- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00934635
A Positron-Emission-Tomography (PET) Study to Measure the Blockade of Dopamine Receptors (D2) in Specific Areas of the Brain in Relation to the Plasma Concentrations of Paliperidone Extended Release (ER) and Oral Risperidone in Schizophrenia Patients and Healthy Controls
January 14, 2014 updated by: Janssen-Cilag G.m.b.H
The "Therapeutic Window" of the "Atypical" Antipsychotic Paliperidone Extended Release (ER)-A Positron Emission Tomography Study With [18F]Fallypride as the Radiotracer
The primary objective of this study is to compare the effect of two different antipsychotic compounds which are used in the treatment of schizophrenia (paliperidone ER and risperidone) at their target sites in two specific areas of the brain in patients with schizophrenia.
A specialized X-ray known as Positron Emission Tomography (PET) Imaging is used to assess the areas of the brain targeted by both compounds.
Study Overview
Status
Terminated
Conditions
Detailed Description
This is an open-label (all people involved know the identity of the intervention), non-randomized (patients are assigned to treatment groups), phase IV, monocentric (at one single study site) interventional study evaluating the blocking effects two different doses of paliperidone ER and oral risperidone have on the dopamine D2 receptors in the brain of subchronic patients with schizophrenia.
Dopamine is a substance produced and released in the brain.
Research indicates that dopamine levels are elevated in some areas of the brain in acute schizophrenia psychosis.
Antipsychotic medications like risperidone and paliperidone ER are used to treat psychosis by blocking the dopamine receptors.
Fallypride is a radioactive tracer (a drug that emits radioactivity) that binds to the dopamine receptors in the brain much the same as antipsychotic medications.
It competes with the antipsychotic compounds at the binding sites and is used when performing a specialized x-ray known as Positron Emission Tomography (PET) Imaging.
After a patient receives Fallypride, it temporally binds to specific target areas in the brain and emits a brief and harmless radioactive signal that is detected by the PET Scanner.
Since paliperidone ER and risperidone compete with Fallypride at the same target sites, the signal will differ according to the binding effect of the compound.
This technique provides an image showing the direct effect medication has on the human brain and allows for comparisons of the effects of different medications to be made.
As this effect will fluctuate depending on the concentration of the drug in the blood, during this study, PET measurements will be correlated with the blood levels sampled.
Patients will receive either paliperidone ER (6 patients with 6 mg per day, 6 patients with 9 mg per day) or oral risperidone (6 patients with 4 mg per day, 6 patients with 6 mg per day).
The primary objective of this study is to compare the blocking effects each medication has on the dopamine D2 receptors at different time points (shortly after taking medication and 24 hours after taking medication) correlated with blood levels of the medication.
The study consists of 3 visits on 3 consecutive days.
Blood levels will be assessed for treatment groups 1 to 4 on day 2 and day 3 and for groups 5 to 8 on day 3 (according to the last intake of study medication).
PET-Scans will be assessed for every group on day 3. Group 1 to 4 consists of patients whose PET Scan will be assessed approximately 2 hours after taking medication (group 1 receives paliperidone ER 6 mg, group 2 receives paliperidone ER 9 mg, group 3 receives risperidone 4 mg, group 4 receives risperidone 6 mg).
Group 5 to 8 consists of patients whose PET Scan will be assessed approximately 24 hours after taking medication (group 5 receives paliperidone ER 6 mg, group 6 receives paliperidone ER 9 mg, group 7 receives risperidone 4 mg, group 8 receives risperidone 6 mg).
Adverse Events (AE's) will be assessed as reported spontaneously throughout the trial.
The dose of antipsychotic medication will represent the most frequent dose used in post acute treatment of schizophrenia.
A group of healthy volunteers (group 9) will serve as a control group to measure fallypride dopamine D2- receptor occupancies under normal circumstances, in patients not affected by schizophrenia.
Patients will receive the same dosage throughout the study as prescribed prior to the start of the study either paliperidone ER 6 mg tablet once daily or 9 mg tablet once daily or risperidone 4 mg tablet once daily or 6 mg daily (two 3 mg tablets).
