New Study Results Provide Additional Data About Short- And Long-Term Use Of Desvenlafaxine Succinate In The Treatment Of Major Depressive Disorder
05/23/07
Data from four new
studies examining safety and efficacy of desvenlafaxine succinate, a
serotonin-norepinephrine reuptake inhibitor (SNRI) being studied as a
potential treatment for adults with major depressive disorder (MDD), were
presented today at the 2007 American Psychiatric Association annual meeting
in San Diego, Calif., by Wyeth Pharmaceuticals, a division of Wyeth (NYSE:
WYE). Results from short-term studies and a six-month relapse prevention
study showed that desvenlafaxine succinate improved symptoms of MDD vs.
placebo in adult patients with depression. In addition, results from a
12-month safety study were presented.
"Depression is a chronic condition where a large number of treated
patients often experience a relapse or a return of symptoms following a
positive response to treatment," says Philip Ninan, M.D., Vice President,
Neuroscience, Global Medical Affairs for Wyeth Pharmaceuticals. "We are
encouraged by these clinical trials, which show that desvenlafaxine, if
approved, may be an important option for the treatment of adult patients
with major depressive disorder."
About the Studies
Poster NR327: Rickels K, et al. A Multicenter, Randomized,
Double-Blind, Placebo-Controlled, Parallel-Group Study of Desvenlafaxine
Succinate for Prevention of Depressive Relapse in Adult Outpatients with
Major Depressive Disorder
Study findings from the double-blind phase showed that patients who
took desvenlafaxine succinate experienced a significantly longer time to
relapse of MDD compared with patients who took placebo. The study also
found that more patients who took desvenlafaxine succinate achieved
remission (Hamilton Rating Scale for Depression [HAM-D17] score of less
than or equal to 7) by Week 4 of the study than those in the placebo group.
The most frequent cause for discontinuation of treatment in the
double-blind study was depression, reported by 4 percent of patients who
took desvenlafaxine succinate and 8 percent of placebo patients. The most
frequent adverse events with desvenlafaxine succinate in the double-blind
phase included headache, nausea, dizziness, asthenia, abnormal dreams and
sweating.
The double-blind study population included 375 adults, 18 to 75 years
old, with a primary diagnosis of MDD who participated in an initial
12-week, open- label study of desvenlafaxine succinate at doses ranging
from 200 to 400 mg/day (desvenlafaxine succinate group, n=190; placebo
group, n=185). The primary efficacy endpoint in the double-blind phase of
the study was time until relapse, defined by a HAM-D17 score greater than
or equal to 16 at any visit; Clinical Global Impressions Scale --
Improvement score greater than or equal to 6 at any visit; or
discontinuation due to unsatisfactory response. The study also assessed the
response and remission of desvenlafaxine succinate vs. placebo as a
secondary objective.
Poster NR344: Ferguson J, et al. A 12-Month, Open-Label Evaluation of
Long-Term Safety and Efficacy of Desvenlafaxine Succinate in Outpatients
with Major Depressive Disorder
The results are from a Phase 3, multicenter, open-label, flexible-dose
study. This study included 104 adults, 18 to 75 years old, with a primary
diagnosis of MDD who took doses of desvenlafaxine succinate ranging from
200 to 400 mg/day over a 12-month period. The primary objective was to
evaluate the long-term safety of desvenlafaxine succinate as determined by
monitoring a variety of indices, including adverse events, patient
discontinuation due to adverse events, electrocardiograms, vital signs and
the results of laboratory tests. The secondary objective was to evaluate
the efficacy of desvenlafaxine succinate by using mean HAM-D17 total
scores.
Study findings showed that the most frequent treatment-emergent adverse
events were nausea and headache. Nausea generally was transient, usually
resolving within the first week. Nine patients (9 percent) had Hypertension
during the trial. Six patients reported a serious adverse event, none of
which was considered related to desvenlafaxine succinate. Adverse events
were noted as the cause of discontinuation from the study in about
one-third of patients -- with the majority of discontinuations occurring in
the first week. Study findings also showed that HAM-D17 mean total scores
steadily decreased from baseline at Day 7 through Day 60 and continued to
decrease through the end of the study.
Poster NR363: Ahmed S, et al. Switch from Venlafaxine to Desvenlafaxine
Succinate Is Well-Tolerated in Patients with Major Depressive Disorder
In this study, patients taking venlafaxine ER were able to transition
to desvenlafaxine succinate with a lower incidence of nausea than patients
who switched from placebo to 200 mg/day of desvenlafaxine succinate.
Furthermore, patients who switched from venlafaxine ER to desvenlafaxine
succinate and those who remained on desvenlafaxine succinate were less
likely to discontinue therapy than patients who switched from placebo to
200 mg/day of desvenlafaxine succinate (without titration).
Before joining the 10-week, open-label study, 517 patients completed
one of two eight-week, double-blind, placebo-controlled, flexible-dose
studies of desvenlafaxine succinate and venlafaxine ER. Patients who
received either placebo (n=186) or venlafaxine ER (n=183) during the
double-blind study began the open-label phase at 200 mg/day of
desvenlafaxine succinate, while patients who took desvenlafaxine succinate
(n=148) during the double-blind study remained on the same dose at the
beginning of the open-label study. Based on clinical response, each
patient's dose of desvenlafaxine succinate could be adjusted during the
open-label study.
