Aticaprant for Depression

(VENTURA-7 Trial)

Recruiting at 45 trial locations

Overseen By Study Contact

Age: 18 - 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 3

Waitlist Available

Sponsor: Janssen Research & Development, LLC

Pivotal Trial (Near Approval)

Prior Safety Data

Trial Summary

What is the purpose of this trial?

This trial is testing if aticaprant can help adults with major depressive disorder who haven't responded well to current antidepressants. The medication works by targeting brain chemicals to improve mood and pleasure.

Do I have to stop taking my current medications for this trial?

No, you don't have to stop taking your current medications. In fact, you need to continue taking your current SSRI or SNRI antidepressant at a stable dose for at least 6 weeks before joining the trial.

What data supports the idea that Aticaprant for Depression is an effective drug?

The available research does not provide any data on Aticaprant for Depression. Instead, it focuses on other drugs and conditions, such as tofacitinib and upadacitinib for conditions like ulcerative colitis, rheumatoid arthritis, and psoriasis. Therefore, there is no information here to support the effectiveness of Aticaprant for Depression. ^{1 2 3 4 5}

What safety data exists for Aticaprant for Depression?

The provided research does not contain specific safety data for Aticaprant or its other names (CERC-501, LY-2456302, JNJ-67953964, JNJ-67953964-AAA, AVTX-501, JSPA-0658, JSPA0658). Therefore, no relevant safety information for this treatment is available in the given abstracts. ^{6 7 8 9 10}

Is the drug Aticaprant a promising treatment for depression?

The information provided does not mention Aticaprant or its effectiveness for depression. The articles focus on a different drug, Aprepitant, which is used for preventing nausea and vomiting during chemotherapy, and its potential use in depression was not supported by later studies. Therefore, we cannot determine if Aticaprant is promising for depression based on this information. ^{11 12 13 14 15}

Research Team

Janssen Research & Development, LLC Clinical Trial

Principal Investigator

Janssen Research & Development, LLC

Eligibility Criteria

This trial is for adults with Major Depressive Disorder who still feel a significant lack of pleasure (anhedonia) despite being on current antidepressants like SSRIs or SNRIs. Participants should have an inadequate response to these treatments.

Treatment Details

Interventions

• Aticaprant (Other)

Trial Overview The study tests Aticaprant, given alongside standard antidepressants, against a placebo (a substance with no active drug). It aims to see if Aticaprant can better improve symptoms of depression in those not helped enough by their current medication.

Participant Groups

Group I: Aticaprant Experimental Treatment 1 Intervention

Group II: Placebo Placebo Group 1 Intervention

Who Is Running the Clinical Trial?

Janssen Research & Development, LLC

Lead Sponsor

Trials

1,022

Recruited

6,408,000+

Giacomo Salvadore

Janssen Research & Development, LLC

Chief Medical Officer since 2023

MD from the University of Rome, Tor Vergata

Ricardo Attar

Janssen Research & Development, LLC

Chief Executive Officer since 2008

PhD in Molecular Biology from the University of Buenos Aires

Findings from Research

Tofacitinib, an oral Janus kinase inhibitor, significantly improved patient-reported outcomes in individuals with active ulcerative colitis, particularly at the 15 mg dose, compared to placebo after 8 weeks of treatment.

Patients who achieved endoscopic remission reported even higher satisfaction and quality of life scores, indicating that tofacitinib not only helps with clinical symptoms but also enhances overall patient well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized trial of tofacitinib in active ulcerative colitis: analysis of efficacy based on patient-reported outcomes. Panés, J., Su, C., Bushmakin, AG., et al.[2022]

Upadacitinib, a selective JAK1 inhibitor, demonstrated an oral bioavailability of approximately 80% for its extended-release formulation compared to the immediate-release version, based on a pharmacokinetic analysis of 11,658 plasma concentrations from 1,145 subjects across multiple studies.

The study found that while certain factors like sex and renal function can affect drug levels in the body, these variations are not expected to lead to clinically significant changes in the drug's effectiveness or safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of Upadacitinib in Healthy Subjects and Subjects With Rheumatoid Arthritis, Crohn's Disease, Ulcerative Colitis, or Atopic Dermatitis: Population Analyses of Phase 1 and 2 Clinical Trials. Nader, A., Stodtmann, S., Friedel, A., et al.[2021]

Tofacitinib, an oral JAK inhibitor, was studied in 2981 patients with psoriasis over a period of up to 56 weeks, revealing that its pharmacokinetics can be effectively modeled using a one-compartment model that accounts for various patient factors.

