Rapastinel (Allergan) is a synthetic tetrapeptide comprising of threonine–proline–proline–threonine that acts as a partial agonist at the glycine site of the NMDA receptor. This mechanism activates pathways involved with long-term plasticity and long-term depression, yielding pro-cognitive and antidepressant effects. Rapastinel has been developed specifically as an NMDA-targeting drug that can produce rapid-onset antidepressant activity without any psychotomimetic effects associated with other products like ketamine. As a peptide, rapastinel must be dosed intravenously to ensure its biological efficacy.
Rapastinel’s Phase III treatment-resistant depression program washout is a significant blow for Allergan. The company has invested a great deal into its development of rapastinel with 10 Phase III pivotal trials in depression spanning treatment-resistant depression and major depressive disorder (MDD), as well as a Phase II trial for MDD with imminent risk of suicide. This has caused the company to miss out on the opportunity to break into the less saturated segment of the depression market.
LIST OF TABLES
6 Table 1: Rapastinel drug profile
8 Table 2: Rapastinel completed Phase III trials in depression
11 Table 3: Rapastinel ongoing Phase III trials in depression
13 Table 4: Rapastinel Phase II data in depression
14 Table 5: Rapastinel ongoing Phase II trial in MDD at imminent risk of suicide
15 Table 6: Rapastinel for depression – SWOT analysis
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