Relapse Prevention Study in Patients With Schizophrenia (REPRIEVE)

A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group Study to Evaluate Prevention of Relapse in Patients With Schizophrenia Receiving Either Flexible Dose Iloperidone or Placebo in Long-term Use (up to 26 Weeks) Followed by up to 52 Weeks of Open-label Extension

The purpose of this study is to determine whether Iloperidone is effective in the prevention of relapse in patients with schizophrenia

Study Overview

• Status: Completed
• Conditions: Schizophrenia
• Intervention / Treatment: Drug: Iloperidone; Drug: Placebo

• Study Type: Interventional
• Enrollment (Actual): 635
• Phase: Phase 3

Contacts and Locations

Study Locations

• India
  • Gujarat
    • Ahmedabad, Gujarat, India, 380013
      • Vanda Investigative Site
  • Karnataka
    • Madhava Nagar, Karnataka, India, 576104
      • Vanda Investigative Site
    • Mangalore, Karnataka, India, 575001
      • Vanda Investigative Site
    • Mangalore, Karnataka, India, 575018
      • Vanda Investigative Site
    • Mysore, Karnataka, India, 570004
      • Vanda Investigative Site
  • Maharashtra
    • Nashik, Maharashtra, India, 422101
      • Vanda Investigative Site
    • Pune, Maharashtra, India, 411030
      • Vanda Investigative Site
  • Rajasthan
    • Jaipur, Rajasthan, India, 302021
      • Vanda Investigative Site
  • Tamilnadu
    • Madurai, Tamilnadu, India, 625020
      • Vanda Investigative Site
  • Uttar Pradesh
    • Kanpur, Uttar Pradesh, India, 208005
      • Vanda Investigative Site
    • Lucknow, Uttar Pradesh, India, 226003
      • Vanda Investigative Site
    • Lucknow, Uttar Pradesh, India, 226006
      • Vanda Investigative Site
    • Varanasi, Uttar Pradesh, India, 221005
      • Vanda Investigative Site
• Ukraine
  • Chernihiv, Ukraine, 14000
    • Vanda Investigative Site
  • Dnipropetrovsk, Ukraine, 49005
    • Vanda Investigative Site
  • Dnipropetrovsk, Ukraine, 49115
    • Vanda Investigative Site
  • Donetsk, Ukraine, 83037
    • Vanda Investigative Site
  • Donezk, Ukraine, 83008
    • Vanda Investigative Site
  • Ivano-Frankivsk, Ukraine, 76014
    • Vanda Investigative Site
  • Kharkiv, Ukraine, 61068
    • Vanda Investigative Site
  • Kharkiv, Ukraine, 68061
    • Vanda Investigive Site
  • Kyiv, Ukraine, 01030
    • Vanda Investigative Site
  • Kyiv, Ukraine, 02660
    • Vanda Investigative Site
  • Kyiv, Ukraine, 04080
    • Vanda Investigative Site
  • Kyiv, Ukraine, 08631
    • Vanda Investigative Site
  • Lugansk, Ukraine, 91045
    • Vanda Investigative Site
  • Odesa, Ukraine, 65014
    • Vanda Investigative Site
  • Poltava, Ukraine, 36006
    • Vanda Investigative Site
  • Simferopol, Ukraine, 95006
    • Vanda Investigative Site
  • Stepanivka, Ukraine, 73488
    • Vanda Investigative Site
  • Ternopil, Ukraine, 46020
    • Vanda Investigative Site
  • Uzhgorod, Ukraine, 88000
    • Vanda Investigative Site
  • Vinnytsya, Ukraine, 21005
    • Vanda Investigative Site
  • AR Crimea
    • Kerch, AR Crimea, Ukraine, 98310
      • Vanda Investigative Site
    • Yevpatoriya, AR Crimea, Ukraine, 97416
      • Vanda Investigative Site
• United States
  • California
    • Anaheim, California, United States, 92604
      • Vanda Investigative Site
    • Bellflower, California, United States, 92706
      • Vanda Investigative Site
    • Costa Mesa, California, United States, 92626
      • Vanda Investigative Site
    • Escondido, California, United States, 92025
      • Vanda Investigative Site
    • La Habra, California, United States, 90631
      • Vanda Investigative Site
    • Oceanside, California, United States, 92056
      • Vanda Investigative Site
    • Orange, California, United States, 92868
      • Vanda Investigative Site
    • Pico Rivera, California, United States, 90660
      • Vanda Investigative Site
    • Riverside, California, United States, 92506
      • Vanda Investigative Site
    • San Diego, California, United States, 92102
      • Vanda Investigative Site
    • San Diego, California, United States, 92103
      • Vanda Investigative Site
    • San Diego, California, United States, 92121
      • Vanda Investigative Site
    • Santa Ana, California, United States, 92705
      • Vanda Investigative Site
  • Florida
    • Melbourne, Florida, United States, 32901
      • Vanda Investigative Site
    • Miami, Florida, United States, 33126
      • Vanda Investigative Site
    • Oakland Park, Florida, United States, 33334
      • Vanda Investigative Site
  • Georgia
    • Atlanta, Georgia, United States, 30308
      • Vanda Investigative Site
    • Atlanta, Georgia, United States, 30328
      • Vanda Investigative Site
  • Missouri
    • Saint Louis, Missouri, United States, 63109
      • Vanda Investigative Site
  • New Hampshire
    • Nashua, New Hampshire, United States, 03060
      • Vanda Investigative Site
  • New Jersey
    • Marlton, New Jersey, United States, 08053
      • Vanda Investigative Site
  • New York
    • Brooklyn, New York, United States, 11235
      • Vanda Investigative Site
    • Staten Island, New York, United States, 10312
      • Vanda Investigative Site
  • North Carolina
    • Hickory, North Carolina, United States, 28601
      • Vanda Investigative Site
  • Ohio
    • Beachwood, Ohio, United States, 44122
      • Vanda Investigative Site
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19139
      • Vanda Investigative Site
  • Texas
    • Irving, Texas, United States, 75062
      • Vanda Investigative Site
  • Utah
    • Salt Lake City, Utah, United States, 84106
      • Vanda Investigative Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients must understand and be capable to communicate adequately with the study coordinator and to participate in cognitive testing.
• Patients must agree to cooperate with all tests and examinations required by the protocol, be willing to comply fully with treatment and able to ingest oral medication.
• Patients must understand the nature of the study and must sign an informed consent document.
• Patients will have a clear diagnosis of schizophrenia according to DSM-IV criteria for at least 1 year.
• Patients must need of ongoing psychiatric treatment and must have a documented reason why a change in treatment is needed which might lead to a clinical improvement
• At screening patients will have a Positive and Negative Syndrome Scale (PANSS) of no more than 100 and a Clinical Global Impression Scale (CGI) of no more than 5 (i.e. must not be severely ill or worse).
• Patients must be outpatients at the time of screening and have not been an inpatient to treat schizophrenia for at least 1 week prior to the screening visit.
• Patients must have a history of at least 2 prior episodes of relapse or impending relapse in the 2 years preceding the screening visit.

