Skip to main content
Erschienen in: Advances in Therapy 2/2017

02.01.2017 | Original Research

Mavoglurant Augmentation in OCD Patients Resistant to Selective Serotonin Reuptake Inhibitors: A Proof-of-Concept, Randomized, Placebo-Controlled, Phase 2 Study

verfasst von: Daniel Rutrick, Dan J. Stein, Ganesan Subramanian, Brian Smith, Maurizio Fava, Gregor Hasler, Jang-Ho Cha, Fabrizio Gasparini, Toni Donchev, Magdalena Ocwieja, Donald Johns, Baltazar Gomez-Mancilla

Erschienen in: Advances in Therapy | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

To determine if mavoglurant (modified release) as an augmentation therapy to selective serotonin reuptake inhibitors (SSRIs) could have beneficial effects reducing Yale–Brown Obsessive Compulsive Scale (Y-BOCS) total score in patients with obsessive–compulsive disorder (OCD) resistant to SSRI treatment.

Methods

This was a multicenter, randomized, double-blind, placebo-controlled, parallel-group, phase 2 study. Patients remained on their SSRI treatment and mavoglurant or placebo was added on. Non-smoking men and women aged 18–65 years primarily diagnosed with OCD according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria were randomized (1:1) to mavoglurant or placebo groups. After 50 patients were randomized, an interim analysis was conducted to determine whether the study should be continued. The primary outcome measure was absolute change in Y-BOCS from baseline at week 17. Safety was assessed by recording adverse events (AEs) and serious adverse events (SAEs).

Results

Interim analysis led to a decision to terminate the study. In total 38 (76.0%) participants completed 17 weeks of treatment and 37 (74.0%) completed the study. There was no significant difference in least squares (LS) mean change from baseline at week 17 in Y-BOCS total score for mavoglurant compared with placebo groups [−6.9 (1.75) vs. −8.0 (1.78), respectively; LS mean difference 1.1; 95% CI −3.9, 6.2; p = 0.671]. The incidence of AEs was higher in the mavoglurant compared with the placebo group (80.8% vs. 70.8%, respectively).

Conclusion

This study of mavoglurant in OCD was terminated because of the lack of efficacy at interim analysis. The study did not support the use of an antagonist of mGluR5 receptors for OCD treatment.

Trial Registration

The study was registered with ClinicalTrials.gov: NCT01813019.

