Open-label study presented at Psych Congress 2018 assessed a promising patient-centered approach that could provide new insights about patients being treated for depression
Deerfield, IL, October 26, 2018– Takeda Pharmaceuticals U.S.A., Inc. (“Takeda”) and Lundbeck, today announced results from an open-label study that evaluated the development and assessment of personalized goals as a way of measuring treatment effectiveness in major depressive disorder (MDD), commonly known as depression. Patients enrolled in the study had switched to TRINTELLIX® (vortioxetine) for treatment of their depression. Patients were considered appropriate for a change in antidepressant medication based on investigator judgement in collaboration with the patient. Some of the reasons for switching medications included inadequate response and tolerability issues.
The results were presented at Psych Congress 2018 in Orlando, Florida on Friday, October 26 during a poster session, and are also being featured in the poster gala from 5:30-7:30 p.m. EST. On Saturday, October 27, the results will be presented during a poster session from 1:30-2:30 p.m. EST.
In the study, the majority of patients successfully reached their personalized treatment goals by week 12 based on predefined study criteria. The study used an assessment tool called the Goal Attainment Scale Adapted for Depression (GAS-D), to quantify how well people living with depression, who switched to the antidepressant TRINTELLIX, achieved their personalized treatment goals. Some examples of these goals included enjoying time with family, making time for self-care, increasing social interaction, and working on hobbies. Additional studies are needed to confirm the outcomes observed in this open-label study.
“This is the first study to use the Goal Attainment Scale as a primary outcome measure in MDD patients, although the scale has been used in clinical care and program assessment for other medical and non-medical indications. It’s a patient-centered approach that encourages a patient to work with their healthcare provider to identify the individual treatment outcomes that are most meaningful to them,” said Dr. David Hellerstein, GAS Clinical Investigator and Professor of Clinical Psychiatry, Columbia University Department of Psychiatry. “It’s a useful way to engage patients more fully in their treatment, since these personalized outcomes may be more meaningful than traditional outcomes like sleep or appetite.”
“In addition to evaluating management of the symptoms of depression, it is also important that Takeda and our partner Lundbeck focus on patient-centric methods to gauge the real impact of this illness on the lives of those affected. Developing individual treatment goals that matter most to the patient, and then closely monitoring those goals to assess progress in therapy was the focus of this study,” said Dr. Louis Mini, Medical Head, Neuroscience, U.S. Medical Office, Takeda. “Continuing down this path of patient-centricity and fostering good patient-clinician engagement will be key factors to advancing the understanding of major depressive disorder.”
About the Study
In the open-label study, adult patients with acute MDD requiring a switch in antidepressant treatment were given flexibly dosed TRINTELLIX (10-20mg) for 12 weeks. Successful attainment of pre-identified goals (primary outcome) was defined as a GAS-D score of ≥50 at week 12. Assessments of mood (PHQ-9), clinician’s global impression of illness severity (CGI-S), cognitive function (PDQ-D), cognitive performance (DSST), functional capacity (VRFCAT), quality of life/life satisfaction (Q-LES-Q), work functioning (LEAPS), emotional well-being (WHO-5) and healthcare resource utilization were completed at week 12.
For the primary endpoint, 57.8% of patients who completed the study (109/116) achieved a GAS-D score of ≥50 at week 12. Measures of depression severity (PHQ-9), cognitive function (PDQ-D), cognitive performance (DSST), emotional well-being (WHO-5), and clinician’s global impression of illness severity (CGI-S) showed statistically significant improvements from baseline at 6 and 12 weeks. Additionally, significant improvements were noted at week 12 from baseline for work function (LEAPS), quality of life/life satisfaction (Q-LES-Q) and Q-LES-Q subscale scores assessing physical health/activity, feelings, work, household duties, leisure time activities, social relations, and general activities. Numerical improvement was observed at week 12 on measures of functional capacity (VRFCAT) but was not statistically significant. No significant increases in number of health care provider visits, hospitalizations, or sick days were observed. Patients with any treatment emergent adverse event (AE) was 68%. Most common AEs were nausea (21%), headache (9%), anxiety (7%), constipation (6%) and diarrhea (6%).
About Major Depressive Disorder (MDD)
MDD is a complex mental health illness that affects approximately 16 million people annually. Also known as clinical depression, MDD is the leading cause of disability worldwide and a major contributor to the overall global burden of disease. MDD may trigger emotional, cognitive and physical symptoms, which includes depressed mood, loss of interest or pleasure, significant weight loss or gain or change in appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, or indecisiveness, and recurrent suicidal ideation.
