OSU6162 for patients with depression not helped by standard treatments

OSU6162 as add-on in SSRI/SNRI-resistant Depression (ODEN): a Double-blind, Placebo-controlled Evaluation of Efficacy and Safety

This study is testing if a new medication called OSU6162 can help people with depression who haven't found relief from standard treatments.

Quick facts

• Phase: PHASE2
• Study type: Interventional
• Enrollment: 180 (estimated)
• Ages: 25 Years to 65 Years
• Sex: All
• Sponsor: Göteborg University (other)
• Locations: 4 sites (Lund, Skåne County and 3 other locations)
• Trial ID: NCT05641623 on ClinicalTrials.gov

What this trial studies

This clinical trial evaluates the efficacy of OSU6162 as an add-on treatment for patients with major depressive disorder who have not responded to standard SSRI/SNRI medications for at least six weeks. It is a randomized, placebo-controlled, parallel-group trial lasting six weeks, with participants making multiple study visits and phone contacts with study staff. The study also includes optional substudy assessments using fMRI to explore changes in brain activity related to reward processing. Those who respond positively to treatment may continue for an additional four weeks without unblinding.

Who should consider this trial

Good fit: Ideal candidates are adults aged 25-65 with major depressive disorder who have not improved after at least six weeks of SSRI/SNRI treatment.

Not a fit: Patients who have not been diagnosed with major depressive disorder or those who have not previously tried SSRI/SNRI medications may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could provide a new option for patients with treatment-resistant depression.

How similar studies have performed: Other studies exploring novel antidepressants have shown promise, but the specific approach of using OSU6162 in this context is relatively novel.

Eligibility criteria

Inclusion Criteria

In order to be included in the study, subjects must meet the following criteria:

1. Signed informed consent.
2. Age: 25-65 on the day of screening.
3. Meeting DSM-5 criteria for major depressive disorder as confirmed by the Mini International Neuropsychiatric Interview (MINI).
4. A symptom-free period preceding the current episode within the past two years confirmed at interview.
5. Not significantly improved, as judged by both doctor and patient, after having been treated with one of the following SSRIs/SNRIs: citalopram, escitalopram, paroxetine, sertraline, fluoxetine, duloxetine, or venlafaxine for at least 6 weeks.
6. Displaying a sum score of MADRS ≥22.
7. In women of childbearing potential (WOCBP): negative result of a pregnancy test and a method of contraception with a failure rate of less than 1 %. Contraception must be used during the treatment and follow-up period. Acceptable forms of contraception are:

   1. Use of combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation

      * oral
      * intravaginal
      * transdermal
   2. progestogen-only hormonal contraception associated with inhibition of ovulation:

      * oral
      * injectable
      * implantable
   3. Placement of intrauterine device (IUD) or intrauterine hormone releasing system (IUS)
   4. Bilateral tubal occlusion or ligation
   5. Vasectomised partner (with appropriate post-vasectomy documentation of the absence of sperm in the ejaculate and provided that male partner is the sole sexual partner of the WOCBP trial participant).
   6. Sexual abstinence.
8. Male patients must agree to use condoms during the study and for 2 weeks after the end of the study/last dose of IMP, unless their partner is using a highly efficient method of contraception, as described above.

Exclusion criteria

Subjects must not be included in the study if any of the following criteria are met:

1. Meeting MINI criteria at interview for suicidality, manic episode, hypomanic episode, bipolar I, bipolar II, bipolar unspecified, bipolar I with psychotic symptoms, panic disorder (current), agoraphobia, posttraumatic stress disorder, alcohol dependency, alcohol abuse, substance dependency (non-alcoholic), substance abuse (non-alcoholic), psychotic disorders, mood disorders with psychotic features, anorexia nervosa, bulimia nervosa, anorexia nervosa binge eating / purging type, or antisocial personality disorder.

   Meeting MINI criteria at interview for generalised anxiety disorder, obsessive compulsive disorder or social anxiety (social phobia), unless the present symptoms can predominantly be attributed to a diagnosis of major depressive disorder.
2. A history of substance/alcohol abuse within 2 years prior to screening.
3. A previous diagnosis of a personality disorder, autism spectrum disorder, attention-deficit/hyperactivity disorder, or intellectual disability.
4. Any other previously diagnosed or suspected CNS disorder that according to the investigator renders the patient unsuitable for participation in the trial.
5. Any factor that according to the investigator renders it unlikely that the patient will comply with the instructions regarding treatment, visits etc.
6. Any somatic illness that according to the investigator renders the patient unsuitable for participation in the trial.
7. Any signs or symptoms of somatic illness resulting from assessment of vital signs, physical examination, clinical laboratory tests, and 12-lead ECG that according to the investigator renders the patient unsuitable for participation for safety reasons, including a QTc-time on ECG exceeding 450 ms in men and 460 ms in women.
8. Any change in dosage of said SSRI/SNRI within 4 weeks prior to screening or at any time during the course of the trial.
9. Treatment with any other psychoactive drug than said SSRI/SNRI with the exception of using mirtazapine up to 15 mg for sleep, occasional use of benzodiazepines and benzodiazepine-like anxiolytics or hypnotics and occasional use of antihistaminergic sedatives (without anti-dopaminergic effects) within 4 weeks prior to screening and at any time during the course of the trial.
10. Patients who are receiving concomitant therapy with potent cytochrome P450 enzyme inhibitors (e.g., bupropion, fluvoxamin, ketoconazole, itraconazole, telithromycin, clarithromycin, protease inhibitors, quinidine, and terbinafine).
11. Ongoing treatment with drugs with a narrow therapeutic window where either lower or higher serum levels are potentially harmful (including but not limited to warfarin along with other anticoagulants, digoxin along with other antiarrythmics, anticonvulsants prescribed for treatment of epilepsy, cyclosporine, immunosuppressants, and lithium).
12. Current treatment with any prescribed or OTC drug that according to the investigator renders the subject unsuitable for participation in the trial.
13. Previous intake of OSU6162.
14. Current participation in another clinical trial.
15. Nursing women.

Where this trial is running

Lund, Skåne County and 3 other locations

• Skåne University Hospital Psychiatry Lund — Lund, Skåne County, Sweden (RECRUITING)
• Sahlgrenska University Hospital — Gothenburg, Västra Götaland County, Sweden (RECRUITING)
• North Stockholm psychiatry Stockholm region — Stockholm, Sweden (NOT_YET_RECRUITING)
• Uppsala University Hospital Department of neuroscience — Uppsala, Sweden (NOT_YET_RECRUITING)

Study contacts

• Study coordinator: Elias Eriksson, Professor

Conditions: Depression, Depressive Disorder, Treatment-Resistant, Depressive Disorder, Depressive Episode, Recurrent Depressive Disorder, Recurrent Depression, Antidepressant, drug therapy, combination