Trial to Assess the Pharmacokinetics, Safety, Tolerability of Oral Brexpiprazole in Children (6 to <13 Years Old) With Central Nervous System Disorders

A Phase 1, Single-dose, Sequential Cohort, Nonrandomized Crossover Trial to Assess the Pharmacokinetics, Safety, and Tolerability of Oral Brexpiprazole in Children (6 to< 13 Years Old) With Central Nervous System Disorders

A study to assess pharmacokinetics, safety and tolerability of brexpiprazole in children ages 6 to <13 years with CNS disorders.

Study Overview

Detailed Description

A US based nonrandomized, sequential cohort, crossover trial to assess pharmacokinetics, safety and tolerability of brexpiprazole in children ages 6 to <13 years with CNS disorders who are receiving antipsychotic treatment for their medical condition.

Study Type

Interventional

Enrollment (Actual)

24

Phase

  • Phase 1

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

    • Arkansas
      • Little Rock, Arkansas, United States, 72211
        • Woodland International Research Group
      • Rogers, Arkansas, United States, 72758
        • Woodland Research Northwest, LLC
    • California
      • Long Beach, California, United States, 90807
        • Alliance for Wellness dba Alliance for Research
    • North Carolina
      • Charlotte, North Carolina, United States, 28211
        • New Hope Clinical Research
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73103
        • IPS Research Company
      • Oklahoma City, Oklahoma, United States, 73116
        • Cutting Edge Research Group
    • Texas
      • San Antonio, Texas, United States, 78229
        • Clinical Trials of Texas, Inc.
      • San Antonio, Texas, United States, 78249
        • Road Runner Research Ltd.
    • Utah
      • Orem, Utah, United States, 84058
        • Aspen Clinical Research

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

6 years to 12 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Male and female subjects between 6 and 12 years of age
  • Subjects with CNS disorders including, but not limited to, ADHD, autism spectrum disorders, bipolar I disorder (subjects 10 to 12 years old only for bipolar), conduct disorder, oppositional defiant disorder, or any psychotic disorder and who are receiving antipsychotic treatment for their medical condition. Subjects' diagnoses will be determined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria and confirmed at screening using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (K-SADS-PL).
  • Subjects must be considered psychiatrically/medically appropriate for participation in a clinical trial in which they will receive two doses of an antipsychotic medication.
  • Subjects with good physical health, as determined by no clinically significant deviation from normal for all of the following, prior to enrollment in the trial:

    1. Medical history
    2. Clinical laboratory determination
    3. ECGs
    4. Physical examinations
  • Subjects who are within the 5th to 95th percentile for gender-specific BMI for age from the Centers for Disease Control and Prevention growth charts and weight at least 15 kg (approx. 33 lbs)
  • Ability to commit to remain fully abstinent or use 2 approved methods of birth control during the trial for 21 (± 2) days following the last dose of IMP for sexually active females of childbearing potential.
  • Ability, in the opinion of the PI, of the subject and the subject's legally acceptable representative or caregiver(s) to understand the nature of the trial and follow protocol requirements, including all of the following:

    1. Comply with prescribed dosage regimens and tablet ingestion, as well as the discontinuation of prohibited concomitant medications
    2. Reliably return for scheduled visits
    3. To be reliably rated on assessment scales

Exclusion Criteria:

  • Subjects with a clinical presentation or history that is consistent with delirium, dementia, amnesia, or other cognitive disorders; subjects with psychotic symptoms that are better accounted for by another general medical condition(s) other than those listed in the second inclusion criterion above, or direct effect of a substance (ie, medication, illicit drug use, etc.).
  • Subjects with a history of at least mild intellectual disability as determined by IQ < 70, clinical evidence, or a social or school history that is suggestive of intellectual disability.
  • Subjects who have any of the following:

    1. A significant risk of committing suicide based on history and the principal investigator's clinical judgment, or routine psychiatric status examination
    2. Current suicidal behavior
    3. Imminent risk of injury; active suicidal ideation
    4. Any lifetime history of suicidal behavior detected by the Children's Baseline/Screening version of the C-SSRS.
  • Subjects with a lifetime history of a substance use disorder (as determined by the DSM-5 criteria), or current substance misuse including alcohol and benzodiazepines, but excluding caffeine and nicotine.
  • Subjects who currently have clinically significant neurological, hepatic, renal, metabolic, hematological, immunological, cardiovascular, pulmonary, or gastrointestinal disorders such as any history of myocardial infarction, congestive heart failure, HIV seropositive status/acquired immunodeficiency syndrome, or chronic hepatitis B or C. Medical conditions that are minor or well-controlled may be considered acceptable if the condition does not expose the subject to an undue risk of significant adverse event or interfere with assessments during the course of the trial.
  • Subjects with insulin dependent diabetes mellitus (IDDM) are excluded. Subjects with non-IDDM may be eligible for the trial if their condition is determined to be stable.
  • Subjects with epilepsy or a history of seizures (except for a single seizure episode, for instance childhood febrile seizure or post traumatic) or a history of severe head trauma or cerebrovascular disease (eg, stroke, transient ischemic attack, etc.).
  • Any major surgery within 30 days prior to the first dose of IMP.
  • Any history of significant bleeding or hemorrhagic tendencies.
  • Blood transfusions within 30 days prior to first dose of IMP.
  • Subjects with a positive drug screen for cocaine, marijuana (even if by prescription), or other illicit drugs, or alcohol are excluded and may not be retested or rescreened.
  • Subjects who have supine or standing diastolic blood pressure, after resting for at least 5 minutes, ≥ 95 mmHg.
  • Subjects who have had a dose of depot antipsychotics within 6 months of screening.
  • Consumption of alcohol or grapefruit, grapefruit juice, Seville oranges, or Seville orange juice within 72 hours prior to the first dose of IMP and throughout the trial
  • Subjects who participated in a clinical trial and were exposed to IMP within the last 30 days prior to screening or who participated in more than 2 interventional clinical trials within the past year.
  • Subjects with a history of neuroleptic malignant syndrome or hypersensitivity to atypical antipsychotics.
  • Subjects with a history of true allergic (i.e. not intolerance) response to more than one class of medications.
  • Subjects with a history of allergic reaction or a known or suspected sensitivity to any substance that is contained in the IMP formula.
  • Subjects who do not tolerate venipuncture or have poor venous access that would cause difficulty for collecting blood samples.
  • Prisoners or subjects who are compulsorily detained (e.g. juvenile detention, court-mandated treatment) for any reason.
  • Inability to tolerate oral medication or swallow tablets.

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: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 10 to <13 Years of Age
Two doses will be administered with a washout period of 14 days between the first dose of 1.5 mg the second dose of 3 mg.
Tablet
Other Names:
  • OPC-34712
Experimental: 6 to <10 Years of Age
Two doses will be administered with a washout period of 14 days between the first dose of 0.75 mg and the second dose of 1.5 mg.
Tablet
Other Names:
  • OPC-34712

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Maximum Plasma Concentration (Cmax) [PK]
Time Frame: Up to 22 days or early termination
The maximum plasma concentration of drug will be assessed for brexpiprazole and its major metabolite DM-3411.
Up to 22 days or early termination
Area under concentration-time curve (AUC) calculated from time zero to time t (AUCt) [PK]
Time Frame: Up to 22 days or early termination
AUCt will be assessed for plasma brexpiprazole and its major metabolite DM-3411 to determine average concentration of drug over time
Up to 22 days or early termination
AUC from time zero to infinity [PK]
Time Frame: Up to 22 days or early termination
AUC infinity will be assessed for plasma brexpiprazole and its major metabolite DM-3411 to determine total drug exposure over time
Up to 22 days or early termination
Time of maximum plasma concentration (tmax) [PK]
Time Frame: Up to 22 days or early termination
The amount of time that the maximum plasma concentration of drug will be assessed for plasma brexpiprazole and its major metabolite DM-3411
Up to 22 days or early termination
Terminal-phase elimination half-life (t½,z) [PK]
Time Frame: Up to 22 days or early termination
t½,z will be assessed for plasma brexpiprazole and its major metabolite DM-3411 to determine drug persistence in the body
Up to 22 days or early termination
Apparent clearance of drug from plasma after extravascular administration (CL/F) [PK]
Time Frame: Up to 22 days or early termination
CL/F for brexpiprazole only
Up to 22 days or early termination