The study found that only creatinine clearance (CrCl) significantly affected drug exposure, indicating that no dosing adjustments are necessary based on age, sex, race, or other baseline characteristics, except for patients with renal impairment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pharmacokinetic Characteristics of Tofacitinib in Adult Patients With Moderate to Severe Chronic Plaque Psoriasis. Ma, G., Xie, R., Strober, B., et al.[2019]

Tofacitinib at doses of 3 mg or higher taken twice daily showed significant efficacy in treating active rheumatoid arthritis, with ACR20 response rates reaching up to 71.9% by week 12, compared to 22.0% for placebo.

The treatment was generally well-tolerated, with manageable side effects, the most common being urinary tract infections and diarrhea, indicating a favorable safety profile for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Phase IIb dose-ranging study of the oral JAK inhibitor tofacitinib (CP-690,550) or adalimumab monotherapy versus placebo in patients with active rheumatoid arthritis with an inadequate response to disease-modifying antirheumatic drugs. Fleischmann, R., Cutolo, M., Genovese, MC., et al.[2022]

Elderly patients with renal failure taking dabigatran are at a higher risk of bleeding, highlighting the need for careful monitoring in this population.

Agomelatine is associated with elevated liver enzymes, indicating a potential safety concern that requires attention during treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Pharmacovigilance update]. Livio, F.[2015]

Over a 30-year period, 1366 reports of adverse drug reactions (ADRs) associated with antidepressants in children and adolescents were identified, highlighting a significant prevalence of neuropsychiatric issues such as sleepiness, agitation, and suicidal thoughts.

The study revealed a concerning trend of increased reporting of suicidal thinking and behavior after 2003, suggesting that black box warnings may have influenced both reporting practices and the use of antidepressants in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse drug reactions in infants, children and adolescents exposed to antidepressants: a French pharmacovigilance study. Barthez, S., Revet, A., Chouchana, L., et al.[2021]

Severe cutaneous adverse drug reactions (CADRs) were found to be more common in patients treated with specific psychotropic medications, particularly clomipramine, maprotiline, carbamazepine, and lamotrigine, highlighting the need for careful monitoring of these drugs.

Women, especially those under 50 years old, were identified as being more vulnerable to CADRs, with factors such as female sex and the use of certain medications like maprotiline and lamotrigine significantly increasing the risk.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cutaneous adverse drug reactions to psychotropic drugs and their risk factors - a case-control study. Greil, W., Zhang, X., Stassen, H., et al.[2019]

A retrospective analysis of 14,670 reports found that montelukast is associated with a significant number of psychiatric disorders in children and adolescents, with 2630 cases specifically linked to these age groups.

The study revealed that suicidal behavior was notably over-represented among children and adolescents taking montelukast, indicating a need for increased awareness and monitoring of neuropsychiatric side effects in young patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychiatric Disorders and Montelukast in Children: A Disproportionality Analysis of the VigiBase(®). Aldea Perona, A., García-Sáiz, M., Sanz Álvarez, E.[2021]

The FDA has mandated a boxed warning for Singulair (montelukast) due to concerns about neuropsychiatric adverse events, particularly for patients using it for allergic rhinitis, limiting its use to those who do not respond to other treatments.

Despite the concerns, the asthma indication for montelukast remains unchanged, indicating that the benefits for asthma patients are considered to outweigh the risks based on the available data.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Boxed Warning for Montelukast: The FDA Perspective. Clarridge, K., Chin, S., Eworuke, E., et al.[2021]

In a phase 2 study involving 236 outpatients with major depressive disorder, the combination of aprepitant and paroxetine did not show a significant improvement in depression scores compared to paroxetine alone after 6 weeks.

Patients taking the combination therapy experienced more adverse events than those on monotherapy, indicating that adding aprepitant may not be beneficial and could increase side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addition of an NK1 receptor antagonist to an SSRI did not enhance the antidepressant effects of SSRI monotherapy: results from a randomized clinical trial in patients with major depressive disorder. Ball, WA., Snavely, DB., Hargreaves, RJ., et al.[2022]

Aprepitant, the first NK1 receptor antagonist approved for preventing chemotherapy-induced nausea and vomiting (CINV), is effective with a dosing regimen of 125 mg on day 1 and 80 mg on days 2 and 3, showing consistent plasma levels and good tolerability.

