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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05603819
Other study ID # EDIT-B
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date June 29, 2022
Est. completion date December 31, 2024

Study information

Verified date July 2023
Source Alcediag
Contact Diana Vetter
Phone +33788970700
Email diana.vetter@alcediag-alcen.com
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Differentiation between major depressive disorder (MDD) and bipolar disorder (BD) as soon as possible in the patient journey represents a major clinical issue. When the patient is in a depressive phase, the symptoms are similar between the two pathologies and the current clinical scales fail in distinguishing them. Physicians often report this difficulty and as a consequence, the mean time from onset to bipolar disorder diagnosis is currently 7.5 years. These diagnostic delays and misdiagnosis lead to damaging consequences for patients and their loved ones: worsening of symptoms, comorbidities, suicide risk and inadequate care resulting in severe impairment in social and occupational functioning. Faced with these high expectations for accurate diagnostic methods for an earlier management of psychiatric patients, the combination of relevant clinical features and biomarkers could stand for a solution, leading to a personalised approach in patients with mood disorders. In a first clinical discovery study, a panel of RNA biomarkers in the blood of patients with a major depressive episode (MDE) has been identified, allowing to differentiate bipolar disorder from MDD (unipolar depression). These biomarkers are based on RNA modifications, namely RNA editing, that could be identified using molecular biology, NGS and artificial intelligence. This panel constitutes EDIT-B test, which is based on Alcediag's proprietary and patented biomarkers and algorithms. The present study aims to validate the biomarker signatures proposed by Alcediag by measuring the association between the modifications of the RNA editing and major depressive disorder/ bipolar disorder diagnosis, in patients with a MDE in real-life setting pilot centres.


Recruitment information / eligibility

Status Recruiting
Enrollment 436
Est. completion date December 31, 2024
Est. primary completion date December 31, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria: 1. Signed informed consent. 2. Male or female = 18 and = 80 years of age at inclusion. 3. MADRS = 20 4. In- and out-patients can be recruited. 5. Diagnosed with MDE with the MINI for DSM-5 6. Currently treated for the MDE 7. Diagnosed with MDD or BD with the MINI for DSM-5. 8. For patients with BD: at least one manic or hypomanic episode 9. For patients with MDD: at least one MDE Exclusion Criteria: 1. MDD patients with first degree family history of bipolar disorder 2. YMRS > 12 3. Pregnant women 4. Unipolar or bipolar depression secondary to major central nervous system affections, including infections in the brain, tumours of the brain, stroke, Alzheimer's disease, Parkinson's disease, Multiple sclerosis, other major brain affections 5. Schizo-affective patients Abbrevations: BD Bipolar Disorder DSM-5 Diagnostic and Statistical Manual of Mental disorders 5 MADRS Montgomery-Asberg Depression Rating Scale MDD Major Depressive Disorder MDE Major Depressive Episode MINI Mini-International Neuropsychiatric Interview YMRS Young Mania Rating Scale

Study Design


Intervention

Device:
EDIT-B
To perform EDIT-B test, questionnaires and 2x0.5 mL whole blood are collected from each patient.

Locations

Country Name City State
Denmark The Capital Region of Denmark Copenhagen
France GHU Paris Psychiatrie & Neurosciences Paris
Spain Hospital Clínic de Barcelona Barcelona
Spain Parc Sanitari Sant Joan de Déu Sant Boi De Llobregat Barcelona

Sponsors (8)

Lead Sponsor Collaborator
Alcediag Fundació Sant Joan de Déu, Fundacion Clinic per a la Recerca Biomédica, GHU Paris Psychiatrie & Neurosciences, Hospital Clinic of Barcelona, Parc Sanitari Sant Joan de Déu, Synlab Italie, The Capital Region of Denmark

Countries where clinical trial is conducted

Denmark,  France,  Spain, 

References & Publications (28)

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Berg KA, Cropper JD, Niswender CM, Sanders-Bush E, Emeson RB, Clarke WP. RNA-editing of the 5-HT(2C) receptor alters agonist-receptor-effector coupling specificity. Br J Pharmacol. 2001 Sep;134(2):386-92. doi: 10.1038/sj.bjp.0704255. — View Citation

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Carvalho AF, Firth J, Vieta E. Bipolar Disorder. N Engl J Med. 2020 Jul 2;383(1):58-66. doi: 10.1056/NEJMra1906193. No abstract available. — View Citation

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Chimienti F, Cavarec L, Vincent L, Salvetat N, Arango V, Underwood MD, Mann JJ, Pujol JF, Weissmann D. Brain region-specific alterations of RNA editing in PDE8A mRNA in suicide decedents. Transl Psychiatry. 2019 Feb 15;9(1):91. doi: 10.1038/s41398-018-0331-3. Erratum In: Transl Psychiatry. 2019 Mar 14;9(1):112. — View Citation

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Giridharan VV, Sayana P, Pinjari OF, Ahmad N, da Rosa MI, Quevedo J, Barichello T. Postmortem evidence of brain inflammatory markers in bipolar disorder: a systematic review. Mol Psychiatry. 2020 Jan;25(1):94-113. doi: 10.1038/s41380-019-0448-7. Epub 2019 Jun 27. — View Citation

