Try the modernized ClinicalTrials.gov beta website. Learn more about the modernization effort.
Working…
ClinicalTrials.gov
ClinicalTrials.gov Menu

A Study to Evaluate SAGE-217 in Participants With Severe Postpartum Depression

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02978326
Recruitment Status : Completed
First Posted : November 30, 2016
Results First Posted : December 16, 2021
Last Update Posted : February 10, 2022
Sponsor:
Information provided by (Responsible Party):
Sage Therapeutics

Brief Summary:
The primary purpose of this study was to determine if treatment with SAGE-217 reduces depressive symptoms in participants with severe postpartum depression (PPD) compared to placebo as assessed by the change from baseline in the 17-item Hamilton Rating Scale for Depression (HAM-D) total score at Day 15 and to evaluate the safety and tolerability of SAGE-217 compared to placebo as assessed by the incidence of adverse events, vital sign measurements, clinical laboratory evaluations, electrocardiogram (ECG) parameters, and the Columbia Suicide Severity Rating Scale (C-SSRS).

Condition or disease Intervention/treatment Phase
Postpartum Depression Drug: SAGE-217 15/20 mg Oral Solution Drug: Placebo Drug: SAGE 217 30 mg Capsules Phase 3

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 276 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multicenter, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating the Efficacy, Safety, and Pharmacokinetics of SAGE-217 in the Treatment of Adult Female Subjects With Severe Postpartum Depression
Actual Study Start Date : January 4, 2017
Actual Primary Completion Date : November 15, 2018
Actual Study Completion Date : December 11, 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Part A: SAGE-217 15/20 mg Oral Solution
Participants received SAGE-217, 15 milligrams (mg), oral solution, twice daily (BID) for first 2 days followed by SAGE-217, 15 or 20 mg, oral solution, BID, starting on Day 3 for up to 14 days as tolerated.
Drug: SAGE-217 15/20 mg Oral Solution
SAGE-217, 15 mg oral solution, BID for Days 1 to 2 followed by 20 mg oral solution BID for Days 3 to 14. If not tolerated, 15 mg for the rest of study (Days 3 to 14).

Placebo Comparator: Part B: Placebo
Participants received SAGE-217 matching placebo, capsules, orally, once daily, for up to 14 days.
Drug: Placebo
SAGE-217 matching placebo, capsules, orally, once daily, for up to 14 days.

Experimental: Part B: SAGE 217 30 mg Capsules
Participants received SAGE-217, 30 mg, capsules, orally, once daily, for up to 14 days.
Drug: SAGE 217 30 mg Capsules
SAGE-217, 30 mg, capsules, orally, once daily, for up to 14 days.




Primary Outcome Measures :
  1. Parts A and B: Change From Baseline in the 17-Item Hamilton Rating Scale for Depression (HAM-D) Total Score at Day 15 [ Time Frame: Parts A and B: Baseline, Day 15 ]
    The 17-item HAM-D is used to rate the severity of depression in participants who are already diagnosed as depressed. Items scored in a range of 0 to 2 include: insomnia (early, middle, late), somatic symptoms (gastrointestinal and general), genital symptoms, loss of weight, and insight. The following items are scored in a range of 0 to 4: agitation, depressed mood, feelings of guilt, suicide, work and activities, retardation, anxiety (psychic and somatic), and hypochondriasis. The HAM-D total score was calculated as the sum of the 17 individual item scores and could range from 0 to 52. Higher scores indicated more severe depression. A negative change from Baseline indicates less depression.


Secondary Outcome Measures :
  1. Parts A and B: Change From Baseline in the HAM-D Total Score at Days 3, 8, 21 and 45 [ Time Frame: Part B: Baseline, Days 3, 8, 21 and 45 ]
    The 17-item HAM-D is used to rate the severity of depression in participants who are already diagnosed as depressed. Items scored in a range of 0 to 2 include: insomnia (early, middle, late), somatic symptoms (gastrointestinal and general), genital symptoms, loss of weight, and insight. The following items are scored in a range of 0 to 4: agitation, depressed mood, feelings of guilt, suicide, work and activities, retardation, anxiety (psychic and somatic), and hypochondriasis. The HAM-D total score was calculated as the sum of the 17 individual item scores and could range from 0 to 52. Higher scores indicated more severe depression. A negative change from Baseline indicates less depression.

