Evidence map›Paper›PMID 36151855›Full record

Trial reportNeuropsychopharmacology reports2022

Central monitoring of depression and anxiety symptoms reduces placebo responses in depression clinical trials: A post hoc exploratory analysis of data from the phase III CCT-004 trial of vortioxetine.

Yoshinori Watanabe, Akira Nishimura, Toshiaki Kikuchi, Norifusa Sawada, Manami Imazaki, Isao Inada, Koichiro Watanabe

Abstract readClinical Trial, Phase III
In one paragraph

Trial report in Neuropsychopharmacology reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yoshinori WatanabeHimorogi Psychiatric Institute, Tokyo, Japan.
Akira NishimuraPharmaceutical Development Division, Towa Pharmaceutical Co., Ltd., Osaka, Japan.ORCID 0000-0003-2064-8421
Toshiaki KikuchiDepartment of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Norifusa SawadaMental and Sleep Disorder Clinic of Narimasu, Tokyo, Japan.
Manami ImazakiNeuroscience Therapeutic Area Strategy Unit, Takeda Development Center Japan, Takeda Pharmaceutical Company Limited, Osaka, Japan.
Isao InadaNeuroscience Therapeutic Area Strategy Unit, Takeda Development Center Japan, Takeda Pharmaceutical Company Limited, Osaka, Japan.
Koichiro WatanabeDepartment of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimClinical trials of antidepressants often fail to demonstrate their efficacy versus placebo, suggesting that patient selection based on physician ratings of depression may contribute to a high placebo response.

methodsIn the CCT-004 trial of vortioxetine, central monitoring was employed to compare physician and patient ratings of depression and anxiety at baseline and over time to identify factors contributing to a large placebo response, as well as to explore the potential of a unique patient-rated clinical measure combining QIDS-J and Himorogi Self-rating Anxiety Scale (HSAS), to contribute to optimal patient selection at baseline and patient monitoring over time.

resultsThe CCT-004 trial showed similar trends between the QIDS-J and MADRS (Montgomery-Åsberg Depression Rating Scale) ratings. It was suggested that central monitoring of the QIDS-J and MADRS ratings of depression and anxiety symptoms helped reduce the baseline score inflation by calling the study sites' attention to discrepancies between these ratings at baseline; it also allowed these ratings to be assessed for their concordance over time. Of note, MDD patients with baseline QIDS-J scores ≥11/HSAS ≤19 were associated with the smallest placebo response, with the effect size being larger than that for those with QIDS-J scores ≤10/HSAS ≥20.

conclusionThe use of both physician and patient ratings of depression and anxiety symptoms at baseline and over time, as well as their central monitoring, helped minimize the baseline score inflation and optimize patient monitoring over time, and allowed the antidepressant to be evaluated for its full therapeutic potential.

Indexed as

DepressionMajor Depressive DisorderAntidepressive AgentsAnxietyDouble-Blind MethodHumansPiperazinesSulfidesVortioxetineAntidepressive AgentsPiperazinesSulfidesVortioxetineanxietydrug monitoringmajor depressive disorderplacebo effectrandomized controlled trials

Identifiers

PMID36151855
PMCPMC9773757

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.