Clinical trial • Phase III • Psychiatry

9-(4-CYCLOHEXYLOXYPHENYL)-7-METHYL-3,4-DIHYDROPYRAZINO[2,1-C][1,2,4]THIADIAZINE 2,2-DIOXIDE for Major depressive disorder

Phase III trial of 9-(4-CYCLOHEXYLOXYPHENYL)-7-METHYL-3,4-DIHYDROPYRAZINO[2,1-C][1,2,4]THIADIAZINE 2,2-DIOXIDE for Major depressive disorder.

Overview

Trial Therapeutic Area
Psychiatry
Trial Disease
Major depressive disorder
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
26-02-2025
First CTIS Authorization Date
18-06-2025

Trial design

Randomised, placebo (identical to nbi-1065845 tablets without active drug); active comparator: nbi-1065845 oral tablet (dose and dosing schedule not specified in the ctis record).-controlled Phase III trial in Croatia, Czechia, Poland.

Randomised
Yes
Comparator
Placebo (Identical to NBI-1065845 tablets without active drug); active comparator: NBI-1065845 oral tablet (dose and dosing schedule not specified in the CTIS record).
Target Sample Size
118
Trial Duration For Participant
56

Eligibility

Recruits 118 Vulnerable population selected in CTIS. Participation requires completed informed consent; all participants are adults (≥18 years). Country-specific informed consent documents and related materials are listed in the dossier (subject information and ICFs for Poland, Croatia, Czechia, pregnancy-specific ICFs, GDPR and audio-recording ICFs)..

Pregnancy Exclusion
9.Pregnant (ie, positive pregnancy test at screening or baseline) or lactating or plans to become pregnant during the study.
Vulnerable Population
Vulnerable population selected in CTIS. Participation requires completed informed consent; all participants are adults (≥18 years). Country-specific informed consent documents and related materials are listed in the dossier (subject information and ICFs for Poland, Croatia, Czechia, pregnancy-specific ICFs, GDPR and audio-recording ICFs).

Inclusion criteria

  • {"criterion_text":"- 1. Completed informed consent.\n- 2.≥18 years of age at the time of signing the informed consent.\n- 4.The subject has a primary diagnosis of recurrent MDD (moderate or severe) or persistent depressive disorder. The MDD diagnosis must be confirmed using the Mini-International Neuropsychiatric Interview (MINI) in a face-to-face evaluation.\n- 5.The subject must be receiving oral antidepressant treatment(s) as defined in the protocol.\n- 6.Subject must have an Inadequate Response (IR) to oral antidepressant treatments that were administered as adequate courses (dose, duration, adherence) in the current episode of depression, as assessed using the Massachusetts General Hospital - Antidepressant Treatment Response Questionnaire (MGH-ATRQ).\n- 7.Total Hamilton Depression Rating Scale-17 Item (HAM-D17) score ≥22 at screening and at study baseline (Day 1).\n- 13. Willing and able to comply with all study procedures and restrictions in the opinion of the investigator."}