  2. Parts A and B: Percentage of Participants With HAM-D Response [ Time Frame: Part B: Days 3, 8, 15, 21 and 45 ]
    HAM-D Response was defined as having a 50 percent (%) or greater reduction from Baseline in HAM-D total score. The HAM-D total score was calculated as the sum of the 17 individual item scores and could range from 0 to 52. The items on HAM-D included: depressed mood (sadness, hopeless, helpless, worthless), feelings of guilt, suicide, insomnia (early night, middle night, early hours [morning]), work and activities, retardation (slowness of thought and speech; impaired ability to concentrate; decreased motor activity), agitation, anxiety (psychic and somatic), somatic symptoms (gastrointestinal and general), genital symptoms, hypochondriasis, loss of weight, and insight. Higher scores indicated more depression.

  3. Parts A and B: Percentage of Participants With HAM-D Remission [ Time Frame: Part B: Days 3, 8, 15, 21 and 45 ]
    HAM-D Remission was defined as a HAM-D total score of less than or equal to (<=)7. The HAM-D total score was calculated as the sum of the 17 individual item scores and could range from 0 to 52. The items on HAM-D included: depressed mood (sadness, hopeless, helpless, worthless), feelings of guilt, suicide, insomnia (early night, middle night, early hours [morning]), work and activities, retardation (slowness of thought and speech; impaired ability to concentrate; decreased motor activity), agitation, anxiety (psychic and somatic), somatic symptoms (gastrointestinal and general), genital symptoms, hypochondriasis, loss of weight, and insight. Higher scores indicated more depression.

  4. Parts A and B: Change From Baseline in HAM-D Subscales Scores [ Time Frame: Part B: Baseline, Days 3, 8, 15, 21 and 45 ]
    HAM-D is used to rate the severity of depression in participants who are already diagnosed as depressed. HAM-D subscales: Core subscale (symptoms-depressed mood, feelings of guilt, suicide, work and activities, and retardation ); Anxiety subscale (symptoms-anxiety [psychic and somatic], somatic symptoms [gastrointestinal and general], hypochondriasis, loss of weight); Bech-6 subscale (symptoms-depressed mood, feelings of guilt, work and activities, retardation, anxiety psychic, and somatic symptoms general); Meier subscale (symptoms-depressed mood, feelings of guilt, work and activities, retardation, agitation, and anxiety psychic). Each item was scored in a range of 0 to 2 or 0 to 4, higher scores=greater degree of depression. Subscale scores were calculated as the sum of the individual item scores comprising each subscale. Scores were transformed to a scale of 0 to 100, with higher scores indicated more severe depression. A negative change from Baseline indicates less depression.

  5. Parts A and B: Change From Baseline in HAM-D Individual Item Scores [ Time Frame: Part B: Baseline, Days 3, 8, 15, 21 and 45 ]
    The 17-item HAM-D is used to rate the severity of depression in participants who are already diagnosed as depressed. Individual items on the scale were scored in a range of 0 to 2 or 0 to 4. Symptoms scored in a range of 0 to 2: insomnia (early, middle, late), somatic symptoms (gastrointestinal and general), genital symptoms, loss of weight, and insight. The following symptoms were scored in a range of 0 to 4: agitation, depressed mood, feelings of guilt, suicide, work and activities, retardation, anxiety (psychic and somatic), and hypochondriasis. Higher scores indicated a greater degree of depression. A negative change from Baseline indicates less depression.

  6. Parts A and B: Change From Baseline in Montgomery and Åsberg Depression Rating Scale (MADRS) Total Score [ Time Frame: Part B: Baseline, Days 3, 8, 15, 21 and 45 ]
    The MADRS is a 10-item questionnaire used to measure the severity of depressive episodes in participants with mood disorders. It includes questions on the following symptoms: apparent sadness; reported sadness; inner tension; reduced sleep; reduced appetite; concentration difficulties; lassitude; inability to feel; pessimistic thoughts; and suicidal thoughts. Each item was scored in a range of 0 (no symptoms) to 6 (symptoms of maximum severity). The MADRS total score was calculated as the sum of the 10 individual item scores and could range from 0 to 60. Higher scores indicated more severe depression. A negative change from Baseline indicates less depression.

  7. Parts A and B: Percentage of Participants With Clinical Global Impression - Improvement (CGI-I) Response [ Time Frame: Part B: Days 3, 8, 15, 21 and 45 ]
    The Clinical Global Impression - Improvement (CGI-I) item of the CGI scale uses a 7-point Likert scale to measure the overall improvement in the participant's condition posttreatment. The investigator rated the participant's total improvement whether or not it was due entirely to drug treatment. Response choices included: 0=not assessed, 1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, and 7=very much worse. CGI response was defined as a CGI-I score of 1 (very much improved) or 2 (much improved). The percentage of participants with overall improvement in post-treatment condition, rated by investigator as very much improved (CGI-I score of 1) or much improved (CGI-I score of 2) is reported.

