NCT02330679

Brief Summary

Despite significant advances in pharmacological treatment, the global burden of depression is increasing worldwide. The major challenge in antidepressant treatment is the clinicians' inability to predict the variability in individual response to the treatment. The development of biomarkers to predict treatment outcomes would enable clinician to find the right medication for a particular patient at the early stage of the treatment and thus could reduce prolonged suffering and ineffective protracted treatment. Brain imaging studies that examined brain predictors of treatment response based on group comparisons have limited value in classifying individuals as responders or non-responders. Machine learning classification techniques such as the support vector machine (SVM) method have proven useful in the classification of individual brain image observations into distinct groups or classes. However, studies that have applied the SVM method to structural and functional magnetic resonance scans (fMRI) involved small sample sizes and were confounded by placebo responses. Furthermore, a recent meta-analysis of clinical trials and EEG studies have shown that early clinical responses and brain changes at the early phase of antidepressant treatment may predict later clinical outcomes suggesting that neural markers measured in the early phase of antidepressant treatment may improve predictive accuracy. However, there is no fMRI study to date that has examined the predictive accuracy of data obtained in early phase of the treatment. We have preliminary fMRI data relating to early treatment response that form the basis of this proposed study. The main objective of this study is to use machine learning method to examine the predictive value (sensitivity, specificity, accuracy) of resting state and emotional task-related fMRI data collected at pre-treatment baseline (week 0) and in the early phase of antidepressant treatment (week 2) in the classification of remitters (\< 10 MADRS scores after 12 weeks of treatment) and non-remitters in patients with major depressive disorder (MDD). A secondary objective is to determine which data set (week 0 or week 2) gives the best predictive value.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
61

participants targeted

Target at P25-P50 for phase_4 major-depressive-disorder

Timeline
Completed

Started Dec 2014

Geographic Reach
1 country

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 1, 2014

Completed
1 month until next milestone

First Submitted

Initial submission to the registry

December 31, 2014

Completed
5 days until next milestone

First Posted

Study publicly available on registry

January 5, 2015

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2016

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2016

Completed
Last Updated

January 5, 2015

Status Verified

December 1, 2014

Enrollment Period

2 years

First QC Date

December 31, 2014

Last Update Submit

January 2, 2015

Conditions

Keywords

Major Depression, Neuroimaging, Desvenlafaxine, Machine learning

Outcome Measures

Primary Outcomes (1)

  • The resting state and emotional task related brain activity pattern at the pretreatment baseline and two weeks post treatment as measured by functional MRI and analyzed by machine learning techniques

    The predictive value of brain activity pattern at the baseline and two weeks post treatment to classify remitters and non-remitters at 12 weeks of antidepressant treatment using machine learning classifiers

    2 weeks

Secondary Outcomes (1)

  • The clinical response to antidepressant treatment as measured by Montgomery-Asberg Depression Rating (MADRS) scale.

    12 weeks

Study Arms (1)

Desvenlafaxine

OTHER

2-week single-blind placebo run-in phase followed by a 12-week open-label trial with desvenlafaxine

Drug: DesvenlafaxineDrug: Placebo

Interventions

The intervention will consist of a 2-week single-blind placebo run-in phase followed by a 12-week open-label trial with desvenlafaxine (a SNRI medication)

Also known as: Prestiq
Desvenlafaxine
Desvenlafaxine

Eligibility Criteria

Age20 Years - 55 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Acute episode of major depressive disorder of unipolar subtype and a score of 22 or higher in the Montgomery-Asberg Depression Rating (MADRS) scale
  • Free of psychotropic medication for a minimum of 4 weeks at recruitment

You may not qualify if:

  • Axis I disorders such as bipolar disorder, anxiety disorders, psychosis or history of substance abuse within 6 months of study participation
  • severe borderline personality disorder
  • severe medical and neurological disorders
  • severe suicidal patients
  • failure to respond to three trials of antidepressant medication

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of Calgary, TRW Building, Foothills Hospital Campus

Calgary, Alberta, T2N4Z6, Canada

RECRUITING

University of Calgary: Foothills Hospital

Calgary, Alberta, T2N4Z6, Canada

RECRUITING

MeSH Terms

Conditions

Depressive Disorder, Major

Interventions

Desvenlafaxine Succinate

Condition Hierarchy (Ancestors)

Depressive DisorderMood DisordersMental Disorders

Intervention Hierarchy (Ancestors)

CyclohexanolsHexanolsFatty AlcoholsAlcoholsOrganic ChemicalsCyclohexanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicHydrocarbonsPhenolsBenzene DerivativesHydrocarbons, AromaticLipids

Study Officials

  • Rajamannar Ramasubbu, MD, FRCP(C)

    University of Calgary

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Rajamannar Ramasubbu, MD, FRCP(C)

CONTACT

Darren Clark, PhD

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
NA
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Prof

Study Record Dates

First Submitted

December 31, 2014

First Posted

January 5, 2015

Study Start

December 1, 2014

Primary Completion

December 1, 2016

Study Completion

December 1, 2016

Last Updated

January 5, 2015

Record last verified: 2014-12

Locations