Head-to-head evidence
Esketamine vs Onfasprodil
Same mechanism, same race: design-graded trial evidence for both assets, with the grading rationale shown. Grades describe the quality of the evidence, never the merits of either security.
Major Depressive Disorder
Shared mechanism: NMDA receptor · full Major Depressive Disorder pipeline
Esketamine · Spravato
Marketed by Johnson & Johnson
NCT02417064 · Phase 3 · completed
The study randomized 346 participants to double-blind 56 mg esketamine, 84 mg esketamine, or matching placebo, each with an oral antidepressant, and used the clinical MADRS depression score as its primary endpoint. The 56 mg dose significantly outperformed placebo, while the 84 mg dose did not, so the primary results were mixed despite the strong trial design.
Next expected readout: December 2026 · NCT07369102 (registry estimate)
Onfasprodil
Developed by Novartis
NCT03756129 · Phase 2 · completed
Participants were randomized and blinded to MIJ821, placebo, or ketamine, but the 70-person study was small and spread across six treatment groups. The clinical primary endpoint was met at 24 hours for both pooled MIJ821 dose groups versus placebo, with statistically significant MADRS score differences, but the limited sample size supports moderate rather than strong evidence.
The full competitive landscape for each asset (every same-race competitor with aligned evidence, sortable) is on the asset pages: Esketamine's landscape · Onfasprodil's landscape