  8. Parts A and B: Change From Baseline in Hamilton Anxiety Rating Scale (HAM-A) Total Score [ Time Frame: Part B: Baseline, Days 3, 8, 15, 21 and 45 ]
    The 14-item HAM-A was used to rate the severity of symptoms of anxiety. Each of the 14 items was defined by a series of symptoms and measured both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety). The individual items were scored in a range of 0 (not present) to 4 (very severe). The HAM-A total score was calculated as the sum of the 14 individual item scores and could range from 0 to 56 where a score of <17=mild severity; 18-24= mild to moderate severity and 25-30=moderate to severe severity. A negative change from Baseline indicates less anxiety.

  9. Parts A and B: Percentage of Participants With MADRS Response [ Time Frame: Part B: Days 3, 8, 15, 21 and 45 ]
    MADRS response was defined as having a 50% or greater reduction from Baseline in MADRS total score. The MADRS is a 10-item questionnaire used to measure the severity of depressive episodes in participants with mood disorders. It includes questions on the following symptoms: apparent sadness; reported sadness; inner tension; reduced sleep; reduced appetite; concentration difficulties; lassitude; inability to feel; pessimistic thoughts; and suicidal thoughts. Each item was scored in a range of 0 (no symptoms) to 6 (symptoms of maximum severity). The MADRS total score was calculated as the sum of the 10 individual item scores and could range from 0 to 60. Higher scores indicated more depression.

  10. Parts A and B: Percentage of Participants With MADRS Remission [ Time Frame: Part B: Days 3, 8, 15, 21 and 45 ]
    MADRS Remission was defined as a MADRS total score of <=10. The MADRS is a 10-item questionnaire used to measure the severity of depressive episodes in participants with mood disorders. It includes questions on the following symptoms: apparent sadness; reported sadness; inner tension; reduced sleep; reduced appetite; concentration difficulties; lassitude; inability to feel; pessimistic thoughts; and suicidal thoughts. Each item was scored in a range of 0 (no symptoms) to 6 (symptoms of maximum severity). The MADRS total score was calculated as the sum of the 10 individual item scores and could range from 0 to 60. Higher scores indicated more depression.

  11. Parts A and B: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) [ Time Frame: Part A: Up to Day 75; Part B: Up to Day 45 ]
    An Adverse Event (AE) was defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (example, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A TEAE was defined as an AE with an onset that occurs after receiving study drug.

  12. Part B: Number of Participants With Potentially Clinically Significant Vital Sign Measurements [ Time Frame: Part B: From first dose of study drug up to 45 days ]
    Vital signs included assessments of supine and standing systolic blood pressure (SBP), supine and standing diastolic blood pressure (DBP), and heart rate.

  13. Part B: Number of Participants With Potentially Clinically Significant Laboratory Evaluations [ Time Frame: Part B: From first dose of study drug up to 45 days ]
    Laboratory tests included tests of Hematology, Chemistry, and Urinalysis.

  14. Part B: Change From Baseline in Electrocardiogram (ECG) Parameter Heart Rate [ Time Frame: Part B: Baseline, Days 8, 15, and 21 ]
    ECG parameters included assessment of the standard 12-lead ECG intervals: QT, QTcF, PR, RR, QRS, and heart rate. Heart rate was measured in terms of beats per minute. Change from Baseline in heart rate at specified time points were reported.

  15. Part B: Change From Baseline in ECG Parameters-PR Interval, RR Interval, QRS Duration, QT Interval, QTcF Interval [ Time Frame: Part B: Baseline, Days 8, 15, and 21 ]
    ECG parameters included assessment of the standard 12-lead ECG intervals: QT, QTcF, PR, RR, QRS, and heart rate. Change from Baseline in PR Interval, RR Interval, QRS Duration, QT Interval, QTcF Interval is reported.

  16. Part B: Number of Participants With a Response of "Yes" to Any Suicidal Ideation or Suicidal Behaviors Item Using the Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Part B: Up to Day 45 ]
    C-SSRS was used to assess the suicidality of participants during the study. The assessment included "yes" or "no" responses for 5 questions, each related to suicidal ideation (wish to be dead, non-specific active suicidal thoughts, active suicidal ideation with any methods, active suicidal ideation with some intent, active suicidal ideation with specific plan) and suicidal behavior (preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, suicide). Numeric ratings were provided for severity of ideation (if present), from 1 to 5, with 5 being the most severe. Number of participants with a response of 'yes' to any suicidal ideation or suicidal behavior item as measured by C-SSRS is reported.



Information from the National Library of Medicine

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, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   Female
Gender Based Eligibility:   Yes
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • Participant either must have ceased lactating at screening or, if still lactating or actively breastfeeding at screening, must agree to temporarily cease giving breast milk to her infant(s)
  • Participant has had a Major Depressive Episode that began no earlier than the third trimester and no later than the first 4 weeks following delivery, as diagnosed by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 Axis I Disorders (SCID-I)
  • Participant was <=six months postpartum.