Exclusion Criteria:-

• Pregnant or nursing (lactating) women, or women who plan on conceiving during the course of the study.
• Patients who meet the DSM-IV criteria for schizophreniform disorder (295.40) and schizoaffective (295.70).
• Patients with active symptoms of any other primary psychiatric diagnosis (Axis I) or prominent Axis II disorder which would interfere with compliance to the protocol.
• Patients who have a diagnosis or history suggestive of chemical dependence, or drug-induced toxic psychosis in the preceding 6 months; diagnosis or history of abuse (except for nicotine and caffeine) within the past 3 months, or a clinical presentation possibly confounded by the use of recreational drugs or alcohol.
• Patients who have a positive urine drug screen (at the screening visit). If opiates are positive at screening and clearly due to the use of pain killing medication, the patient may be re screened after the medication has been discontinued and enrolled in the study if urine drug screen is negative.
• Note: Occasional users of recreational drugs other than cocaine, amphetamines, hallucinogens, or parenteral drugs may be recruited. Patients who are dependent on nicotine, caffeine, or theophylline are allowed to enter the study.
• Patients who are mentally disabled (moderate to severe).
• Patients who have had a history of being in a coma for more than 24 hrs.
• Patients who have had thoughts of committing suicide within 6 months prior to screening or at baseline or suicide behaviors within 2 years prior to screening or at baseline.
• Patients thought to be of imminent risk of harm to others or in imminent legal difficulty.
• Patients under any form of legal compulsion to remain hospitalized or undergo treatment or assessment.
• Patients who have any disability that prevent them from completing any of the study requirements.
• Patients with a known clinically significant ECG abnormality including PR interval >240 msec, QRS complex >110 msec, QTcF >=450 msec, or congenital long QT syndrome based on central ECG reading results
• Treatment naive, first episode patients,
• Patients taking iloperidone at the screening visit or with a known hypersensitivity to drugs chemically related to benzioxazoles.
• Note: Active medical conditions that are minor or well-controlled are not exclusionary if they do not affect risk to the patient or the study results.

