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The purpose of this study is to compare the efficacy of quetiapine fumarate monotherapy with quetiapine fumarate in combination with lithium in the treatment of a major depressive episode in patients with bipolar disorder.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Quetiapin fumarate XR | Experimental | Quetiapine XR (extended release) will be administered once daily at bedtime in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. |
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| Quetiapin fumarate XR+Lithium carbonate | Experimental | Quetiapine XR will be administered like monotherapy arm. Lithium will be administered twice daily from Day 1 to Day 56. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quetiapine fumarate XR | Drug | Quetiapine XR (extended release) will be administered once daily at bedtime in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score. | The change of MADRS Total Score from baseline to the end of treatment was calculated by subtracting the MADRS Total Score assessed at week 8 from the baseline one (Baseline - 8 weeks). The MADRS is a 10-item scale that evaluates the core symptoms and cognitive features of clinical depression. Each MADRS item is rated on a 0 to 6 scale. The MADRS Total score ranges from 0 (min) to 60 (max). Higher MADRS scores indicate higher levels of depressive symptoms. | Baseline, 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Response Rate for MADRS. | Response rate defined as the percentage of patients with a ≥50% reduction from baseline in the MADRS total score to the final assessment at week 8. The MADRS is a 10-item scale that evaluates the core symptoms and cognitive features of clinical depression. Each MADRS item is rated on a 0 to 6 scale. The MADRS Total score ranges from 0 (min) to 60 (max). Higher MADRS scores indicate higher levels of depressive symptoms. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Simavi Vahip, Prof. Dr. | Ege University Faculty of Medicine Psychiatry Department İzmir | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Research Site | La Plata | Buenos Aires | Argentina | |||
| Research Site |
An enrollment period of up to 7 days and if applicable a wash-out period for 7-28 days depending on the medication being used, ie. antidepressants, antipsychotics and/or mood stabilizers.
First Subject in (FSI): 22 Apr 2009, Last Subject Last Visit (LSLV): 01 Mar 2011, in 9 countries, 29 Psychiatry centres, 421 randomised participants
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| ID | Title | Description |
|---|---|---|
| FG000 | Quetiapine XR | Quetiapine XR administered once daily in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. |
| FG001 | Quatiapine XR + Lithium | Quetiapine XR administered once daily in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. Lithium carbonate administered twice daily from Day 1 to Day 56. From Day 1 to Day 7, the total daily dose within the dose range 300 mg/day to 1800 mg/day. From Day 8 to Day 56, the total daily dose adjusted from 600 to 1800 mg/day. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Lithium carbonate | Drug | Twice daily from Day 1 to Day 56. From Day 1 to Day 7, the total daily dose of lithium could be increased gradually within the dose range 300 mg/day to 1800 mg/day. From Day 8 to Day 56, the total daily dose could be adjusted from 600 to 1800 mg/day |
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| baseline, week 8 |
| Hamilton Rating Scale for Depression (HAM-D) Total Score. | The mean change of HAM-D Total Score from baseline to the end of treatment was calculated by subtracting the HAM-D Total Score assessed at week 8 from the baseline one (Baseline - week 8). HAM-D is a multiple choice questionnaire used to rate the severity of a patient's major depression. It consists of 17 different items with possible scores from 0 to 4 or 0 to 2 or 0 to 6 depending on the items. Sum the total of all seventeen items gives the HAM-D Total Score, which may range from 0 (min) to 53 (max). The higher the score, the more severe the depression. | Baseline, 8 Weeks |
| Change in Hamilton Rating Scale for Anxiety (HAM-A) Total Score | The mean change in HAM-A total score from baseline to final assessment was calculated by subtracting the HAM-A Total score assessed at week 8 from the total score assessed at the baseline (baseline - week 8). The HAM-A is a 14-item scale that assesses anxiety symptoms of anxiety such as "anxious mood", "tension" or "fears". Each item is scored on a 5-point scale, ranging from 0=not present to 4=severe. Sum the scores from all 14 parameters gives the HAM-A Total Score which may range from 0 (min) to 56 (max). | baseline, 8 weeks |
| Change in the Clinical Global Impression Severity (CGI-S) Score. | The reported mean change in the CGI-S score was calculated as baseline - week 8. CGI-S is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment. A patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill. | baseline, 8 weeks |
