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RecruitingNCT07845604PDATUpdated Sep 29, 2026

Precision Depression Adalimumab Trial

A Phase 2 interventional study of Adalimumab Biosimilars Injection and Placebo in Major Depressive Disorder (MDD), sponsored by Daniel Moriarity. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.

Sponsored by Daniel Moriarity · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to learn if the anti-inflammatory medication adalimumab improves depressive symptoms in adults with Major Depressive Disorder (MDD) who are already taking the anti-depressant medication Lexapro (escitalopram).

The main questions it aims to answer are:

  1. Does adalimumab improve the symptoms of some patients with MDD who are already taking an anti-depressant?
  2. What characteristics predict for whom adalimumab has anti-depressant properties.

Researchers will compare adalimumab to a placebo (a look-alike substance that contains no drug) to see if adalimumab works to improve depressive symptoms as an add-on drug to the anti-depressant Lexapro (escitalopram).

For these primary aims the participants will:

  1. Visit the clinic once every 2 weeks for a checkups and injection of adalimumab or placebo from the study psychiatrist (Day 1, 15, 29, and 43 for injections)
  2. Complete short (\<5 min) daily surveys for the 57 day duration of the study.
Read the detailed description

This is a 57-day intensive longitudinal study of 60 adult subjects with Major Depressive Disorder and elevated baseline tumor necrosis factor (TNF) levels. A triple-blind, placebo-controlled pharmacological investigation of adalimumab as an adjunctive medication to escitalopram will be conducted to determine anti-depressant efficacy of adalimumab. Patients will be screened for depression, health concerns, and a minimum of 1.5 pg/mL TNFa. It is hypothesized that adalimumab will lead to improved treatment outcomes (specifically somatic/neurovegetative symptoms). It is hypothesized that, if more symptoms than somatic/neurovegetative respond, they will do so less quickly than somatic/neurovegetative symptoms.

Enrolled participants will be randomized in a 2:1 ratio to adjunctive adalimumab or placebo in addition to the participant's regular dose of escitalopram each day (both conditions). Patients will be matched for sex. Enrolled patients will attend 4 clinic visits, at which point they will receive injections of adalimumab or placebo from the study psychiatrist (Day 1, 15, 29, and 43 for injections), in addition to clinician-assessed measures. Daily self-report assessments of depression symptoms will be collected for 57 days.

02

Conditions studied

  • Major Depressive Disorder (MDD)

Keywords

  • inflammation
  • depression
  • psychoneuroimmunology
  • intensive longitudinal study
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Provision of signed and dated informed consent form
  • Stated willingness to comply with all study procedures and availability for the duration of the study
  • Male or female, aged 18+ years
  • Meet DSM-5 criteria for Major Depressive Disorder
  • baseline serum TNF-alpha (average of two samples in the same week) greater than 1.5 pg/mL
  • Taking a steady dose of Lexapro (escitalopram) for at least 4 weeks
  • Ability to take oral medication and physician-administered subcutaneous injection and be willing to adhere to the study protocol
  • For females of reproductive potential: use of highly effective contraception for at least 1 month
  • Access to a phone or computer with a camera

Exclusion criteria

Exclusion Criteria:

  1. Pregnant or breastfeeding
  2. Active, chronic or recurrent infection
  3. Known malignancy
  4. Current use of immune modulating medications
  5. Immunocompromised, current autoimmune condition or history of severe immune condition (e.g., history of cancer, HIV/AIDS)
  6. History of, or positive test for, Hepatitis B surface antigen or core antibody positivity or tuberculosis (TB)
  7. Congestive heart failure
  8. History of demyelinating disease (multiple sclerosis (MS), optic neuritis, Guillain-Barre syndrome)
  9. History of seizure disorder
  10. Symptomatic hyponatremia
  11. Monoamine oxidase inhibitors (MAOI) use within 14 days
  12. Recent use of Rituxan (rituximab)
  13. Concomitant use of:

    1. Immunosuppressants
    2. Kineret (anakinra)
    3. Orencia (abatacept)
    4. Remicade (infliximab)
    5. Enbrel (etanercept)
    6. Cimzia (certolizumab pegol)
    7. Simponi (golimumab)
    8. Imuran (azathioprine)
    9. Purinethol (6-mercaptopurine)
    10. Linezolid
    11. IV methylene blue
    12. Pimozide
    13. Antiplatelet agents
    14. Strong anticoagulants (e.g. warfarin, large doses of NSAIDs)
    15. Other SSRIs, SNRIs, tryptophan
  14. Clinically relevant substance use disorder
  15. Known allergic reactions to components of adalimumab and/or escitalopram
  16. Treatment with another investigational drug or other intervention while participating in the study
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Active Treatment Arm

    80 mg adalimumab administered on Day 1 subcutaneously, then 40 mg adalimumab administered on Days 15, 29, and 43 subcutaneously by study psychiatrist.