Funding

This study was sponsored by Novartis Pharma AG, Basel, Switzerland.
Literatur
1.
2.
Zurück zum Zitat Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive–compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014;15(6):410–24.CrossRefPubMed Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive–compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014;15(6):410–24.CrossRefPubMed
3.
Zurück zum Zitat Fontenelle LF, Mendlowicz MV, Versiani M. The descriptive epidemiology of obsessive–compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):327–37.CrossRefPubMed Fontenelle LF, Mendlowicz MV, Versiani M. The descriptive epidemiology of obsessive–compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):327–37.CrossRefPubMed
4.
Zurück zum Zitat Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive–compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.CrossRefPubMed Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive–compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.CrossRefPubMed
5.
Zurück zum Zitat van Grootheest DS, Cath DC, Beekman AT, Boomsma DI. Twin studies on obsessive–compulsive disorder: a review. Twin Res Hum Genet. 2005;8(5):450–8.CrossRefPubMed van Grootheest DS, Cath DC, Beekman AT, Boomsma DI. Twin studies on obsessive–compulsive disorder: a review. Twin Res Hum Genet. 2005;8(5):450–8.CrossRefPubMed
6.
Zurück zum Zitat Stewart SE, Yu D, Scharf JM, et al. Genome-wide association study of obsessive–compulsive disorder. Mol Psychiatry. 2013;18(7):788–98.CrossRefPubMed Stewart SE, Yu D, Scharf JM, et al. Genome-wide association study of obsessive–compulsive disorder. Mol Psychiatry. 2013;18(7):788–98.CrossRefPubMed
7.
Zurück zum Zitat Bronstein YL, Cummings JL. Neurochemistry of frontal subcortical circuits. In: Lichter DG, Cummings JL, editors. Frontal-subcortical circuits in psychiatric and neurological disorders. New York: Guilford; 2001. p. 63–6. Bronstein YL, Cummings JL. Neurochemistry of frontal subcortical circuits. In: Lichter DG, Cummings JL, editors. Frontal-subcortical circuits in psychiatric and neurological disorders. New York: Guilford; 2001. p. 63–6.
8.
Zurück zum Zitat Sundaram RS, Gowtham L, Nayak BS. The role of excitatory neurotransmitter glutamate in brain physiology and pathology. Asian J Pharm Clin Res. 2012;5(2):1–7. Sundaram RS, Gowtham L, Nayak BS. The role of excitatory neurotransmitter glutamate in brain physiology and pathology. Asian J Pharm Clin Res. 2012;5(2):1–7.
9.
Zurück zum Zitat Meldrum BS. Glutamate as a neurotransmitter in the brain: review of physiology and pathology. J Nutr. 2000;130(4S Suppl):1007s–15s.PubMed Meldrum BS. Glutamate as a neurotransmitter in the brain: review of physiology and pathology. J Nutr. 2000;130(4S Suppl):1007s–15s.PubMed
10.
Zurück zum Zitat Wu K, Hanna GL, Rosenberg DR, Arnold PD. The role of glutamate signaling in the pathogenesis and treatment of obsessive–compulsive disorder. Pharmacol Biochem Behav. 2012;100(4):726–35.CrossRefPubMed Wu K, Hanna GL, Rosenberg DR, Arnold PD. The role of glutamate signaling in the pathogenesis and treatment of obsessive–compulsive disorder. Pharmacol Biochem Behav. 2012;100(4):726–35.CrossRefPubMed
11.
Zurück zum Zitat Ting JT, Feng G. Neurobiology of obsessive–compulsive disorder: insights into neural circuitry dysfunction through mouse genetics. Curr Opin Neurobiol. 2011;21(6):842–8.CrossRefPubMedPubMedCentral Ting JT, Feng G. Neurobiology of obsessive–compulsive disorder: insights into neural circuitry dysfunction through mouse genetics. Curr Opin Neurobiol. 2011;21(6):842–8.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Kariuki-Nyuthe C, Gomez-Mancilla B, Stein DJ. Obsessive compulsive disorder and the glutamatergic system. Curr Opin Psychiatry. 2014;27(1):32–7.CrossRefPubMed Kariuki-Nyuthe C, Gomez-Mancilla B, Stein DJ. Obsessive compulsive disorder and the glutamatergic system. Curr Opin Psychiatry. 2014;27(1):32–7.CrossRefPubMed
14.
Zurück zum Zitat Akkus F, Terbeck S, Ametamey SM, et al. Metabotropic glutamate receptor 5 binding in patients with obsessive–compulsive disorder. Int J Neuropsychopharmacol. 2014;17(12):1915–22.CrossRefPubMed Akkus F, Terbeck S, Ametamey SM, et al. Metabotropic glutamate receptor 5 binding in patients with obsessive–compulsive disorder. Int J Neuropsychopharmacol. 2014;17(12):1915–22.CrossRefPubMed
15.
