NRX100 vs. Placebo for Rapid Stabilization of Acute Suicidal Ideation and Behavior in Bipolar Depression (SevereBD)
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|ClinicalTrials.gov Identifier: NCT03396601|
Recruitment Status : Recruiting
First Posted : January 11, 2018
Last Update Posted : October 30, 2020
|Condition or disease||Intervention/treatment||Phase|
|Bipolar Depression Suicidal Ideation||Drug: Ketamine Hydrochloride Drug: Placebo||Phase 3|
Background and Rationale: NMDA antagonist drugs have increasingly been demonstrated to reduce symptoms of depression and suicidal ideation. Specifically, NRX-100 (ketamine HCl, 0.5 mg/kg IV over 40 minutes) has been shown to induce acute reductions in suicidality and depression in patients with bipolar depression, relative to control. Numerous reports have documented a 50% reduction in the MADRS depression scale and a 75% reduction in suicidality following a single infusion of ketamine in patients with suicidal ideation and depression. While the repeat use of ketamine is not supported and may be contraindicated by the literature, D-cycloserine (DCS), when combined with SSRI antidepressants in patients with treatment resistant depression, and when combined with atypical antipsychotics, in particular lurasidone (NRX-101), has shown separation from control and ability to maintain remission from suicidality and depression over 6 weeks with oral use.
• To test the hypothesis that a single infusion of NRX-100 is superior to placebo infusion in the rapid stabilization of patients with severe Bipolar Depression and Acute Suicidal Ideation and Behavior (ASIB).
• Key secondary: To test the hypothesis that there is a more favorable reduction in the mean change from baseline on the Montgomery Asberg Depression Rating Scale (MADRS) between NRX-100 and saline groups on day 1 and day 2.
Methodology: A multi-center, randomized, double-blind, trial involving a single IV infusion to achieve response by 24 hours. The randomization will be 3:1 favoring NRX-100 (ketamine) infusion (n=105) vs. Saline infusion (n=35). Subjects who respond successfully to treatment will be offered enrollment in a six week followup study of NRX-101 (an oral fixed dose combination of d-cycloserine and lurasidone) vs. standard of care in order to ascertain maintenance of the ketamine effect.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||150 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Masking Description:||Participants and Care Providers will be masked with regard to medication administered. Outcomes Assessors will not be present during IV infusion of medication.|
|Official Title:||Administration of Intravenous NRX100 (Ketamine) vs Placebo Infusion for Rapid Stabilization of Acute Suicidal Ideation and Behavior in Patients With Bipolar Depression|
|Actual Study Start Date :||June 25, 2019|
|Estimated Primary Completion Date :||June 30, 2021|
|Estimated Study Completion Date :||August 31, 2021|
Experimental: NRX-100 infusion
Infusion of IV NRX-100 (ketamine)
Drug: Ketamine Hydrochloride
Ketamine HCl will be infused intravenously at a dose of 0.5 mg/kg over 40 minutes
Experimental: Saline (placebo) infusion
Infusion of IV Saline
Normal Saline placebo will be infused IV over 40 minutes
- Suicidal Ideation [ Time Frame: 24 hours ]A score of 3 or less on the Columbia Suicidality Severity Rating Scale (C-SSRS). The scale is scored from 0 to 5 on suicidal ideation.
- Depression [ Time Frame: 24 hours ]Mean change from baseline on Montgomery Asberg Depression Rating Scale (MADRS) between NRX-100 and saline infusion. The scale consists of 10 items, each scored from 0-6, for a possible total score of 60.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03396601
|Contact: Martin Brecher, MDfirstname.lastname@example.org|
|United States, Florida|
|Research Centers of America||Recruiting|
|Hollywood, Florida, United States, 33024|
|Contact: Peter Ventre, MD 954-990-7649|
|United States, Texas|
|JP Smith Hospital||Recruiting|
|Fort Worth, Texas, United States, 76104|
|Contact: Alan Podawiltz, DO, MS, FAPA 817-702-3100 APodawil@JPSHealth.org|
|Contact: Cindy Claassen, PhD 817-702-5647 CClasse@JPSHealth.org|
|Study Director:||Martin Brecher, MD||VP, Clinical Development, NeuroRx, Inc.|