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Kim SH, Kim HJ, Lee SI, Jo MW. Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Qual Life Res. 2012 Aug;21(6):1065-73. doi: 10.1007/s11136-011-0018-1. Epub 2011 Sep 23. — View Citation

Lamers MM, van den Hoogen BG, Haagmans BL. ADAR1: "Editor-in-Chief" of Cytoplasmic Innate Immunity. Front Immunol. 2019 Jul 25;10:1763. doi: 10.3389/fimmu.2019.01763. eCollection 2019. — View Citation

Maes M, Carvalho AF. The Compensatory Immune-Regulatory Reflex System (CIRS) in Depression and Bipolar Disorder. Mol Neurobiol. 2018 Dec;55(12):8885-8903. doi: 10.1007/s12035-018-1016-x. Epub 2018 Apr 2. — View Citation

Mannion NM, Greenwood SM, Young R, Cox S, Brindle J, Read D, Nellaker C, Vesely C, Ponting CP, McLaughlin PJ, Jantsch MF, Dorin J, Adams IR, Scadden AD, Ohman M, Keegan LP, O'Connell MA. The RNA-editing enzyme ADAR1 controls innate immune responses to RNA. Cell Rep. 2014 Nov 20;9(4):1482-94. doi: 10.1016/j.celrep.2014.10.041. Epub 2014 Nov 13. — View Citation

Merikangas KR, Jin R, He JP, Kessler RC, Lee S, Sampson NA, Viana MC, Andrade LH, Hu C, Karam EG, Ladea M, Medina-Mora ME, Ono Y, Posada-Villa J, Sagar R, Wells JE, Zarkov Z. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011 Mar;68(3):241-51. doi: 10.1001/archgenpsychiatry.2011.12. — View Citation

Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979 Apr;134:382-9. doi: 10.1192/bjp.134.4.382. — View Citation

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Rosenthal JJ, Seeburg PH. A-to-I RNA editing: effects on proteins key to neural excitability. Neuron. 2012 May 10;74(3):432-9. doi: 10.1016/j.neuron.2012.04.010. — View Citation

Salvetat N, Checa-Robles FJ, Patel V, Cayzac C, Dubuc B, Chimienti F, Abraham JD, Dupre P, Vetter D, Mereuze S, Lang JP, Kupfer DJ, Courtet P, Weissmann D. A game changer for bipolar disorder diagnosis using RNA editing-based biomarkers. Transl Psychiatry. 2022 May 4;12(1):182. doi: 10.1038/s41398-022-01938-6. — View Citation

Salvetat N, Chimienti F, Cayzac C, Dubuc B, Checa-Robles F, Dupre P, Mereuze S, Patel V, Genty C, Lang JP, Pujol JF, Courtet P, Weissmann D. Phosphodiesterase 8A to discriminate in blood samples depressed patients and suicide attempters from healthy controls based on A-to-I RNA editing modifications. Transl Psychiatry. 2021 Apr 30;11(1):255. doi: 10.1038/s41398-021-01377-9. — View Citation

Salvetat N, Van der Laan S, Vire B, Chimienti F, Cleophax S, Bronowicki JP, Doffoel M, Bourliere M, Schwan R, Lang JP, Pujol JF, Weissmann D. RNA editing blood biomarkers for predicting mood alterations in HCV patients. J Neurovirol. 2019 Dec;25(6):825-836. doi: 10.1007/s13365-019-00772-9. Epub 2019 Jul 22. — View Citation

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57. — View Citation

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Weissmann D, van der Laan S, Underwood MD, Salvetat N, Cavarec L, Vincent L, Molina F, Mann JJ, Arango V, Pujol JF. Region-specific alterations of A-to-I RNA editing of serotonin 2c receptor in the cortex of suicides with major depression. Transl Psychiatry. 2016 Aug 30;6(8):e878. doi: 10.1038/tp.2016.121. — View Citation

Yang W, Wang Q, Kanes SJ, Murray JM, Nishikura K. Altered RNA editing of serotonin 5-HT2C receptor induced by interferon: implications for depression associated with cytokine therapy. Brain Res Mol Brain Res. 2004 Apr 29;124(1):70-8. doi: 10.1016/j.molbrainres.2004.02.010. — View Citation

Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978 Nov;133:429-35. doi: 10.1192/bjp.133.5.429. — View Citation

* Note: There are 28 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Diagnostic performances of EDIT-B signatures on MDD vs. BD differentiation in patients with depression. The objective of this study is to estimate three EDIT-B signatures in term of their external validity. For this purpose, performances of the tests will be estimated by calculating for each signature its Sensitivity (i.e. the probability that a test will indicate 'bipolar disorders' among those with this disease), Specificity (i.e. the fraction of those without bipolar disorders who will have a negative test result) and its Accuracy to predict the diagnosis of bipolar disorders. In addition, Area under the ROC curves of each EDIT-B signature will be calculated.
The categorisation of the type of disorder (MDD vs. BD) by experts will be based on the MINI considered as the gold standard for diagnosis.
The performances of the tested signatures will be compared on a two-by-two basis by comparing sensitivities and specificity , using the methods based on Mac Nemar test proposed by Hawass. AUC-ROC of the 3 signatures will also be compared by DeLong method.
Specimen collection needed for evaluation of diagnostic performances: 1 day (= 1 visit).
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