Zurück zum Zitat Fontenelle LF, Nascimento AL, Mendlowicz MV, Shavitt RG, Versiani M. An update on the pharmacological treatment of obsessive–compulsive disorder. Expert Opin Pharmacother. 2007;8(5):563–83.CrossRefPubMed Fontenelle LF, Nascimento AL, Mendlowicz MV, Shavitt RG, Versiani M. An update on the pharmacological treatment of obsessive–compulsive disorder. Expert Opin Pharmacother. 2007;8(5):563–83.CrossRefPubMed
16.
Zurück zum Zitat Fenske JN, Schwenk TL. Obsessive compulsive disorder: diagnosis and management. Am Fam Physician. 2009;80(3):239–45.PubMed Fenske JN, Schwenk TL. Obsessive compulsive disorder: diagnosis and management. Am Fam Physician. 2009;80(3):239–45.PubMed
17.
Zurück zum Zitat Fenske JN, Petersen K. Obsessive–compulsive disorder: diagnosis and management. Am Fam Physician. 2015;92(10):896–903.PubMed Fenske JN, Petersen K. Obsessive–compulsive disorder: diagnosis and management. Am Fam Physician. 2015;92(10):896–903.PubMed
18.
Zurück zum Zitat Soomro GM, Altman D, Rajagopal S, Oakley-Browne M. Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev. 2008;1:CD001765. Soomro GM, Altman D, Rajagopal S, Oakley-Browne M. Selective serotonin re-uptake inhibitors (SSRIs) versus placebo for obsessive compulsive disorder (OCD). Cochrane Database Syst Rev. 2008;1:CD001765.
19.
Zurück zum Zitat Arumugham SS, Reddy JYC. Augmentation strategies in obsessive–compulsive disorder. Expert Rev Neurother. 2013;13(2):187–202.CrossRefPubMed Arumugham SS, Reddy JYC. Augmentation strategies in obsessive–compulsive disorder. Expert Rev Neurother. 2013;13(2):187–202.CrossRefPubMed
20.
Zurück zum Zitat Albert U, Carmassi C, Cosci F, et al. Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive–compulsive disorder, trauma-related, and somatic symptom disorders: a systematized review. Int Clin Psychopharmacol. 2016;31(5):249–58.CrossRefPubMed Albert U, Carmassi C, Cosci F, et al. Role and clinical implications of atypical antipsychotics in anxiety disorders, obsessive–compulsive disorder, trauma-related, and somatic symptom disorders: a systematized review. Int Clin Psychopharmacol. 2016;31(5):249–58.CrossRefPubMed
21.
Zurück zum Zitat Haghighi M, Jahangard L, Mohammad-Beigi H, et al. In a double-blind, randomized and placebo-controlled trial, adjuvant memantine improved symptoms in inpatients suffering from refractory obsessive–compulsive disorders (OCD). Psychopharmacology. 2013;228(4):633–40.CrossRefPubMed Haghighi M, Jahangard L, Mohammad-Beigi H, et al. In a double-blind, randomized and placebo-controlled trial, adjuvant memantine improved symptoms in inpatients suffering from refractory obsessive–compulsive disorders (OCD). Psychopharmacology. 2013;228(4):633–40.CrossRefPubMed
22.
Zurück zum Zitat Bruno A, Micò U, Pandolfo G, et al. Lamotrigine augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive–compulsive disorder: a double-blind, placebo-controlled study. J Psychopharmacol. 2012;26(11):1456–62.CrossRefPubMed Bruno A, Micò U, Pandolfo G, et al. Lamotrigine augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive–compulsive disorder: a double-blind, placebo-controlled study. J Psychopharmacol. 2012;26(11):1456–62.CrossRefPubMed
23.
Zurück zum Zitat Paydary K, Akamaloo A, Ahmadipour A, Pishgar F, Emamzadehfard S, Akhondzadeh S. N-Acetylcysteine augmentation therapy for moderate-to-severe obsessive–compulsive disorder: randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther. 2016;41(2):214–9.CrossRefPubMed Paydary K, Akamaloo A, Ahmadipour A, Pishgar F, Emamzadehfard S, Akhondzadeh S. N-Acetylcysteine augmentation therapy for moderate-to-severe obsessive–compulsive disorder: randomized, double-blind, placebo-controlled trial. J Clin Pharm Ther. 2016;41(2):214–9.CrossRefPubMed
24.
Zurück zum Zitat Vranesic I, Ofner S, Flor PJ, et al. AFQ056/mavoglurant, a novel clinically effective mGluR5 antagonist: identification, SAR and pharmacological characterization. Bioorg Med Chem. 2014;22(21):5790–803.CrossRefPubMed Vranesic I, Ofner S, Flor PJ, et al. AFQ056/mavoglurant, a novel clinically effective mGluR5 antagonist: identification, SAR and pharmacological characterization. Bioorg Med Chem. 2014;22(21):5790–803.CrossRefPubMed
25.
Zurück zum Zitat Berg D, Godau J, Trenkwalder C, et al. AFQ056 treatment of levodopa-induced dyskinesias: results of 2 randomized controlled trials. Mov Disord. 2011;26(7):1243–50.CrossRefPubMed Berg D, Godau J, Trenkwalder C, et al. AFQ056 treatment of levodopa-induced dyskinesias: results of 2 randomized controlled trials. Mov Disord. 2011;26(7):1243–50.CrossRefPubMed