| Change in Young Mania Rating Scale (YMRS) Total Score. | The YMRS is a rating scale to assess manic symptoms. The scale has 11 items and is based upon patient's subjective report of his or hers clinical condition over the previous 48 hours. The mean change in YMRS Total score reported was calculated as baseline - week 8. The YMRS total score ranges from 0 to 60 where higher scores indicate more severe mania, thus, a negative change (or decrease) from baseline indicates a reduction (or improvement) in manic symptoms. Total score ≤12 indicates remission (13-19=minimal symptoms; 20-25=mild mania, 26-37=moderate mania, 38-60=severe mania). | baseline, 8 weeks |
| Change in the Pittsburgh Sleep Quality Index (PSQI)Total Score. | The mean change in PSQI score from baseline to final assessment at week 8 was calculated as baseline - week 8. PSQI evaluates 7 areas of quality and pattern of sleep: sleep quality, duration getting to sleep, sleep duration, sleep adequacy, sleep disturbance, use of sleeping pill, and somnolence). Each area is rated on a scale from 0 (better) to 3 (worse) with a total score ranging from 0 to 21. Reduction in total scores are associated with better sleep quality. | Baseline, 8 weeks |
| Change in Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) Total Score. | The mean change in (Q-LES-Q-Short Form) Total Score from baseline to week 8 was calculated by subtracting the 8 week value from baseline value (baseline - week 8). The Q-LES-Q-SF is a patient self assessment questionnaire consisting of 16 self-rated questions (1 being very poor - 5 very good); the first 14 will be incorporated into a total score. Higher scores indicate better quality of life. | baseline, 8 weeks |
| Change in the Sheehan Disability Scale (SDS) Total Score. | The mean change in the SDS Total score from baseline to week 8 (baseline- week 8). Sheehan Disability Scale is a 5 item scale, with a visual analog scale evaluating work/school work, social life and family life ranging from 0 to a maximum score of 30. Each one of the 3 domains is rated from 0-10 (no impairment to most severe impairment) with evaluation of not at all (0), mild (1-3), moderate (4-6), marked (7-9) and extreme (10) disability. A total score will be calculated. A score of 30 indicates most severe impairment. | baseline, 8 weeks |
| Treatment Satisfaction Questionnaire (TSQ) Scores. | The 14-item TAQ questionnaire evaluates the patient's overall level of satisfaction with the study medication, the effectiveness, side effects and convenience of the medication. Effectiveness, side effects, convenience and global satisfaction is rated on a scale of 0 being the worst and 100 being very effective, no side effects or very convenient or very satisfied. Overall satisfaction is rated over a score of 5 and 5 being the best overall satisfaction. | baseline, 8 weeks |
| Godoy Cruz |
| Mendoza Province |
| Argentina |
| Research Site | Mendoza | Mendoza Province | Argentina |
| Research Site | Caba | Argentina |
| Research Site | Aparecida de Goiânia | Goiás | Brazil |
| Research Site | Rio de Janeiro | Rio de Janeiro | Brazil |
| Research Site | São Paulo | São Paulo | Brazil |
| Research Site | Santiago | Chile | Chile |
| Research Site | Medellín | Antioquia | Colombia |
| Research Site | Bogota D.c | Cundinamarca | Colombia |
| Research Site | Guatemala City | Ciudad de Guatemala | Guatemala |
| Research Site | Monterrey | Nuevo León | Mexico |
| Research Site | San Luis Potosí City | San Luis Potosí | Mexico |
| Research Site | Durango | Mexico |
| Research Site | Monterrey | Mexico |
| Research Site | Lima | Lima Province | Peru |
| Research Site | Ankara | Turkey | Turkey (Türkiye) |
| Research Site | Elâzığ | Turkey | Turkey (Türkiye) |
| Research Site | Istanbul | Turkey | Turkey (Türkiye) |
| Research Site | Izmir | Turkey | Turkey (Türkiye) |
| Research Site | Kocaeli | Turkey | Turkey (Türkiye) |
| Research Site | Malatya | Turkey | Turkey (Türkiye) |
| Research Site | Manisa | Turkey | Turkey (Türkiye) |
| Research Site | Caracas | Venezuela |
| Intention To Treat Analysis Population |
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| Per Protocol Analysis Population |
|
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Quetiapine XR | Quetiapine XR administered once daily in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. |
| BG001 | Quatiapine XR + Lithium | Quetiapine XR administered once daily in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. Lithium carbonate administered twice daily from Day 1 to Day 56. From Day 1 to Day 7, the total daily dose within the dose range 300 mg/day to 1800 mg/day. From Day 8 to Day 56, the total daily dose adjusted from 600 to 1800 mg/day. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean | Standard Deviation | Years |
