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Vortioxetine

Phase 3

Depressive Disorder, Major | Small molecule | Other |Takeda Pharmaceutical Company Limited|Last Updated: Sep 22, 2022

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-BlindCONTROLLEDDMCBiomarker
Total Trials7
Total Enrollment4,505
FDA Designations
No designations recorded
Clinical Trials (7)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02709655Active Reference (Fluoxetine) Fixed-dose Study of Vortioxetine in Paediatric Participants Aged 7 to 11 Years With Major Depressive Disorder (MDD)PHASE3 COMPLETED 683May 18, 2016Jan 21, 2022Sep 22, 202298 United States, Bulgaria +17
NCT01152996Safety and Tolerability of Vortioxetine (LuAA21004) - Open Label Extension StudyPHASE3 COMPLETED 1,075Sep 1, 2010May 1, 2013May 28, 2014 -
NCT01179516Safety and Efficacy Study of Vortioxetine (Lu AA21004) in Adults With Major Depressive DisorderPHASE3 COMPLETED 469Aug 1, 2010Jun 1, 2012Dec 18, 201361 United States
NCT01163266Efficacy and Safety Study of Vortioxetine (Lu AA21004) in Adults With Major Depressive DisorderPHASE3 COMPLETED 462Jul 1, 2010Jan 1, 2012Dec 18, 201339 United States
NCT01153009Safety and Efficacy of Vortioxetine (Lu AA21004) in Adults With Major Depressive DisorderPHASE3 COMPLETED 614Jun 1, 2010Mar 1, 2012Dec 18, 201356 United States
NCT01564862Efficacy of Lu AA21004 on Cognitive Dysfunction in Major Depressive DisorderPHASE2 COMPLETED 602Apr 1, 2012Feb 1, 2014Feb 5, 201592 United States, Bulgaria +5
NCT01255787Efficacy and Safety Study of Vortioxetine (Lu AA21004) for Treatment of Major Depressive DisorderPHASE2 COMPLETED 600Nov 1, 2010Apr 1, 2012Dec 18, 201370 Croatia, Finland +14
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Study Endpoints
Primary Endpoints
Change From Baseline in Children Depression Rating Scale - Revised (CDRS-R) Total Score at Week 8 of Phase B
Baseline (Week 4 of Phase A), Week 8 of Phase B

The CDRS-R is a clinician-rated scale to measure the severity of depression in children and adolescents. The CDRS-R was rated by a clinician following interviews with the child and parent and consisted of 17 items out of which 3 items rated nonverbal observations (listless speech, hypoactivity, and depressed affect). Fourteen items were rated on a 7-point scale from 1 to 7, and 3 items (sleep disturbance, appetite disturbance, and listless speech) were scored on a 5-point scale from 1 to 5. A rating of 1 indicated normal functioning and a higher number indicated a greater degree of depression. The total score ranged from 17 (normal) to 113 (severe depression). Least square (LS) mean was estimated using a restricted maximum likelihood (REML)-based Mixed Model Repeated Measurements (MMRM) approach.

Number of Participants With Treatment-Emergent Adverse Events at a Frequency Threshold of ≥5%
Over the 52 week period

Treatment-emergent adverse events (TEAE) are adverse events with an onset that occurs after receiving study drug and within 30 days after receiving the last dose of study drug. A TEAE may also be a pretreatment adverse event or a concurrent medical condition diagnosed prior to the date of first dose of study drug that increases in severity after the start of dosing.

Number of Participants With Serious Treatment-Emergent Adverse Events
Over the 52 week period

Serious treatment-emergent adverse events (serious-TEAE) are adverse events with an onset that occurs after receiving study drug and within 30 days after receiving the last dose of study drug. A serious-TEAE may also be a pretreatment adverse event or a concurrent medical condition diagnosed prior to the date of first dose of study drug that increases in severity after the start of dosing. Serious Adverse Events include adverse events that result in death, require either inpatient hospitalization or the prolongation of hospitalization, are life-threatening, result in a persistent or significant disability/incapacity or result in a congenital anomaly/birth defect. Other important medical events, based upon appropriate medical judgment, may also be considered serious adverse events if a trial participant's health is at risk and intervention is required to prevent an outcome mentioned.

Treatment-Emergent Adverse Events Leading to Study Discontinuation
Over the 52 week period

Treatment-emergent adverse events are adverse events with an onset that occurs after receiving study drug and within 30 days after receiving the last dose of study drug. A TEAE may also be a pre-treatment adverse event or a concurrent medical condition diagnosed prior to the date of first dose of study drug that increases in severity after the start of dosing.

Change From Baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) Total Score
Baseline and Week 8

The MADRS is a depression rating scale consisting of 10 items, each rated 0 (normal) to 6 (most abnormal). The 10 items represent the core symptoms of depressive illness. The overall score ranges from 0 (symptoms absent) to 60 (severe depression). A decrease in the total score or on individual items indicates improvement. Least squares (LS) means are from a mixed model for repeated measurements (MMRM) analysis of covariance (ANCOVA) with treatment, center, week, treatment-by-week interaction, Baseline MADRS total score-by-week as fixed effects.