Exclusion criteria

  • {"criterion_text":"- 1.A current or prior psychiatric disorder diagnosis in the last 1 year that was the primary focus of treatment other than MDD (assessed by the MINI); a comorbid personality disorder that has been evident outside of depressive episodes or that may interfere with participation in the study; or a diagnosis of neurodegenerative disorder (including but not limited to dementia), eating disorder (except binge eating disorder), schizophrenia, schizoaffective disorder, bipolar disorder, MDD with psychotic features or mixed features, intellectual disability, or mental disorder due to a general medical condition as defined in DSM-5.\n- 2.Are considered by the investigator to be at imminent risk of suicide or injury to self or others.\n- 6.The subject’s depressive symptoms have previously demonstrated nonresponse to an adequate course of treatment with electroconvulsive therapy (ECT) in the current major depressive episode, defined as at least 7 treatments with unilateral/bilateral ECT.\n- 9.Pregnant (ie, positive pregnancy test at screening or baseline) or lactating or plans to become pregnant during the study.\n- 10.An unstable medical condition or unstable chronic disease (including history of neurological [including cognitive impairment, myasthenia gravis], hepatic, renal, cardiovascular, gastrointestinal, pulmonary, autoimmune, or endocrine disease that may affect study participation or results) within 3 months before Day 1, or malignancy within 6 months before Day 1.\n- 11.Any laboratory abnormality suggestive of clinically significant, poorly or unmanaged, undiagnosed disease.\n- 12.History of epilepsy, seizures, or convulsions\n- 13.History of neurological abnormalities including brain injury (including traumatic injury), perinatal cerebropathy, and postnatal brain damage, blood- brain barrier abnormality, and cavernous angioma.\n- 20. Any reason that makes the subject unsuitable for participation in this study (eg, subject is homeless, known to have difficulty complying with treatment or medical procedures, known to provide inaccurate medical information, or known to attempt participation in clinical trials inappropriately) per the investigator, Medical Monitor, and/or Sponsor."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary endpoint for this study will be the change from baseline in total MADRS score at Day 56.","definition_or_measurement_approach":"Change from baseline in total Montgomery-Asberg Depression Rating Scale (MADRS) score at Day 56; measured using the MADRS instrument."}

Secondary endpoints

  • {"endpoint_text":"- Change from baseline in SDS total score at Day 56","definition_or_measurement_approach":"Change from baseline in Sheehan Disability Scale (SDS) total score at Day 56; measured using the SDS instrument."}
  • {"endpoint_text":"- Change from baseline in CGI-S score at Day 56","definition_or_measurement_approach":"Change from baseline in Clinical Global Impression-Severity (CGI-S) score at Day 56; measured using the CGI-S instrument."}

Recruitment

Planned Sample Size
118
Recruitment Window Months
24
Consent Approach
Participants must provide completed written informed consent. Subjects are adults (≥18 years). Country-specific ICFs and related subject information documents are provided (documents include main ICFs and versions for Poland, Croatia, Czechia, pregnancy ICFs, GDPR and audio-recording ICFs, participant guides and ID cards), indicating consent materials are available in local languages.

Geography

Total Number Of Sites
23
Total Number Of Participants
82

Croatia

Earliest CTIS Part Ii Submission Date
05-06-2025
Latest Decision Or Authorization Date
11-05-2026
Processing Time Days
340
Number Of Sites
8
Number Of Participants
22

Sites

Site Name
Clinic for psychiatry Sveti Ivan
Department Name
Clinic for Psychiatry
Principal Investigator Name
Igor Filipcic
Principal Investigator Email
igor.filipcic@pbsvi.hr
Contact Person Name
Igor Filipcic
Contact Person Email
igor.filipcic@pbsvi.hr
Site Name
Poliklinika Solmed d.o.o.
Department Name
Poliklinika Solmed
Principal Investigator Name
Vjekoslav Peitl
Principal Investigator Email
vjekoslav.peitl@gmail.com
Contact Person Name
Vjekoslav Peitl
Contact Person Email
vjekoslav.peitl@gmail.com
Site Name
Klinika za psihijatriju Vrapce
Department Name
Affective Disorders
Principal Investigator Name
Porin Makaric
Principal Investigator Email
porin.makaric@bolnica-vrapce.hr
Contact Person Name
Porin Makaric
Site Name
Klinika za psihijatriju Vrapce
Department Name
Biological Psychiatry and Psychogeriatrics
Principal Investigator Name
Ninoslav Mimica
Principal Investigator Email
ninoslav.mimica@bolnica-vrapce.hr
Contact Person Name
Ninoslav Mimica
Site Name
Poliklinika Neuron
Department Name
Polyclinic Neuron
Principal Investigator Name
Neven Henigsberg
Principal Investigator Email
neven.henigsberg@zg.ht.hr
Contact Person Name
Neven Henigsberg
Contact Person Email
neven.henigsberg@zg.ht.hr
Site Name
KBC Zagreb
Department Name
Psychiatry
Principal Investigator Name
Marina Sagud
Principal Investigator Email
msagud@kbc-zagreb.hr
Contact Person Name
Marina Sagud
Contact Person Email
msagud@kbc-zagreb.hr
Site Name
KBC Zagreb
Department Name
Psychiatry
Principal Investigator Name
Alma Mihaljevic-Peles
Principal Investigator Email
almamihaljevic12@gmail.com
Contact Person Name
Alma Mihaljevic-Peles
Contact Person Email
almamihaljevic12@gmail.com
Site Name
Klinika za psihijatriju Vrapce
Department Name
Psychiatry
Principal Investigator Name
Miroslav Herceg
Principal Investigator Email
miroslav.herceg@bolnica-vrapce.hr
Contact Person Name
Miroslav Herceg