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment-Emergent Adverse Events (TEAES) [Safety]
Time Frame: Up to 22 days or early termination with a 21 day follow-up period
Up to 22 days or early termination with a 21 day follow-up period
Clinical laboratory tests [Safety]
Time Frame: Up to 22 days or early termination
Collect hematology, serum chemistry,and urinalysis will be assessed to determine the safety and tolerability of drug
Up to 22 days or early termination
Vital signs observed and change from baseline data (systolic and diastolic blood pressure) [Safety]
Time Frame: Up to 22 days or early termination
Up to 22 days or early termination
Vital signs observed and change from baseline data (heart rate) [Safety]
Time Frame: Up to 22 days or early termination
Up to 22 days or early termination
Vital signs observed and change from baseline data (respiratory rate) [Safety]
Time Frame: Up to 22 days or early termination
Up to 22 days or early termination
Vital signs observed and change from baseline data (body temperature) [Safety]
Time Frame: Up to 22 days or early termination
Up to 22 days or early termination
12-lead electrocardiogram (ECGs) [Safety]
Time Frame: Up to 22 days or early termination
Up to 22 days or early termination
Physical examinations (height) [Safety]
Time Frame: Up to 22 days or early termination
Height is measured in cm,and will be used to calculate Body Mass Index (BMI)
Up to 22 days or early termination
Physical examinations (weight) [Safety]
Time Frame: Up to 22 days or early termination
Weight is measured in kg, and will be used to calculate Body Mass Index (BMI)
Up to 22 days or early termination
Physical examinations- Body Mass Index (BMI) [Safety]
Time Frame: Up to 22 days or early termination
Body Mass Index (BMI) measured using height (cm) and weight (kg)
Up to 22 days or early termination
Physical examinations- review of body systems [Safety]
Time Frame: Up to 22 days or early termination
Subject will be examined by site staff for any notable changes
Up to 22 days or early termination
Simpson-Angus Scale (SAS) rating scale [Safety]
Time Frame: Up to 22 days or early termination
Will be used in analysis of Extrapyramidal Symptoms (EPS)
Up to 22 days or early termination
Abnormal Involuntary Movement Scale (AIMS) [Safety]
Time Frame: Up to 22 days or early termination
Will be used in analysis of Extrapyramidal Symptoms (EPS)
Up to 22 days or early termination
Barnes Akathisia Rating Scale (BARS) [Safety]
Time Frame: Up to 22 days or early termination
Will be used in analysis of Extrapyramidal Symptoms (EPS)
Up to 22 days or early termination
Columbia-Suicide Severity Rating Scale (C-SSRS) [Safety]
Time Frame: Up to 22 days or early termination
Up to 22 days or early termination

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

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 (Actual)

October 10, 2017

Primary Completion (Actual)

May 21, 2018

Study Completion (Actual)

May 21, 2018

Study Registration Dates

First Submitted

September 21, 2017

First Submitted That Met QC Criteria

September 21, 2017

First Posted (Actual)

September 26, 2017

Study Record Updates

Last Update Posted (Actual)

June 12, 2018

Last Update Submitted That Met QC Criteria

June 11, 2018

Last Verified

June 1, 2018

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

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.

Clinical Trials on ADHD

Clinical Trials on Brexpiprazole

3
Subscribe