Study Type
Interventional
Enrollment (Actual)
2
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Aachen, Germany
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 50 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients with a diagnosis of schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria
- Patients with a specified severity of the disease (Clinical Global Impression Scale of Severity (CGI-S) range of > 2 < 5)
- Patients must be on antipsychotic medication with either paliperidone ER or oral risperidone in monotherapy for at least two weeks and must be at least five days on a stable dose of either paliperidone ER 6 mg or 9 mg or oral risperidone 4 mg or 6 mg once daily
- Female patients of childbearing potential must have a negative human chorionic gonadotropin urine pregnancy test (ß-HCG) at visit 1 or must be postmenopausal for at least 1 year, surgically sterile, abstinent, or, if sexually active, agree to practice an effective method of birth control before entry, throughout the study and at least one month after study end
- Healthy control volunteers must be off all standard prescription drug therapy, over the counter compounds (OTC) and recreational substances/drugs for at least one week prior to participation in the study
- Female volunteers of childbearing potential must have a negative ß -HCG pregnancy test at visit 1 or be postmenopausal for at least 1 year, surgically sterile, abstinent, or, if sexually active, agree to practice an effective method of birth control before entry, throughout the study and at least one month after the study end
- Patients and volunteers must be able to read, understand and sign the Institutional Review Board approved informed consent form
Exclusion Criteria:
- Patients: Any depot neuroleptic medication (long acting injectables) in the last three months
- Any antipsychotic compound, antidepressant, antiepileptic ("mood stabilizers"), lithium, anticholinergic within 2 weeks prior to study
- Any psychopharmacologically active medication (except benzodiazepines, paracetamol and zopiclone as rescue medication) taken within the trial
- Physical and psychological conditions that interfere with the study procedures, or could influence the study results, or could endanger the patient during the study
- Alcohol and/or drug abuse four weeks prior to study start (patients with alcohol or drug abuse as defined by the DSM-IV criteria can participate if free of their of abuse for at least four weeks)
- Clinically relevant laboratory abnormality
- Pregnant or breast feeding patients
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: 002
Paliperidone ER 9 mg tablet once a day followed by PET scan in approximately 2 hours
|
9 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
9 mg tablet once a day followed by PET scan in approximately 24 hours
|
ACTIVE_COMPARATOR: 003
Oral risperidone 4 mg tablet once a day followed by PET scan in approximately 2 hours
|
6 mg tablet once a day followed by PET scan in approximately 2 hours
4 mg tablet once a day followed by PET scan in approximately 24 hours
4 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
|
ACTIVE_COMPARATOR: 004
Oral risperidone 6 mg tablet once a day followed by PET scan in approximately 2 hours
|
6 mg tablet once a day followed by PET scan in approximately 2 hours
4 mg tablet once a day followed by PET scan in approximately 24 hours
4 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
|
ACTIVE_COMPARATOR: 005
Paliperidone ER 6 mg tablet once a day followed by PET scan in approximately 24 hours
|
9 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
9 mg tablet once a day followed by PET scan in approximately 24 hours
|
ACTIVE_COMPARATOR: 006
Paliperidone ER 9 mg tablet once a day followed by PET scan in approximately 24 hours
|
9 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
9 mg tablet once a day followed by PET scan in approximately 24 hours
|
ACTIVE_COMPARATOR: 007
Oral risperidone 4 mg tablet once a day followed by PET scan in approximately 24 hours
|
6 mg tablet once a day followed by PET scan in approximately 2 hours
4 mg tablet once a day followed by PET scan in approximately 24 hours
4 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
|
ACTIVE_COMPARATOR: 008
Oral risperidone 6 mg tablet once a day followed by PET scan in approximately 24 hours
|
6 mg tablet once a day followed by PET scan in approximately 2 hours
4 mg tablet once a day followed by PET scan in approximately 24 hours
4 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
|
OTHER: 009
PET Scan PET Scan
|
PET Scan
|
ACTIVE_COMPARATOR: 001
Paliperidone ER 6 mg tablet once a day followed by PET scan in approximately 2 hours
|
9 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 2 hours
6 mg tablet once a day followed by PET scan in approximately 24 hours
9 mg tablet once a day followed by PET scan in approximately 24 hours
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Percentage of Paliperidone or Risperidone Dopamine D2 Receptor Occupancies
Time Frame: Visit 3 (on day 3)
|
Visit 3 (on day 3)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma Concentrations of Paliperidone and Risperidone
Time Frame: Measurement of plasma concentration at Visit 3 (day 3)
|
No measures available due to early termination of trial
|
Measurement of plasma concentration at Visit 3 (day 3)
|
Assessment of the Ratio of Dopamine D2-receptor Occupancies in Two Different Areas of the Brain
Time Frame: Analysis of PET scans at Visit 3 (day 3)
|
No measures available due to early termination of trial
|
Analysis of PET scans at Visit 3 (day 3)
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2009
Primary Completion (ACTUAL)
December 1, 2009
Study Completion (ACTUAL)
December 1, 2009
Study Registration Dates
First Submitted
July 6, 2009
First Submitted That Met QC Criteria
July 7, 2009
First Posted (ESTIMATE)
July 8, 2009
Study Record Updates
Last Update Posted (ESTIMATE)
February 11, 2014
Last Update Submitted That Met QC Criteria
January 14, 2014
Last Verified
January 1, 2014
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Schizophrenia Spectrum and Other Psychotic Disorders
- Schizophrenia
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Antipsychotic Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Serotonin Agents
- Dopamine Agents
- Serotonin 5-HT2 Receptor Antagonists
- Serotonin Antagonists
- Dopamine D2 Receptor Antagonists
- Dopamine Antagonists
- Paliperidone Palmitate
- Risperidone
Other Study ID Numbers
- CR015277
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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