Czechia

Earliest CTIS Part Ii Submission Date
05-06-2025
Latest Decision Or Authorization Date
04-05-2026
Processing Time Days
333
Number Of Sites
7
Number Of Participants
24

Sites

Site Name
Medical Services Prague s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Erik Herman
Principal Investigator Email
erik.herman@seznam.cz
Contact Person Name
Erik Herman
Contact Person Email
erik.herman@seznam.cz
Site Name
Clintrial s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Zdeněk Šolle
Principal Investigator Email
zdenek.solle@clintrial.cz
Contact Person Name
Zdeněk Šolle
Contact Person Email
zdenek.solle@clintrial.cz
Site Name
Neuropsychiatrie Petrska s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Aleš Urban
Principal Investigator Email
ordinace@psychiatrie-urban.cz
Contact Person Name
Aleš Urban
Contact Person Email
ordinace@psychiatrie-urban.cz
Site Name
Praglandia s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Radka Šafandová
Principal Investigator Email
r.safand@praglandia.cz
Contact Person Name
Radka Šafandová
Contact Person Email
r.safand@praglandia.cz
Site Name
A-Shine s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Luboš Janů
Principal Investigator Email
lubos.janu@seznam.cz
Contact Person Name
Luboš Janů
Contact Person Email
lubos.janu@seznam.cz
Site Name
INEP medical s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Alexander Nawka
Principal Investigator Email
nawka@inep.cz
Contact Person Name
Alexander Nawka
Contact Person Email
nawka@inep.cz
Site Name
Praglandia s.r.o.
Department Name
Psychiatry
Principal Investigator Name
Radka Šafandová
Principal Investigator Email
r.safand@praglandia.cz
Contact Person Name
Radka Šafandová
Contact Person Email
r.safand@praglandia.cz

Poland

Earliest CTIS Part Ii Submission Date
05-06-2025
Latest Decision Or Authorization Date
06-05-2026
Processing Time Days
335
Number Of Sites
8
Number Of Participants
36