About TRINTELLIX (vortioxetine)
The mechanism of the antidepressant effect of TRINTELLIX is not fully understood. It is an inhibitor of serotonin (5-HT) reuptake and that is thought to be a mechanism of its action. It is also an agonist at 5-HT1A receptors, a partial agonist at 5-HT1B receptors and an antagonist at 5-HT3, 5-HT1D and 5-HT7 receptors. The contribution of each of these activities to TRINTELLIX’s antidepressant effect has not been established. It is considered to be the first and only compound with this combination of pharmacodynamic activity. The clinical relevance of this is unknown.
The most commonly observed adverse events in MDD patients treated with TRINTELLIX in 6-8 week placebo-controlled studies (incidence greater than or equal to 5 percent and at least twice the rate of placebo) were nausea, constipation and vomiting. Overall, 5 to 8 percent of the patients who received TRINTELLIX 5 to 20 mg/day in short-term trials discontinued treatment due to an adverse reaction, the most common being nausea, compared with 4 percent of placebo-treated patients in these studies. TRINTELLIX and other antidepressants may cause serious side effects. See Important Safety Information below.
Voluntary reports of sexual dysfunction with TRINTELLIX in 6-8 week controlled trials were <5%. Because voluntary reports of sexual dysfunction are known to be underreported, a separate, self-rated questionnaire was provided to patients prospectively in TRINTELLIX clinical studies. When assessed proactively in patients without sexual dysfunction at baseline, reports of treatment emergent sexual dysfunction across doses 5 mg, 10 mg, 20 mg were 16%, 20%, 29% in males (N=212) respectively and females 22%, 23% and 34% (N=226) respectively, compared to 14% (N=162) and 20% (N=135), respectively, in placebo.
In clinical studies, TRINTELLIX had no significant effect on body weight as measured by the mean change from baseline in 6-8 week placebo-controlled studies. In the 6-month, double-blind, placebo-controlled phase of a long-term study in patients who had responded to TRINTELLIX during the initial 12-week, open-label phase, there was no significant effect on body weight between TRINTELLIX and placebo-treated patients. Some reports of weight gain have been received since product approval. TRINTELLIX has not been associated with any clinically significant effects on vital signs, including systolic and diastolic blood pressure and heart rate, as measured in placebo-controlled studies.
TRINTELLIX was discovered by Lundbeck researchers in Copenhagen, Denmark. The clinical trial program in the U.S. was conducted jointly by Lundbeck and Takeda, and Takeda holds the new drug application for the U.S. market. TRINTELLIX is a trademark of H. Lundbeck A/S and is used under license by Takeda Pharmaceuticals U.S.A., Inc. For more information, visit www.Trintellix.com.
The World Health Organization has issued an Anatomical Therapeutic Chemical (ATC) code for TRINTELLIX that places it in the category of “Other” antidepressants.
The recommended starting dose of TRINTELLIX is 10 mg once daily without regard to meals. The dose should then be increased to 20 mg/day, as tolerated, because higher doses demonstrated better treatment effects in trials conducted in the U.S. A dose decrease down to 5 mg/day may be considered for patients who do not tolerate higher doses. The available doses provide important flexibility for physicians to help address the variability of patient needs.
TRINTELLIX is available as 5 mg, 10 mg and 20 mg tablets.
IMPORTANT SAFETY INFORMATION
Suicidal Thoughts and Actions and Antidepressant Drugs
Antidepressants may increase suicidal thoughts or actions in some children, teens or young adults within the first few months of treatment or when the dose is changed. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. People who have (or have a family history of) bipolar illness, or suicidal thoughts or actions may have a particularly high risk. Pay close attention to any changes, especially sudden changes in mood, behavior, thoughts or feelings. Call your healthcare provider right away if symptoms such as anxiety, irritability, impulsivity, trouble sleeping, aggressive behavior or suicidal thoughts are new, worse or worry you. TRINTELLIX has not been evaluated for use in patients under 18.
Do not take TRINTELLIX if you:
TRINTELLIX may cause serious side effects including:
Serotonin Syndrome: A potentially life-threatening problem that can happen when medicines such as TRINTELLIX are taken with certain other medicines. Symptoms may include agitation, hallucinations, coma or other changes in mental status; problems controlling movements or muscle twitching, stiffness or tightness; fast heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting or diarrhea.
Abnormal bleeding or bruising: TRINTELLIX and other serotonergic antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin.
Manic episode: Symptoms may include greatly increased energy; severe trouble sleeping; racing thoughts; reckless behavior; unusually grand ideas; excessive happiness or irritability; talking more or faster than usual.
Visual problems: May include eye pain, changes in vision, swelling or redness in or around the eye. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.
Low salt (sodium) levels in the blood: Symptoms may include headache; difficulty concentrating, memory changes or confusion; weakness and unsteadiness on your feet; and in severe or sudden cases hallucinations, fainting, seizures or coma. If not treated, severe low sodium levels can cause death.