The bioavailability of aprepitant is not significantly affected by food intake, allowing it to be taken independently of meals, which simplifies its administration for patients undergoing chemotherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of aprepitant after single and multiple oral doses in healthy volunteers. Majumdar, AK., Howard, L., Goldberg, MR., et al.[2018]

Aprepitant, an NK1 receptor antagonist, significantly improves the prevention of chemotherapy-induced nausea and vomiting (CINV) when added to standard antiemetic therapy, with complete response rates increasing from 43.3%-52.3% to 58.8%-71% in clinical trials involving multiple cycles of highly emetogenic chemotherapy.

The addition of aprepitant is well tolerated, with adverse events similar to standard therapy, and it effectively reduces the impact of CINV on patients' daily lives, making it a valuable option for patients undergoing chemotherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Antiemetic studies on the NK1 receptor antagonist aprepitant. Stoutenburg, JP., Raftopoulos, H.[2019]

In a phase 3 trial involving 196 patients receiving carboplatin, the fixed antiemetic combination NEPA (netupitant and palonosetron) demonstrated similar efficacy to the standard regimen of aprepitant, palonosetron, and dexamethasone in preventing nausea and vomiting, with complete response rates ranging from 80% to 93%.

Both NEPA and aprepitant showed comparable rates of no significant nausea, suggesting that NEPA is an effective alternative for managing chemotherapy-induced nausea and vomiting in carboplatin-treated patients, supporting the recommendation for NK1 receptor antagonists in treatment guidelines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin: supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens. Jordan, K., Gralla, R., Rizzi, G., et al.[2018]

In a randomized trial comparing 5 mg olanzapine and aprepitant for preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving cisplatin, both medications showed similar effectiveness in total protection rates during acute, delayed, and overall phases, with no significant differences in outcomes.

While both treatments were effective, olanzapine was associated with increased sedation as a side effect, while aprepitant led to constipation, suggesting that olanzapine may offer a cost-effective alternative for managing CINV despite its sedative effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Comparison of the Efficacy of 5 mg Olanzapine and Aprepitant in the Prevention of Multiple-Day Cisplatin Chemotherapy-Induced Nausea and Vomiting. Liu, G., Jin, Y., Jiang, Y., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Randomized trial of tofacitinib in active ulcerative colitis: analysis of efficacy based on patient-reported outcomes. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of Upadacitinib in Healthy Subjects and Subjects With Rheumatoid Arthritis, Crohn's Disease, Ulcerative Colitis, or Atopic Dermatitis: Population Analyses of Phase 1 and 2 Clinical Trials. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Pharmacokinetic Characteristics of Tofacitinib in Adult Patients With Moderate to Severe Chronic Plaque Psoriasis. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Phase IIb dose-ranging study of the oral JAK inhibitor tofacitinib (CP-690,550) or adalimumab monotherapy versus placebo in patients with active rheumatoid arthritis with an inadequate response to disease-modifying antirheumatic drugs. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Population Pharmacokinetics of Tofacitinib in Patients With Moderate to Severe Ulcerative Colitis. [2021]

6. Switzerland pubmed.ncbi.nlm.nih.gov

[Pharmacovigilance update]. [2015]

7. Germany pubmed.ncbi.nlm.nih.gov

Adverse drug reactions in infants, children and adolescents exposed to antidepressants: a French pharmacovigilance study. [2021]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Cutaneous adverse drug reactions to psychotropic drugs and their risk factors - a case-control study. [2019]

9. New Zealand pubmed.ncbi.nlm.nih.gov

Psychiatric Disorders and Montelukast in Children: A Disproportionality Analysis of the VigiBase(®). [2021]

10. United States pubmed.ncbi.nlm.nih.gov

A Boxed Warning for Montelukast: The FDA Perspective. [2021]

11. England pubmed.ncbi.nlm.nih.gov

Addition of an NK1 receptor antagonist to an SSRI did not enhance the antidepressant effects of SSRI monotherapy: results from a randomized clinical trial in patients with major depressive disorder. [2022]

12. England pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of aprepitant after single and multiple oral doses in healthy volunteers. [2018]

13. United States pubmed.ncbi.nlm.nih.gov

Antiemetic studies on the NK1 receptor antagonist aprepitant. [2019]

14. Germany pubmed.ncbi.nlm.nih.gov

Efficacy benefit of an NK1 receptor antagonist (NK1RA) in patients receiving carboplatin: supportive evidence with NEPA (a fixed combination of the NK1 RA, netupitant, and palonosetron) and aprepitant regimens. [2018]

15. India pubmed.ncbi.nlm.nih.gov

A Comparison of the Efficacy of 5 mg Olanzapine and Aprepitant in the Prevention of Multiple-Day Cisplatin Chemotherapy-Induced Nausea and Vomiting. [2022]