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| Age, Customized | Median | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Body weight | The overall number of subject the measures are reported is 398- the weight of one patient from Quatiapine XR + Lithium Arm has not been recorded at baseline. | Mean | Standard Deviation | Kilograms |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score. | The change of MADRS Total Score from baseline to the end of treatment was calculated by subtracting the MADRS Total Score assessed at week 8 from the baseline one (Baseline - 8 weeks). The MADRS is a 10-item scale that evaluates the core symptoms and cognitive features of clinical depression. Each MADRS item is rated on a 0 to 6 scale. The MADRS Total score ranges from 0 (min) to 60 (max). Higher MADRS scores indicate higher levels of depressive symptoms. | The analysis population was "Per Protocol" (PP).This population included all randomized patients, classified according to medication actually received, who took study medication with not less than 75% compliance and who had a randomisation MADRS assessment and all post-randomisation MADRS assessments within pre-defined time windows at each visit. | Posted | Mar 2012 | Mean | Standard Deviation | scores on a scale | Baseline, 8 weeks |
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| Secondary | Response Rate for MADRS. | Response rate defined as the percentage of patients with a ≥50% reduction from baseline in the MADRS total score to the final assessment at week 8. The MADRS is a 10-item scale that evaluates the core symptoms and cognitive features of clinical depression. Each MADRS item is rated on a 0 to 6 scale. The MADRS Total score ranges from 0 (min) to 60 (max). Higher MADRS scores indicate higher levels of depressive symptoms. | The analysis population was "Per Protocol" (PP).This population included all randomized patients, classified according to medication actually received, who took study medication with not less than 75% compliance and who had a randomisation MADRS assessment and all post-randomisation MADRS assessments within pre-defined time windows at each visit. | Posted | Mar 2012 | Number | percentage of participants | baseline, week 8 |
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| Secondary | Hamilton Rating Scale for Depression (HAM-D) Total Score. | The mean change of HAM-D Total Score from baseline to the end of treatment was calculated by subtracting the HAM-D Total Score assessed at week 8 from the baseline one (Baseline - week 8). HAM-D is a multiple choice questionnaire used to rate the severity of a patient's major depression. It consists of 17 different items with possible scores from 0 to 4 or 0 to 2 or 0 to 6 depending on the items. Sum the total of all seventeen items gives the HAM-D Total Score, which may range from 0 (min) to 53 (max). The higher the score, the more severe the depression. | The analysis population was "Per Protocol" (PP). | Posted | Mar 2012 | Mean | Standard Deviation | scores on a scale | Baseline, 8 Weeks |
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| Secondary | Change in Hamilton Rating Scale for Anxiety (HAM-A) Total Score | The mean change in HAM-A total score from baseline to final assessment was calculated by subtracting the HAM-A Total score assessed at week 8 from the total score assessed at the baseline (baseline - week 8). The HAM-A is a 14-item scale that assesses anxiety symptoms of anxiety such as "anxious mood", "tension" or "fears". Each item is scored on a 5-point scale, ranging from 0=not present to 4=severe. Sum the scores from all 14 parameters gives the HAM-A Total Score which may range from 0 (min) to 56 (max). | The analysis population was "Per Protocol" (PP). | Posted | Mar 2012 | Mean | Standard Deviation | scores on a scale | baseline, 8 weeks |
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| Secondary | Change in the Clinical Global Impression Severity (CGI-S) Score. | The reported mean change in the CGI-S score was calculated as baseline - week 8. CGI-S is a 7-point scale that requires the clinician to rate the severity of the patient's illness at the time of assessment. A patient is assessed on severity of mental illness at the time of rating 1, normal, not at all ill; 2, borderline mentally ill; 3, mildly ill; 4, moderately ill; 5, markedly ill; 6, severely ill; or 7, extremely ill. | The analysis population was "Per Protocol" (PP). | Posted | Mar 2012 | Mean | Standard Deviation | scores on a scale | baseline, 8 weeks |
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| Secondary | Change in Young Mania Rating Scale (YMRS) Total Score. | The YMRS is a rating scale to assess manic symptoms. The scale has 11 items and is based upon patient's subjective report of his or hers clinical condition over the previous 48 hours. The mean change in YMRS Total score reported was calculated as baseline - week 8. The YMRS total score ranges from 0 to 60 where higher scores indicate more severe mania, thus, a negative change (or decrease) from baseline indicates a reduction (or improvement) in manic symptoms. Total score ≤12 indicates remission (13-19=minimal symptoms; 20-25=mild mania, 26-37=moderate mania, 38-60=severe mania). | The analysis population was "Per Protocol" (PP). | Posted | Mar 2012 | Mean | Standard Deviation | scores on a scale | baseline, 8 weeks |
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| Secondary | Change in the Pittsburgh Sleep Quality Index (PSQI)Total Score. | The mean change in PSQI score from baseline to final assessment at week 8 was calculated as baseline - week 8. PSQI evaluates 7 areas of quality and pattern of sleep: sleep quality, duration getting to sleep, sleep duration, sleep adequacy, sleep disturbance, use of sleeping pill, and somnolence). Each area is rated on a scale from 0 (better) to 3 (worse) with a total score ranging from 0 to 21. Reduction in total scores are associated with better sleep quality. | The analysis has been performed in modified Per Protocol (PP) population as this Outcome Measure was included after protocol amendment at the stage the recruitment period was already on-going. | Posted | Mar 2012 | Mean | 95% Confidence Interval | Scores on a scale | Baseline, 8 weeks |