Sites

Site Name
Przychodnie Grudziadz Sp. z o.o.
Principal Investigator Name
Barbara Janczewska
Principal Investigator Email
b.janczewskaa@gmail.com
Contact Person Name
Barbara Janczewska
Contact Person Email
b.janczewskaa@gmail.com
Site Name
Centrum Badan Klinicznych Pi-House Sp. z o.o.
Principal Investigator Name
Katarzyna Binkowska-Michalik
Principal Investigator Email
k.binkmich@pihouse.pl
Contact Person Name
Katarzyna Binkowska-Michalik
Contact Person Email
k.binkmich@pihouse.pl
Site Name
Clinic BBP Bożena Pawełczyk
Principal Investigator Name
Bożena Pawełczyk
Principal Investigator Email
bozena.pawelczyk@clinicbbp.com
Contact Person Name
Bożena Pawełczyk
Contact Person Email
bozena.pawelczyk@clinicbbp.com
Site Name
Podlaskie Centrum Psychogeriatrii
Principal Investigator Name
Jacek Dobryniewski
Principal Investigator Email
jacekdobryniewski@gmail.com
Contact Person Name
Jacek Dobryniewski
Contact Person Email
jacekdobryniewski@gmail.com
Site Name
Ośrodek Badań Klinicznych Clinsante s.c. Ewa Galczak-Nowak, Malgorzata Trzaska
Department Name
Ośrodek Badań Klinicznych Clinsante
Principal Investigator Name
Gerard Kowalkowski
Principal Investigator Email
gkowalkowski@wp.pl
Contact Person Name
Gerard Kowalkowski
Contact Person Email
gkowalkowski@wp.pl
Site Name
Care Clinic Sp. z o.o.
Department Name
Care Clinic Centrum Medyczne
Principal Investigator Name
Maciej Żerdziński
Principal Investigator Email
avalone@wp.pl
Contact Person Name
Maciej Żerdziński
Contact Person Email
avalone@wp.pl
Site Name
Gabinet Lekarski Psychiatryczny Ireneusz Kaczorowski
Principal Investigator Name
Ireneusz Kaczorowski
Principal Investigator Email
irek.k@tlen.pl
Contact Person Name
Ireneusz Kaczorowski
Contact Person Email
irek.k@tlen.pl
Site Name
MłynowaMed Specjalistyczny Psychiatryczny Gabinet Lekarski Joanna Łazarczyk
Principal Investigator Name
Joanna Łazarczyk
Principal Investigator Email
joannalaz@wp.pl
Contact Person Name
Joanna Łazarczyk
Contact Person Email
joannalaz@wp.pl

Sponsor

Primary sponsor

Full Name
Neurocrine Biosciences Inc.
Organisation Type
Pharmaceutical company
Country Of Registered Address
United States

Contract research organisations

Name
IQVIA Limited
Responsibilities
sponsorDuties codes:1,12,15 (Cardiac services and supplying ECG machines),2,5
Name
Ppd Inc.
Responsibilities
PK analysis
Name
Marken LLP
Responsibilities
Direct to patient IP delivery
Name
Medidata Solutions Inc.
Responsibilities
sponsorDuties codes:7
Name
Signant Health Global LLC
Responsibilities
sponsorDuties codes:3
Name
Iqvia Laboratories Limited
Responsibilities
sponsorDuties codes:4
Name
Eresearchtechnology Inc.
Responsibilities
sponsorDuties codes:7
Name
Cytel Inc.
Responsibilities
Adjudication Committee

Third parties

  • {"country":"United Kingdom","full_name":"IQVIA Limited","duties_or_roles":"sponsorDuties codes:1,12,15 (Cardiac services and supplying ECG machines),2,5","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"sponsorDuties codes:7","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Cytel Inc.","duties_or_roles":"Adjudication Committee","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Iqvia Laboratories Limited","duties_or_roles":"sponsorDuties codes:4","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"United States","full_name":"Epilepsy Study Consortium Inc.","duties_or_roles":"Adjudication Committee","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Massachusetts General Hospital","duties_or_roles":"participant quality assurance","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"United States","full_name":"Eresearchtechnology Inc.","duties_or_roles":"sponsorDuties codes:7","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Marken LLP","duties_or_roles":"Direct to patient IP delivery","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Ppd Inc.","duties_or_roles":"PK analysis","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Signant Health Global LLC","duties_or_roles":"sponsorDuties codes:3","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
NBI-1065845
Active Substance
9-(4-CYCLOHEXYLOXYPHENYL)-7-METHYL-3,4-DIHYDROPYRAZINO[2,1-C][1,2,4]THIADIAZINE 2,2-DIOXIDE
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Investigational Product Name
Identical to NBI-1065845 tablets without active drug
Modality
Other
Combination Treatment
Yes

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