Journal of Psychiatric Practice Vol. 21, No. 2 140 March 2015
Background. Approximately 45% of patients with
major depressive disorder (MDD) do not remit when
treated with biogenic amine antidepressants.
Consequently, there is a significant need for antide-
pressant agents with different mechanisms of
action. Early proof of concept (POC) studies with
such novel agents play a significant role in helping
drug developers identify agents and mechanisms of
action that merit more intensive research. Studies
have demonstrated that high affinity N-methyl-D-
aspartate (NMDA) receptor blockers (eg, ketamine)
can produce rapid antidepressant effects in patients
who have not responded to currently available
agents, but treatment with these agents is accompa-
nied by psychotomimetic effects that make their use
problematic. This column describes a POC study
involving GLYX-13, an N-methyl-D-aspartate recep-
tor glycine site functional partial agonist. Method.
In this double-blind, randomized, placebo-con-
trolled study, a single intravenous (IV) dose of
GLYX-13 (1, 5, 10, or 30 mg/kg) or placebo was admin-
istered to 116 subjects with MDD who had not bene-
fitted from a trial of at least one biogenic amine
antidepressant during the current episode. The pri-
mary outcome measure was score on the Hamilton
Depression Rating Scale-17 (Ham-D
17
), which was
used to rate overall depressive symptoms at base-
line and at 24 hours and days 3, 7, 14, and, in some
arms, days 21 and 28 after administration. Results.
GLYX-13, 5 or 10 mg/kg IV, reduced depressive symp-
toms as assessed by the Ham-D
17
at days 1 through 7.
Onset of action as assessed using the Bech-6
occurred within 2 hours. GLYX-13 did not elicit psy-
chotomimetic or other significant side effects.
wide LLC, St Louis, MO; and Gary Zammit, PhD, Clinilabs, New
York, NY.
Funding for this study was provided in its entirety by Naurex, Inc,
1801 Maple Avenue, Suite 4300, Evanston IL 60201, which owns
patents, patent applications, and commercialization rights to
GLYX-13. Dr. Burch is an employee of Naurex and has received
financial compensation and stock. Drs. Macaluso, Mehra, Presko-
rn, and Zammit were paid clinical investigators for Naurex. Dur-
ing the past 12 months, Dr. Preskorn has been a consultant for
AssureX, Delphor, Eisai, Johnson & Johnson, Merck, Naurex,
Sunovion, and Tashio. Dr. Moskal is the founder of Naurex, Inc. He
has founders' shares of stock in the company and receives financial
compensation as a consultant.
Clinical trial registration. Single IV Dose of GLYX-13 in Patients
With Treatment-Resistant Depression, http://www.clinicaltrials
.gov/ct2/show/NCT01234558?term=Naurex&rank=2,
NCT01234558; Single Ascending Dose Safety, Tolerability and
Pharmacokinetics Study of GLYX-13 in Normal Volunteers,
http://www.clinicaltrials.gov/ct2/show/NCT01014650?term=Nau-
rex&rank=3, NCT01014650.
Note: Portions of this column are adapted with permission from
Moskal et al. 2014.
9
DOI: 10.1097/01.pra.0000462606.17725.93
PRESKORN and MACALUSO: University of Kansas School of
Medicine, Wichita, KS; MEHRA: Artemis Institute for Clinical
Research, San Diego, CA; ZAMMIT: CliniLabs, New York, NY;
MOSKAL: Dept Biomedical Engineering, Falk Center for
Molecular Therapeutics, McCormick School of Engineering and
Applied Sciences, Northwestern University, and Naurex Inc,
Evanston, IL; BURCH: Naurex Inc, Evanston, IL.
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Please send correspondence to: Ronald M Burch, MD, PhD,
Naurex, Inc, 1801 Maple Avenue, Suite 4300, Evanston IL, 60201
ronburch@naurex.com
Acknowledgements. The GLYX-13 Clinical Study Group Principal
Investigators were Misha Backonja, MD, Lifetree Clinical
Research, Salt Lake City, UT; Daniel Greuner, MD, Lifetree Clini-
cal Research, Philadelphia, PA; Paul Gross, MD, Lehigh Center for
Clinical Research, Allentown, PA; David Krefetz, DO, Lifetree Clin-
ical Research, Willingboro, NJ; Benji Kurian, MD, University of
Texas Southwestern Medical Center, Dallas, TX; Michael Lesem,
MD, Claghorn-Lesem Clinical Research Ltd, Houston, TX;
Matthew Macaluso, DO, and Sheldon Preskorn, MD, University of
Kansas School of Medicine, Wichita, KS; Raymond Manning, MD,
CNRI-LA, Pico Rivera, CA; Vishaal Mehra, MD, Artemis Institute
for Clinical Research, San Diego, CA; Rick Mofsen, MD, CRI World-
Randomized Proof of Concept Trial of GLYX-13,
an N-Methyl-D-Aspartate Receptor Glycine Site
Partial Agonist, in Major Depressive Disorder
Nonresponsive to a Previous Antidepressant Agent
Psychopharmacology
SHELDON PRESKORN, MD
MATTHEW MACALUSO, DO
VISHAAL MEHRA, MD
GARY ZAMMIT, MD
JOSEPH R. MOSKAL PhD
RONALD M BURCH, MD, PhD
and the GLYX-13 Clinical Study Group
Copyright © WoltersKluwerHealth,Inc. Unauthorized reproduction of this article is prohibited.