A Longitudinal Observational Cohort Study of NSI-189, With Out-Patients With Major Depressive Disorder

Study Overview
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Brief Summary
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All subjects completing the randomized treatment period in Protocol NS2014-1 will discontinue study drug and be asked to provide consent to be followed in this 6-month study, at their final safety visit. The study will consist of an enrollment visit, followed by bi-monthly in-clinic visits with monthly telephone visits between in-clinic visits.

Detailed Description
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Following completion of the NS2014-1 final study visit procedures, Subjects will be offered the opportunity to enroll in this longitudinal observational cohort protocol to monitor their depression and to assess durability of effect and long-term safety of NSI-189. The Enrollment Visit begins when informed consent is signed.The duration of the follow-up period will be up to 6 months, until the start of a new antidepressant treatment. Subjects who provide consent will be seen for in-person visits every 8 weeks, with bi-monthly phone visits occurring between in-person visits. Safety assessments and efficacy assessments will be performed at each visit. No study drug will be taken during the Longitudinal Observational Cohort study.

Official Title
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A Longitudinal Observational Cohort Study of NSI-189, a Neurogenic Compound Among Out-Patients With Major Depressive Disorder

Conditions
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Major Depressive Disorder

Intervention / Treatment
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* Drug: NSI-189


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subject has the ability to understand the purpose, potential benefits and risks of the study and to provide signed and dated informed consent, authorizing the use of protected health information in accordance with national and local Subject privacy regulations. Subject completed the 12-week randomized treatment period and final study visit for the NS2014-1 clinical study. Exclusion Criteria: Subjects taking excluded medications. Subject who, in the opinion of the Site Investigator, are unable to understand the protocol requirements, instructions and study-related restrictions, the nature, scope and possible consequences of the clinical study. Subject who, in the opinion of the Site Investigator, are unlikely to comply with the protocol requirements, instructions and study-related restrictions; e.g., uncooperative attitude, inability to return for follow-up and improbability of completing the clinical study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 61 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Longitudinal Observational Cohort<br>Following completion of the NS2014-1 final study visit procedures, Subjects will be offered the opportunity to enroll in this longitudinal observational cohort protocol to monitor their depression and to assess durability of effect and long-term safety of NSI-189. | Drug: NSI-189<br>* 0 Milligrams, 40 Milligrams or 80 Milligrams administered in the acute study only<br>* Other names: NSI-189 Phosphate;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary Objective: Durability of Effect defined as the time until the start of a new antidepressant treatment (ADT) | The primary objective is to determine the durability of effect of NSI-189 phosphate compared to placebo in subjects with Major Depressive Disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5TH EDITION). Durability of effect is defined as the time until the start of a new antidepressant treatment (ADT). | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Montgomery-Asberg Depression Rating Scale (MADRS) | Compare the continued Montgomery-Asberg Depression Rating Scale (MADRS) response and remission rates of subjects treated with NSI-189 to those of subjects assigned to placebo. Response is defined as a 50% or greater reduction from baseline to endpoint on the Montgomery-Asberg Depression Rating Scale (MADRS) total score. Remission is defined as an endpoint MADRS total score of 10. The duration of 50% or greater reduction in Montgomery-Asberg Depression Rating Scale (MADRS) total score sustained following treatment will be noted. | 6 months | 
| Quick Inventory of Depressive Symptomatology - Self-Rated (QIDS-SR) | Compare the continued antidepressant efficacy of NSI-189 with that of placebo. | 6 months | 
| Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (MGH CPFQ) | Evaluate the continued efficacy of NSI-189 compared to placebo on the cognitive aspects associated with Major Depressive Disorder, and the onset and duration of improvement. | 6 months | 
| Cogscreen Battery | Evaluate the continued efficacy of NSI-189 compared to placebo on the cognitive aspects associated with Major Depressive Disorder, and the onset and duration of improvement. | 6 months | 
| Symptoms of Depression Questionnaire (SDQ) | Compare the continued efficacy of NSI-189 with that of placebo, as measured by the Symptoms of Depression Questionnaire (SDQ) | 6 months | 
| Massachusetts General Hospital Sexual Functioning Inventory (MGH SFI) | Characterize the safety and tolerability of NSI-189, compared to placebo. | 6 months | 
| The Columbia Suicide Severity Rating Scale (C-SSRS) | Characterize the safety and tolerability of NSI-189, compared to placebo. | 6 months | 
| 17-item Hamilton Depression Rating Scale (HAMD17) | HAMD17 will be used to characterize the safety and tolerability of NSI-189, compared to placebo. | 6 months | 
| Discontinuation rates | Characterize the safety and tolerability of NSI-189, compared to placebo. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Major Depressive Disorder (MDD), Major Depressive Disorder, Neurogenesis, Synaptogenesis, NSI-189, Neuralstem