Before starting TRINTELLIX, tell your healthcare provider if you have or had liver problems, seizures or convulsions, bipolar disorder (manic depression) or mania, low salt (sodium) levels in your blood, bleeding problems, drink alcohol, have any other medical conditions or if you are pregnant, nursing, plan to become pregnant, or plan to nurse.
TRINTELLIX and some medicines may interact with each other, may not work as well, or may cause serious side effects when taken together. Tell your healthcare provider if you plan on or are taking any other prescription and non-prescription medicines, vitamins and herbal supplements including medicines for migraine headaches, such as triptans; medicines used to treat mood, anxiety, psychotic or thought disorders such as tricyclics, lithium, SSRIs, SNRIs, bupropion, buspirone or antipsychotics; MAOIs including linezolid (a specific antibiotic); over-the-counter supplements such as tryptophan or St. John's wort; and the following medicines: aspirin, NSAIDs, warfarin (Coumadin®, Jantoven®), diuretics, rifampin, carbamazepine, phenytoin, quinidine, tramadol or fentanyl.
Common side effects of TRINTELLIX include: nausea, constipation or vomiting. These are not all the possible side effects of TRINTELLIX.
Do not start or stop taking TRINTELLIX without talking to your healthcare provider first. Suddenly stopping TRINTELLIX when you take higher doses may cause you to have side effects including headache, stiff muscles, mood swings, sudden outbursts of anger, dizziness or feeling lightheaded, or runny nose.
Talk to your healthcare provider.
TRINTELLIX is a prescription medicine used to treat Major Depressive Disorder (MDD) in adults.
About Takeda Pharmaceutical Company Limited
Takeda Pharmaceutical Company Limited (TSE: 4502) is a global, research and development-driven pharmaceutical company committed to bringing better health and a brighter future to patients by translating science into life-changing medicines. Takeda focuses its R&D efforts on oncology, gastroenterology and neuroscience therapeutic areas plus vaccines. Takeda conducts R&D both internally and with partners to stay at the leading edge of innovation. Innovative products, especially in oncology and gastroenterology, as well as Takeda’s presence in emerging markets, are currently fueling the growth of Takeda. Around 30,000 Takeda employees are committed to improving quality of life for patients, working with Takeda’s partners in health care in more than 70 countries. For more information, visit https://www.takeda.com/newsroom/.
Takeda Pharmaceuticals U.S.A., Inc. is located in Deerfield, Ill., and is the U.S. marketing and sales organization of Takeda Pharmaceutical Company Limited.
Additional information about Takeda is available through its corporate website, www.takeda.com, and additional information about Takeda Pharmaceuticals U.S.A., Inc. is available through its website, www.takeda.us.
About Takeda Neuroscience
Neuroscience is a core therapeutic area for Takeda. Our mission is to bring innovative medicines to patients suffering from neurologic and psychiatric diseases for whom there are no treatments available. We identify targets either genetically linked with specific neurologic or psychiatric disorders or with high association to the disease pathophysiology, design and operationalize clinical trials in novel ways in an effort to overcome historical challenges, and collaborate with patients, academic institutions, pharmaceutical and biotechnology partners, payors, regulators and prescribers to integrate their unique expertise and perspective. The current Takeda Neuroscience global portfolio consists of five approved medicines, which treat adults with Major Depressive Disorder, Alzheimer’s-type dementia, insomnia, multiple sclerosis, and Parkinson's disease. In addition, there are many assets in clinical development for targeted patient populations.
About H. Lundbeck A/S
H. Lundbeck A/S (LUN.CO, LUN DC, HLUYY) is a global pharmaceutical company specialized in psychiatric and neurological disorders. For more than 70 years, we have been at the forefront of research within neuroscience. Our key areas of focus are Alzheimer's disease, depression, Parkinson's disease and schizophrenia.
Our approximately 5,000 employees in 55 countries are engaged in the entire value chain throughout research, development, manufacturing, marketing and sales. Our pipeline consists of several late-stage development programs and our products are available in more than 100 countries. We have production facilities in Denmark, France and Italy. Lundbeck generated revenue of DKK 17.2 billion in 2017 (EUR 2.3 billion; USD 2.6 billion).
For additional information, visit www.lundbeck.com and connect on Twitter at @Lundbeck.
Lundbeck in the U.S.
In the U.S., Lundbeck employs more than 800 people focused solely on accelerating therapies for brain disorders. With a special commitment to the lives of patients, families and caregivers, Lundbeck U.S. actively engages in hundreds of initiatives each year that support our patient communities.
For additional information, visit www.lundbeckus.com and connect on Twitter at @LundbeckUS.
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