Cognitive and Neural Effects of ARA290
Condition: Depression
MeSH terms: Depression
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      Studies on the hormone Erythropoietin (EPO) have indicated that EPO may have antidepressant
      properties. However, EPO may cause serious side-effects with repeated administration
      (thrombosis), which limits its usefulness as an antidepressant. ARA290 is a peptide that does
      not have the effects of EPO on blood cells but may still have its effect on brain function.
      In an attempt to replicate previous findings with (a single dose of) EPO in healthy
      volunteers, we study the effects of ARA290 on the cognitive and neural processing of emotions
      in healthy volunteers. We hypothesize that a single dose of ARA290 will lead to a positive
      shift in information processing compared to placebo, 7 days post-administration.
    

Detailed description: 
      SUMMARY Rationale: Studies on the cognitive and neuronal effects of a single administration
      of Erythropoietin (EPO) in healthy volunteers and in depressed patients have suggested that
      EPO may have antidepressant effects. Due to its haematopoietic effects, EPO may cause serious
      side-effects with repeated administration, which limits its usefulness as an antidepressant.
      ARA290 is a peptide that does not have the haematopoietic effects of EPO but may still have
      its neurotrophic effects.

      Objective: To study the effects of ARA290 on the cognitive and neural processing of emotions
      in healthy volunteers 7 days post-administration.

      Study design: Randomized double-blind placebo-controlled experiment. Study population: Male
      and female healthy volunteers, n= 36; 18-35 yr old. Intervention: One group receives a single
      dose of 2 mg ARA290, the other group receives placebo.

      Main study parameters/endpoints:

        1. Behavioral study: Performance on an Emotional Test battery (ETB) which has been shown
           sensitive to antidepressant administration in healthy volunteers. The ETB includes a
           measure of facial expression recognition, emotional memory and attentional vigilance.

        2. Neuroimaging study: Neural processing of emotions, in particular amygdala, hippocampal
           and VMPFC response to viewing facial stimuli expressing negative versus positive
           emotions.

      Nature and extent of the burden and risks and benefits associated with participation:

      Risks: No adverse events have been associated with the administration of a single dose of 70
      -2000 μg ARA290 among 36 individuals, with the exception of one individual (with an
      undisclosed significant prior history of fainting) who fainted shortly after the intravenous
      dose administration of 700 μg ARA290 and recovered without medical intervention. Fourteen
      individuals have participated in a multiple dosing study with no serious adverse effects.
      Single doses of ARA290 in patients with renal impairment did not raise a safety signal.

      Burden: Minimal. Emotional information processing test battery, burden comparable with
      playing computer games. fMRI measurement.

      Benefits: Probably none. Possibly transient and small improvement of mood state. Financial
      compensation for participating.
    

Intervention name(s): ARA290; Placebo
Intervention type(s): Drug; Drug
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Basic Science
Keywords: depression; cognition; emotion perception; information processing