Other protocol-defined inclusion/exclusion criteria may apply

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Iloperidone; After meeting all entry criteria, completing a 1-week open-label iloperidone titation period (up to 12 mg/day), followed by a 14-24 week open-label iloperidone flexible dose-stabilization period (up to 24 mg/day), approximately 260 patients will be randomized to one of two arms in a 1:1 ratio of iloperidone (flexible dosing 8-24 mg/day) to placebo. Post-randomization double-blind study medication will be administered orally twice daily for up to 26 weeks to evaluate relapse prevention. Subsequently, during the extension period, after a 1-week mock double-blind titration, open-label iloperidone (8-24 mg/day) is administered for up to 51 weeks to evaluate long-term safety.	Drug: Iloperidone; Over-encapsulated iloperidone tablets were administered orally using a bid schedule; the strengths used include 1, 2, 4, 6, 8, 10, and 12 mg.; Other Names: Fanapt®
Placebo Comparator: Placebo; Post-randomization matching placebo is administered orally bid during the double-blind period.	Drug: Placebo; Matching placebo capsules were administered orally using a bid schedule during the double-blind period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to Relapse or Impending Relapse	Relapse or impending relapse was defined as any of the following: hospitalization due to worsening of schizophrenia; increase (worsening) of the PANSS total score of greater than or equal to 30% from randomization, PANSS total score confirmed at a second visit conducted within 1-7 days; clinically significant emergent or worsening suicidal, homicidal, or aggressive behavior; a CGI-Improvement (CGI-I) score of 6 (much worse) or 7 (very much worse) after randomization; a dose increase in study medication or a need for additional open-label antipsychotic treatment.	Up to 26 weeks post-randomization

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PANSS Total Score, Change From Baseline to Last Visit	The 30-item Positive and Negative Syndrome Scale (PANSS) was developed to assess the severity of symptoms of schizophrenia. The PANSS items are divided into positive, negative, and general psychopathology factors. All items were rated on a scale of 1 (absent) to 7 (extremely severe). The PANSS total score (or rating) is the sum of all 30 PANSS items taken together (the sum of its 3 subscales), with a maximum score of 210. Change from baseline is calculated as post value minus baseline value. A negative change indicates improvement.	Up to 26 weeks post-randomization
CGI-S, Last Visit	The 7-item Clinical Global Impression of Severity (CGI-S) scale was developed to assess the overall, absolute degree of illness at any point in time. A rating of 1 is equivalent to "normal, not at all ill," and a rating of 7 is equivalent to "among the most extremely ill patients."	Up to 26 weeks post-randomization
SDS Total Score, Change From Baseline to Last Visit	The Sheehan Disability Scale (SDS) a self-reported measure that was developed to assess functional impairment in 3 inter-related domains (i.e., work/school, social, and family life). It is a 10-point visual analog scale with 0 being not impaired at all and 10 extremely impaired. Change from baseline is calculated as post value minus baseline value. A negative change indicates improvement.	Up to 26 weeks post-randomization

Collaborators and Investigators

• Sponsor: Vanda Pharmaceuticals

Publications and helpful links

General Publications

• Weiden PJ, Manning R, Wolfgang CD, Ryan JM, Mancione L, Han G, Ahmed S, Mayo MG. A Randomized Trial of Iloperidone for Prevention of Relapse in Schizophrenia: The REPRIEVE Study. CNS Drugs. 2016 Aug;30(8):735-47. doi: 10.1007/s40263-016-0345-4.

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2011
• Primary Completion (Actual): March 1, 2014
• Study Completion (Actual): March 1, 2015

Study Registration Dates

• First Submitted: February 3, 2011
• First Submitted That Met QC Criteria: February 5, 2011
• First Posted (Estimated): February 8, 2011

Study Record Updates

• Last Update Posted (Actual): July 17, 2023
• Last Update Submitted That Met QC Criteria: July 11, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Keywords: Schizophrenia; Antipsychotic Agents; Mental Disorders; Relapse Prevention; Iloperidone
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease Attributes; Schizophrenia Spectrum and Other Psychotic Disorders; Schizophrenia; Recurrence; Physiological Effects of Drugs; Central Nervous System Depressants; Antipsychotic Agents; Tranquilizing Agents; Psychotropic Drugs; Iloperidone
• Other Study ID Numbers: CILO522D2301

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No