Key Exclusion Criteria:

  • Active psychosis
  • Attempted suicide associated with current episode of postpartum depression
  • Medical history of seizures
  • Medical history of bipolar disorder, schizophrenia, and/or schizoaffective disorder.

Note: suicidal ideation was not an exclusion. Other protocol-defined inclusion/exclusion criteria might apply.


Information from the National Library of Medicine

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): NCT02978326


Locations
Layout table for location information
United States, Arkansas
Sage Investigational Site
Little Rock, Arkansas, United States, 72209
United States, California
Sage Investigational Site
Beverly Hills, California, United States, 90212
Sage Investigational Site
Oceanside, California, United States, 92056
Sage Investigational Site
Wildomar, California, United States, 92595
United States, District of Columbia
Sage Investigational Site
Washington, District of Columbia, United States, 20011
United States, Florida
Sage Investigational Site
Aventura, Florida, United States, 33027
Sage Investigational Site
Miami, Florida, United States, 33173
Sage Investigational Site
Orlando, Florida, United States, 32807
Sage Investigational Site
Pensacola, Florida, United States, 32502
Sage Investigational SIte
Pinellas Park, Florida, United States, 33782
United States, Georgia
Sage Investigational Site
Atlanta, Georgia, United States, 30331
Sage Investigational Site
Decatur, Georgia, United States, 30030
United States, Illinois
Sage Investigational Site
Hoffman Estates, Illinois, United States, 60169
United States, Kentucky
Sage Investigational Site
Owensboro, Kentucky, United States, 42303
United States, Louisiana
Sage Investigational Site
Lake Charles, Louisiana, United States, 70629
Sage Investigational Site
New Orleans, Louisiana, United States, 70115
United States, Missouri
Sage Investigational Site
Saint Charles, Missouri, United States, 63304
United States, Nevada
Sage Investigational Site
Las Vegas, Nevada, United States, 89102
United States, New York
Sage Investigational Site
Manhasset, New York, United States, 11030
Sage Investigational Site
New York, New York, United States, 10036
United States, North Carolina
Sage Investigational Site
Chapel Hill, North Carolina, United States, 27599
Sage Investigational Site
Raleigh, North Carolina, United States, 27612
United States, Rhode Island
Sage Investigational Site
Providence, Rhode Island, United States, 02904
United States, Texas
Sage Investigational Site
Fort Worth, Texas, United States, 76060
Sage Investigational Site
Houston, Texas, United States, 77058
Sage Investigational Site
Richardson, Texas, United States, 75080
United States, Utah
Sage Investigational Site
Orem, Utah, United States, 84058
Sponsors and Collaborators
Sage Therapeutics
  Study Documents (Full-Text)

Documents provided by Sage Therapeutics:
Study Protocol  [PDF] July 2, 2018
Statistical Analysis Plan  [PDF] December 11, 2018

Additional Information:
Publications of Results:
Deligiannidis K, Lasser R, Gunduz-Bruce H, Silber C, Sankoh AJ, Li Si, et al. A Phase 3, Double-Blind, Placebo- Controlled Trial of SAGE-217 in Postpartum Depression: Assessment of Depressive Symptoms Across Multiple Measures. Abstract presented at: American Society of Clinical Psychopharmacology 2019 Annual Meeting; May 28-31, 2019; Scottsdale, AZ.
Lasser R, Deligiannidis K, Gunduz-Bruce H, Silber C, Sankoh AJ, Li Si, et al. A Phase 3, Double-Blind, Placebo- Controlled Trial of SAGE-217 in Postpartum Depression: Topline Assessment of Secondary Efficacy Measures of Anxiety and Depression. Abstract presented at: American Society of Clinical Psychopharmacology 2019 Annual Meeting; May 28-31, 2019; Scottsdale, AZ.

Layout table for additonal information
Responsible Party: Sage Therapeutics
ClinicalTrials.gov Identifier: NCT02978326    
Other Study ID Numbers: 217-PPD-201
First Posted: November 30, 2016    Key Record Dates
Results First Posted: December 16, 2021
Last Update Posted: February 10, 2022
Last Verified: February 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Data sharing will be consistent with the results submission policy of ClinicalTrials.gov.

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Sage Therapeutics:
Postpartum Care
Additional relevant MeSH terms:
Layout table for MeSH terms
Depression, Postpartum
Depression
Depressive Disorder
Behavioral Symptoms
Mood Disorders
Mental Disorders
Puerperal Disorders
Pregnancy Complications