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| Secondary | Change in Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) Total Score. | The mean change in (Q-LES-Q-Short Form) Total Score from baseline to week 8 was calculated by subtracting the 8 week value from baseline value (baseline - week 8). The Q-LES-Q-SF is a patient self assessment questionnaire consisting of 16 self-rated questions (1 being very poor - 5 very good); the first 14 will be incorporated into a total score. Higher scores indicate better quality of life. | The analysis has been performed in modified Per Protocol (PP) population as this Outcome Measure was included after protocol amendment at the stage the recruitment period was already on-going. | Posted | Mar 2012 | Mean | Standard Deviation | scores on a scale | baseline, 8 weeks |
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| Secondary | Change in the Sheehan Disability Scale (SDS) Total Score. | The mean change in the SDS Total score from baseline to week 8 (baseline- week 8). Sheehan Disability Scale is a 5 item scale, with a visual analog scale evaluating work/school work, social life and family life ranging from 0 to a maximum score of 30. Each one of the 3 domains is rated from 0-10 (no impairment to most severe impairment) with evaluation of not at all (0), mild (1-3), moderate (4-6), marked (7-9) and extreme (10) disability. A total score will be calculated. A score of 30 indicates most severe impairment. | The analysis has been performed in modified Per Protocol (PP) population as this Outcome Measure was included after protocol amendment at the stage the recruitment period was already on-going. | Posted | Mar 2012 | Mean | 95% Confidence Interval | scores on a scale | baseline, 8 weeks |
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| Secondary | Treatment Satisfaction Questionnaire (TSQ) Scores. | The 14-item TAQ questionnaire evaluates the patient's overall level of satisfaction with the study medication, the effectiveness, side effects and convenience of the medication. Effectiveness, side effects, convenience and global satisfaction is rated on a scale of 0 being the worst and 100 being very effective, no side effects or very convenient or very satisfied. Overall satisfaction is rated over a score of 5 and 5 being the best overall satisfaction. | The analysis has been performed in modified Per Protocol (PP) population as this Outcome Measure was included after protocol amendment at the stage the recruitment period was already on-going. | Posted | Mar 2012 | Mean | Standard Deviation | Scores on a scale | baseline, 8 weeks |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Quetiapine XR | Quetiapine XR administered once daily in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. | 5 | 212 | 147 | 212 | ||
| EG001 | Quatiapine XR + Lithium | Quetiapine XR administered once daily in oral tablet form, Day 1: 50 mg, Day 2: 100 mg, Day 3: 200 mg, Day 4 onwards: 300 mg. Lithium carbonate administered twice daily from Day 1 to Day 56. From Day 1 to Day 7, the total daily dose within the dose range 300 mg/day to 1800 mg/day. From Day 8 to Day 56, the total daily dose adjusted from 600 to 1800 mg/day. | 5 | 209 | 149 | 209 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hospitalization due to suicide risk | Psychiatric disorders | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Peritonitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Appendicitis | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Somnolance | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Hypothyroidism | Endocrine disorders | MedDRA 10.0 | Systematic Assessment |
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| Confusion | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Exacerbation of symptoms | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Burn | Injury, poisoning and procedural complications | MedDRA 10.0 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Dry mouth | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Somnolance | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Anxiety | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Increased appetite | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Tremor | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Sedation | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Weight gain | General disorders | MedDRA 10.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gerard Lynch | AstraZeneca | aztrial_results_posting@astrazeneca.com |
| ID | Term |
|---|---|
| D016651 | Lithium Carbonate |
| ID | Term |
|---|---|
| D002254 | Carbonates |
| D000468 | Alkalies |
| D007287 | Inorganic Chemicals |
| D002255 | Carbonic Acid |
| D017554 | Carbon Compounds, Inorganic |
| D018020 | Lithium Compounds |
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