Change From Baseline in the Montgomery-Åsberg Depression Rating Scale (MADRS) Total Score
Baseline and Week 8

The MADRS is a depression rating scale consisting of 10 items, each rated 0 (normal) to 6 (most abnormal). The 10 items represent the core symptoms of depressive illness. The overall score ranges from 0 (symptoms absent) to 60 (severe depression). A decrease in the total score or on individual items indicates improvement. Least squares (LS) means are from a mixed model for repeated measurements (MMRM) analysis of covariance (ANCOVA) with treatment, center, week, treatment-by-week interaction, Baseline MADRS total score-by-week as fixed effects.

Change From Baseline to Week 8 in the Digit Symbol Substitution Test (DSST)
Baseline and Week 8

The DSST assesses relative contributions of speed, memory, executive function and visual scanning. Participants are required to copy symbols that are paired with simple geometric shapes or numbers within a specific time for a total possible score of 0 to 133. Higher scores-correct number of symbols reflects greater objective cognitive functioning. An increase in score represents an improvement in an integrated measure of cognitive function. An Analysis of Covariance (ANCOVA) model was used with treatment and center as fixed factors and the Baseline value as a covariate.

Secondary Endpoints
Change From Baseline in CDRS-R Total Score at Weeks 2, 4, and 6 of Phase B
Baseline (Week 4 of Phase A), Weeks 2, 4, and 6 of Phase B
Change From Baseline in CDRS-R Subscores (Mood, Somatic, Subjective, and Behaviour) at Weeks 2, 4, 6, and 8 of Phase B
Baseline (Week 4 of Phase A), Weeks 2, 4, 6, and 8 of Phase B
Percentage of Participants With CDRS-R Response
Weeks 2, 4, 6, and 8 of Phase B
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Vortioxetine 10 mg/dayEXPERIMENTAL -
Vortioxetine 20 mg/dayEXPERIMENTAL -
Fluoxetine 20 mg/day,ACTIVE_COMPARATORA decision has been taken to stop recruitment into this treatment arm.
PlaceboPLACEBO_COMPARATOR -
VortioxetineEXPERIMENTALVortioxetine 10 mg, capsules, orally, once daily for the first week of treatment; then vortioxetine up-titrated to 15 mg or 20 mg, capsules, orally, once daily for up to 51 weeks.
Vortioxetine 10 mgEXPERIMENTALVortioxetine 10 mg, encapsulated tablets, orally, once daily for up to 8 weeks.
Vortioxetine 15 mgEXPERIMENTALVortioxetine 10 mg, encapsulated tablets, orally, once daily for one week, then vortioxetine 15 mg, encapsulated tablets, orally, once daily for up to 7 weeks.
Vortioxetine 20 mgEXPERIMENTALVortioxetine 10 mg, encapsulated tablets, orally, once daily for one week then vortioxetine 20 mg, encapsulated tablets, orally, once daily for up to 7 weeks.
Duloxetine 60 mgACTIVE_COMPARATORDuloxetine 30 mg capsules, orally, once daily for one week then duloxetine 60 mg, capsules, orally, once daily for 7 weeks, then duloxetine 30 mg capsules, once daily, for one week.
Vortioxetine (Lu AA21004) QDEXPERIMENTALVortioxetine (Lu AA21004) 10 mg, capsules, orally, once daily for one week; then dose adjustment to a maximum 20 mg, capsules, orally, once daily for up to 7 weeks.
Duloxetine QDACTIVE_COMPARATORDuloxetine 60 mg, capsules, orally, for up to 8 weeks. Duloxetine 30 mg, capsule, orally, once daily for 1 week taper-down period.
Placebo QDPLACEBO_COMPARATORPlacebo matching capsules, orally, once daily for up to 9 weeks (includes 1 week taper down period).
Vortioxetine 5 mgEXPERIMENTALVortioxetine 5 mg, tablets, orally, once daily for 8 weeks, followed by vortioxetine placebo-matching tablets, orally, once daily for 2 weeks.
Interventions
NameTypeDescription
Vortioxetine 10 mg/dayDRUG10 mg/day, encapsulated tablet, orally (with addition of lower initial dose levels). Based on tolerability the dose may be reduced by 5 mg/day. No dose increase will be allowed
Vortioxetine 20 mg/dayDRUG20 mg/day, encapsulated tablet, orally (with addition of lower initial dose levels). Based on tolerability the dose may be reduced by 5 mg/day. No dose increase will be allowed
Fluoxetine 20mg/dayDRUG20 mg/day, encapsulated tablet, orally (with addition of lower initial dose levels). Based on tolerability the dose may be reduced by 10 mg/day. No dose increase will be allowed
PlaceboOTHEREncapsulated tablet, orally
VortioxetineDRUGVortioxetine tablets
DuloxetineDRUGOverencapsulated duloxetine delayed-release capsules
vortioxetine (Lu AA21004)DRUGLu AA21004 capsules
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Eligibility Criteria
Age Range7 Years — 11 Years
SexALL
Healthy VolunteersNo
Study Sites98

Inclusion Criteria: 1. The participant has MDD, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5™). 2. The participant has a CDRS-R total score ≥45 at the Screening Visit and the Baseline. 3. The participant has a CGI-S score ≥4 at the Screening Visit...

Countries:United StatesBulgariaCanadaColombiaEstoniaFranceGermanyHungaryIsraelItalyLatviaMexicoPolandRussiaSerbiaSouth AfricaSouth KoreaSpainUkraineFinlandCroatiaHong KongIndiaJapanMalaysiaPhilippinesRomaniaTaiwan
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