26.
Zurück zum Zitat Targum SD, Pollack MH, Fava M. Redefining affective disorders: relevance for drug development. CNS Neurosci Ther. 2008;14(1):2–9.CrossRefPubMed Targum SD, Pollack MH, Fava M. Redefining affective disorders: relevance for drug development. CNS Neurosci Ther. 2008;14(1):2–9.CrossRefPubMed
27.
Zurück zum Zitat Desseilles M, Witte J, Chang TE, et al. Massachusetts General Hospital SAFER criteria for clinical trials and research. Harv Rev Psychiatry. 2013;21(5):269–74.CrossRefPubMed Desseilles M, Witte J, Chang TE, et al. Massachusetts General Hospital SAFER criteria for clinical trials and research. Harv Rev Psychiatry. 2013;21(5):269–74.CrossRefPubMed
28.
Zurück zum Zitat Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Erlbaum; 1988. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Erlbaum; 1988.
29.
Zurück zum Zitat CHMP. European Medicines Agency. Committee for Medicinal Products for Human Use. Guideline on clinical investigation of medicinal products for the treatment of obsessive compulsive disorder. CHMP/EWP/4279/02. London, UK; 2005. CHMP. European Medicines Agency. Committee for Medicinal Products for Human Use. Guideline on clinical investigation of medicinal products for the treatment of obsessive compulsive disorder. CHMP/EWP/4279/02. London, UK; 2005.
30.
Zurück zum Zitat Ghaleiha A, Entezari N, Modabbernia A, et al. Memantine add-on in moderate to severe obsessive–compulsive disorder: randomized double-blind placebo-controlled study. J Psychiatr Res. 2013;47(2):175–80.CrossRefPubMed Ghaleiha A, Entezari N, Modabbernia A, et al. Memantine add-on in moderate to severe obsessive–compulsive disorder: randomized double-blind placebo-controlled study. J Psychiatr Res. 2013;47(2):175–80.CrossRefPubMed
31.
Zurück zum Zitat Heidari M, Zarei M, Hosseini SM, et al. Ondansetron or placebo in the augmentation of fluvoxamine response over 8 weeks in obsessive–compulsive disorder. Int Clin Psychopharmacol. 2014;29(6):344–50.CrossRefPubMed Heidari M, Zarei M, Hosseini SM, et al. Ondansetron or placebo in the augmentation of fluvoxamine response over 8 weeks in obsessive–compulsive disorder. Int Clin Psychopharmacol. 2014;29(6):344–50.CrossRefPubMed
32.
Zurück zum Zitat Ackerman DL, Greenland S. Multivariate meta-analysis of controlled drug studies for obsessive–compulsive disorder. J Clin Psychopharmacol. 2002;22(3):309–17.CrossRefPubMed Ackerman DL, Greenland S. Multivariate meta-analysis of controlled drug studies for obsessive–compulsive disorder. J Clin Psychopharmacol. 2002;22(3):309–17.CrossRefPubMed
33.
Zurück zum Zitat Veale D, Miles S, Smallcombe N, Ghezai H, Goldacre B, Hodsoll J. Atypical antipsychotic augmentation in SSRI treatment refractory obsessive–compulsive disorder: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:317.CrossRefPubMedPubMedCentral Veale D, Miles S, Smallcombe N, Ghezai H, Goldacre B, Hodsoll J. Atypical antipsychotic augmentation in SSRI treatment refractory obsessive–compulsive disorder: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:317.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Pallanti S, Quercioli L. Treatment-refractory obsessive–compulsive disorder: methodological issues, operational definitions and therapeutic lines. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):400–12.CrossRefPubMed Pallanti S, Quercioli L. Treatment-refractory obsessive–compulsive disorder: methodological issues, operational definitions and therapeutic lines. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):400–12.CrossRefPubMed
Metadaten
Titel
Mavoglurant Augmentation in OCD Patients Resistant to Selective Serotonin Reuptake Inhibitors: A Proof-of-Concept, Randomized, Placebo-Controlled, Phase 2 Study
verfasst von
Daniel Rutrick
Dan J. Stein
Ganesan Subramanian
Brian Smith
Maurizio Fava
Gregor Hasler
Jang-Ho Cha
Fabrizio Gasparini
Toni Donchev
Magdalena Ocwieja
Donald Johns
Baltazar Gomez-Mancilla
Publikationsdatum
02.01.2017
Verlag
Springer Healthcare
Erschienen in
Advances in Therapy / Ausgabe 2/2017
Print ISSN: 0741-238X
Elektronische ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-016-0468-5

Weitere Artikel der Ausgabe 2/2017

Advances in Therapy 2/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.