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Desvenlafaxine Sustained-Release

Phase 3

Major Depressive Disorder | Small molecule | Psychiatry |Pfizer, Inc.|Last Updated: Jan 15, 2019

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials5
Total Enrollment2,563
FDA Designations
No designations recorded
Clinical Trials (5)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01372150A Study Of DVS SR In Treatment Of Children And Adolescent Outpatients With MDDPHASE3 COMPLETED 340Nov 17, 2011Mar 20, 2015Jan 15, 201943 United States, Mexico
NCT01371734A Study Of DVS SR In Treatment Of Children And Adolescent Outpatients With MDDPHASE3 COMPLETED 363Aug 1, 2011Sep 1, 2015Mar 20, 201742 United States, Chile +1
NCT00887224Relapse Prevention Study Of Desvenlafaxine Succinate Sustained Release In Outpatients With Major Depressive DisorderPHASE3 COMPLETED 874Jun 1, 2009Mar 1, 2011Nov 21, 201490 United States, Canada +12
NCT00863798Study Evaluating Desvenlafaxine Succinate Sustained Release In Adults With Major Depressive DisorderPHASE3 COMPLETED 682Apr 1, 2009Mar 1, 2010May 6, 201124 United States
NCT00831415Study Evaluating Long-Term Safety of Desvenlafaxine Succinate Sustained Release With Japanese Adult Subjects in Major Depressive Disorder (MDD)PHASE3 COMPLETED 304Mar 1, 2009Mar 1, 2011Dec 7, 201817 Japan
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Study Endpoints
Primary Endpoints
Change From Baseline to Week 8 in the Children's Depression Rating Scale, Revised (CDRS-R) Total Score
Baseline and Week 8

Clinician-rated interview-based scale (with both child and parent or guardian) to assess 17 distinct symptom areas to derive an index of depression severity. Discrepancies between informants' responses were resolved by using most impaired rating given by valid informant. Rated on a 7-point scale; range from 1 (no impairment) to 7 (indicates greater impairment). Total score calculated as sum of the 17 items (range 1 to 119); higher score indicates greater impairment. Adjusted mean presented.

Change From Baseline to Week 8 in the Children's Depression Rating Scale, Revised (CDRS-R) Total Score (n=102, 104, 106)
Baseline and Week 8

Clinician-rated interview-based scale (with both child and parent or guardian) to assess 17 distinct symptom areas to derive an index of depression severity. Discrepancies between informants' responses were resolved by using most impaired rating given by valid informant. Rated on a 7-point scale; range from 1 (no impairment) to 7 (indicates greater impairment). Total score calculated as sum of the 17 items (range 1 to 119); higher score indicates greater impairment. Mean change from baseline was adjusted for the baseline total score, age group and gender.

Time to Relapse Following Randomization to the Double-blind (DB) Phase: Estimated Probability (Percent) of Relapse at DB Day 185
Double-blind phase Baseline (Study Day 140) up to DB Day 185 (Study Day 325)

Time to relapse analyzed using log-rank test; defined as Hamilton Psychiatric Scale for Depression-17 item score ≥16 at any time during DB phase, discontinuation for unsatisfactory response or efficacy (need for additional or alternate treatment for depression, investigator decision to remove participant for efficacy reasons, or failure to return if investigator determined related to efficacy), hospitalization for depression, suicide attempt, or suicide. Participants who relapsed after DB day 185 or completed DB therapy without relapse were considered as censored on DB day 185 (study day 325).

Change From Baseline in HAM-D17 Total Score at Final On-therapy (FOT) Evaluation (Week 8 or ET)
Baseline and Week 8 (or ET)

HAM-D17: a standardized, clinician-administered rating scale that assesses 17 items characteristically associated with major depression. Items are scored on either a 3 point (0 to 2) or a 5 point scale (0 to 4), with 0=none/absent and 4=most severe, for a maximum total score of 50.