    Drug: Adalimumab Biosimilars Injection

  • Placebo comparator
    Placebo Comparison Arm

    0.8 mL saline placebo administered on Day 1 subcutaneously, then 0.4 mL saline placebo administered on Days 15, 29, and 43 subcutaneously by study psychiatrist.

    Other: Placebo

Interventions

  • DrugAdalimumab Biosimilars Injection

    adalimumab biosimilar 100mg/mL

  • OtherPlacebo

    placebo injection of same volume as active medication for that visit

    Also known as: saline placebo

05

What researchers measure

Primary outcomes

  1. Change from baseline in individual somatic, affective, and motivational depressive symptoms, as measured by the Quick Inventory of Depressive Symptomatology (QIDS)

    The QIDS (Trivedi et al., 2004; Rush et al., 2003) is a rating scale that assesses the nine criterion symptom domains designated by the American Psychiatric Association's (2000) DSM-IV to diagnose a major depressive episode. There are 16 items in the adult versions of the QIDS16 measuring the nine criterion symptom domains (sleep, sad mood, appetite/weight, concentration/decision making, self-view, thoughts of death or suicide, general interest, energy level, and restlessness/agitation) that define a major depressive episode according to the DSM-IV. The scores for three domains (sleep, appetite/weight, and restlessness/agitation) are based upon the maximum score (most pathological) of two or more questions for the total score analysis. Each of the remaining domains is rated by a single item. All domains are scored from 0 to 3, with higher scores reflecting greater psychopathology. Source: Yeung, A. et al. (2012). The QIDS. The Journal of nervous and mental disease, 200(8), 712-715.

    Time frame: From start of trial to the end of study (Day 57)

Secondary outcomes

  1. Change from baseline in the total depression score, as measured by the Quick Inventory of Depressive Symptomatology

    as for primary

    Time frame: From start of trial to the end of study (Day 57)

06

Study locations

1 of 1 sites recruiting
  • University of Pennsylvania
    Philadelphia, Pennsylvania 19104, United States
    Recruiting
07

References and documents

Publications

  • Menter A, Augustin M, Signorovitch J, Yu AP, Wu EQ, Gupta SR, Bao Y, Mulani P. The effect of adalimumab on reducing depression symptoms in patients with moderate to severe psoriasis: a randomized clinical trial. J Am Acad Dermatol. 2010 May;62(5):812-8. doi: 10.1016/j.jaad.2009.07.022. Epub 2010 Mar 9. PubMed 20219265 ↗
  • Abbasian F, Bagheri S, Moradi K, Keykhaei M, Etemadi A, Shalbafan M, Shariati B, Vaseghi S, Samsami FS, Akhondzadeh S. Evidence for Anti-inflammatory Effects of Adalimumab in Treatment of Patients With Major Depressive Disorder: A Pilot, Randomized, Controlled Trial. Clin Neuropharmacol. 2022 Sep-Oct 01;45(5):128-134. doi: 10.1097/WNF.0000000000000518. Epub 2022 Sep 7. PubMed 36093920 ↗

Individual participant data

Plan to share: Yes — Publication-specific

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

08

Registry details

Key details

Study ID
NCT07845604
Lead sponsor
Daniel Moriarity
Collaborators
Brain & Behavior Research Foundation
Responsible party
Daniel Moriarity (Assistant Professor of Clinical Psychology, University of Pennsylvania) — Sponsor-investigator
First posted
Sep 29, 2026
Start date
Sep 2026 (estimated)
Primary completion
Jul 2031 (estimated)
Completion
Sep 2031 (estimated)
Last update
Sep 29, 2026

Study contacts

Daniel P Moriarity, PhD
Contact
dmori@upenn.edu
(484) 808-5930
Daniel P. Moriarity, PhD
principal investigator · University of Pennsylvania

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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