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Randomized Controlled Trial
. 2015 Oct 14:16:459.
doi: 10.1186/s13063-015-0985-6.

Strategic use of new generation antidepressants for depression: SUN(^_^) D protocol update and statistical analysis plan

Naohiro Yonemoto  1   2 , Shiro Tanaka  3 , Toshi A Furukawa  4   5 , Tadashi Kato  6 , Akio Mantani  7 , Yusuke Ogawa  8 , Aran Tajika  9 , Nozomi Takeshima  10 , Yu Hayasaka  11 , Kiyomi Shinohara  12 , Kazuhira Miki  13 , Masatoshi Inagaki  14 , Shinji Shimodera  15 , Tatsuo Akechi  16 , Mitsuhiko Yamada  17 , Norio Watanabe  18 , Gordon H Guyatt  19 ; SUN(^_^)D Investigators
Affiliations
Randomized Controlled Trial

Strategic use of new generation antidepressants for depression: SUN(^_^) D protocol update and statistical analysis plan

Naohiro Yonemoto et al. Trials. .

Abstract

Background: SUN(^_^)D, the Strategic Use of New generation antidepressants for Depression, is an assessor-blinded, parallel-group, multicenter pragmatic mega-trial to examine the optimum treatment strategy for the first- and second-line treatments for unipolar major depressive episodes. The trial has three steps and two randomizations. Step I randomization compares the minimum and the maximum dosing strategy for the first-line antidepressant. Step II randomization compares the continuation, augmentation or switching strategy for the second-line antidepressant treatment. Step III is a naturalistic continuation phase. The original protocol was published in 2011, and we hereby report its updated protocol including the statistical analysis plan.

Results: We implemented two important changes to the original protocol. One is about the required sample size, reflecting the smaller number of dropouts than had been expected. Another is in the organization of the primary and secondary outcomes in order to make the report of the main trial results as pertinent and interpretable as possible for clinical practices. Due to the complexity of the trial, we plan to report the main results in two separate reports, and this updated protocol and the statistical analysis plan have laid out respective primary and secondary outcomes and their analyses. We will convene the blind interpretation committee before the randomization code is broken.

Conclusion: This paper presents the updated protocol and the detailed statistical analysis plan for the SUN(^_^)D trial in order to avoid reporting bias and data-driven results.

Trial registration: ClinicalTrials.gov: NCT01109693 (registered on 21 April 2010).

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Figures

Fig. 1
Fig. 1
Flow diagram of the trial
See this image and copyright information in PMC

References

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