Study findings show that overall treatment-emergent adverse events
reported during the 10-week study were similar for all treatment groups --
91 percent reported at least one adverse event in the
placebo/desvenlafaxine succinate group; 86 percent in the venlafaxine
ER/desvenlafaxine succinate group; and 86 percent in the desvenlafaxine
succinate/desvenlafaxine succinate group. The incidence of nausea was
highest for the placebo/desvenlafaxine succinate group during the first
week of treatment and decreased to rates similar to the venlafaxine
ER/desvenlafaxine succinate group (p= 0.03) and the desvenlafaxine
succinate/desvenlafaxine succinate group at Day 8 and beyond. Additionally,
discontinuation rates due to adverse events were highest in the
placebo/desvenlafaxine succinate group and lowest in the desvenlafaxine
succinate/desvenlafaxine succinate group (placebo/desvenlafaxine succinate:
23 percent; venlafaxine ER/desvenlafaxine succinate: 16 percent;
desvenlafaxine succinate/desvenlafaxine succinate: 11 percent).
Poster NR299: Feiger AD, et al. A Placebo-Controlled Efficacy and
Safety Study of a Flexible Dose of Desvenlafaxine Succinate in Outpatients
with Major Depressive Disorder
According to the results of a Phase 3, multicenter, double-blind,
placebo- controlled, parallel-group, flexible-dose study, there was no
significant difference between patients receiving placebo and those
receiving desvenlafaxine succinate based on the primary endpoint of change
from baseline in the HAM-D17 total score at the final evaluation of Week 8,
using analysis of co-variance with last-observation-carried-forward (LOCF)
analyses. However, based on observed-cases analysis of the primary
endpoint, there was a significant difference at Week 8 between patients who
took desvenlafaxine succinate vs. patients receiving placebo. Based on LOCF
and observed-case analysis of various secondary endpoints, desvenlafaxine
succinate was significantly better than placebo.
Patients in this study were randomized to receive desvenlafaxine
succinate 200 to 400 mg/day (n=117) or placebo (n=118). Significantly more
patients in the desvenlafaxine succinate group responded to treatment
compared with the placebo group (51 percent vs. 32 percent, respectively)
at the final study evaluation. When individual items from the HAM-D17 were
analyzed, desvenlafaxine succinate patients experienced a statistically
significant improvement in depressed mood, psychic anxiety, general somatic
symptoms and suicidal thoughts. Treatment-emergent adverse events reported
in this study were consistent with the SNRI class and included nausea, dry
mouth, insomnia, somnolence, sweating, anorexia (loss of appetite), tremor
and impotence.
About Desvenlafaxine
Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI)
studied as a potential treatment for adult men and women with MDD. Wyeth
submitted a New drug Application (NDA) for MDD on December 22, 2005. The
Company also has filed an NDA for vasomotor symptoms (VMS) associated with
menopause and expects a U.S. Food and Drug Administration (FDA) action
letter in the third quarter of 2007. If approved, desvenlafaxine will be
the first and only non-hormonal Medicine for the treatment of VMS
associated with menopause. Wyeth is a leader in both neuroscience and
women's health care.
Wyeth discovered and developed the first SNRI approved by the FDA,
which currently is the most widely used Antidepressant in the world.
Desvenlafaxine represents Wyeth's latest efforts and continued commitment
to developing therapies to help improve the lives of patients suffering
from mental health disorders.
According to a large depression trial funded by the National Institute
of Mental Health, only 28 percent of patients with depression achieved
remission with initial antidepressant treatment. This leaves a large
percentage of patients still suffering from depression. Clearly, additional
Medicines are needed for treating MDD.
About Antidepressants
Antidepressants increased the risk of suicidal thinking and behavior
(suicidality) in short-term studies in children and adolescents with major
depressive disorder and other psychiatric disorders. Anyone considering the
use of any antidepressant in a child or adolescent must balance this risk
with the clinical need. Patients who are on such therapy should be observed
closely for clinical worsening, suicidality or unusual changes in behavior.
Families and caregivers should be advised of the need for close observation
and communication with their prescriber.
About Major Depressive Disorder
Major depressive disorder is a serious medical condition that is
different from "feeling blue" and is not something people just "get over."
Criteria for major depressive disorder include five or more of the
following symptoms that have been present for at least two weeks, and at
least one of the symptoms must be either depressed mood or loss of interest
or pleasure.
-- Depressed mood
-- Loss of interest or pleasure
-- Changes in appetite or weight
-- Changes in sleeping patterns
-- Psychomotor agitation or retardation
-- Fatigue or low energy
-- Feeling worthless or guilty for no reason
-- Difficulty thinking or concentrating
-- Thoughts of death or suicide
Further, people with major depressive disorder may experience
clinically significant distress or impairment in social, occupational or
other important areas of functioning. If a person experiences these
symptoms, he or she should speak with a health care professional.
Major depressive disorder is a common mental disorder, affecting about
121 million people worldwide. In the United States, it is estimated that
depression affects about 19 million American adults each year. The lifetime
risk of major depression has been assessed from 10 percent to 25 percent
for women and 5 percent to 12 percent for men. Research has shown that
hormonal changes, including estrogen decline, or life stressors experienced
by women may contribute to a major depressive episode.
About Wyeth Pharmaceuticals
Wyeth Pharmaceuticals, a division of Wyeth, has leading products in the
areas of women's health care, infectious disease, gastrointestinal health,
central nervous system, inflammation, transplantation, hemophilia,
oncology, vaccines and nutritional products.
Wyeth is one of the world's largest research-driven pharmaceutical and
health care products companies. It is a leader in the discovery,
development, manufacturing and marketing of pharmaceuticals, vaccines,
biotechnology products and non-prescription medicines that improve the
quality of life for people worldwide. The Company's major divisions include
Wyeth Pharmaceuticals, Wyeth Consumer Healthcare and Fort Dodge Animal
Health.
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