This is a multicenter, randomized, double-blind, placebo- and active-controlled study to assess the efficacy and safety of CD-008-0045 in patients with generalized anxiety disorder (GAD). Each patient will participate in the study for the period of approximately 37 weeks: Screening and Run-in period: 1 week; Study Treatment period: 32 weeks; Follow-up period: 4 weeks.
The study drug CD-008-0045 has a multi-targeted activity, i.e., able to inhibit adrenergic, dopamine, serotonin, and histamine receptors, thus allowing to assume its wide therapeutic potential. At Screening, the patients who meet the inclusion/exclusion criteria will be included into one-week single-blind Placebo Run-in period. At Week 0 the patients will be start double-blind Placebo and active comparator treatment period. The patients will be randomized to receive CD-008-0045 40 mg daily or Placebo or Afobazol (fabomotizole) for 8 weeks. After that, there will be an open-label treatment period for 26 weeks. The potential withdrawal syndrome will be assessed during four-week Follow-up Period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
200
CD-008-0045 20 mg capsules
Placebo capsules
Afobazol 10 mg tabletes
Change in total score of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) at Week 8 from baseline.
Mean change of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) score \[the values from 0 to 56; the higher scores mean a worse outcome\] \[score\]
Time frame: Baseline to Week 8
The frequency of decrease in total score of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) by 50% or more at week 8 from baseline
Proportion of patients who demonstrate ≥ 50% decrease of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) \[the values from 0 to 56; the higher scores mean a worse outcome\] total score from baseline \[% of patients\]
Time frame: Baseline to Week 8
Change in total score and sum of scores of the subscales for assessment of the mental and somatic anxiety of the Hamilton Anxiety Rating Scale (SIGH-A) structured interview for each parameter at Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Mean change of the score sum of the mental and somatic anxiety subscales of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) \[the values from 0 to 24 (the mental subscale) and from 0 to 32 (the somatic subscale); the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Change of score of items 1 (Anxious mood) and 2 (Tension) of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) from baseline at Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Mean change of the score in items 1 (Anxious mood) and 2 (Tension) of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) \[the values from 0 to 4; the higher scores mean a worse outcome\] \[score\]
Time frame: Baseline to Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Proportion of patients who reached a medically induced remission (the sum of scores of the SIGH-A ≤ 7) at Week 8 and Week32
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Proportion of patients with the sum of scores of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) ≤ 7 at Week 8 and Week32
Time frame: Baseline to Week 8 and Week 32
Changes in the sum of scores of the Montgomery-Asberg Depression Rating Scale (MADRS) at Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32 from baseline
Mean change of the Montgomery-Asberg Depression Rating Scale (MADRS) \[the values from 0 to 54; the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Change in the Clinical Global Impression-Severity (CGI-S) at Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32 from baseline
Mean change of the Clinical Global Impression-Severity (CGI-S) score \[the values from 1 to 7; the higher scores mean a worse outcome\] \[score\]
Time frame: Time Frame: Baseline to Week 2, Week 2 to Week 4, Week 4 to Week 8, Week 8 to Week 16, Week 16 to Week 24, Week 24 to Week 32
Change in the Clinical Global Impression-Improvement (CGI-I) at Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Mean change of the Clinical Global Impression-Improvement (CGI-I) score \[the values from 1 to 7; the higher scores mean a worse outcome\] \[score\]
Time frame: Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Change of daytime somnolence level based on Visual Analogue Scale (VAS)
Mean change of the Visual Analogue Scale (VAS) \[the values from 0 to 10; the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Week 2, Week 4, Week 8, Week 16, Week 24 and Week 32
Change in total score of the Visual Analog Sheehan Disability Scale (SDS) at Week 8, Week 16, Week 24 and Week 32 from baseline
Mean change of the Visual Analog Sheehan Disability Scale (SDS) score \[the values from 0 to 10; the higher scores mean a worse outcome\] \[score\]
Time frame: Baseline to Week 8, Week 16, Week 24 and Week 32
Change in results of the Trail Making Test (TMT) at Week 4, Week 8, Week 16, Week 24 and Week 32 from baseline
Mean change of the Trail Making Test (TMT) results
Time frame: Baseline to Week 4, Week 8, Week 16, Week 24 and Week 32
Change in total score of the Quality of Life Scale (SF-20) at Week 8, Week 16, Week 24 and Week 32 from baseline
Mean change of the Quality of Life Scale (SF-20) \[the values from 0 to 78; the higher scores mean a better outcome\]
Time frame: Baseline to Week 8, Week 16, Week 24 and Week 32
Change in total score of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) at Week 4 after the last dose of therapy and baseline
Mean change of the Hamilton Anxiety Rating Scale structured interview (SIGH-A) \[the values from 0 to 56; the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Weeks 4 after the last dose of therapy. The last dose of therapy to 4 Weeks after that
Change in total score of the Montgomery-Asberg Depression Rating Scale (MADRS) at Week 4 after the last dose of therapy and baseline
Mean change of the Montgomery-Asberg Depression Rating Scale (MADRS) \[the values from 0 to 54; the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Weeks 4 after the last dose of therapy. The last dose of therapy to 4 Weeks after that
Change in the Clinical Global Impression-Severity (CGI-S) score at Week 4 after the last dose of therapy and baseline
Mean change of the Clinical Global Impression-Severity (CGI-S) \[the values from 1 to 7; the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Weeks 4 after the last dose of therapy. The last dose of therapy to 4 Weeks after that
Change in total score of the Visual Analog Sheehan Disability Scale (SDS) at Weeks 4 after the last dose of therapy and baseline
Mean change of the Visual Analog Sheehan Disability Scale (SDS) \[the values from 0 to 10; the higher scores mean a worse outcome\] score \[score\]
Time frame: Baseline to Weeks 4 after the last dose of therapy. The last dose of therapy to 4 Weeks after that
Change in the Clinical Global Impression-Improvement (CGI-I) at Weeks 4 after the last dose of therapy
Mean change of the Clinical Global Impression-Improvement (CGI-I) \[the values from 1 to 7; the higher scores mean a worse outcome\] score \[score\]
Time frame: The last dose of therapy to 4 Weeks after that
Concentration of CD-008-0045 and its metabolite М1 1 hour after first dose of the study drug and before next doses at visits (Ctrough)
Ctrough of CD-008-0045 \[ng/ml\], Ctrough of M1 \[ng/ml\]
Time frame: [Time Frame: Week 4, Week 8]
Impact of CYP2D6 polymorphism on the pharmacokinetic values of the study drug
CYP2D6 polymorphism \[type of metabolism\], Ctrough of CD-008-0045 \[ng/ml\], Ctrough of M1 \[ng/ml\]
Time frame: [Time Frame: Week 4, Week 8]