Add-On Study of MSI-195 (S-Adenosyl-L-Methionine, SAMe) for Patients With Major Depressive Disorder (MDD)

• ClinicalTrials.gov Identifier: NCT01912196
• Recruitment Status: Completed
• First Posted: July 31, 2013
• Last Update Posted: March 18, 2016
• Sponsor: MSI Methylation Sciences, Inc.
• Information provided by (Responsible Party): MSI Methylation Sciences, Inc.

Tracking Information

• First Submitted Date: July 26, 2013
• First Posted Date: July 31, 2013
• Last Update Posted Date: March 18, 2016
• Study Start Date: October 2013
• Actual Primary Completion Date: September 2015 (Final data collection date for primary outcome measure)

Current Primary Outcome Measures (submitted: July 30, 2013)

Change in the total Hamilton Depression Rating Scale (HAM-D17) between randomization and end of study. [ Time Frame: assessed from baseline to week 8 (end of study) ]

Based on historical data, the standard deviation is assumed to range between 9 and 12. With a standard effect size of 0.367 a total of at least 120 evaluable patients per group are needed to provide 80% power with a two-sided 5% significance level. HAM-D17 will be derived from the Combined HAM-D28-MADRS Instrument.

• Original Primary Outcome Measures: Same as current

Current Secondary Outcome Measures (submitted: July 30, 2013)

• change in the total score of the Montgomery-Asberg Depression Rating Scale (MADRS) [ Time Frame: collected at baseline, weeks 2, 4, 6, 7 and 8 (end of study) ]
  for the MADRS, the number and proportion of patients who are responders at the end of the study and the number and proportion of patients who are in remission at the end of the study will be summarized by treatment group, along with the difference and 95% confidence interval for the difference (based on the Wilson Score method).
• change in total score of the Clinical Global Impression Improvement Scale (CGI-S) [ Time Frame: assessed from baseline, weeks 2, 4, 7 and 8 (end of study) ]
  the number and proportion of patients who are responders at the end of the study and the number and proportion of patients who are in remission at the end of the study will be summarized by treatment group, along with the difference and 95% confidence interval for the difference (based on the Wilson Score method). Remission is defined as a score of 1 or 2.
• change from randomization to each study visit in the total score of the Inventory of Depressive Symptomatology-Self Rated (IDS-SR30) [ Time Frame: assessed on baseline visit, Week 2, 4, 6, and 8 (end of study). ]
  A response is defined as a reduction in the IDS-SR30 score of ≥50% and remission is defined as a score of ≤14.
• Adverse events [ Time Frame: collected at baseline, weeks 1, 2, 3, 4, 6, 8 and 9 (follow up) ]
  collected from signing informed consent through 7 days after the last dose of study treatment. Ascertained by qualified clinician.
• Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: assessed at baseline, weeks 2, 4, 6 and 8 (end of study) ]
  administered by qualified clinician

• Original Secondary Outcome Measures: Same as current
• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: Add-On Study of MSI-195 (S-Adenosyl-L-Methionine, SAMe) for Patients With Major Depressive Disorder (MDD)
• Official Title: A Double-Blind, Placebo-Controlled, Randomized Add-On Study of MSI-195 (Methylation Sciences Inc. S-Adenosyl-L-Methionine, SAMe) For Patients With Major Depressive Disorder(MDD) Who Have Had An Inadequate Response to Current Antidepressant Therapy
• Brief Summary: The purpose of this study is to determine the efficacy and safety of 800 mg MSI-195 in reducing symptoms of depression in Major Depressive Disorder (MDD)patients with inadequate response to current antidepressant therapy.
• Detailed Description: Not Provided
• Study Type: Interventional
• Study Phase: Phase 2
• Study Design: Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: Triple (Participant, Care Provider, Investigator); Primary Purpose: Treatment
• Condition: Major Depressive Disorder (MDD)

Intervention

• Drug: MSI-195
• Drug: Placebo

Study Arms

• Experimental: MSI-195

  Patients randomized to the MSI-195 arm will receive treatment with 2 tablets (800 mg) of MSI-195 plus on-going antidepressant therapy (ADT).

  MSI-195 800 mg (two tablets) taken orally once a day in the morning on an empty stomach with water (food should be avoided for at least 1 hr after taking the study drug)

  Intervention: Drug: MSI-195
• Placebo Comparator: Placebo

  Patients randomized to the placebo arm will receive 2 tablets placebo plus on-going antidepressant therapy (ADT).

  Placebo (two tablets) taken orally once a day in the morning on an empty stomach with water (food should be avoided for at least 1 hr after taking the study drug).

  Intervention: Drug: Placebo

• Publications *: Targum SD, Cameron BR, Ferreira L, MacDonald ID. An augmentation study of MSI-195 (S-adenosylmethionine) in Major Depressive Disorder. J Psychiatr Res. 2018 Dec;107:86-96. doi: 10.1016/j.jpsychires.2018.10.010. Epub 2018 Oct 18.

Recruitment Information

• Recruitment Status: Completed
• Actual Enrollment (submitted: March 17, 2016): 376
• Original Estimated Enrollment (submitted: July 30, 2013): 286
• Actual Study Completion Date: September 2015
• Actual Primary Completion Date: September 2015 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

• Meets the Diagnostic and Statistical Manual of Mental Disorder, 4th Edition, Text Revision (DSM-IV-TR) criteria for Major Depressive Disorder (MDD)
• A total score of 16 or higher on the Hamilton Rating Scale for Depression- 17 item version (HAM-D17) at the Screening and Baseline Visits, with a score of ≥2 on mood item 1.
• Have experienced 1-4 prior Major Depressive Episodes. Patients with more than 5 lifetime episodes (including current episode) will require discussion with the medical monitor prior to inclusion.
• Failed 1-3 treatment regimens in the current depressive episode
• Received an adequate dose and duration of Antidepressant Therapy (ADT) (on ADT for at least 6 weeks with a stable dose for at least 3 weeks)

Exclusion Criteria:

• Failed 4 or more adequate treatment regimens in current episode of depression
• patient may have a significant risk for suicidal behavior during the course of their participation in the study
• Intolerance to SAMe; Prior use of MSI-195
• History of any of the following psychiatric disorders: eating disorder within 6 months; obsessive compulsive disorder, psychotic disorder, bipolar disorder, mental retardation, dementia or other forms of cognitive impairment at any time or alcohol or substance abuse
• >3X upper limit of normal (ULN) Alkaline Phosphatase, aspartate aminotransferase (AST), alanine aminotransferase (ALT); >1.5X ULN total bilirubin
• Pregnant or lactating women
• Any history of seizures, excluding febrile seizures
• Known positivity for human immunodeficiency virus

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 21 Years to 70 Years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: United States

Administrative Information

• NCT Number: NCT01912196
• Other Study ID Numbers: MSI-CP.002
• Has Data Monitoring Committee: Yes
• U.S. FDA-regulated Product: Not Provided
• IPD Sharing Statement: Not Provided
• Current Responsible Party: MSI Methylation Sciences, Inc.
• Original Responsible Party: Same as current
• Current Study Sponsor: MSI Methylation Sciences, Inc.
• Original Study Sponsor: Same as current
• Collaborators: Not Provided
• Investigators: Not Provided
• PRS Account: MSI Methylation Sciences, Inc.
• Verification Date: March 2016