
Behavioral Symptoms

ClinicalTrials.gov processed this record on September 21, 2017