Change From Baseline in Hamilton Psychiatric Scale for Depression-17 Item (HAM-D17) Score
Baseline (Extension Study) up to Day 308 or Final On-Therapy (FOT) Evaluation

HAM-D17 is a standardized, clinician-administered rating scale that assesses 17 items characteristically associated with major depression. Items are scored on either a 3-point (0 to 2) or a 5-point scale (0 to 4) with 0=none/absent and 4=most severe, for a maximum total score of 50. Higher scores indicate greater severity. FOT evaluation is defined as the last "on-therapy" evaluation, regardless of the number of days on therapy. Analysis on Observed cases (non-missing data) and Last observation carried forward (LOCF); LOCF method of imputation for any missing value at any visit.

Percentage of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs)
Baseline (Extension Study) up to Day 329 or 15 days after last dose of study treatment

Any untoward medical occurrence in a participant who received study treatment was considered an AE without regard to possibility of causal relationship. An AE resulting in any of the following outcomes, or deemed to be significant for any other reason, was considered to be an SAE: death; initial or prolonged inpatient hospitalization; a life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; or congenital anomaly.

Secondary Endpoints
Change From Baseline to Week 8 in the Clinical Global Impression of Severity (CGI-S) Score
Baseline and Week 8
Percentage of Participants by Clinical Global Impression Improvement (CGI-I) Score at Weeks 1, 2, 3, 4, 6, and 8
Baseline and Weeks 1, 2, 3, 4, 6, and 8
Percentage of Participants With a CGI-I Response Defined as a Score of 'Very Much Improved' or 'Much Improved'
Weeks 1, 2, 3, 4, 6, and 8
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Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
DVS SREXPERIMENTAL -
FluoxetineOTHERActive control for assay sensitivity
PlaceboEXPERIMENTAL -
Experimental Arm 1 - high doseEXPERIMENTAL -
Experimental Arm 2 - low doseEXPERIMENTAL -
Placebo ArmPLACEBO_COMPARATOR -
Desvenlafaxine succinate sustained release 50 mgEXPERIMENTAL -
Desvenlafaxine succinate sustained release 10 mgEXPERIMENTAL -
1EXPERIMENTALDVS SR
Interventions
NameTypeDescription
desvenlafaxine succinate sustained releaseDRUGSubjects randomized to DVS SR group receive 25, 35 or 50 mg/day based on subject weight at the Baseline visit. DVS SR provided as oral tablets.
fluoxetineDRUGSubjects randomized to the fluoxetine group receive 20 mg/day. Fluoxetine provided as oral capsules
placeboDRUGSubjects randomized to the placebo group receive corresponding placebo tablets and/capsules
Desvenlafaxine Succinate Sustained-ReleaseDRUGSubjects randomized to DVS SR treatment arm will receive 25, 35, or 50 mg/day based on subject weight at the Baseline visit.
Desvenlafaxine succinate sustained release 50 mgDRUG50 mg tablet, once daily. 5 months open-label duration for all enrolled subjects; additional 6 months double-blind duration for randomized subjects assigned to this arm.
Desvenlafaxine succinate sustained release 25 mgDRUG25 mg tablet for taper, once daily for 1 week
Desvenlafaxine Succinate Sustained-Release 10mgDRUG10 mg tablet, once daily dosing for 8 weeks
Desvenlafaxine Succinate Sustained-Release 50 mgDRUG50 mg tablet, once daily dosing for 8 weeks
desvenlafaxine succinate sustained release tabletsDRUG25-mg or 50-mg DVS SR tablets taken orally, once daily, at the same time each day. 100 mg dose will be supplied as 2 tablets of 50-mg tablet.
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Eligibility Criteria
Age Range7 Years — 17 Years
SexALL
Healthy VolunteersNo
Study Sites43

Inclusion Criteria: * Age \>=7 and \<18 years of age * Primary diagnosis of major depressive disorder (MDD) * CDRS-R score \>40 Exclusion Criteria: * History of suicidal behaviour, or requires precaution against suicide * Not in generally healthy medical condition * History of psychosis or bipola...

Countries:United StatesMexicoChileCanadaColombiaCroatiaEstoniaFinlandFranceLatviaLithuaniaPolandRomaniaSlovakiaSouth AfricaJapan
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