ITI-007 for the Treatment of Schizophrenia: A 4-Week Randomized, Double-Blind, Controlled Trial
Jeffrey A Lieberman, Robert E Davis, Christoph U Correll, Donald C Goff, John M Kane, Carol A Tamminga, Sharon Mates, Kimberly E Vanover, Jeffrey A Lieberman, Robert E Davis, Christoph U Correll, Donald C Goff, John M Kane, Carol A Tamminga, Sharon Mates, Kimberly E Vanover
Abstract
Background: An urgent need exists for new treatments of schizophrenia that are effective against a broad range of symptoms and free of limiting safety issues. ITI-007 is a new molecular entity with a pharmacologic profile that combines dose-related monoamine modulation with phosphorylation of intracellular signaling proteins.
Methods: A phase II randomized, double-blind, placebo-controlled, and active-controlled trial was conducted at eight sites in the United States with randomization of 335 acutely psychotic adults with schizophrenia. ITI-007 (60 mg and 120 mg), placebo, and risperidone, included for assay sensitivity, were evaluated as monotherapy for 4 weeks. The primary outcome measure was the Positive and Negative Syndrome Scale total score, with secondary analyses conducted on symptom subscales.
Results: ITI-007 60 mg (p = .017, effect size = .4) and risperidone (p = .013, effect size = .4) demonstrated antipsychotic efficacy superiority over placebo on the primary end point. The results of secondary analyses reflected improvements in negative and depressive symptoms by ITI-007 60 mg. ITI-007 120 mg did not separate from placebo. However, both doses of ITI-007 were well tolerated in this patient population, as evidenced by low discontinuation and adverse event rates, and were associated with a benign metabolic profile as evidenced by significantly lower levels of prolactin, fasting glucose, total cholesterol, and triglycerides than risperidone.
Conclusions: The mechanistically novel investigational drug ITI-007 was effective for the treatment of schizophrenia and comparable with placebo on safety measures in this trial. Secondary analyses indicated that ITI-007 improved negative and depression symptoms and might have expanded therapeutic efficacy in comparison with current antipsychotic drugs.
Trial registration: ClinicalTrials.gov NCT01499563.
Keywords: Antipsychotic; Comorbid depression; Negative symptoms; Positive symptoms; Prosocial factor; Safety.
Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
Source: PubMed