Crisugabalin capsules for adults with generalized anxiety disorder

Evaluation of the Efficacy and Safety of Crisugabalin Capsules Versus Placebo and Venlafaxine Extended-Release (XR) Capsules in Chinese Patients With Generalized Anxiety Disorder: A Prospective, Multicenter, Randomized, Double-Blind, Double-Dummy, Active- and Placebo-Controlled Clinical Trial.

This trial will test whether 40 mg/day of Crisugabalin reduces anxiety symptoms in adults with generalized anxiety disorder compared with venlafaxine and placebo.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 216 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Anhui Medical University (Academic / other)
• Locations: 1 site (Hefei, Anhui)
• Trial ID: NCT07330648 on ClinicalTrials.gov

What this trial studies

This was a prospective, multicenter, randomized, double-blind, double-dummy, active- and placebo-controlled Phase 2 trial with a 1:1:1 randomization to Crisugabalin, venlafaxine XR, or placebo for an 8-week double-blind treatment period. Crisugabalin was given as 20 mg twice daily (40 mg/day) and venlafaxine XR as 75 mg twice daily; matching placebo capsules were used for blinding. After the double-blind phase, participants could either end participation or join a 4-week open-label extension in which all received Crisugabalin 80 mg/day (40 mg twice daily). Subjects were followed from baseline through a 14-week period with nine visits in total.

Who should consider this trial

Good fit: Adults aged 18 or older who meet DSM-5 criteria for GAD, have HAMA ≥20, require pharmacological treatment, and can provide informed consent and attend visits at the study site are ideal candidates.

Not a fit: Patients with other primary psychiatric disorders, high current suicide risk, HAMD-17 >17, or those unable to attend the Hefei site are unlikely to benefit from participation.

Why it matters

Potential benefit: If effective, Crisugabalin could offer a new oral medication option to reduce anxiety symptoms in adults with GAD.

How similar studies have performed: Some drugs in the gabapentinoid class have shown mixed or limited benefit for anxiety, and Crisugabalin is a novel agent with limited prior clinical data.

Eligibility criteria

Inclusion Criteria:

* Able to understand and voluntarily participate in the trial, and provide written informed consent form (ICF);
* Male or female aged ≥18 years (inclusive of the threshold value);
* Met the diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for generalized anxiety disorder (GAD) and confirmed by the Brief International Neuropsychiatric Interview (M.I.N.I.);
* Require pharmacological treatment for psychiatric symptoms;
* Hamilton Anxiety Scale (HAMA) score ≥20, Hamilton Depression Scale (HAMD-17) score ≤2, Clinical Global Impression Scale (CGI-S) score ≥4 at screening and baseline Points;

Exclusion Criteria:

* subjects with serious suicide risk at present, or HAMD-17 item 3-suicide score ≥3;
* subjects with HAMD-17 \> 17;
* subjects whose HAMA scores decreased by ≥20% in the baseline period compared with the screening period:
* Those who met the DSM-5 diagnostic criteria for other mental disorders except GAD;
* subjects with previous history of depression, obsessive-compulsive disorder, bipolar disorder, psychotic disorder, factitious disorder and somatoform disorder; There were severe personality disorders, especially antisocial, borderline, or histrionic personality disorder, which were judged by the investigator to affect the patient's adherence to the study protocol;
* Alcohol or drug abuse or dependence within 180 days before screening;
* With severe or unstable has clinical significance of somatic disease, including any cardiovascular, cancer, kidney, respiratory, endocrine (including abnormal thyroid function), digestion, blood (such as with bleeding tendency) or nervous system diseases;
* History of inadequate response to at least two prior antidepressant drugs and/or benzodiazepines after adequate dose and duration of treatment (i.e., at least 4 weeks at a clinically appropriate dose), or failure to achieve sufficient clinical efficacy with pregabalin ≥300 mg/day (i.e., subject-reported insufficient response or lack of meaningful clinical improvement).
* History of severe hypersensitivity reactions (e.g., anaphylaxis) or allergies to at least two classes of drugs (including photosensitivity), or known hypersensitivity to pregabalin, the investigational drug, structurally related compounds, or any of their excipients.
* subjects whose physical examination or vital signs were abnormal and clinically significant (e.g. inadequately controlled hypertension, systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg);
* subjects with a history of epilepsy or any other disease that may induce seizures, except convulsions caused by febrile convulsions in children;
* Severe hematologic, hepatic or renal dysfunction during the screening period, the subject will be excluded if: a. Neutrophils \< 1.5 × 10\^9/L, or platelet \< 90 × 10\^9/L, or hemoglobin \< 100 g/L; b. AST/ALT \> 2.5 × upper limit of normal (ULN), or TBIL \> 1.5 × ULN; c. Estimation of glomerular filtration rate (eGFR) \< 60 mL/min / 1.73 m\^2; d. Creatine kinase \> 2.0 × ULN.
* Clinically significant abnormalities on electrocardiography (QT interval corrected by Fridericia method: ≥450 ms for men or ≥470 ms for women) or conditions deemed ineligible by the investigators;
* Subjects who had undergone psychiatric surgery, electroconvulsive therapy or transcranial magnetic stimulation within 90 days before screening;
* Use of β-blockers within 90 days prior to screening with an ongoing need for continued treatment;
* Receiving systemic psychotherapy or other non-pharmacological treatments (e.g., acupuncture, hypnosis, or phototherapy) within 6 weeks before the baseline visit;
* Subjects with dysphagia or inability to tolerate oral medications.
* Subjects with active gastrointestinal disorders (including any history of gastrointestinal surgery) that, in the investigator's judgment, may interfere with the absorption of the investigational drug.
* Those who had used benzodiazepines within -7 to -1 days before screening, such as lorazepam, oxazepam, and alprazolam for less than 5 half-lives; The use of benzodiazepines with longer half-lives, such as diazepam, clonazepam, nitrazepam, estazolam, and flurazepam, not more than 5 half-lives or less than 30 days from the screening period, or the use of barbiturates not more than 5 half-lives or less than 30 days from the screening period;
* Patients who discontinued traditional Chinese medicine, melatonin, and St. John's wort for less than 3 days before the baseline visit;
* Pregnant or preparing for pregnancy or breastfeeding during the study period, or subjects were not willing to use reliable contraceptives methods from the date of ICF signature until 28 days after the last trial drug administration, or planning to use progesterone contraceptives during this period;
* Individuals engaged in potentially hazardous mechanical operations such as working at heights or operating motor vehicles.
* Participants enrolled in other clinical trials within 30 days before screening;
* Subjects with other conditions deemed by the investigator to be ineligible for enrollment.

Where this trial is running

Hefei, Anhui

• The First Affiliated Hospital of Anhui Medical University — Hefei, Anhui, China (Recruiting)

Study contacts

• Study coordinator: Kai Wang

Conditions Generalized Anxiety Disorder